Membership theory, rationalism, and the claim to adequacy in health services

The immediate, practical purpose of this paper is to discuss and elaborate upon the concept of adequacy, especially when applicable to an understanding of the social work role in health policy making. The relevant topics under the general category of adequacy are (1) the perception and definition of the citizen/client; (2) the concept of rationality in health planning broken down into conditionality and prioritization, and (3) the concept of adequacy itself. Each will be addressed from the standpoint of recent experience and what may be done in the future to clarify and rationalize each. Clarity about clients, about rational approaches to policy making and planning, leading to a clear idea about adequacy in health care are presented as the indispensable elements in social work. Conditionality and prioritization are significant because no society will bring within equal reach of all members the benefits of health care, which usually means that health care is not rendered arbitrarily but as a result, among other things, of rational planning.