in responses to norheim’s editorial, this commentary offers reflections from thailand, how the five unacceptable trade-offs were applied to the universal health coverage (uhc) reforms between 1975 and 2002 when the whole 64 million people were covered by one of the three public health insurance systems. this commentary aims to generate global discussions on how best uhc can be gradually achieve...

In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious ...

Writing in 1975, Arthur Okun is generally credited with popularizing the idea of a “great tradeoff" between equity and efficiency. Indeed, a generation of economists has been brought up thinking that in the allocation of scarce resources to competing ends, the tradeoff between “equity” and “efficiency” is just another one of the many tough choices that economically rational individuals have to ...

In a standard framework of choice theory, we formulate two contrasting principles for social choice under the efficiency-equity trade-off. The equity-first principle states that we should select from equitable allocations if any, but if the equity criterion is not at all effective for selection either because all the available allocations are equitable or because no allocation is equitable, we ...