Abstract

Some see health care as primarily an individual responsibility. Others see it as a public responsibility. Behind these approaches are strong conflicting beliefs about ethical matters, specifically about the kind of good that health care is. On the one side the underlying belief is that health care is no more than an individual good and hence calls for a distributive policy based on the market. On the other side the underlying belief is that it is a public good and hence calls for a distributive policy based on widespread agreement.' There will be intermediate approaches which try with varying success to justify themselves by piecing together beliefs from both sides. I shall explain what is involved in calling something a public good. Then I shall try to show that, if health care is to satisfy some rather plausible criteria, it must have the character of a public good.