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Markkula Center for Applied Ethics


Tradeoff Negotiation: The Importance of Getting in the Game

Ann Mongoven, Associate Director of Health Care Ethics, comments.

Swiss-CHAT’s playful approach to public rationing can be considered in terms of deliberative process design as well as in terms of health policy. The process’ forced negotiation of trade-offs exposed unexamined driving questions, and challenged prevalent presumptions about health care demand and about conditions of public reasoning that enable transparent rationing. While the experiment provided grounds for optimism that public deliberation can contribute to the design of fair insurance service-packages, it also left unanswered questions. What are the ethical and policy implications of non-consensuses? What is the presumed relationship between process and justice of outcome?

Excerpted from an article by Ann Mongoven in the International Journal of Health Policy and Management.