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The importance of care.

T van Schie¹, D Seedhouse

¹Westmere Physiotherapy Clinic, Auckland, New Zealand.

Health Care Analysis : HCA : Journal of Health Philosophy and Policy

|November 3, 1997

Summary

Economic rationalism (ER) in health systems does not increase consumer choice and restricts participation. An

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Health care analysis : HCA : journal of health philosophy and policy·1998

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.

Keywords:

Analytical Approach Health Care and Public Health

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