ABSTRACT
This chapter considers the contradictions involved in a welfare system whose aim is to ensure that there is universal access to basic human needs whilst at the same time operating as part of the modern capitalist state. The duality of the welfare state for Marxism is that it can be heralded as a prize for the working class, but at the same time it fulfils important functions for the capitalist state. Intermediate needs such as health care should therefore be organised on the basis of the goal of minimising disabled social participation. The drive towards markets and greater competition within the health care sector failed to take account of the need for a framework for discussing needs. Health Economists for example have successfully argued for the application of the concept of opportunity cost to the problem of scarce health care resources. The chapter also presents an overview of the key concepts discussed in this book.
