What is just or fair in the distribution of healthcare resources? Libertarians, utilitarians and egalitarians have different viewpoints.

Utilitarian

Utilitarian theories aim to maximises the amount of health gained. This can be measured by metrics such as QALY (or alternatives like DALY), which stands for quality-adjusted life year where one year of perfect health equals one QALY. Of course, it can be hard to define what constitutes “quality life” as it differs between individuals. This framework of healthcare is used in recommendations by NICE (UK). Proponents include Alan Williams.

Libertarian

Libertarian theories focus on the liberty of individuals. Individuals and organisations are free to decide what they want and how much something is worth. This means there is a free market on the distribution of healthcare services or resources. For example, if sufficient individuals are willing to pay for insulin at a high price, then pharmaceutical companies should be able sell at this high price to maximise profit, even if poorer individuals miss out. A libertarian healthcare model is used in USA. Proponents include Robert Nozick.

Egalitarian

Egalitarian theories prioritise equal opportunity. Resources should be distributed equally, unless an unequal distribution is advantageous for everyone (e.g. if you prioritise healing doctors, the doctor may then be able to then heal more individuals). A proponent is John Rawls, who proposed the “veil of ignorance”: How would you distribute things if you did not know anything about yourself like your position in society or abilities?