Social welfare and the Affordable Care Act: Is it ever optimal to set aside comparative cost?
The creation of the Patient-Centered Outcomes Research Institute (PCORI) under the Affordable Care Act has set comparative effectiveness research (CER) at centre stage of US health care reform. Comparative cost analysis has remained marginalised and it now appears unlikely that the PCORI will require comparative cost data to be collected as an essential component of CER. In this paper, we review the literature to identify ethical and distributional objectives that might motivate calls to set priorities without regard to comparative cost. We then present argument and evidence to consider whether there is any plausible set of objectives and constraints against which priorities can be set without reference to comparative cost. We conclude that – to set aside comparative cost even after accounting for ethical and distributional constraints – would be truly to act as if money is no object.
Volume (Year): 75 (2012)
Issue (Month): 7 ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Coast, Joanna & Smith, Richard D. & Lorgelly, Paula, 2008. "Welfarism, extra-welfarism and capability: The spread of ideas in health economics," Social Science & Medicine, Elsevier, vol. 67(7), pages 1190-1198, October.
- Lindsay, Cotton M, 1969. "Medical Care and the Economics of Sharing," Economica, London School of Economics and Political Science, vol. 36(144), pages 351-62, November.
- Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November.
- Coast, Joanna, 2009. "Maximisation in extra-welfarism: A critique of the current position in health economics," Social Science & Medicine, Elsevier, vol. 69(5), pages 786-792, September.
- Gold, Marthe Rachel & Franks, Peter & Siegelberg, Taryn & Sofaer, Shoshanna, 2007. "Does providing cost-effectiveness information change coverage priorities for citizens acting as social decision makers?," Health Policy, Elsevier, vol. 83(1), pages 65-72, September.
- Johannesson, Magnus & Weinstein, Milton C., 1993. "On the decision rules of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 12(4), pages 459-467, December.
- Culyer, A J, 1971. "Medical Care and the Economics of Giving," Economica, London School of Economics and Political Science, vol. 38(151), pages 295-303, August.
- 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.
- Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Who cares about cost? Does economic analysis impose or reflect social values?," Health Policy, Elsevier, vol. 34(2), pages 79-94, November.
- Birch, Stephen & Gafni, Amiram, 1993. "Changing the problem to fit the solution: Johannesson and Weinstein's (mis) application of economics to real world problems," Journal of Health Economics, Elsevier, vol. 12(4), pages 469-476, December.
- Lancsar, Emily & Wildman, John & Donaldson, Cam & Ryan, Mandy & Baker, Rachel, 2011. "Deriving distributional weights for QALYs through discrete choice experiments," Journal of Health Economics, Elsevier, vol. 30(2), pages 466-478, March.
- Mentzakis, Emmanouil & Stefanowska, Patricia & Hurley, Jeremiah, 2011. "A discrete choice experiment investigating preferences for funding drugs used to treat orphan diseases: an exploratory study," Health Economics, Policy and Law, Cambridge University Press, vol. 6(03), pages 405-433, June.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:7:p:1156-1162. See general information about how to correct material in RePEc.
If references are entirely missing, you can add them using this form.