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Your Money or Your Life: A Prescriptive Model for Health, Safety, and Consumption Decisions


  • James E. Smith

    () (Fuqua School of Business, Duke University, Durham, North Carolina 27708)

  • Ralph L. Keeney

    () (Fuqua School of Business, Duke University, Durham, North Carolina 27708)


In this paper we develop a conceptual framework and model for valuing risks to an individual's health and life and to support decision making about investments in health, quality of life, and safety. Our treatment of health risks in the model builds on the popular quality-adjusted-life-year (QALY) framework that balances health quality and length of life issues. We extend this framework to consider financial concerns as well as health quality and length of life. Our model considers uncertainty in income and health and incorporates the decision maker's ability to adjust consumption over time in response to changes in expectations about health and income. We use this model to study the optimal tradeoffs between financial gains or losses and improvements or reductions in health or longevity and apply it in two example medical decision problems.

Suggested Citation

  • James E. Smith & Ralph L. Keeney, 2005. "Your Money or Your Life: A Prescriptive Model for Health, Safety, and Consumption Decisions," Management Science, INFORMS, vol. 51(9), pages 1309-1325, September.
  • Handle: RePEc:inm:ormnsc:v:51:y:2005:i:9:p:1309-1325

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    References listed on IDEAS

    1. William J Furlong & David H. Feeny & George W. Torrance & Ronald D. Barr, 2001. "The Health Utilities Index (HUI®) System for Assessing Health-Related Quality of Life in Clinical Studies," Centre for Health Economics and Policy Analysis Working Paper Series 2001-02, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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    6. James E. Smith, 1998. "Evaluating Income Streams: A Decision Analysis Approach," Management Science, INFORMS, vol. 44(12-Part-1), pages 1690-1708, December.
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    Cited by:

    1. Savage David A., 2016. "Surviving the Storm: Behavioural Economics in the Conflict Environment," Peace Economics, Peace Science, and Public Policy, De Gruyter, vol. 22(2), pages 105-129, April.
    2. Kenneth C. Lichtendahl & Samuel E. Bodily, 2012. "Multiplicative Utilities for Health and Consumption," Decision Analysis, INFORMS, vol. 9(4), pages 314-328, December.
    3. Bruno S. Frey & David A. Savage & Benno Torgler, 2009. "Surviving the Titanic Disaster: Economic, Natural and Social Determinants," School of Economics and Finance Discussion Papers and Working Papers Series 245, School of Economics and Finance, Queensland University of Technology.
    4. William B. Haskell & Wenjie Huang & Huifu Xu, 2018. "Preference Elicitation and Robust Optimization with Multi-Attribute Quasi-Concave Choice Functions," Papers 1805.06632,
    5. Strand, Jon, 2006. "Valuation of environmental improvements in continuous time with mortality and morbidity effects," Resource and Energy Economics, Elsevier, vol. 28(3), pages 229-241, August.
    6. Kenneth C. Lichtendahl & Samuel E. Bodily, 2010. "Preferences for Consumption Streams: Scale Invariance, Correlation Aversion, and Delay Aversion Under Mortality Risk," Operations Research, INFORMS, vol. 58(4-part-1), pages 985-997, August.
    7. Donnelly, Catherine & Guillén, Montserrat & Nielsen, Jens Perch, 2014. "Bringing cost transparency to the life annuity market," Insurance: Mathematics and Economics, Elsevier, vol. 56(C), pages 14-27.
    8. Han Bleichrodt & Ulrich Schmidt & Horst Zank, 2009. "Additive Utility in Prospect Theory," Management Science, INFORMS, vol. 55(5), pages 863-873, May.
    9. Kenneth C. Lichtendahl & Raul O. Chao & Samuel E. Bodily, 2012. "Habit Formation from Correlation Aversion," Operations Research, INFORMS, vol. 60(3), pages 625-637, June.
    10. Richard Cookson & Owen Cotton-Barrett & Matthew Adler & Miqdad Asaria & Toby Ord, 2016. "Years of good life based on income and health: Re-engineering cost-benefit analysis to examine policy impacts on wellbeing and distributive justice," Working Papers 132cherp, Centre for Health Economics, University of York.
    11. Baruch Keren & Joseph Pliskin, 2011. "Optimal timing of joint replacement using mathematical programming and stochastic programming models," Health Care Management Science, Springer, vol. 14(4), pages 361-369, November.


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