Abstract

‘Welfare’ is a vague term, the meaning of which depends on ideology, values and judgements. Material resources are just means to enhance people's well-being, but growth of Gross Domestic Product is still the standard measure of a society's success. Fortunately, recent advances in measuring social performance include health, education and other social outcomes. Because ‘what we measure affects what we do’, it is hoped that social policies will change, and that a contribution will be made by Health in All Policies and associated health impact assessment methodology. The task consists of designing transversal policies that consider health and other welfare goals, the short-term and long-term implications and intergenerational redistributions of resources. Cross-sectoral policies are required for efficiency and fairness. Unless inefficiencies in current healthcare systems are reduced, welfare states will fail to consolidate and overall economic well-being could be in serious trouble. In this essay, some policy solutions are sketched. An independent agency, the National Institute for Welfare Enhancement, is proposed for long-term fair and efficient social policies in which health plays a central role.