ABSTRACT
This chapter outlines the relationship between theoretical and practical understandings of health care needs on the one hand and the determination of policy on the other. It explores the nature of our understandings and interpretation of health care needs and their capacity to both inform policy decisions and legitimate policy making. The chapter utilizes the components of basic needs framework to evaluate the work of the renal review group. It looks at the theoretical debates concerning health care needs, justice and rights to health care. The economic approach therefore uses the idea of the subjectivity of ‘needs’ to postulate an alternative paradigm of ‘need’. Because of the ‘subjectivity’ of needs, the process of needs assessment is inevitably value laden, given that opinion on a patient’s needs is usually made by a third party (usually a doctor). The economic definition of need is popular however because it enables conventional marginal product theory to adjudicate among competing claims for health care.
