Health egalitarianism and health maximization are two viewpoints held over the provision of health care to all members of the population, both locally and globally. There are similarities as well as differences that exist between health egalitarians and health maximizers and these need further elaboration as is addressed in this paper.
Both philosophical views of the health, egalitarianism and health maximization, are aimed at achieving some form of equity in health. For health egalitarians, their principal aim is to have every member of the population healthy. The normal functioning (health) should be attained and maintained throughout the normal lifespan of individuals (Daniels, 2006). In this case, health egalitarians make sure that all persons become healthy by first addressing the less healthy individuals and helping them attain full health. The health maximizers’ final goal is similar to that of egalitarians in that they argue that the normal functioning of every member of the population, given a normal lifespan, leads to maximized population health. In other words, the pursuit of a healthy population is an achievable thing and it has a limit i.e. when all persons attain normal functioning throughout their lifespan (Daniels, 2006).
The main differences between the health egalitarian and health maximizer views on health is how or the means to achieve their goals. As such, it becomes evident that health egalitarians are concerned about equity of health distribution while health maximizers are not. Instead, health maximizers pursue normal functioning for all by looking for maximum benefits for resources invested in attainment of health. In essence, health maximizers apply strategies that ensure cost effectiveness and thus health benefits are maximized at the cost -effective ratio without regard of health distribution issues. While the egalitarians achieve equitable health distribution by first attending to the worst off cases and then the better off in that order, health maximizers do not adhere to such (Daniels, 2006). Instead, there is always a temptation to achieve the target results at the expense of fair distribution. In this regard, resources are injected into populations that can produce the expected results easily (mainly the already better off persons) and the worse off populations are ignored. The lack of paying attention to the worse off cases makes such persons even needier health wise (Daniels, 2008).
While the health egalitarians seek equal health benefits to all members of the population regardless of the health condition, health maximizers are prone to aggregation as a cost-effectiveness measure. This makes them fall prone to pursuing small benefits over a large population and neglecting major health benefits to a small population. In addition, the health maximizers are too committed to maximization such that they do not achieve fair distribution of health interventions and benefits. While health egalitarians mobilize their resources to ensure fair and equal health benefits are achieved across the population, health maximizers tend to focus more on the best outcomes (Daniels, 2006). As such, health interventions that do not lead to great outcomes are not given much attention. This essentially creates unfair distribution of health.
From the above discussion, it is evident that health egalitarians have almost the same ultimate goal of having all population members achieve a healthy life. However, the health egalitarians end up achieving equitable distribution as opposed to the health maximizers. The differences in distribution of health persist due to differences in strategies applied in attaining the ultimate goal.
Daniels, N. (2006). Equity and population health: Toward a broader bioethics agenda. Hastings Center Report 36(4): 22-35.
Daniels, N. (2008). Just health: meeting health needs fairly. Cambridge, MA: Cambridge University Press.