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Evaluation & the Health Professions
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Beyond Access to Medical Care

Pursuit of Health and Prevention of Ills

David G. Gil

Brandeis University

This essay expands the public discourse on reform of health care. It examines the meaning of health, societal requirements for attaining health and preventing ills, and values and goals to guide health policy reform. The essay suggests a universal model of health and development in human societies, according to which levels of health and of human development and levels of ill health and of human underdevelopment tend to reflect, and to vary with, the extent to which people can meet their intrinsic needs in the context of the social, economic, and political institutions of their societies and the dominant values that shape these institutions and their dynamics. It applies this model to an examination of health in the United States and reveals that the extent to which people can realize their intrinsic needs is limited and that their health and development are, consequently, unsatisfactory. The essay also examines implications of this analysis for policy development and advocates transformations of our social, economic, political, and cultural institutions in ways conducive to the fulfillment of everyone's intrinsic human needs. This could be achieved by enacting an Economic Bill of Rights in line with President Roosevelt's proposals and the standards of the United Nations' Universal Declaration of Human Rights.

Evaluation & the Health Professions, Vol. 16, No. 3, 251-277 (1993)
DOI: 10.1177/016327879301600301
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