HEALTh CARE ECONOMICS The analytical approach of standard health economics has so far failed to sufficiently account for the nature of care This has important ramifications for the analysis and valuation of care, and therefore for the pattern of health and medical care provision This book sets out an alternative approach, which places care at the center of an economics of health, showing how essential it is that care is appropriately recognized in policy as a means of enhancing the dignity of the individual Whereas traditional health economics has tended to eschew value issues, this book embraces them, introducing care as a normative element at the center of theoretical analysis Drawing upon care theory from feminist works, philosophy, nursing and medicine, and political economy, the authors develop a health care economics with a moral basis in health care systems In providing deeper insights into the nature of care and caring, this book seeks to redress the shortcomings of the standard approach and contribute to the development of a more person-based approach to health and medical care in economics Health Care Economics will be of interest to researchers and postgraduate students in health economics, heterodox economists, and those interested in health and medical care John B Davis is Professor of Economics at Marquette University, USA, and Professor of Economics at the University of Amsterdam, the Netherlands He is co-editor of the Journal of Economic Methodology He is author of Individuals and Identity in Economics (2011), The Theory of the Individual in Economics (2003), and Keynes’s Philosophical Development (1994) Robert McMaster is Professor of Political Economy in the Adam Smith Business School at the University of Glasgow, UK He was a co-editor of the Review of Social Economy from 2005 to 2016 He has published numerous academic articles and is a co-editor of the four-volume Social Economics collection in the Routledge series on Critical Concepts in Economics Routledge Advances in Social Economics Edited by John B Davis, Marquette University This series presents new advances and developments in social economics thinking on a variety of subjects that concern the link between social values and economics Need, justice and equity, gender, cooperation, work poverty, the environment, class, institutions, public policy and methodology are some of the most important themes Among the orientations of the authors are social economist, institutionalist, humanist, solidarist, cooperatist, radical and Marxist, feminist, post-Keynesian, behaviouralist, and environmentalist The series offers new contributions from today’s most foremost thinkers on the social character of the economy Published in conjunction with the Association of Social Economics For a full list of titles in this series, please visit www.routledge.com/RoutledgeAdvances-in-Social-Economics/book-series/SE0071 21 The Economics of Values-Based Organizations An Introduction Luigino Bruni and Alessandra Smerilli 22 The Economics of Resource-Allocation in Healthcare Cost-Utility, Social Value and Fairness Andrea Klonschinski 23 Economics as Social Science Economics Imperialism and the Challenge of Interdisciplinarity Roberto Marchionatti and Mario Cedrini 24 Health Care Economics John B Davis and Robert McMaster HEALTh CARE ECONOMICS John B Davis and Robert McMaster First published 2017 by Routledge Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2017 John B Davis and Robert McMaster The right of John B Davis and Robert McMaster to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988 All rights reserved No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Names: Davis, John B., author | McMaster, Robert (Political economist) author Title: Health care economics / John B Davis and Robert McMaster Description: Milton Park, Abingdon, Oxon; New York, NY: Routledge, 2017 | Includes index Identifiers: LCCN 2016058389| ISBN 9781138183032 (hbk) | ISBN 9781138183049 (pbk) | ISBN 9781315646107 (ebk) Subjects: LCSH: Medical economics Classification: LCC RA410 D28 2017 | DDC 338.4/73621–dc23 LC record available at https://lccn.loc.gov/2016058389 ISBN: 978-1-138-18303-2 (hbk) ISBN: 978-1-138-18304-9 (pbk) ISBN: 978-1-315-64610-7 (ebk) Typeset in Bembo by Cenveo Publisher Services From John, his genuine gratitude to his family, immediate and extended, for their care, kindness, and support over many years in so many ways in connection with this project as in others And from Robert, his sincere gratitude, love and deepest affection to Allison and Ailidh for their love, seemingly endless toleration, kindness, and for teaching me so much about care and caring CONTENTS List of illustrations x Forewordxi Preface and acknowledgements xiii 1 Health care economics? 1.1 Introduction: mainstream health “care” economics? 1.2 The microeconomics of health care markets: principal–agent theory, moral hazard, and care 1.3 Care as a market externality: caring externalities 1.4 The problematic nature of caring externalities 1.5 Care and the socially embedded individual 10 1.6 An alternative health economics 14 1.7 Outline of the argument of the book 15 Notes 17 PArT I Health care notions: health economics and the biomedical approach 19 Health care, medical care, and the biomedical approach 21 2.1 Introduction: health care and medical care 21 2.2 Medical care: the biomedical approach 23 2.3 Health economics and the biomedical approach 26 2.4 The biomedical approach to medical care: issues and concerns 30 viii Contents 2.5 Delineating medical care and health care 41 Notes 43 On identifying and categorizing health and medical care 45 3.1 Introduction 45 3.2 The array and types of health care 47 3.3 Delivery levels of medical care 51 3.4 Medical (and health) care as distinctive measures 56 3.5 Some concluding thoughts 64 Notes 65 PArT II Theories of care: towards health and medical care 67 Economics and care 69 4.1 Introduction 69 4.2 Care in “early” economic thought 70 4.3 Kenneth Boulding: health economist? 