Basic yet Major Concepts of Health Economics

2. Want

The second basic word in our set of words is “want” that is as important as need,
especially in the field of resource management. Generally, it is assumed there is neither
limitation nor restriction on what people want to possess, such as a penthouse on one of
the most expensive streets in New York without considering their ability to afford it. In
other words, what you desire to fulfill has nothing to do with your socioeconomic and
financial background.

Distinguishing this concept in health sector is of utmost importance, for not paying
attention to it is likely to have detrimental effects on health resources. Health sector is
believed to have become one of the most challenging sectors where expenditures are
facing an ever-increasing trend; therefore, whatever view is applied to it should not only
be studied but also be assessed.

In health sector, there are some items that can expand people's want, ranging from lab tests
to medicines, the most considerable of which would be health insurance coverage,
especially when it comes to low-priced products like antibiotics. Imagine that you have to
go to a doctor's office for the flu. The physician will examine you and based on your
symptoms and sings may prescribe a course of medication like antibiotics or recommend
that you just stay at home and drink plenty of liquids. Whether the physician suggests
taking antibiotics or simply getting some rest at home is based on the “need” view and it
should be valued by the patient, yet these recommendations may or may not live up to the
patients’ expectation. To clarify the situation some scenarios can be made as follows.

The patient may want to be prescribed the latest generation of antibiotics for the flu
because he or she believes that this is the best cure for their ailment. Patients might feel
recuperation period is reduced by taking antibiotics and they can start their own business
as soon as they are back on their feet. On the contrary, if physicians insist on their view,
not prescribing the latest generation of antibiotics, and recommend that the patient stays at
home, he or she is bound to lose their patients, eventually his or her income will dwindle,
although they would be satisfied because with doing so, they made a professional decision.
In the third scenario the physician may make no attempt to alter, change or mould the
patients' view regarding the effectiveness of the suggested methods to cure the illness and
they accompany the patient and prescribe what they want, leading to an increase in the
level of antibiotic consumption as well as antibiotic resistance and health expenditures in a
society.

Take Iran as an example where the level of antibiotic consumption is estimated

approximately 4 times greater than the universal average and this issue is mainly rooted in
conflicting views between "need" and "want", which are perceived not only by physicians
but also by patients. This conflict will get worse should the patient is under the coverage
of health insurance and he or she can easily, thanks to their health insurance, go to any
hospital or doctor's office without being charged a considerable amount of money.

To tackle the issue, firstly, health policy makers should be required to raise the awareness
of service providers and recipients regarding both expenses and side effects of taking too
much medication like antibiotic resistance. Moreover, patients' freedom to have access to
different health providers should be regulated by implementing schemes like assigning
certain general practitioners to be the first level of contact in order to meet the health needs
as well as briefing experts who should be responsible on how to refer patients to
specialists within a health system based on their physical or mental problems.

Overall, the whole situation depends on the level of overlap between the “need”,
distinguished by qualified physicians, and the “want” that is desired by patients. If the
overlap between the "need" and the "want" increases by applying feasible approaches such
as developing medical guidelines and implementing educational plans or regulating the
health system, the results can be seen in improving both resource management and health
status of the whole society.

Sattar Mehrban, reseatcher in the field of health economics, drsattarm@yahoo.com