Health Policy
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Health Policy

Choice, Equality and Cost

David Reisman

This lucid and comprehensive book explores the ways in which the State, the market and the citizen can collaborate to satisfy people’s health care needs. It argues that health care is not a commodity like any other. It asks if its unique properties mean that there is a role for social regulation and political management. Apples and oranges can be left to the buyers and the sellers. Health care may require an input from the consensus, the experts, the insurers, the politicians and the bureaucrats as well. David Reisman makes a fresh contribution to the debate. He argues that the three policy issues that are of primary importance are choice, equality and cost.
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Chapter 2: Good health

David Reisman


Everyone wants good health. Along with opera, vodka, cigarettes, hang gliding, high-fat grease, tennis, serial promiscuity, university education and fast cars, it is one of the good things in life that people are observed to want. This chapter is about good health. It says that robust definitions are not easy to come by and that the end-states are a mix. It attempts nonetheless to shed some light on what is meant by a satisfactory health status. Health and health care are elusive concepts. Few, however, are so highly valued or figure so often in the eye of debate. Section 2.1, ‘The definition’, states what good health is. Section 2.2, ‘Mortality’, and section 2.3, ‘Morbidity’, consider medical indicators which suggest that the body is in good shape or bad. Section 2.4, ‘The social context’, shows that the body is closely connected to the role. Section 2.5, ‘Objective and subjective’, turns from medicine and sociology to individual satisfaction, self-perceived. It is the gateway to section 2.6, ‘Rational choice’, which is about ignorance; and to section 2.7, ‘Probability’, which is about chance. Role, satisfaction, unknowledge, imagination – the message that this chapter sends to the statisticians is clear: ‘One man’s explicandum is another man’s conundrum’ (Reisman, 1993: 240). We are not all the same. That is why we need to talk: ‘A market for health … must also be a market for ideas’ (Reisman, 1993: 240). There is nothing else that it could be. The World Health Organization (WHO) has made it all clear.

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