The theory of justice and health developed in this book should help guide our understanding in practical ways about the just design of health systems. Our beliefs about the acceptable design of health systems should also have a bearing on what we think is just health and health care. After all, ethical theory should help guide practice and, conversely, acceptable moral practice should constrain ethical theory. We should look to such a “reflective equilibrium” between different levels of moral belief and practice as a source of justification in the ethics of health policy, just as we should more generally (Rawls 1971; Daniels 1996a). In Part III, we explore applications of the theory elaborated in Part I and defended in Part II in order to examine the adequacy of the theory to the demands of our practice in health policy.

The main goal of this chapter is to show how the theory of just health developed in earlier chapters can guide our practical concerns about health systems in both developed and developing countries and how our beliefs about just institutional arrangements constrain the theory. I do this by describing a tool, the Benchmarks of Fairness, that I helped devise for monitoring and evaluating the fairness of health sector reforms (Daniels et al. 1996; Daniels, Bryant, et al. 2000). The Benchmarks translate central ideas about justice and health into an evidence-based approach to improving health policy.