The philosophy of need and the normative foundations of health policy

Philippe Batifoulier, John Latsis and Jacques Merchiers

Table of Contents


The concept of need plays an essential role in defining legitimate health inequalities. The debate on equity in healthcare policy has so far evolved independently of the philosophical discussions of need. This article draws on moral and political philosophy in order to develop a conception of need that goes beyond the current dichotomy between universal lists and individual preferences. We propose an institutionalist approach to needs that emphasises the role of social processes in creating and consolidating specific and situated healthcare needs.

JEL : I11, I18, D63, B52


  • healthcare needs
  • health care priority setting
  • equity
  • institutionalist economics
  • philosophy of economics


  • Implicit and explicit conceptions of need in health economics
  • In search of ethical foundations for need
    • Moral justification
    • From moral and political ideals to institutional configurations
  • An institutionalist approach to need
    • Institutionalism in health economics and the problem of universal needs‑lists
    • The political dimension of needs
    • The justification of healthcare needs and the political process
  • Conclusion