Abstract

The primary concern of the present study is social or macrolevel decision making about the distribution of health care resources. Decisions about the ethically appropriate way to spread health care resources throughout the community are particularly crucial in developing societies and must be made since demand and supply are out of balance. Selected theories of justice are examined in order to find the most plausible framework for answering this question. Theories examined included those of John Rawls, who supports an egalitarian approach; Norman Daniels, who proposes that health care has its goal in broadening an individual's range of opportunities; Robert Nozick, who argues that market mechanisms should be employed; and Allen Buchanan, who introduces a view of the decent minimum of health care. The notion of the right to health care is also investigated within the framework of distributive justice since it could have a major impact on macroallocation decisions and society's overall priorities. Along the lines developed by Allen Buchanan, I propose that a decent minimum of health care should be regarded as a floor below which no individual ought to fall, not a ceiling above which no one may arise. I conclude by arguing that this notion of the decent minimum is the most plausible approach in handling macroallocation decisions in Thailand.