The Concept of Need for Health Services

Abstract

Tile concept of need is often looked upon rather unfavorably by economists, in contrast with the concept of demand. Both, however, have their own strengths and weaknesses. The need concept is criticized as being too mechanical, as denying the autonomy and individuality of the human person, and as implying that the human being is a machine which needs fuel in the shape of food, engine dope in the shape of medicine, and spare parts provided by the surgeon. Even if the need concept is expanded to include psychological and emotional needs, the end result would seem to be a wire run into the pleasure center of the brain which could provide a life of unlimited and meaningless ecstasy. Demand, by contrast, implies autonomy of the individual, choice, and a tailoring of inputs of all kinds to individual preferences. Only the slave has needs; the free man has demands. In spite of the economist's uneasiness about it, a considerable demand exists for the concept of need. As even the most liberal of economists cannot deny the right of a demand to call forth a supply, the development and elaboration of concepts of need can hardly be denied. The demand, however, may be for a number of different concepts, and a single concept will not serve the purpose. The demands for this concept are quite varied, and the supply must be correspondingly differentiated. No single concept of need exists, and especially no single concept of need for health services. One demand for a concept of need arises because the concept of demand itself has serious weaknesses and limitations. It assumes away,