ABSTRACT

Health economists should move away from their dominant linear mode of thinking - the belief that complex systems can be understood by an analysis of their component parts and the predictable interactions between them. This approach is often at odds with the providers of healthcare who live in a complex environment and who seek generic predictions of trends rather than exact solutions. There are those who are less generous of the whole economic programme and claim that economics is what economists do, and what economists do is study questions that can be handled with their own expertise. Health economists should move away from institutionalised theory that practitioners and managers are expected to apply and which invariably bears no relationship to their requirements for pragmatic strategies. The theoretical framework needs to be grounded more appropriately in the everyday experience of those engaging with healthcare systems in a world that is socially constructed but which can accommodate goal seeking behaviour.