77 4.4 Gavin Mooney on health care: from community ties to participation to reciprocity 81 4.5 Caring labor as a characteristic human activity: feminist economics 83 Notes 88 Capturing care 89 5.1 Introduction 89 5.2 An overarching definition of care? 91 5.3 Care of the self 95 5.4 The aims of care 99 5.5 Phases and types of care 102 5.6 Some final thoughts 111 Notes 112 PArT III Care systems, human flourishing, and policy 113 Institutions, groups, and the morality of care 115 6.1 Introduction 115 6.2 Institutions and institutional economics 116 Contents ix 6.3 Health and medical care institutions: medical pluralism and the three sectors of health care 126 6.4 Moral groups of care 132 6.5 Medical groups of care 136 Notes 139 Developing capabilities and the dignity of the individual 140 7.1 Introduction 140 7.2 Health capabilities and their social embeddedness in care relationships 142 7.3 The values of socially embedded health care capabilities 150 7.4 The nature of the person as a focus of care in socially embedded care relationships 154 Notes 159 Social values in health care systems 160 8.1 Introduction 160 8.2 Public health and the social causes of inequalities in health 162 8.3 Public health and health capability improvement 168 8.4 The normative objectives of health care systems 172 8.5 The institutional and normative foundations of health care 178 Note 178 Towards dignity in comprehensive health caring 179 9.1 The polarity in conceptions of care 179 9.2 The importance of dignity 184 9.3 Health policy for today and the future 187 9.4 Whither economics? 189 Note 191 Bibliography192 Index210 204 Bibliography Robeyns, I (2005) The capability approach: a theoretical survey, Journal of Human Development, 6: 93–114 Robeyns, I (2011) The capability approach, in E Zalta (ed.), The Stanford Encyclopedia of Philosophy, online at http://plato.stanford.edu/entries/capability-approach/ Robinson, J (1962) Economic Philosophy London: Penguin Rogers, W A (2004) Evidence based medicine and justice: a framework for looking at the impact of EBM upon vulnerable or disadvantaged groups, Journal of Medical Ethics, 30: 141–5 Rosenbaum, E F (2000) What is a market? On the methodology of a contested concept, Review of Social Economy, 58: 455–82 Rosenberg, C E (1995) The Care of Strangers:The Rise of America’s Hospital System Baltimore, MD: Basic Books Ruger, J P (2006) “Toward a theory of a right to health: capability and incompletely theorized agreements, Yale Journal of Law and the Humanities, 18 (2): 273–326 Ruger, J P (2010) Health and Social Justice Oxford: Oxford University Press Runciman, W G (1966) Relative Deprivation and Social Justice: A Study of Attitudes to Social Inequality in Twentieth-Century England London: Routledge Rutherford, M H (1995) The old and the new institutionalism: can bridges be built? Journal of Economic Issues, 29: 443–51 Rutherford, M H (1997) American institutionalism and the history of economics, Journal of the History of Economic Thought, 19: 178–95 Rutherford, M H (2001) Institutional economics: then and now, Journal of Economic Perspectives, 15: 173–94 Ryan, M., Gerard, K., and Currie, G (2006) Using discrete choice experiments in health economics, in A Jones (ed.), The Elgar Companion to Health Economics Cheltenham: Edward Elgar Saad, S M A., Fatima, S S., and Faruq, A A (2011) Students’ views regarding selecting medicine as a profession, Journal of the Pakistan Medical Association, 61: 832–6 Sackett, D L (2002) The Arrongance of Preventive Medicine, Canadian Medical Association Journal, 167: 363–4 Sackett, D L., Rosenberg,W M C., Gray, J A M., Haynes, R B., and Richardson,W S (1996) Evidence-based medicine: what it is and what it isn’t, online at http://www.cebm.net Samuels, W J (1977) The political economy of Adam Smith, Ethics, 87: 189–207 Samuels, W J (1995a) The instrumentalist value principle and its role, in C M A Clark (ed.), Institutional Economics and the Theory of Social Value: Essays in Honor of Marc R.Tool Norwell, MA: Kluwer Samuels, W J (1995b) The present state of institutional economics, Cambridge Journal of Economics, 19: 569–90 Sandel, M J (2012) What Money Can’t Buy:The Moral Limits of Markets London: Penguin Sayer, A (2014) Contributive justice, class divisions and the capabilities approach, in H.-U Otto and H Ziegler (eds), Critical Social Policy and the Capability Approach Opladen: Springer Verlag Schall, M., Sevin, C., and Wasson, J H (2009) Making high-quality, patient-centered care a reality, Journal of Ambulatory Care Management, 32: 3–7 Schechtman, M (1996) The Constitution of Selves Ithaca, NY: Cornell University Press Schwarzenbach, S (1996) On civic friendship, Ethics, 107: 97–128 Scott, A (2000) Economics of General Practice, in A J Culyer and J P Newhouse (eds), Handbook of Health Economics,Vol Amsterdam: Elsevier Scott, A and Vick, S (1999) Patients, doctors and contracts: an application of principalagent theory to the doctor-patient relationship, Scottish Journal of Political Economy, 46: 111–34 Bibliography 205 Scott, I., Vaughan, L., and Bell, D (2009) Effectiveness of acute medical units, International Journal for Quality in Health Care, 21: 397–407 Searle, J (1990) Collective intentions and actions, in P Cohen, J Morgan, and M E Pollack (eds), Intentions in Communication Cambridge, MA: MIT Press Searle, J (1995) The Construction of Social Reality New York: Free Press Searle, J R (2005) What is an institution? Journal of Institutional Economics, 1: 1–22 Sen, A (1977) Rational fools: a critique of the behavioral foundations of economic theory, Philosophy and Public Affairs, 6: 317–44 Sen, A (1993) Capability and well-being, in M Nussbaum and A Sen (eds), The Quality of Life Oxford: Oxford University Press, pp 30–53 Sen, A (1999) Development as Freedom Oxford: Oxford University Press Sen, A (2002a) Why health equity? Health Economics, 11: 659–66 Sen, A (2002b) Rationality and Freedom Cambridge, MA: Belknap Press of Harvard University Press Sen, A (2004) Why health equity? in S