Jennifer J. Prah
Faculty Chair, Center for High Impact Philanthropy, University of Pennsylvania
Dissertation Title: "Aristotelian Justice and Health Policy: Capability and Incompletely Theorized Agreements"
The dissertation focuses on the implications for health policy of Aristotelian/Capability lines of reasoning to social justice and efficiency. The monograph draws on philosophical and economic analysis and social choice theory in the examination of health capabilities as: (i) a central focal variable for the assessment of equality and efficiency in health policy; (ii) the product of health and other public policies; and (iii) the object of social choice.
Drawing on moral and political philosophy, the Aristotelian/Capability lines of reasoning provide the basis for the special moral importance of health capabilities as the central focal variable for assessing equality and efficiency in health policy. These lines of thought take a universal view of humans' capability to flourish as an end of political activity and provide an analytical framework to address questions of justice and efficiency in public policy in a way that other philosophical schools do not.
Drawing on economic analysis, the monograph makes a case for focusing attention in health economics and health policy on the economics of health, per se, as differentiated from the economics of medical care, and as such emphasizes the analysis of empirical evidence on the instrumental effectiveness and cost-effectiveness of the various determinants of health and the public policies associated with these determinants. Further investigations of the determinants and consequences of variations in health capabilities is necessary to fully understand the patterns and public policies associated with health production.
And finally, drawing on social choice literature, this monograph identifies and defends a particular approach to collective decision making in public policy - incompletely theorized agreements (ICTA). In matters of social decision making about health capabilities in health policy, the ICTA framework is particularly useful and complementary to the capability approach. Health, and thus health capabilities, is a multidimensional concept about which different people have different, and sometimes, conflicting, views. Since no unique view of health capabilities exists and is ideal for all evaluative purposes, the pragmatism of both the incomplete ordering of the capability approach and the incompletely theorized agreement on that ordering of the ICTA approach allow for reasoned public policy decision making and analysis in particular situations in the face of plural goods and different, even conflicting, views.