The nature, meaning and measurement of health and illness: An economic viewpoint

Health can be seen as a capital asset, subject to depreciation due both to the passage of time (ageing) and to 'wear and tear'. It is valued for the flow of pain-free time and energy it offers us, and we can increase the quantity and quality of this 'flow' by appropriate care and maintenance, which may take the form of adopting a healthy life style or in seeking health care. The valuation of health (as a capital stock) can then be seen as the valuation of the time profile of the stream of pain-free time and energy we expect to get out of it. This in turn depends on the uses to which this time and energy can be put. Its use in paid work is relatively easily valued but unpaid work (especially work in the home) continues to be a source of difficulty, both in principle and in practice, in the search for appropriate money values. Leisure time is still more difficult, though for those in paid work whose remuneration is sensitive to the work/leisure balance, foregone net earnings at that margin may be used in the marginal value of leisure time. But the appropriateness of any valuation depends on the use to which it is to be put, and it is important to distinguish whether it is to reflect 'individual' or 'group' values, and whether it is for ex post compensation associated with some particular event, or for use in ex ante decision making where it is not known who the particular gainers and losers will be.