How does the operation of PHARMAC's 'Community Exceptional ...

of their consequences (Basu & Ravi, 2008). Consequently, Sen has taken
Rawls’ difference principle further and validated alternative elements of justice.
Sen advanced the notion of justice as fairness by addressing the issue of the
capability of persons and institutions to ‘be’ just and ‘act’ justly. Therefore any
theory of justice, or a general and adequate theory of normative social choice,
has to be concerned with both the fairness of the process involved and the
equity and efficiency of the substantive opportunities that people can enjoy (Sen
A, 1980). For this reason Sen, unlike Rawls, included the capability of good
health and a lack of physical incapability as an element of equality.
In any discussion of social equity and justice, illness and health must
figure as a major concern. I take that as my point of departure – the
ubiquity of health as a social consideration – and [note] that health equity
cannot but be a central feature of the justice of social arrangements in
general. The reach of health equity is immense.
(Sen A, 2002, p. 2)
Sen explained in his theory that a developed view of justice, based on
capability, should not only concentrate on the utility of an individual’s happiness
but also concentrate the use of resources in assessing how advantaged a
person is in relation to another. This description of justice must take account of
a person’s capability to access the enjoyment of the things a person has reason
to value. The freedom to actually be able to achieve the things we want to do is
as important, if not more important, than having access to the resources to
achieve what we want to do.
This capability approach to fairness and equity points to the assessment of
social disparities and the social consequences of such disparities, both for the
individuals concerned and for communities. Unlike Rawls, Sen drew attention
to the notion of fairness compared to the ‘primary goods’ which he identified as
income, wealth, self-respect and power. He argued that no matter what quantity
of these resources (income, wealth, self-respect and power) a person has, the
lack of capacity to use them increased the level of inequity rather than reducing
it.
Sen’s reasoning in favour of capacity gave a far more advanced view of equity
than Rawls reasoning in favour of fairness. For example, a person who has
significant wealth but who might be very prone to chronic illness or pain, is not
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