Can we rely on the altruism of professionals or the public service ethos to deliver good quality health and education services? How should patients, parents and pupils behave - as grateful recipients or active consumers? The book provides new answers to these questions, and evaluates recent government policies in health services, education, social security and taxation, and puts forward proposals for policy reform: universal capital or 'demogrants', discriminating vouchers, matching grants for pensions and for long-term care and hypothecated taxes.

Offering a new answer to an age-old problem: the meaning of a just or equitable distribution of resources, Julian Le Grand examines the principal interpretations of equity used by economists and political philosophers. He argues that none captures the essence of the term as well as an alternative conception relating equity to the existence or otherwise of individual choice. Le Grand shows that this conception is not only philosophically well-grounded but is also directly relevant to key areas of distributional policy. (...) His theoretical argument is complemented by detailed discussion of the application of the central idea to specific areas of policy, including the distribution of health and health care, central government grants to local governments and the measurement of income for tax purposes. Equity and Choice is written by an economist, but is intended for political philosophers and social policy analysts as well as economists. Hence the key chapters are written in a non-technical fashion, with specialized material relegated to appendices. This book is a unique combination of philosophical, economic and policy analysis and represents a major contribution in all three areas. (shrink)

Publicly funded services such as health care and education often offer their users little by way of choice of provider. Partly in consequence they often create substantial inequities, with the less well off utilizing those services less relative to their needs than the better off. Contrary to popular perception, policies that offer choice of provider within these services can increase equity — provided that those policies are properly designed.

Publicly funded services such as health care and education often offer their users little by way of choice of provider. Partly in consequence they often create substantial inequities, with the less well off utilizing those services less relative to their needs than the better off. Contrary to popular perception, policies that offer choice of provider within these services can increase equity — provided that those policies are properly designed.

Mathias Risse has provided a thoughtful critique of my book, raising serious points about a major part of the argument. I am glad to have the opportunity to reflect further on it.