Beyond health outcomes: The benefits of health care

Most of the debate surrounding standards in medical care, issues of medical audit and what constitutes benefit from health care assumes that what is obtained from health care is health and only that. This is an assumption which most health economists at least implicitly appear to endorse. This paper questions that assumption. There are various outcomes beyond health and there are various processes involved in health care about which patients are not indifferent. This paper calls for a fuller investigation as to what it is that patients want from their health services and the adoption of a more pluralistic conception of health care benefits. It is further argued that the objectives of health care systems are those in which citizens qua citizens also have interests and which may be different from those of patients. It is yet less likely that citizens' interests in health care will be restricted to health. (C) 1998 John Wiley & Sons, Ltd.