Anand, F Peter, and A Sen (eds), Public Health, Ethics, and Equity Oxford: Oxford University Press Sen, A (2009) The Idea of Justice London: Penguin Sevenhuijsen, S (1998) Citizenship and an Ethics of Care: Feminist Considerations on Justice, Morality, and Politics, trans L Savage London: Routledge Sevenhuijsen, S (2000) Caring in the Third Way: the relation between obligation, responsibility and care in Third Way discourse, Critical Social Policy, 20: 5–37 Silence, E., Briggs, P., Harris, P R., and Fishwick, L (2007) How patients evaluate and make use of online health information? Social Science and Medicine, 64: 1853–62 Silk, J (2000) Caring at a distance: (im)partiality, moral motivation and the ethics of representation – Introduction, Ethics, Place, and Environment, 3: 303–9 Silver, G A (1987) Virchow, the heroic model in medicine: health policy by accolade, American Journal of Public Health, 77: 82–8 Simon, H A (1997 [1945]) Administrative Behavior: A Study of Decision-Making Processes in Administrative Organizations, 4th edn New York: Free Press Singer, M (2004) The social origins and expressions of illness, British Medical Bulletin, 69: 9–19 Smith, A (2000 [1759]) The Theory of Moral Sentiments Amherst, MA: Prometheus Books Smith, D M (1998) How far should we care? On the spatial scope of beneficence, Progress in Human Geography, 22: 15–38 Smith, M K (2004) Nel Noddings, the ethics of care and education, The Encyclopaedia of Informal Education, online at http://www.infed.org/thinkers/noddings.htm Solar, O and Irwin, A (2010) A Conceptual Framework for Action on the Social Determinants of Health Geneva: WHO Spencer, D A (2009) The Political Economy of Work London: Routledge Ssorin-Chaikov, N (2006) On heterochrony: birthday gifts to Stalin, 1949, Journal of the Royal Anthropological Institute, 12: 355–75 Starfield, B., Hyde, J., Gérvas, J., and Heath, I (2008) The concept of prevention: a good idea gone astray? Journal of Epidemiology and Community Health, 62: 580–3 Starr, P (1982) The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry New York: Basic Books Stewart, J (2008a) Africana studies and economics: in search of a new progressive partnership, Journal of Black Studies, 38 (5): 495–805 Stewart, J (2008b) Stratification economics, in W Darity Jr (ed.), International Encyclopedia of the Social Sciences, 2nd edn Detroit: Macmillan Reference USA, pp 530–1 Stjernswärd, J., Foley, K M., and Ferris, F D (2007) The public health strategy for palliative care, Journal of Pain and Symptom Management, 33: 486–93 206 Bibliography Strang, P., Strang, S., Hultborn, R., and Arnér, S (2004) Existential pain – an entity, a provocation, or a challenge? Journal of Pain and Symptom Management, 27: 241–50 Streuning, K (2002) New Family Values: Liberty, Equality, Diversity Lanham, MD: Rowman & Littlefield Sugden, R (2002) Beyond sympathy and empathy: Adam Smith’s concept of fellow-feeling, Economics and Philosophy, 18: 63–87 Sulmasy, D P (1993) What’s so special about medicine? Theoretical Medicine, 14: 27–42 Suls, J and Rothman, A (2004) Evolution of the biopsychosocial model: prospects and challenges for health psychology, Health Psychology, 23: 119–25 Sybylla, R (2001) Hearing whose voice? The ethics of care and the practices of liberty: a critique, Economy and Society, 30: 66–84 Syme, S L (2004) Social determinants of health: the community as an empowered partner, Public Health Research, Practice, and Policy, 1: 1–5 Syme, S L (2007) The prevention of disease and promotion of health: the need for a new approach (Viewpoint), European Journal of Public Health, 17: 329–33 Syme, S L and Berkman, L F (1976) Social class, susceptibility and sickness, American Journal of Epidemiology, 104: 1–8 Taffel, S M., Placek, P J., and Liss, T (1987) Trends in the United States’ cesarean section rate and reasons for the 1980–85 rise, American Journal of Public Health, 77: 955–9 Thaler, R H and Sunstein, C R (2008) Nudge: Improving Decisions About Health, Wealth and Happiness London: Penguin Thomas, C (1993) De-constructing concepts of care, Sociology, 17: 649–69 Tollefsen, D (2002) Collective intentionality and the social sciences, Philosophy of the Social Sciences, 32 (1): 25–50 Tonelli, M R (1998) The philosophical limitations of evidence-based medicine, Academic Medicine, 73: 1234–40 Tool, M R (1995) Pricing, Valuation and Systems: Essays in Neoinstitutional Economics Cheltenham: Edward Elgar Torrance, G W (1986) Measurement of health state utilities for economic appraisal: a review, Journal of Health Economics, 5: 1–30 Trigg, A B (2001) Veblen, Bourdieu, and conspicuous consumption, Journal of Economic Issues, 35: 99–115 Tronto, J C (1987) Beyond gender difference to a theory of care, Signs, 12: 644–63 Tronto, J C (1993) Moral Boundaries: A Political Argument for an Ethic of Care London: Routledge Tronto, J C (2011) A feminist democratic ethics of care and global care workers: citizenship and responsibility, in R Mahon and F Robinson (eds), Feminist Ethics and Social Policy: Towards a New Global Political Economy of Care.Vancouver, BC: UBC Press Tronto, J C (2013) Caring Democracy: Markets, Equality, and Justice New York: New York University Press Tuohy, C H and Glied, S (2011) The political economy of health care, in S Glied and P C Smith (eds), The Oxford Handbook of Health Economics Oxford: Oxford University Press Tuomela, R (1995) The Importance of Us: A Philosophical Study of Basic Social Notions Stanford, CA: Stanford University Press Turner, J., Hogg, M., Oakes, P., Reicher, S., and Wetherell, M (1987) Rediscovering the Social Group: A Self-Categorization Theory Oxford: Blackwell Twomey, P (1998) Reviving Veblenian economic psychology, Cambridge Journal of Economics, 22: 433–48 Unschild, P U (2009) What Is Medicine? Western and Eastern Approaches to Healing Berkeley, CA: University of California Press Bibliography 207 Upshur, R E G and Collak, E (2003) Argumentation and evidence, Theoretical Medicine, 24: 283–99 Upshur, R E G., VanDenKerkhof, E