A Just Healthcare

PART I

In An Ideal World…

Each individual will get…

• what they want/need

• of high quality care

• at an affordable cost

But In The Real World…

The money has got to come from somewhere

Resources are limited

If the resources go to A, they can’t go to B, C etc. (Opportunity cost)

RATIONING

CUT COST

Who gets treatment

What treatment to subsidize

Theories of Allocation

1. Life expectancy

2. Quality adjusted life years

3. Social worth

4. Moral worth

5. Responsibility for our own ill health

Theories of Allocation

1. Life expectancy

2.Quality adjusted life years3. Social worth

4. Moral worth

5. Responsibility for our own ill health

A national organization like

National Institute for Health and Clinical Excellence (NICE)

Issues

Professional ethics

End of life care, ageist?

Less choices?

Cutting cost

Spending more ≠ better healthcare

Educate doctors, spend more time with patients

The case of ‘lap choley’

PART II

Young Vs Old

Curative Vs Palliative

Individual Vs Society

Care For The PoorAl-Fajr: 15-20

Healthcare is not all about CURE

Prevention Strategies

Social Care

Working outside the system

Social Business:

a) Grameen Kalyan and Grameen Health Care Services

b) Heart Institute of The Caribbean

CONCLUSION

Thank You