Co-payment for Unfunded Additional Care in Publicly Funded Healthcare Systems: Ethical Issues

Original Research

Open Access. Journal of Bioethical Inquiry volume 16, p515–524(2019). Published online: 24 June 2019

Joakim Färdow, Linus Broström & Mats Johansson

Abstract: The burdens of resource constraints in publicly funded healthcare systems urge decision makers in countries like Sweden, Norway and the UK to find new financial solutions. One proposal that has been put forward is co-payment—a financial model where some treatment or care is made available to patients who are willing and able to pay the costs that exceed the available alternatives fully covered by public means. Co-payment of this sort has been associated with various ethical concerns. These range from worries that it has a negative impact on patients’ wellbeing and on health care institutions, to fears that co-payment is in conflict with core values of publicly funded health care systems. This article provides an overview of the main ethical issues associated with co-payment, and ethical arguments both in support of and against it will be presented and analyzed.

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