Red de Revistas Científicas de América Latina y el Caribe, España y Portugal
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¿Estado, mercado y análisis económico: Complementos, o substitutos?

The main approaches (libertarian and egalitarian) underlying the ideological debate on healthcare systems are essentially divergent regarding the desired market-State mix. Libertarianismproposes that access to health care services is determined by the free interplay of supply anddemand; egalitarianism proposes a State obligation to distribute income and opportunities.Using microeconomic analysis does not necessarily imply embracing any of these twoapproaches, yet such analysis is more useful for market approaches. It is rather its normativeuse which is determined by ideological stances. Managed care tools and challenges toprofessional autonomy and the beneficence principle, addressed by those who criticize marketapproaches, are not the exclusive domain of such approaches but are a response to the universal challenge to optimise the use of available resources.
Keywords: Justice, medical ethics, right to health care, managed care.