Advertisement

Health Care Analysis

, Volume 15, Issue 3, pp 195–210 | Cite as

The Individual in Mainstream Health Economics: A Case of Persona Non-grata

  • John B. Davis
  • Robert McMaster
Original Article

Abstract

This paper is motivated by Davis’ [14] theory of the individual in economics. Davis’ analysis is applied to health economics, where the individual is conceived as a utility maximiser, although capable of regarding others’ welfare through interdependent utility functions. Nonetheless, this provides a restrictive and flawed account, engendering a narrow and abstract conception of care grounded in Paretian value and Cartesian analytical frames. Instead, a richer account of the socially embedded individual is advocated, which employs collective intentionality analysis. This provides a sound foundation for research into an approach to health policy that promotes health as a basic human right.

Keywords

Care Deontology Groups Individual Instrumental rationality Mainstream health economics 

Notes

Acknowledgements

The comments and criticisms of the editors and referees of this journal, participants at a session of the European Association for Evolutionary Political Economy 2004 conference, and the 2005 Association of Heterodox Economics conference are gratefully acknowledged. We are also pleased to acknowledge the financial support of the Carnegie Trust for the Universities of Scotland and the British Academy without implicating these bodies in any way. All errors and views expressed are the authors’ alone.

References

  1. 1.
    Arrow KJ (1963) Uncertainty and the welfare economics of medical care. Am Econ Rev 53:941–973Google Scholar
  2. 2.
    Becker GS (1996) Accounting for tastes. Harvard University Press, Cambridge, MAGoogle Scholar
  3. 3.
    Birch S, Donaldson C (2003) Valuing the benefits and costs of health care programmes: where’s the ‘extra’ in extra-welfarism? Soc Sci Med 56:1121–1133PubMedCrossRefGoogle Scholar
  4. 4.
    Blustein J (1991) Care and commitment: taking the personal point of view. Oxford University Press, OxfordGoogle Scholar
  5. 5.
    Cartwright D, Zander A (1968) Group dynamics research and theory. Harper and Row, New YorkGoogle Scholar
  6. 6.
    Cohen J, Ubel P (2001) Accounting for fairness and efficiency in health economics. In: Davis JB (ed) The social economics of health care. Routledge, London and New YorkGoogle Scholar
  7. 7.
    Culyer AJ (1976) Need and the national service. Martin Robertson, OxfordGoogle Scholar
  8. 8.
    Culyer AJ (1989) The normative economics of health care finance and provision. Oxford Rev Econ Pol 5:34–58CrossRefGoogle Scholar
  9. 9.
    Culyer AJ (1990) Commodities, characteristics of commodities, characteristics of people, utilities and the quality of life. In: Baldwin S, Godfer C, Propper C (eds) Quality of life: perspectives and policy. Routledge, LondonGoogle Scholar
  10. 10.
    Culyer AJ (1998) How ought health economists to treat value judgements in their analyses? In: Barer ML, Getzen TE, Stoddart GL (eds) Health, health care, and health economics: perspectives on distribution. Wiley, ChichesterGoogle Scholar
  11. 11.
    Culyer AJ, Newhouse JP (2000) Introduction. In: Culyer AJ, Newhouse JP (eds) The handbook of health economics, vol 1A. Amsterdam, North-HollandGoogle Scholar
  12. 12.
    Davis JB (ed) (2001) The social economics of health care. Routledge, London and New YorkGoogle Scholar
  13. 13.
    Davis JB (2002) The emperor’s clothes. J Hist Econ Thought 24:141–154CrossRefGoogle Scholar
  14. 14.
    Davis JB (2003) The theory of the individual in economics: identity and value. Routledge, London and New YorkGoogle Scholar
  15. 15.
    Davis JB (Forthcoming) Identity and commitment: Sen’s conception of the individual. In: Schmid B, Peters F (eds) Rationality and commitment. Oxford University Press, OxfordGoogle Scholar
  16. 16.
    Dewey J (1963) Philosophy and civilization. Capricorn Books, New York (originally published 1931)Google Scholar