G., and Goel, V (2001) Meaning and measurement: n inclusive model of evidence in health care, Journal of Evaluation in Clinical Practice, (2): 91–6 van Staveren, I (2001) The Values of Economics: An Aristotelian Approach London: Routledge van Staveren, I (2005) Modelling care, Review of Social Economy, 63: 567–86 van Staveren, I (2015) Capabilities and wellbeing, in J B Davis and W Dolfsma (eds), The Elgar Companion to Social Economics, 2nd edn Cheltenham: Edward Elgar Veblen, T B (1898) Why is economics not an evolutionary science? Quarterly Journal of Economics, 12: 373–97 Veblen, T B (1969) The Place of Science in Modern Civilization and Other Essays, Capricorn Books: New York (originally published 1919) Veblen, T B (1994) Theory of the Leisure Class: An Economic Study of Institutions Mineola, NY: Dover (originally published 1899) Veblen, T B (2000 [1914]) The Instinct of Workmanship and the State of the Industrial Arts Whitefish, MN: Kessinger Veblen, T B (2005 [1904]) Theory of Business Enterprise Whitefish, MN: Kessinger Veblen, T B (2011) The evolution of the scientific point of view, in C Camic and G M Hodgson (eds), The Essential Writings of Thorstein Veblen London: Routledge Wade, D.T and Halligan, P.W (2004) Do biomedical models of illness make for good healthcare systems? British Medical Journal, 329: 1398–401 Waerness, K (1984) Caring as women’s work in the welfare state, in H Holter (ed.), Patriarchy in a Welfare Society Oslo: Universitetsforlaget, pp 67–87 Wagman, B and Folbre, N (1996) Household services and economic growth in the U.S., 1870–1930, Feminist Economics, (1): 43–66 Wagstaff, A and van Doorslaer, E (2000) Equity in health care finance and delivery, in A J Culyer and P J Newhouse (eds), Handbook of Health Economics Amsterdam: Elsevier Waitzkin, H (1981) The social origins of illness: a neglected history, International Journal of Health Services, 11: 77–103 Walsh, J and Warren, K (1980) Selective primary health care: an interim strategy for disease control in developing countries, Social Science and Medicine, 14C: 145–64 Watson, J (1997) The theory of human caring: retrospective and prospective, Nursing Science Quarterly, 10: 49–52 Watson, J (2006) Caring theory as ethical guide to administrative and clinical practices, Nursing Administrative Quarterly, 30: 48–55 Watson, J (2008) Nursing:The Philosophy and Science of Caring, rev edn Boulder, CO: University Press of Colorado Watson, J (2009) Caring science and human caring theory: transforming personal and professional practices of nursing and health care, Journal of Health and Human Services Administration, 31: 466–82 Watson, J (2010) Core Concepts of Jean Watson’s Theory of Human Caring/Caring Science Watson Caring Science Institute Watson, J and Smith, M C (2002) Caring science and the science of unitary human beings: a trans-theoretical discourse for nursing knowledge development, Journal of Advanced Nursing, 37: 452–61 Webb, K A (2002) From County Hospital to NHS Trust: The History and Archives of NHS Hospitals, Services and Management inYork, 1740–2000,Vol 1: History.York: University of York Wheeler, M (2013) Martin Heidegger, in E Zalta (ed.), The Stanford Encyclopedia of Philosophy, online at http://plato.stanford.edu/archives/spr2013/entries/heidegger/ 208 Bibliography White, F., Stallones, L., and Last, J M (2013) Public Health: Ecological Foundations Oxford: Oxford University Press White, W D (2004) Reason, rationalization, and professionalism in the era of managed care, Journal of Health Politics, Policy and Law, 29: 853–68 Whynes, D K (1996) Towards an evidence-based National Health Service? Economic Journal, 106: 1702–12 Wilkinson, R (1992) Income distribution and life expectancy, British Medical Journal, 304: 165–8 Wilkinson, R (1996) Unhealthy Societies:The Afflictions of Inequality London: Routledge Wilkinson, R and Pickett, K (2010) The Spirit Level: Why Equality is Better for Everyone London: Penguin Williams, A (1998) “If we are going to get a fair innings, someone will need to keep the score!” in M Barer et al (eds), Health, Health Care and Health Economics New York: Wiley Williamson, O E (1985) The Economic Institutions of Capitalism: Firms, Markets, Relational Contracting New York: Free Press Williamson, O E (2000) The new institutional economics: taking stock, looking ahead, Journal of Economic Literature, 38: 595–613 Wittgenstein, L (1953) Philosophical Investigations, eds G E M Anscombe and R Rhees, trans G E M Anscombe Oxford: Blackwell Wood, A (1999) Kant’s Ethical Thought Cambridge: Cambridge University Press World Health Organization (1946) Constitution of the World Health Organization, online at http://www.who.int/library/collections/historical/en/index3.html World Health Organization (1976) World Health Organization: Basic Documents, 26th edn Geneva: WHO World Health Organization (1978) Report of the International Conference on Primary Health Care, Alma-Ata, USSR, September, Health for All Series, No Geneva: World Health Organization World Health Organization (2001) Macroeconomics and Health: Investing in Health for Economic Development, Report of the Commission on Macroeconomics and Health, chaired by J D Sachs Geneva: World Health Organization World Health Organization (2002) World Health Report Geneva: WHO World Health Organization (2004) Poverty, online at http://www.euro.who.int/envhealthpolicy/HealthEnv/20020822_1 World Health Organization (2006) World Health Report – Working Together for Health Geneva: WHO World Health Organization (2008) World Health Report – Primary Care (Now More Than Ever) Geneva: WHO World Health Organization (2010) World Health Report – Health Systems Financing: The Path to Universal Coverage Geneva: WHO World Health Organization (2011) Palliative Care for Older People: Better Practices Copenhagen: WHO Regional Office for Europe World Health Organization (2012) Prof Donald Sloane Shepard, http://www.who.int/ neglected_diseases/shepard/en/index.html World Health Organization (2014) Disability and