Teams of collaborators from Colombia, Mexico, Pakistan, and Thailand have adapted a policy tool originally developed for evaluating US health insurance reforms into “benchmarks of fairness” for assessing health system reform in developing countries..Fairness is a multi-dimensional concept that includes equity in exposure to risk factors and health outcomes, in access to all forms of care, and in financing. It also includes efficiency in management and allocation, so that needs can be met under resource constraints, accountability, and patient and provider autonomy. The benchmarks tie these general aspects of fairness to various operational criteria. Reforms are then evaluated by scoring them according to the degree to which they improve the situation relative to the status quo on each of the criteria. A rationale is provided for the scoring, providing an objective base of reasons for the evaluation. The object is to promote deliberation about fairness across the disciplinary divisions that keep policy analysts and the public from understanding how tradeoffs among these features of system reform affect the overall fairness of the reform. The benchmarks can be used at both national and provincial or district levels, and we describe plans for such uses in the collaborating sites. A striking feature of the adaptation process is that convergence on this ethical framework across countries and cultures.
Learning Objectives: To appreciate the ways in which fairness, or justice, interact with health care reform options, and how the benchmarks of fairness can help policy makers to delineate options that are fair or unfair, and the extent of those differences
Keywords: Ethics, Developing Countries
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.