Valuing Health For Policy

How much should citizens invest in promoting health, and how should resources be allocated to cover the costs? A major contribution to economic approaches to the value of health, this volume brings together classic and up-to-date research by economists and public health experts on theories and measurements of health values, providing useful information for shaping public policy.

How stringent should environmental and occupational safety regulations be? How far should Medicaid support go? Should funding for research on Alzheimer's disease be increased? Should more money be spent on programs to discourage smoking? What are appropriate ways to determine damages in wrongful injury or death suits? Toward answering such questions, this volume examines various models of health valuation, including the cost-of-illness, preventive-expenditures, and quality-adjusted-life-year approaches. The authors favor a willingness-to-pay approach grounded in individual preferences.

In Valuing Health Daniel M. Hausman provides a philosophically sophisticated overview of generic health measurement that suggests improvements in standard methods and proposes a radical alternative. He shows how to avoid relying on surveys and instead evaluate health states directly. Hausman goes on to tackle the deep problems of evaluation, offering an account of fundamental evaluation that does not presuppose the assignment of values to the properties and consequences of alternatives. After discussing the purposes of generic health measurement, Hausman defends a naturalistic concept of health and its relations to measures such as quality-adjusted life-years (QALYs) and disability-adjusted life years (DALYs). In examining current health-measurement systems, Valuing Health clarifies their value commitments and the objections to relying on preference surveys to assign values to health states. Relying on an interpretation of liberal political philosophy, Hausman argues that the public value of health states should be understood in terms of the activity limits and suffering that health states impose. Hausman also addresses the moral conundrums that arise when policy-makers attempt to employ the values of health states to estimate the health benefits of alternative policies and to adopt the most cost-effective. He concludes with a general discussion of the difficulties of combining consequentialist and non-consequentialist moral considerations in policy-making.

With limited resources and funding, it is impossible to invest in all potentially beneficial health care interventions. Choices have to be made, and this guide allows the reader to measure and value the benefits of interventions, a key component of economic evaluation, which permits comparisons between interventions.

This publication examines current efforts to improve health care efficiency, including tools that show promise in helping health systems provide the best care for their money.

This title was first published in 2002. Most of those working in health services are aware of scarcity and the need for choice, and many also know that health sector choices in the future may be made on a "cost per quality-adjusted-life-year" (QALY) basis. This volume explains health service choice, focusing in particular on the QALY success story, and the merits and drawbacks of this measure are explained. On the basis of some of the problems identified, a new QALY-based approach to resource allocation is developed, and other methods of priority setting are explained, ranging from heart surgery to Alzheimer's Disease. The author explains the problems of health sector choice from first principles, in an approach that should be particularly useful to healthcare professionals, pharmaceutical industry managers, and students of economics.

Promoting human health and safety by reducing exposures to risks and harms through regulatory interventions is among the most important responsibilities of the government. Such efforts encompass a wide array of activities in many different contexts: improving air and water quality; safeguarding the food supply; reducing the risk of injury on the job, in transportation, and from consumer products; and minimizing exposure to toxic chemicals. Estimating the magnitude of the expected health and longevity benefits and reductions in mortality, morbidity, and injury risks helps policy makers decide whether particular interventions merit the expected costs associated with achieving these benefits and inform their choices among alternative strategies. Valuing Health for Regulatory Cost-Effectiveness Analysis provides useful recommendations for how to measure health-related quality of- life impacts for diverse public health, safety, and environmental regulations. Public decision makers, regulatory analysts, scholars, and students in the field will find this an essential review text. It will become a standard reference for all government agencies and those consultants and contractors who support the work of regulatory programs.