Health, Fact Sheet No 352, online at http:// www.who.int/mediacentre/factsheets/fs352/en/ (accessed February 2015) World Medical Association (2009) WMA Medical Ethics Manual, 2nd edn World Medical Association at http://www.wma.net World Medical Association (originally published 1963, amended 1983, rescinded 2006) Statement on the Twelve Principles of Provision of Health Care in any National Health Care System, online at http://www.wma.net/en/30publications/10policies/20archives/h6/ (accessed December 2014) Bibliography 209 Wueste, D E (ed.) (1994) Professional Ethics and Social Responsibility Lanham, MD: Rowman & Littlefield Wujastyk, D (1997) “The Nurses Should be Able to Sing and Play Instruments”: The Evidence for Early Hospitals in South Asia, unpublished manuscript, online at http:// www.ucl.ac.uk/∼ucgadkw/papers/HistoryOfHospitalsInIndia.pdf Yeates, N (2011) Going global: the transnationalization of care, Development and Change, 42: 1109–30 Zeckhauser, R J and Shepard, D (1976) Where now for saving lives? Law and Contemporary Problems, 40: 5–45 INDEX AA see Alcoholics Anonymous abortion 38 acupuncture 129 acute medical care 59–60 Adams,V 61 affect 46 agency achievement 148–9, 152–3, 157, 169, 184; and value of human rights 152–3 agency freedom 149, 153–4, 157–8, 169, 172–4, 184; and value of freedom 153–4 AIDS 63–4 aims of care 99–102; caritas 101–2 Alcoholics Anonymous 128 alcoholism 121–2 alienation 40 Allende, Salvador 42–3 altercentric altruism 6–7 alternative health economics 14–15 altruism 2, 6–10, 71, 110, 138, 180 AMA see American Medical Association American capitalism 122 American Economics Association 77 American Medical Association 46, 61 American Psychiatric Association 32, 63 Ancient Greek thought 24–5, 38 anti-tobacco campaigns 50 Antonovsky, A 36–8, 144 APA see American Psychiatric Association Appleby, John 189 archetypical caring relationship 90 Aristotle 74, 77, 81, 141–2, 181 array of health care 47–51; see also types of health care Arrow, Kenneth 26–7, 29, 180–81 assemblages of values 115–16 assisted living 55–6 Association of American Medical Colleges 41 asymmetries in care 90 atomistic conceptualization of individual 125–6, 136, 165 attachment 106 attentiveness 133–4 attribution errors 31–3, 137 authentic care 97 autonomy 40, 46, 61, 78–81, 109, 117–18, 131–9, 143–52, 157, 176–7 Ayres, Clarence 115–18 ayurvedic medicine 128–9 Baier, Annette 94–5, 109, 136 Barbour, Allen 30, 33 “barefoot doctors” 52 Baumol, W J 85 Becker, Gary 29, 71, 111 Being and Time 94–6 being-in-the-world 94–7 Bellah, R 40 beneficence 39, 71–2, 106, 108, 138, 174 Bentham, Jeremy 27, 98 Berkman, L F 30 Berlin, Isaiah 142 Berliner, H S 130 bio-psychological model 34–5, 41 biomedical approach to health economics 26–30 Index 211 biomedical approaches to health care 19–66; identifying health care 45–66; medical care 21–44 biomedicalization of prevention 58 Birch, S 30, 34 Black Report 162–3 Blustein, Jeffrey 106–111, 132, 134, 150, 183 Bobinac, A Boston Psychiatric Hospital 61 Boulding, Kenneth 16, 30–32, 39–40, 77–81, 111, 134–5, 138, 142–6, 163, 182, 189 bounded rationality 123 Bourdieu, Pierre 111, 121 bourgeois values 100 Bowen, W G 85 brainwashing 123 Brenner, Patricia 97 Bubeck, Diemut 106, 108 business enterprise 122 butcher–baker tale 71; see also Smith, Adam Butler, Samuel 79 calculation 120–23 “calling” 40–41 capability approach 154–6 Capital 40 capital stock 27, 29, 48, 180–81 capitalism 74–5 capturing care 89–112; aims of care 99–102; care of self 95–9; conclusion 111–12; introduction 89–91; overarching definition 91–5; phases of care 102–11 care beyond medical facilities 55–6 care as commodity 48–9 care groups 115–39; see also morality of care Care International 188 care relationships and social embeddedness 142–50; see also social embeddedness care of self 95–9, 103; existentialism 96–8; power, knowledge 98–9 care systems see human flourishing caregiver effect carer–patient relationship see clinician– patient relationship caring deficit 90, 101, 105–6, 109, 134, 144 Caring Democracy 90 caring externalities 5–10; problematic nature of 8–10 caring externality 2–10 caring labor 83–7 “caring moments” 104 caritas 41, 90, 101–2, 104 Carse, A L 106, 135 Cartesian grounding of care 22–5, 55, 64, 77, 101, 137 Cartesian mind–body dichotomy 24–5, 28–30, 41–6, 79, 101, 120, 159, 180 Cassel, Eric 63 categorizing care see identifying care causes of inequalities in health 162–8; effects of discrimination 166–8; social causation model 163–6 cellular abnormality 23 cellular pathology 43 centrality of care 89–91 Chadwick, Edwin 42 Challenging Health Economics characteristic human activity 83–7 Chicago School 71, 74 child mortality 52 chronic conditions 54 Churchland, Patricia 95, 109 clinician–patient relationship 3–4, 9–15, 22, 29–33, 52, 126, 130, 140–41, 176; dynamics of 52 “close-to-client” provision 53; see also primary care CMH see Commission on Macroeconomics and Health co-morbidity 29, 34 Coase, Ronald 116 codes of hospitality 109 cognitive capability 123 coherence 37–8 combining values 173–4 commission bias 137 Commission on Macroeconomics and Health 53 Commission on Social Determinants of Health 162–3 Commons, John 115–18 communitarian paradigm 81–3 communitarian reciprocity 82 comprehensive health caring 179–91; future health policy 187–9; importance of dignity 184–7; polarity in care concepts 179–84; where is economics heading? 