Costs
in the health sector are substantial, and resources
are limited. On the other hand, the range of possible
healthcare interventions is multiplying, as well
as the expectations and hopes of people. The common
question in Tanzania and Tajikistan – and
in Switzerland: Where in the health sector is
it worthwhile to invest? How can healthcare be
aligned more effectively to the needs of the population?
Where is the fair way between necessary restriction
and requirements respectively freedom of choice
of the people?
„Cost-effectiveness is only one of
at least nine criteria that a health system may
be asked to respect. A health system ought to
protect people from financial risk, to be consistent
with the goal of fair financial contribution.
This means that the cost matters, and not only
its relation to health results, whether money
is public or private. A health system should strive
for both horizontal and vertical equity –
treating alike all those who face the same health
need, and treating preferentially those with the
greatest needs – to be consistent with the
goal of reducing health inequalities. And it should
assure not only that the healthy subsidize the
sick, as any prepayment arrangement will do in
part, but also that the burden of financing is
fairly shared by having the better-off subsidize
the less well-off. This generally requires spending
public funds in favour of the poor. (World Health
Report 2000, Health Systems: Improving Performance,
p. 52)
The 2003 Symposium of Medicus Mundi Switzerland contributed to the discussion
about priority setting and resources allocation in healthcare – focusing
on equitable access and the needs of the poor.
