Health Affairs

Health Affairs, 28, no. 5 (2009): w909-w916 (Published online 18 August 2009) doi: 10.1377/hlthaff.28.5.w909 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Access, Cost, And Financing: Achieving An Ethical Health Reform

Norman Daniels, Brendan Saloner and Adriane H. Gelpi

Three key ethical issues should inform the broader debate about health reform: (1) Why pursue universal coverage? (2) Why is cost containment an ethical issue? (3) What is fairness in financing? After examining these issues, we conclude that the core ethical values underlying each of these goals—including expanding opportunity, sharing burdens equally, and respect for persons—limit the means that can be pursued in health reform. Although national health reform will not accomplish all of the objectives of social justice, true comprehensive reform—even under conditions of political compromise—represents an important step forward.

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