  17. 17.
    Donald A (2001) The Wal-Marting of American Psychiatry: an ethnography of psychiatric practice in the late 20th century. Cul Med Psychiat 25:427–439CrossRefGoogle Scholar
  18. 18.
    Evans RG (1974) Supplier-induced demand: some empirical evidence and implications. In: Perlman M (ed) The economics of health and medical care. Macmillan, LondonGoogle Scholar
  19. 19.
    Evans RG (1998) Toward a healthier economics: reflections on Ken Bassett’s problem. In: Barer ML, Getzen TE, Stoddart GL (eds) Health, health care, and health economics: perspectives on distribution. Wiley, ChichesterGoogle Scholar
  20. 20.
    Fine B (2001) Social capital versus social theory: political economy and social science at the turn of the millennium. Routledge, London and New YorkGoogle Scholar
  21. 21.
    Fitzgerald R (2004) The New Zealand health reforms: dividing the labour of care. Soc Sci Med 58:331–341PubMedCrossRefGoogle Scholar
  22. 22.
    Folbre N (1995) “Holding hands at midnight”: the paradox of caring labor. Fem Econ 1:73–92CrossRefGoogle Scholar
  23. 23.
    Folbre N, Nelson JA (2000) For love or money – or both? J Econ Perspect 14:123–140.CrossRefGoogle Scholar
  24. 24.
    Folbre N, Goodin RE (2004) Revealling altruism. Rev Soc Econ 62:1–25CrossRefGoogle Scholar
  25. 25.
    Forget EL (2004) Contested histories of an applied field: the case of health economics. Hist Polit Econ 36:617–637CrossRefGoogle Scholar
  26. 26.
    Fuchs VR (1996) Economics, values, and health care reform. Am Econ Rev 86:1–24PubMedGoogle Scholar
  27. 27.
    Gilson L (2003) Trust and the development of health care as a social institution. Soc Sci Med 56:1453–1468PubMedCrossRefGoogle Scholar
  28. 28.
    Goddard M, Mannion R, Smith P (2000) Enhancing performance in health care: a theoretical perspective on agency and the role of information. Health Econ 9:95–107.PubMedCrossRefGoogle Scholar
  29. 29.
    Grossman M (1972) On the concept of health capital and the demand for health. J Pol Econ 80:223–255Google Scholar
  30. 30.
    Hodgson GM (2003) The hidden persuaders: institutions and individuals in economic theory. Cambridge J Econ 27:159–175.CrossRefGoogle Scholar
  31. 31.
    Hodgson GM (2004) The evolution of institutional economics: agency, structure and Darwinism in American institutionalism. Routledge, New York and LondonGoogle Scholar
  32. 32.
    Hopper K (2001) Commentary: on the transformation of the moral economy of care. Cult Med Psychiat 25:473–484CrossRefGoogle Scholar
  33. 33.
    Hutton J, Maynard A (2000) A NICE challenge for health economics. Health Econ 9:89–93PubMedCrossRefGoogle Scholar
  34. 34.
    Hurley J (1998) Welfarism, extra-welfarism and evaluative economic analysis in the health sector. In: Barer ML, Getzen TE, Stoddart GL (eds) Health, health care, and health economics: perspectives on distribution. Wiley, ChichesterGoogle Scholar
  35. 35.
    Hurley J (2000) An overview of the normative economics of the health sector. In: Culyer AJ, Newhouse JP (eds) The handbook of health economics, vol 1A. Amsterdam, North-HollandGoogle Scholar
  36. 36.
    Kennedy I (1981) The unmasking of medicine: a searching look at health care today. Allen and Unwin, George, LondonGoogle Scholar
  37. 37.
    Khalil EL (2003) What is altruism?, (critical commentary). J Econ Psychol 25:97–123CrossRefGoogle Scholar
  38. 38.
    Lawson T (1997) Economics and reality. Routledge, LondonGoogle Scholar
  39. 39.
    Lawson T (2003) Reorienting economics. Routledge, LondonGoogle Scholar
  40. 40.
    McGuire A, Henderson J, Mooney G (1982) The economics of health care: an introductory text. Routldege and Kegan Paul, LondonGoogle Scholar
  41. 41.
    McGuire TG (2000) Physician agency. In: Culyer AJ, Newhouse JP (eds) The handbook of health economics, vol 1A. Amsterdam, North-HollandGoogle Scholar
  42. 42.