189–91 conceptions of care 179–84 conceptualization of care 21–3 confirmation bias 137 conflict between goals and values 174–6 congruence of beliefs 128 conscious resolve 120–21, 123 consequentialistic reasoning 174–6 consumerism 137 contributing to human flourishing 140–42 212 Index coping mechanisms 37 CSDH see Commission on Social Determinants of Health Cueto, M 52–3 Culyer, Tony 6, 8–9, 41, 47–8 cura personalis 181 curative medical care 59–62; acute medical care 59–60; therapeutic medical care 60–62 current state of health care 187–9 DALYs see Disability Adjusted Life Years Darwin, Charles 119–20 Dasein 96–8, 100 Davies, Christie 131 Davis, John B 6–8, 10, 124 debt of gratitude 72 deductivism 99 defining disease 30–33 definitions of institutions 116–20 delineating medical/health care 41–3 delivery levels of medical care 51–6 DeMartino, G F 138–9 Democritus 141 Denzau, A T 123 deontic powers 118 dependency 134–5, 138 depersonalization 30, 41 Descartes, René 24–5, 181 deservingness 176–8 developing capabilities 140–59; health capabilities 142–50; introduction 140–42; person’s nature as focus of care 154–9; value of socially embedded capabilities 150–54 Dewey, John 35, 94, 120–22 diabetes 36, 53, 148 Diagnosis Related Groups 24 Diagnostic Manual of Mental Disorders 63 dignity 140–59, 176–91; capability approach 154–6; importance of 184–7; individual 140–59; normative values 156–8; of person deserving of care 176–8; towards 179–91 dignity conception of person 158–9 “dis-ease” 36–8 Disability Adjusted Life Years 28–9, 143–4 discrimination 34, 165–8 disease diagnosis 143 disease eradication 38, 188 “disease of moral judgment” 80 disease prevention levels 58 disease/illness 30–36 disposedness 96 disregard 95 distinctive measures of medical care 56–64; curative medical care 59–62; palliative care 62–4; preventive care 56–9 diversity in delivery 64–5 Dossey, B M 61–2 Dowdle, J R 60 Doyal, Len 42, 57–8, 143 Doyal, Lesley 140 “drapetomania” 32 Durkheim, Émile 92 dyadic relational emphasis 104–5 dynamics of clinician–patient relationship 52 early economic thought 70–77; Adam Smith 71–4; Karl Marx 74–5; Thorstein Veblen 75–7 EBM see evidence-based medicine economic inequality 166–8 economics of the arts 85 economics and care 69–88; early economic thought 70–77; feminist economics 83–7; Gavin Mooney 81–3; introduction 69–70; Kenneth Boulding 77–81 ecosocial theory 34, 162 effects of discrimination 166–8 efficacy 28, 48, 52–3, 60, 65, 90, 103, 143 egocentric altruism 6–7 Eisikovits, Z 32 embedded capabilities 142–54; value of 142–54; see also social embeddedness embodied selfhood 61 embodiment 34, 63, 162, 181 emotional investment 110 empathy 108, 133 end-of-life care 64; see also palliative care Engel, George 30, 34–7, 144, 181 engrossment 103–4, 108–9, 150, 183 Engster, Daniel 100–101, 133–6, 145, 152 entanglement 136, 185 Entfremdung 40 Entwistle,Vicki 176–7, 187–8 epidemiology 143 epilepsy 79 equality 151, 166–8 Erewhon 79 ethics 69–71, 80, 111, 132–5, 137–8, 174–5 EU see European Union euphoria 80 European Union 54 euthanasia 38 Evensky, Jerry 71 evidence-based medicine 25–6, 29–30, 33, 36, 58 evolution 119 Index 213 Evolution of Morality 125 evolutionary analysis 77–81 ex ante responsibility 151–2, 156–7, 161, 173–6, 184 ex post responsibility 151–2 exchange system 189 exclusionism 35 existentialism 96–8 extra welfarism 47 feminist economics 16, 83–7, 90 Feminist Economics 83 fertility control 149, 153–4, 171 fetishism 74 Fisher, B 91–5, 100, 111 Folbre, Nancy 108–10 Foley, D K 74 folk health care systems 35, 127–31 Forget, Evelyn 189 Foucault, Michel 16, 30, 32, 98–100, 111, 182 framing effects 34, 39–40 Frankenberg, Ronald 30–34 Frankfurt, Harry 95, 108 free riding 87 freedom 153–4 Freidson, E 126 Fuchs,Victor 22, 39 functionality of care 24–5, 27–8 functionings 142–5; see also social embeddedness funding myopia 53 future of health care 187–9 Gafni, A 30 game theory 10–11 Gilligan, Carol 95 Gish, O 53 Glied, S Goffman, Erving 126, 131–2 Goodin, R E 110 Gordon, R 58 Gough, Ian 42, 57–8, 143 Grant, James 52 greed 122, 131 Greenblatt, M 61 Groopman, Jerome 30–33, 35–6, 137–8 Grossman, Michael 22, 27–9, 47–8, 79, 159, 165, 180–81 ground-up moral values 15, 173–4 Guevera, Che 43 habits 120–23 “habitus” 121 Haidt, Jonathan 132 Halligan, P W 23, 32 Han, G.-S 129–30 Handbook of Health Economics 47 Hardern, R A 59–60 healer–patient relationship see clinician– patient relationship health capabilities and social embeddedness 142–50; see also social embeddedness health capability improvement 168–72 health care institutions 49–51 health care notions see biomedical approaches to health care Health Foundation 59 health insurance 50 Health and Social Justice 144 “health-ease” 36–8 healthogenesis 102 Heidegger, Martin 16, 63, 94–101, 103, 111, 182 Held,Virginia 92–5, 104–5, 111 Helman, C G 127, 129 Hemmings, C P 129 herbalism 129 hierarchy of resort 128 Himmelweit, S 85 Hippocratic Oath 8, 38–41, 79–80, 138–9, 174 Hippocratic tradition 22, 30, 38–41, 69, 127, 137, 181; tensions with 38–41 Hodgson, Geoffrey 93, 116–19, 121–3, 125, 132, 141 holistic orientation 35, 53 Holloway, Wendy 89, 95 homeostatic need 78, 80 Homo economicus 10–11, 15, 71–2, 82, 84, 118, 120, 176, 180, 189 homosexuality 32, 79 Horton, R 31–2 hospice movement 63–4 Huber, M 36–7 human artefacts 118 human capital theory 27 human flourishing 113–91; developing capabilities 140–59; morality of care 115–39; social values 160–78; towards dignity 179–91 human rights 152–3, 161, 173–6, 184, 187 humanitarian spillover 2, 5–8, 41, 69–70 Hume, David 73, 77 Hurley, J 22, 47–8 husbandry 87 Hutton, J 190 hypertension 148, 169–71 214 Index “I-intention” 124 IAFFE see International Association for Feminist Economics iatrogenic problems 57–9 IBM Blue Gene 123 identifying care 45–66; conclusion 64–5; delivery levels 51–6; distinctive measures 56–64; introduction 45–7; types of health care 47–51 iHEA see International Health Economics Association Illich, Ivan 30, 52, 126 imbalance of bio-chemicals 23–6 immigration 127 importance of dignity 184–7 individual dignity see developing capabilities inequalities in health 162–8 inequality 166–8 innate capabilities 100 Instinct of Workmanship 75–6 instinct-habit psychology 75–6, 120 instincts 75–6, 102, 120–23 institutional economics 115–26; defining institutions 116–20; habits, instincts, calculations 120–23; shared intentionality 124–6 institutional foundations of health care 178 institutions for care 49–51, 115–39; see also morality of care instrumental valuation principle 94, 189–90 intactness 63, 181 integrated organisms 38, 189 intellectual monopoly 138 interlocking