Utilities vs. Rights to Publicly Provided Goods: Arguments and Evidence from Health-Care Rationing
AbstractThis 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.
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Bibliographic InfoPaper provided by The Open University, Faculty of Social Sciences, Department of Economics in its series Open Discussion Papers in Economics with number 14.
Date of creation: Jan 2000
Date of revision:
Publication status: Published in Economica, London School of Economics and Political Science, vol. 67(268), pages 543-77, November
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Web page: http://www.open.ac.uk/socialsciences/about-the-faculty/departments/economics/research/discussion-papers.php
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- Anand, Paul & Wailoo, Allan, 2000. "Utilities versus Rights to Publicly Provided Goods: Arguments and Evidence from Health Care Rationing," Economica, London School of Economics and Political Science, vol. 67(268), pages 543-77, November.
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- 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.
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Open Discussion Papers in Economics
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- 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.
- Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666.
- Johansson-Stenman, Olof & Martinsson, Peter, 2003. "Are Some Lives More Valuable?," Working Papers in Economics 96, University of Gothenburg, Department of Economics.
- 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.
- Anand, Paul & van Hees, Martin, 2006. "Capabilities and achievements: An empirical study," The Journal of Socio-Economics, Elsevier, vol. 35(2), pages 268-284, April.
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