    Maclean A (1993) The elimination of morality: reflections on utilitarianism and bioethics. Routledge, LondonGoogle Scholar
  43. 43.
    McMaster R (2001) The national health service, the ‘Internal Market’ and trust. In: Davis JB (ed) The social economics of health care. Routledge, London and New YorkGoogle Scholar
  44. 44.
    Margalit A, Raz J (1990) National self-determination. J Philos 87:439–461.CrossRefGoogle Scholar
  45. 45.
    Margolis H (1982) Selfishness, Altruism, and Rationality: A Theory of Social Choice, Cambridge University Press: CambridgeGoogle Scholar
  46. 46.
    Mooney G (2005) Communitarian claims and community capabilities: furthering priority setting? Soc Sci Med 60:247–255PubMedCrossRefGoogle Scholar
  47. 47.
    Mooney G, Ryan M (1993) Agency in health care: getting beyond first principles. J Health Econ 12:125–135.PubMedCrossRefGoogle Scholar
  48. 48.
    Mooney G, Russell E (2003) Equity in health care: the need for a new economics paradigm? In: Scott A, Maynard A, Elliott R (eds) Advances in health economics. Wiley, ChichesterGoogle Scholar
  49. 49.
    Nelson JA (1999) Of markets and martyrs: is it OK to pay well for care? Fem Econ 5:43–59CrossRefGoogle Scholar
  50. 50.
    Rice T (1998A) The economics of health reconsidered. Health Administration Press, ChicagoGoogle Scholar
  51. 51.
    Rice T (1998B) The desirability of market-based health reforms: a reconsideration of economic theory. In: Barer ML, Getzen TE, Stoddart GL (eds) Health, health care and health economics: perspectives on distribution. John Wiley & Sons, HobokenGoogle Scholar
  52. 52.
    Rice T (2001) Should consumer choice be encouraged in health care? In: Davis JB (ed.) The social economics of health care. Routledge, London and New YorkGoogle Scholar
  53. 53.
    Robins CS (2001) Generating revenues: fiscal changes in public mental health care and the emergence of moral conflicts among care-givers. Cul Med Psychiat 25:457–466CrossRefGoogle Scholar
  54. 54.
    Rudnick A (2001) A meta-ethical critique of care ethics. Theor Med 22:505–517CrossRefGoogle Scholar
  55. 55.
    Scott A, Vick S (1999) Patients, doctors and contracts: an application of principal-agent theory to the doctor-patient relationship. Scot J Polit Econ 46(2):111–134CrossRefGoogle Scholar
  56. 56.
    Scott A, Farrar S (2003) Incentives in health care. In: Scott A, Maynard A, Elliott R (eds) Advances in health economics. Wiley, ChichesterGoogle Scholar
  57. 57.
    Searle J (1995) The construction of social reality. Free Press, New YorkGoogle Scholar
  58. 58.
    Simon HA (1991) Organizations and markets. J Econ Perspect 5:25–44Google Scholar
  59. 59.
    Tuomela R (1995) The importance of Us: a philosophical study of basic social notions. Stanford University Press, StanfordGoogle Scholar
  60. 60.
    Van Der Geest S, Finkler K (2004) Hospital ethnography: introduction. Soc Sci Med 59:1995–2001PubMedCrossRefGoogle Scholar
  61. 61.
    van Staveren I (2001) The values of economics: an aristotelian approach. Routledge, London and New YorkGoogle Scholar
  62. 62.
    van Staveren I (2005) Modelling care. Rev Soc Econ 63:567–586CrossRefGoogle Scholar
  63. 63.
    Williams A (1988) Priority setting in public and private health care, a guide through the methodological jungle. J Health Econ 7:173–183PubMedCrossRefGoogle Scholar
  64. 64.
    Williams B (1985) Ethics and the limits of philosophy. Fontana, LondonGoogle Scholar
  65. 65.
    Wiseman V (1997) Caring: the neglected health outcome? or input? Health Policy 39:43–53PubMedCrossRefGoogle Scholar
  66. 66.
    Wiseman V, Mooney G, Berry G, Tang KC (2003) Involving the general public in priority setting: experiences from Australia. Soc Sci Med 56:1001–1012PubMedCrossRefGoogle Scholar
  67. 67.
    World Health Organization (2002) World health report. World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.University of Amsterdam and Marquette UniversityMilwaukeeUSA
  2. 2.University of GlasgowGlasgowUK

Personalised recommendations