New Zealanders believe in justice or fairness. In the context of the allocation of scarce resources in health care, different concepts of justice are in conflict. This is particularly important when considering socio-economic disadvantage. Economists would argue not to do so is unethical. Resources are scarce and we have to make choices in health care.
Any choice results in an opportunity cost equal to the value of the alternative that is forgone.
Wrong choices are unethical. However, as we have experienced in New Zealand, making choices in health care is not that easy. We need to recognise the different competing concepts of justice. Traditionally the doctor has imposed his or her own personal understanding of the Hippocratic view on society. This view maximises the health of individual patients at the expense of social health gain.