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Where is the voice of the 'tax payer: priority setting in health care
- Andrea Litva (13 October 2000)
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Andrea Litva, Lecturer in Medical Sociology University of Liverpool
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Dear Editor I have followed with great interest the debate occurring within your journal about whether the public should be involved in priority setting. Many of the arguments for and against appear very logical and worth considering. Indeed, rationing is a painful process and hard decision have to be made that require medical expertise. However, I also agree that decisions- any decision - are informed by sets of values. In priority setting it would be important that decision take on board 'societal values' , particularly if they are to be widely accepted without comment. What surprises me, however, is the lack of 'the tax payer's' voice in this debate. These arguements rest upon the assumption that the 'tax payer' actually wants to be involved in priority setting. As well, what is meant by the term 'involvement' is problematic and not made particularly clear. Can this be a case of putting the cart in front of the horse? Despite a push for greater public involvement in priority setting, we don't really know whether tax payers want to be involved in priority setting, why they want to be involved and how they want their input used? If, for instance, the public didn't want to be involved in setting priorites, or if they only wanted to know how priorities are determined, wouldn't many of these arguments be pointless? I think this debate might take a different perspective if it included lay views of public involvement in priority setting. Dr. Andrea Litva
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