Health maximization rejected. The view of Swedish politicians

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Abstract
The meaning of the equity target in Swedish public health policy and its relationship to efficiency is investigated. Three interpretations of the relationship are analysed and the support given to each of them by 449 Swedish politicians is investigated in a postal questionnaire. The common health economics interpretation that equity is embodied in the health maximization principle, which implies that distribution is unimportant, is rejected by approximately 70%. The results also refute the lexicograhpical interpretation, since support for the equity target depends upon the magnitude of the efficiency sacrificed. The third interpretation could be labelled plural targets or trade-off, implying that achievements in respect of 1 target must be weighed against losses in respect of some other target. Approximately 70% of the respondents were prepared to sacrifice health benefits in exchange for equity of health. However, support for the different interpretations of equity are strongly associated with sex and political affiliation. Men and representatives of the Conservative Party have much greater sympathy for the health maximization principle.

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