Norman Daniels' 'prudential lifespan account' and Frances Kamm's work on allocation both demonstrate that just health systems routinely subordinate aggregate QALY gains to considerations of equal treatment and urgent need.

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Aggregate QALY gains(what health systems might prioritize if they only cared about maximum overall benefit): The total amount of health improvement you could create by adding up benefits across all patients—essentially, the 'biggest bang for your buck' in pure numbers.
Allocation(refers to how health systems decide who gets treatment): The process of deciding how to distribute limited resources (like healthcare, money, or medicine) among people who need them.
Equal treatment(a value that sometimes conflicts with just maximizing total health benefits): The principle that people should be treated fairly and have equal access to similar care, rather than some people getting much better treatment than others.
Frances Kamm(mentioned as another major thinker on allocation problems): A prominent philosopher who writes about ethics and how to make fair decisions when you can't help everyone—especially relevant to healthcare choices.

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