Caring or Curing? On the Nature of Health Care in Modern Societies
Is health care a luxury or a necessity? Ever since the publication of Newhouse paper in 1977, this question has put forth a multitude of studies but still the substantive question is open. The empirical research on the nature of health care is mostly based on macro respectively micro level relationships among measures of wealth and expenditure for health care. Depending on the elasticity estimated, health care is classified by a study as a luxury, a necessity or both.
Based on a micro level explanation of why wealth may change the preferences of citizens with regard to health care, this paper supplements these studies by making an inference from the satisfaction of the citizens with a health care system in combination with information on what the health care system is actually delivering on the preferences and expectations citizens hold with regard to health care and the health care system.
Combining micro and macro level data, the evidence shows that wealth has indeed an effect on what citizens expect from a health care system. However, this change cannot be interpreted in the classical caring or curing distinction of medical services as proposed by Newhouse: even though curing, i.e. a health care system delivering what is necessary and performing well in restoring physiological health, surely no longer is enough to satisfy the citizens, the information available is insufficient to tell what the citizens actually want.