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Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

This article problematizes the concept of freedom rooted in liberalism, examining the detention of historian Ilan Pappe by the Federal Bureau of Investigation (FBI) at Detroit Airport in the United States as an emblematic case study.

The research adopts a methodological triangulation approach, based on an analysis that combines data about the event and theories about the concept of freedom, problematizing authors who focused on the relationship between the individual and society in a liberal context, where individualism serves as the basis for specific conceptions of social relations.

Through the use of authors such as John Stuart Mill and John Locke, as well as the contributions of authors like Norbert Elias, it is argued that true freedom is relational, rooted in social interdependencies and the social construction of an individuality that is not individualistic but intrinsically linked to collective aspects.

Pappe’s case illustrates the tensions between individual freedom and collective interests, highlighting the need to reassess freedom of expression in complex political and social contexts.

This article proposes a more inclusive and interconnected view of human freedom, where individual and collective interests are negotiated within a dynamic web of social relations.