Comments on the Significance of Economic Arguments in the Health-Care Sector

Abstract

Political discussions in the health-care sector include the following two arguments:

• 1. Empirical analyses have shown a growth of expenditure in the health-care sector significantly above that of the economy at large, an increase largely independent of the allocative steering mechanism. ^(1,2) On examining the various devisions of the health-care sector separately, one finds that the highest increase in expenditure was observed in in-house health services. Political appraisal of this development differs fundamentally from the valuation of cost trends in other sectors of the economy. This trend in expenditure is examined separately from the output, or benefit, side; therefore, cost containment may be the most pressing goal in national health policy. This point of view has produced rather strange stylistic errors from those who proclaim — even though limited to calculation models — that some day the entire gross national product will be used for health expenditure. Quite apart from a logical impossibility due to economic interrelations, such predictions appear logically untenable in the light of the actual share of such expenditure in the gross national product of at present 10%, and such prognostications can therefore be relegated to what may be called “the closet of economic curiosities.”

• 2. On the other hand, an analysis of the programmes of political parties and political declarations reveals that preventive health care is increasingly looked upon as a public responsibility no longer to be left to the individual but instead to be considered a collective service; from this argument one could derive a citizens’ right to free medical care in case of illness.