Costs in the health sector are substantial, and resources are limited. On the other hand, the range of possible healthcare interventions is multiplying, as well as the expectations and hopes of people. The common question in Tanzania and Tajikistan – and in Switzerland: Where in the health sector is it worthwhile to invest? How can healthcare be aligned more effectively to the needs of the population? Where is the fair way between necessary restriction and requirements respectively freedom of choice of the people?
„Cost-effectiveness is only one of at least nine criteria that a health system may be asked to respect. A health system ought to protect people from financial risk, to be consistent with the goal of fair financial contribution. This means that the cost matters, and not only its relation to health results, whether money is public or private. A health system should strive for both horizontal and vertical equity – treating alike all those who face the same health need, and treating preferentially those with the greatest needs – to be consistent with the goal of reducing health inequalities. And it should assure not only that the healthy subsidize the sick, as any prepayment arrangement will do in part, but also that the burden of financing is fairly shared by having the better-off subsidize the less well-off. This generally requires spending public funds in favour of the poor. (World Health Report 2000, Health Systems: Improving Performance, p. 52)
The 2003 Symposium of Medicus Mundi Switzerland contributed to the discussion about priority setting and resources allocation in healthcare – focusing on equitable access and the needs of the poor.