Costas G Dikeos
The article examines the positive concept of health as a goal of healthcare provision, as well as the political and ideological preconditions for its attainment. It focuses on Health Promotion and Health Prevention as important factors in health care and therefore health care policy, politics and management. Promotion and prevention are analysed as assistance to (a) achieving a healthy or else sound and robust life (a goal by itself) and (b) cost reduction.
On a more general level the concept of health is approached versus concepts of political theory such as ‘dignity’, ‘liberty’ (‘positive’ and/or ‘negative’), ‘general will’ and ‘good life’.
It then turns to discussion of critique against health promotion as an individual (-istic) matter related to personal behaviour and attitudes (exercise, diet, smoking), whereas social issues and choices of political factors (infrastructure, working conditions, access to primary care, spare time enough for exercise, access to information concerning promotion etc.) may prevail as causes of illness, whilst these causes are socio-political.
It claims that similar points may be raised against health prevention mainly in the form of primary prevention as far as individual (-istic) choices in life-style are under question (possibly leading towards libertarian ideology), and secondary prevention as far as health-care infrastructure and services and accessibility to them are under question.
The relationship between social, political, managerial and technical and medical sciences is stressed in the last part.
