Mannion R, Small N
Centre for Health Economics, University of York, Heslington, UK.
Health Care Anal. 1999;7(3):255-72. doi: 10.1023/A:1009400926449.
Postmodernism and health economics are both concerned with questions about choices and values, risk and uncertainty. Postmodernists seek to respond to such questions in the context of a world of uncoordinated and often contradictory chances, a world devoid of clear-cut standards. Health economics seeks to respond using the constructs of modernity, including the application of reason to generate better order. In this article we present two sorts of voice. First we introduce postmodernism and those seeking to contribute to economics from a postmodern perspective. Second, we consider critics of a prevalent neo-classicism within health economics both from outside that paradigm and from those more closely associated with it. It is increasingly evident that (health) economics, as presently constituted, is failing both in its descriptive powers and its prescriptive possibilities. Postmodernism offers not just an alternative theoretical approach but the possibility of both expanding the scope of health economics and grounding it more appropriately in the everyday experience of those engaging with health systems.
后现代主义和健康经济学都关注有关选择与价值观、风险与不确定性的问题。后现代主义者试图在一个缺乏协调且常常相互矛盾的机会的世界、一个没有明确标准的世界背景下回应此类问题。健康经济学则试图运用现代性的架构来回应,包括运用理性来创造更好的秩序。在本文中,我们呈现两种声音。首先,我们介绍后现代主义以及那些试图从后现代视角为经济学做出贡献的人。其次,我们考虑健康经济学内部流行的新古典主义的批评者,这些批评者既有来自该范式之外的,也有与其联系更为紧密的人。越来越明显的是,目前构成的(健康)经济学在其描述能力和规范可能性方面都失败了。后现代主义不仅提供了一种替代性的理论方法,还提供了扩大健康经济学范围并使其更恰当地基于参与卫生系统者的日常经验的可能性。