social identity relationships 13 International Association for Feminist Economics 83 International Association for the Study of Pain 63 International Classification of Diseases 24 International Health Economics Association 41–2 International Red Cross 188 interpersonal interaction 46, 110 intuition 84 Invisible Hand 71 Irwin, A 162–3 issues with biomedical approach 30–41; salutogenesis 36–8; social sphere 30–36; tensions in Hippocratic tradition 38–41 IVP see instrumental valuation principle James, William 120 Jarvis, M 23 Jong-wook, Lee 162 Journal of Accident and Emergency Medicine 59 Joyce, Richard 125 Karnieli-Miller, O 32 Kennedy, Ian 30, 32, 35 Keynes, John Maynard 70 Khalil, Elias 6–7 Kierkegaard, Søren 63 Kittay, Eva Feder 94 Klaes, Matthias 93 Kleinman, Arthur 126–9 knowledge 98–9 Kontos, P C 61 Krieger, Nancy 30, 34, 63, 144, 162, 181 Landy, David 45, 126–9 Langlois, R N 137 large-scale monopoly capitalism 130 Lasagna, L 39 levels of disease prevention 58 Lindemann Nelson, H 106, 135 longevity 34 love economy 16 MacDougall, C 62 McDougall, William 120 McGuire, T G 48 McKeown, Thomas 52 McMaster, Robert 6–8, 10 mainstream care economics 1–3 making of disease 30–35 malfunction of biological process 23 marginalization 90, 98 market externalities 2–3, 5–8 Marx, Karl 40, 74–5, 77, 94, 111, 118, 120, 130 Maynard, Alan 29–30, 189–90 measures of medical care see distinctive measures of medical care mechanical precision 122–3 medical care delivery levels 51–6; care beyond medical facilities 55–6; primary care 51–3; secondary care 53–5; tertiary and quaternary care 55 medical groups of care 136–9 Medical Nemesis 52 medical pluralism 63, 126–32; overlapping health care sectors 127–31; social embeddedness of medical systems 127; “total institution” 131–2 medical/health care 21–44, 101–2; biomedical approach to 23–6; delineating medical–health care 41–3; health economics 26–30; introduction 21–3; issues with biomedical approach 30–41; Watson’s caritas 101–2 Index 215 medicalization 33, 36–7, 70 Médicins Sans Frontières 188 mental disorders 23 meta-capability 155 microeconomics of markets 2–5 Miles, S H 39 mind–body dichotomy 79 misattribution 124 Mitchell, Wesley 115–18 Modern Rise of Population 52 Mol, Annemarie 90–91, 102, 135–6 monopoly capitalism 130 Mont Perelin Society 71 Mooney, Gavin 1–2, 8, 14–15, 41–2, 47–8, 81–3, 86, 179–81; from participation to reciprocity 81–3 moral deviance 129 moral dispositions 132 moral groups of care 132–6, 141 moral hazard 3–5 moral imperative 46, 111 moral inseparability 40 moral values 173–6 morality of care 115–39; institutional economics 116–26; introduction 115–16; medical groups of care 136–9; medical pluralism 126–32; moral groups of care 132–6 morbidity 37–8, 43, 163–4 mortality 37–8, 42–3, 145–7, 163–4 motivational displacement 103–4, 108–9 Mushkin, Selma 27 music as therapy 61–2 Naglie, G 61 National Health Service 64 nature of person as focus of care 154–9 Navarro,V 130 negative freedom 153–4, 161, 173–6, 184 Nelson, Julie 61, 87, 92 neo-liberalism 82–3 neoclassical economics 116–17, 189 network of mutual beliefs 125 new institutionalism 116–17 Newhouse, J P 47–8 NHS see National Health Service Nobel Prize 116, 141 Noddings, Nel 16, 90, 97, 103–11, 115, 133, 150, 152, 183 non-maleficence 138 non-market relations 26–7 normative foundations of health care 178 normative objectives of care systems 172–8; person-centered care 176–8; social stigmatization 174–6; top-down goals, ground-up values 173–4 normative values of social embeddedness 156–8 North, Douglass 116, 123 notions of health care see biomedical approach; biomedical approaches to health care Nussbaum, Martha 94, 100, 141–2 obesity 41–3 opportunism 117 orthodox medicine 129–30 other-regard 9–10, 13–15, 72, 75–8, 86, 109, 120, 125–6 over-prescription 57 overarching definition of care 91–5 overlapping health care systems 127–31 Oxfam 188 pain relief 27 palliative care 62–4 Panopticon 98 “parental bent” 75–7, 120, 182–3 Pareto optimality 77, 189–90 Parkin, David 189–90 participation to reciprocity 81–3 paternalism 58, 80–81, 135 patient-centered care 176–8 patient–clinician relationship see clinician– patient relationship Pennell, Imogen 140 perfect information games 123 person deserving of care 176–8 person as focus of care 154–9; capability approach 154–6; dignity conception vs utility conception 158–9; normative values 156–8 “person-al capabilities” 177, 188 person-centered care 176–91 phases of care 102–11 philanthropy 55 Pierce, Charles Sanders 120 placebo effect 35–6 pluralism 45–6, 63–4, 99, 126–30; see also medical pluralism polarity in conceptions of care 179–84 policy on care see human flourishing pollution Polyani, Karl 92, 111 popular health care systems 127–31 population-based public health 57 Porcino, A 62 positive freedom 153–4, 161, 173–6, 184 postmodernism 99 poverty 41–2 power 98–9 216 Index preventive medicine 56–9 primary care 51–3 primordial prevention 57, 95 Primum Non Nocere 138, 174; see also Hippocratic Oath principal–agent theory 3–6, 11–12 problematic nature of caring externalities 8–10 productivity of caring 182 professional health care systems 48, 127–31 proxy for care 70, 84–7 public health 57, 162–72; and health capability improvement 168–72; inequalities 162–8155 public transport provision 165–6 putting the care into health care economics 1–18; alternative health economics 14–15; arguing for health care economics 15–17; caring externalities 5–8; mainstream economics 1–3; principal– agent theory 3–5; problematic nature of caring externalities 8–10; socially embedded individuals 10–14 QALYs see Quality Adjusted Life Years Quality Adjusted Life Years 28–9, 47, 143–4, 158, 181 quaternary medical care 55 randomized controlled trials 26, 33–4 rationality 117 Rawls, John 100–101 RCTs see randomized controlled trials reciprocity 81–3 Red Crescent Movement 188 reductionism 35, 41, 47, 99 rehabilitation 57 remuneration 5–6 replication 119 reproductive labor 94–6 res cogitans 24 res extensa 24 respect 102, 133, 135, 