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A universal preference for equality in health? Reasons to reconsider properties of applied social welfare functions

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  • Mæstad, Ottar
  • Norheim, Ole Frithjof

Abstract

The literature on how to combine efficiency and equity considerations in the social valuation of health allocations has borrowed extensively from applied welfare economics, including the literature on inequality measurement. By so doing, it has adopted normative assumptions that have been applied for evaluating the allocation of welfare (or income) rather than the allocation of health, including the assumption of a monotonically declining social marginal value of welfare/income/health. At the same time, empirical studies that have elicited social preferences for allocation of health have reported results that are seemingly incompatible with this assumption. There are two ways of addressing this inconsistency; we may censor the stated preferences by arguing that they cannot be supported by normative arguments, or we may reject or modify the analytical framework in order to accommodate the stated preferences. We argue that the stated preferences can be supported by normative reasoning and therefore conclude that one should be cautious in applying the standard welfare economic framework to the allocation of health.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 75 (2012)
Issue (Month): 10 ()
Pages: 1836-1843

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Handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1836-1843

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Related research

Keywords: Health equity; Social welfare function; Eliciting preferences;

References

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  18. Busschbach, Jan J. V. & Hessing, Dick J. & De Charro, Frank Th., 1993. "The utility of health at different stages in life: A quantitative approach," Social Science & Medicine, Elsevier, vol. 37(2), pages 153-158, July.
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  21. 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.
  22. Tsuchiya, Aki & Dolan, Paul & Shaw, Rebecca, 2003. "Measuring people's preferences regarding ageism in health: some methodological issues and some fresh evidence," Social Science & Medicine, Elsevier, vol. 57(4), pages 687-696, August.
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