The Concept of “Public Health” – A Critical Assessment

Abstract

The article discusses the fundamental differences between an orientation towards individual health and the concept of health on which public health systems are built. It is shown that health in its original sense, as the “virtue of the body” (Aristotle), has to be understood as the ability to realize purposes in the actions of individuals. In public healthcare on the other hand, “health” has always been conceived as a public good and as an expression of certain public interests, a conception which does not have to be consistent with the interests of the individual in any way. “Public health” is normally designed in a utilitarian way and can be highly susceptible to ideology. In extreme cases the individual becomes subject to a “health obligation” which is to be rejected on legal, philosophical and ethical grounds. In place of a “scientific” medicine that reduces people to a statistical magnitude, a self-understanding of medicine should be restored which defines “health” from the point of view of the task of enabling real interpersonality in the space of the empirical existence of individuals self-determined as free.