Why a theory of health-care needs?

A theory of health-care needs should serve two central purposes. First, it should illuminate the sense in which many of us think health care is special and should be treated differently from other social goods. A theory of health-care needs should show how these needs are connected to other central notions in an acceptable theory of justice. It should help us see what kind of social good health care is by properly relating it to social goods whose importance is similar and for which we may have a clearer grasp of appropriate distributive principles.

Second, such a theory should provide a basis for distinguishing the more from the less important among the many kinds of things health care does for us. It should tell us which health-care services are more special than others – which is why I start with a theory of needs, not services. Thus a broad category of health-services functions to improve quality of life, not to extend or save it. Some of these services restore or compensate for diminished capacities and functions; others improve life quality in other ways. We do draw distinctions about the urgency and importance of such services (though not always in these terms). Our theory of healthcare needs should provide a basis for a reasonable set of such distinctions.