This paper explores how medical practice ought to be conducted, in the face of scarcity, if our objective is to maximise the benefits of health. After explaining briefly what the cost-per-QALY criterion means, a series of ethical objections to it are considered one by one. The objectors fall...

The EuroQol measure of health-related quality of life (HRQoL) has many purposes other than the calculation of QALYs, but it is upon that particular use that this paper concentrates. For that purpose a simple generic measure yielding a single index score for each health state is required. The...

The reasons why politics protrude so prominently into health matters are because: a) health is important to people b) health care is costly c) it invariably requires public regulation d) it increasingly attracts public subsidisation e) it is often provided by institutions which are publicly...

Amongst the many methodologies and philosophical problems that have to be confronted sooner or later by those involved in the measurement of health status is how best to compare the health status of one person with that of another. It is an activity which some people do routinely many times a...

An important consideration when establishing priorities in health care is the likely effects that alternative allocations of resources will have on health-related quality of life (HRQoL). This paper reports on the analysis of data from a study which elicited health state valuations (using the...

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A review of relevant literature within health economics, psychology and moral philosophy suggests that people want resource allocation decisions in health to be informed by considerations of equity as well as efficiency. A number of empirical studies demonstrate that people are willing to...

Objective: to measure a health-related quality of life in a way that reflects salient features of health as perceived by a representative sample of the adult population of the UK. Choosing a descriptive system: with data from a survey of 600 people in the West Midlands, we appraised 6 existing...

Priority setting reflects ideology, and so, more surprisingly, does the quest for “efficiency”. A great deal of the current debate about alternative methods of finance and about reform of management structures, in health services all over the world, purports to be about some notion of...

In evolutionary physiology the human body is viewed as a resource allocation mechanism working according to a predetermined set of priorities to maximise reproductive capacity. In health economics, people are viewed as having a portfolio of assets (health; wealth; and wisdom) which they manage...