The importance of care.

Area of Science:

• Health economics
• Bioethics
• Health policy analysis

Background:

• Economic rationalism (ER) is a dominant, utilitarian approach in many health systems.
• ER proponents claim it enhances consumer choice, but evidence is lacking.
• Existing 'ethic of care' counterarguments have not influenced health policy due to a lack of a robust framework.

Purpose of the Study:

• Critique the dominance of economic rationalism in healthcare.
• Analyze the limitations of the 'ethic of care' in health policy.
• Propose an alternative framework for governing healthcare.

Main Methods:

• Conceptual analysis of economic rationalism and the 'ethic of care'.
• Examination of evidence from New Zealand health systems.
• Development of a taxonomy of care and a theory of health.

Main Results:

• Economic rationalism does not demonstrably increase consumer choice and tends to restrict participation.
• The 'ethic of care' lacks a powerful, compatible language to challenge ER effectively.
• Care is a secondary concept; a guiding theory of health is necessary for practice.

Conclusions:

• The dominance of economic rationalism in health systems must be challenged.
• A 'foundations theory of health' is proposed as a humane alternative to ER.
• Successful challenges require detailed theoretical analysis and practical policy development.