Public Discourse and Health Policies by Nicoletta Bosco

Author:Nicoletta Bosco [Bosco, Nicoletta]
Language: eng
Format: epub
ISBN: 9780367427016
Google: r1WHzgEACAAJ
Publisher: Routledge
Published: 2021-11-30T04:29:18+00:00

3 Areas that “do not stand the light of day”

The thought experiments and Oregon’s healthcare policies are not central to the line of thought we will propose here. Nevertheless, they help us bring two important points into sharper focus: the first has to do with the nature of the questions facing us, which often makes us forget that the problems of allocating resources and rationing have a lengthy history in healthcare system practices as well as in choice theory and thus do not arise only in emergencies such as the 2020 pandemic.

The second point is that issues of justice and fairness—and, especially, how they translate into practice—inhabit an objectively complex sphere, where the forms of communication are of paramount importance. The questions here are not limited to who should make the decisions but also concern whether (and how) decisions should be explicit, or in other words discussed and justified to the public. The dilemmas that questions involve are likely to lead to strategies of denial and repression and make it difficult to explain the assumptions behind choices, given that they could involve visions that are potentially irreconcilable and thus risky for those who, like the institutions, need to have the legitimacy of their decisions acknowledged at all times. As a result, particularly complex policy issues often tend to be removed from the public debate because they are highly divisive, or are presented in terms of partisan politics even though their actual content might have some appeal across party divisions:

Politicians are obviously concerned with the impact that policies could have on society (or rather, on certain social categories), but what concerns them most is the impact of policies on politics and its equilibriums.

(Bobbio et al., 2015, p. 520)

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