The Problem

The answer given to a question depends, of course, to a large extent on how the question itself has been phrased. In this study, and the book on which it is based, I am far more concerned to persuade readers I have formulated the question correctly than to gain assent to the answers I give. I regard argument about the answers as inevitable, but let there at least be agreement about the questions.

Scarcity – in which human wants outstrip the ability to satisfy them with the resources available – is the central subject of examinations in economics. Nowhere, at present, does the general problem of scarcity appear more acutely – one might say more brutally and mercilessly – than in the health sector. Human knowledge, science, and technology offer many more opportunities for avoiding and curing disease, relieving suffering, and prolonging life than the health sector can apply in practice. That is the fundamental problem of health care. There are patients who might be treated, as far as human knowledge is concerned, yet they are not treated, or not treated enough. This applies even to the richest countries, and, within them, not just to the poorest members of society, but to richer people as well. Not even there is the provision taken to the limit where the marginal health-enhancing effect of an increment in health-care expenditure would become zero; they stop far short of that. The same holds true a fortiori for a country at a medium level of development, such as Hungary.