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Utilities versus Rights to Publicly Provided Goods: Arguments and Evidence from Health Care Rationing

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  • Anand, Paul
  • Wailoo, Allan

Abstract

This paper challenges the QALY maximizing approach to rationing health care on the grounds of the consequentialist (and sometimes approximately utilitarian) moral framework on which it is based. An alternative methodological approach is suggested and, in addition to consequences, four normative determinants of health care entitlements are identified: rights, public opinion, social contracts and community values. Survey evidence is presented which shows support for these alternative frameworks and a rejection of consequentialism. The paper suggests that a (if not the) major challenge facing the designers of rationing guidelines is that of pluralism, i.e. the need to integrate considerations from a set of frameworks. Copyright 2000 by The London School of Economics and Political Science

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Bibliographic Info

Article provided by London School of Economics and Political Science in its journal Economica.

Volume (Year): 67 (2000)
Issue (Month): 268 (November)
Pages: 543-77

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Handle: RePEc:bla:econom:v:67:y:2000:i:268:p:543-77

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Cited by:
  1. Johansson-Stenman, Olof & Martinsson, Peter, 2003. "Are Some Lives More Valuable?," Working Papers in Economics 96, University of Gothenburg, Department of Economics.
  2. Anand, Paul & van Hees, Martin, 2006. "Capabilities and achievements: An empirical study," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 35(2), pages 268-284, April.
  3. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208.
  4. Daniel Eisenberg & Gary Freed & Matthew Davis & Dianne Singer & Lisa Prosser, 2011. "Valuing health at different ages," Applied Health Economics and Health Policy, Springer, vol. 9(3), pages 149-156, May.
  5. Richardson, Jeff & McKie, John, 2007. "Economic evaluation of services for a National Health Scheme: The case for a fairness-based framework," Journal of Health Economics, Elsevier, vol. 26(4), pages 785-799, July.
  6. Johansson-Stenman, Olof & Martinsson, Peter, 2008. "Are some lives more valuable? An ethical preferences approach," Journal of Health Economics, Elsevier, vol. 27(3), pages 739-752, May.
  7. Anand, Paul, 2003. "The integration of claims to health-care: a programming approach," Journal of Health Economics, Elsevier, vol. 22(5), pages 731-745, September.
  8. Tania Stafinski & Devidas Menon & Deborah Marshall & Timothy Caulfield, 2011. "Societal Values in the Allocation of Healthcare Resources," The Patient: Patient-Centered Outcomes Research, Springer, vol. 4(4), pages 207-225, December.
  9. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666.

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