142, 155–6 “revolutiona” 32 revolutionary medicine 43 risk management 43 Robbins, Lionel Rogers, W A 33–4 Rosenberg, Charles 55 Royal College of Physicians 60 Ruger, Jennifer 144, 188 Sackett, David 59 sadomasochism 10 St Christopher’s Hospice 64 salutogenesis 30, 36–8, 144 Samuels, Warren 94, 132 Sandel, Michael 92 Sartre, Jean-Paul 63 satisficing 123 Saunders, Cicely 63–4, 147, 181 Savage, D A 137 Sayer, A 143 schizophrenia 36 Schwarzenbach, Sibyl 94–6, 100 Scott, A 52, 59–60 Searle, John 99 secondary care 53–5 sectors of health care 126–32; see also medical pluralism self-arrangement 118 self-care see care of self self-concept 155, 157–8 self-determination 153–7, 171 self-development 95 self-esteem 23, 41 self-help 128 self-interest 7, 72, 81–2, 85–6, 133 self-love 72 self-regard 9–10, 72, 75 self-respect 186 self-sacrifice 95 self-scrutiny 154–5 self-treatment 128 Sen, Amartya 30, 94, 141–51, 154–6, 158–9, 180, 183 Sevenhuijsen, Selma 100, 104, 134 shared intentionality 124–6, 148–9, 152–4, 170–71, 183–4 shared mental models 123 Simon, Herbert 123 Singer, M 24, 31–3 Smith, Adam 16, 71–8, 81, 84–5, 111–12, 133, 182; and care 71–4 Smith, D M 106, 109–110 Smith, Robert 128 “social causation” model 16–17, 161, 163–70, 172 social causes of health inequalities 162–8 social determinants of health 160–62 social embeddedness 10–14, 49–51, 120–27, 142–58; health capabilities and 142–50; and health care institutions 49–51; the individual 10–14; of medical systems 127; normative values of 156–8; person as focus of care 154–9; shared intentionality 124–6; towards individual 120–23 social goals 173–6 social groupings 34 social medicine movement 42–3, 52 Index 217 social sphere 30–36 social stigmatization 16–17, 173–7 social ties 81–3 social values in care systems 160–78; causes of health inequalities 162–8; health capability improvement 168–72; introduction 160–62; normative foundations of health care 178; normative objectives 172–8 socioeconomic class 43, 130 “soft” skill 90 Solar, O 162–3 somatic pathogens 23–4, 36 Sorge 96–8 spiritual practices 101 standard microeconomic theory 3–5 standardization 122 Starfield, B 57–9 Starr, Paul 136–7 stigmatization 16–17, 128, 167, 169–71, 174–7, 186 Stjernswärd, J 63–4 Stoicism 72 Strang, P 63 stratification economics 166–7 stress 37 Streuning, K 94 structure of health care institutions 49–51 subjective–objectivity duality 34 substance abuse treatment 55–6 Sulmasy, Daniel 39–40, 142 supply-side economics 47–8 Sybylla, R 135 Syme, S Leonard 30, 34 sympathy 6–10, 71–4, 133 “total pain” 63–4, 181 towards dignity see comprehensive health caring towards health care see theories of care towards socially embedded individual 120–23 “traditional” medicine 51 transcending awareness 61–2 Treatise on Human Behavior 73 Tronto, Joan 16, 75, 90–95, 98–101, 105–11, 115, 119–20, 132–6, 142–4, 152, 182–4 Tuohy, C H Tuomela, Raino 124–5 types of health care 47–51; health care institutions 49–51; health economics 47–9 types of health care institutions 49–51 taxonomies of medical care 40, 46, 49–51, 62 tensions with Hippocratic tradition 38–41 tertiary medical care 55 The Care of the Self 98–9 theories of care 67–112; capturing care 89–112; economics and care 69–88 Theory of Business Enterprise 122 Theory of the Leisure Class 122 Theory of Moral Sentiments 16, 71–6, 78, 81, 84, 111, 133, 182 therapeutic intervention 46 therapeutic medical care 60–62 thrownness 97 time allocation decisions 69–70 Tool, Marc 94, 132 top-down social goals 15, 173–4 Torrance, G W 28 “total institution” 126, 131–2 value of equality 151 value of ex ante responsibility 151–2 value of freedom 153–4 value of human rights 152–3 value theory 75 values of socially embedded capabilities 150–54; agency achievement 152–3; ex ante responsibility 151–2; value of freedom 153–4; wellbeing achievement 151; see also social embeddedness van Staveren, I 84 Veblen, Thorstein 16, 35, 40, 72, 75–7, 111, 115–23, 182–3; and the “parental bent” 75–7 vicious circle 164, 167–8 Vick, S 52 Virchow, Rudolph 23, 42–3 virtuous circle 164, 166–7, 169–70 vulnerability 37, 134 UN Universal Declaration of Human Rights 187–8 unaˉni medicine 128–9 “Uncertainty and the Welfare Economics of Medical Care” 27 UNICEF see United Nations Children’s Fund United Nations 187–8; Children’s Fund 52, 188; other bodies 188; Universal Declaration of Human Rights 187–8 United Nations Children’s Fund 52, 188 unpaid labor see proxy for care Upshur, R E G 33 utilitarianism 142, 189 utility conception of person 158–9 utility maximization 7–9, 29, 71, 92, 123, 180 218 Index Wade, D T 23, 32 Waitzkin, Howard 30, 33, 35 Walsh, J 53 Warren, K 52–3 Watson, Jean 16, 90–91, 101–2, 104–11, 115, 183 Watson Caring Science Institute and International Caritas Consortium 90, 101, 104; see also caritas; Watson, Jean Watt, Ian 176–7, 187–8 “we-intention” 124, 130–31 Wealth of Nations 71, 74, 111 “web of causation” 162 wellbeing achievement 147, 151, 156–7, 169, 171, 173–4, 183–4; and value of equality 151 wellbeing freedom 147–9, 151–2, 157, 169, 183–4; and value of ex ante responsibility 151–2 Wheeler, M 97 where economics is heading 189–91 White, W D 137 WHO see World Health Organization Whynes, D K 29 Williamson, Oliver 116–17 Wilson, William 128 Working Together for Health 45 World Congress on Health Economics 41–2 World Health Organization 27, 34, 36–8, 45–7, 52–4, 62–4, 148, 162, 188 World Health Report 53 Wujastyk, D 54–5 ... to health and medical care in economics Health Care Economics will be of interest to researchers and postgraduate students in health economics, heterodox economists, and those interested in health. .. authors develop a health care economics with a moral basis in health care systems In providing deeper insights into the nature of care and caring, this book seeks to redress the shortcomings of the... and place of care in the health care economy To defend these conclusions, this chapter begins by first examining how the concept of care has been interpreted in standard health care economics