Health And Social Justice

Health and Social Justice

Societies make decisions and take actions that profoundly impact the distribution of health. Why and how should collective choices be made, and policies implemented, to address health inequalities under conditions of resource scarcity? How should societies conceptualize and measure health disparities, and determine whether they've been adequately addressed? Who is responsible for various aspects of this important social problem? In Health and Social Justice, Jennifer Prah Ruger elucidates principles to guide these decisions, the evidence that should inform them, and the policies necessary to build equitable and efficient health systems world-wide. This book weaves together original insights and disparate constructs to produce a foundational new theory, the health capability paradigm.Ruger's theory takes the ongoing debates about the theoretical underpinnings of national health disparities and systems in striking new directions. It shows the limitations of existing approaches (utilitarian, libertarian, Rawlsian, communitarian), and effectively balances a consequentialist focus on health outcomes and costs with a proceduralist respect for individuals' health agency. Through what Ruger calls shared health governance, it emphasizes responsibility and choice. It allows broader assessment of injustices, including attributes and conditions affecting individuals' "human flourishing," as well as societal structures within which resource distribution occurs. Addressing complex issues at the intersection of philosophy, economics, and politics in health, this fresh perspective bridges the divide between the collective and the individual, between personal freedom and social welfare, equality and efficiency, and science and economics.Review"Ruger enhances the reach of her powerful perspective by enlightening investigations of human flourishing.... By producing a book of such richness concerning a major area of human agency and policy, Jennifer Prah Ruger has substantially advanced the reach of public reasoning, not just about health care, but about social justice in general."--From the foreword by Amartya Sen, Thomas W. Lamont University Professor and Professor of Economics and Philosophy, Harvard University"Jennifer Prah Ruger has produced a masterpiece--a beautifully written and strikingly bold 'health capability paradigm' for the analysis of problems of health and social justice.... This gem of a book is destined to push forward current debates about health care reform and its theoretical foundations. It will more than contribute to this field of investigation; it will be a defining moment."--Tom L. Beauchamp, Professor of Philosophy and Senior Research Scholar at the Kennedy Institute of Ethics, Georgetown University"I have no doubt that this book will become a beacon for the debates on health system reform in the United States and around the world."--Julio Frenk, Dean and T & G Angelopoulos Professor of Public Health and International Development, Harvard School of Public Health"[A]n original synthesis...that illuminates a way forward toward a more rational health policy and health policy process.... [A] must read for all serious students of health policy."--Joseph P. Newhouse, John D. MacArthur Professor of Health Policy and Management and Director of the Division of Health Policy Research and Education, Harvard University"[A]n attractive, concrete vision of a health society, strongly grounded in philosophy, economics and public health."--Thomas Pogge, Leitner Professor of Philosophy and International Affairs, Yale University and Professorial Fellow, Centre for Applied Philosophy and Public Ethics, Australian National University"Ruger articulates a persuasive case...for grounding reform in a commitment to human flourishing...[and] presents us with practical tools for determining what to cover and how to allocate resources at a time when cost-containment must be a constraint on future policy.