Socio-economic theory and practice in health care delivery

Abstract

This paper provides the main results of various research works concerning the system of health care in Belgium. It also shows how the aim of rationality that sociologists and economists want to introduce into the process of health care delivery is often deflected by the subtle workings of the institutions involved. Such mechanisms are illustrated by examples about the availability of medical care (hospital beds as well as doctors and pharmacists), about the health insurance and about medico-social services. Finally, a few policies are listed: they vary according to the type of criteria which are chosen (consciously or not) to guide the action. Economists and sociologists can evaluate the needs, provide budgetary estimates, and indicate the advantages and disadvantages of the various possibilities. The final decisions though, about the criteria of action and the type of policy to recommend, do not rest with them: those options are essentially political.