Health care analysis : HCA : journal of health philosophy and policy
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Health care systems throughout the developed world face 'crises' of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. ⋯ Priority setting at the macro level has yet to demonstrate real successes. This paper describes international approaches to explicit prioritisation at the macro-governmental level in the six experiences most published in the English literature; analyzes the ways in which values, principles and other normative concepts were presented in these international priority setting experiences; and identifies key elements of a more robust framework for ethical analysis which could promote meaningful and effective health priority setting.