Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism
Article first published online: 16 MAY 2008
Copyright © 2008 John Wiley & Sons, Ltd.
Volume 18, Issue 2, pages 147–159, February 2009
How to Cite
Tsuchiya, A. and Dolan, P. (2009), Equality of what in health? Distinguishing between outcome egalitarianism and gain egalitarianism. Health Econ., 18: 147–159. doi: 10.1002/hec.1355
- Issue published online: 6 JAN 2009
- Article first published online: 16 MAY 2008
- Manuscript Accepted: 13 FEB 2008
- Manuscript Revised: 12 FEB 2008
- Manuscript Received: 9 FEB 2007
When deciding how to weigh benefits to different groups, standard economic models assume that people focus on the final distribution of utility, health or whatever. Thus, an egalitarian is assumed to be an egalitarian in the outcome space. But what about egalitarianism in the gains space, such that people focus instead on how equally benefits are distributed? This paper reports on a study in which members of the public were asked to rank a number of health programmes that differed in the distribution of benefits and final outcomes in ways that enabled us to distinguish between different types of egalitarianism. The results suggest that outcome egalitarianism dominates, particularly for differences in health by social class, but a sizeable minority of respondents appear to be gain egalitarians, especially when the health differences are by sex. These results have important implications for how we think about outcome-based social welfare functions in economics. Copyright © 2008 John Wiley & Sons, Ltd.