ABSTRACT

If one supposes, as a first approximation, that the health department in some country has a fixed budget and that one of its central objectives is to enhance population health, then it needs to be able to compare the contributions made by different health-care interventions and their costs. If one assumes that the contributions of health-care interventions consist of the difference between the values of pretreatment and posttreatment of health conditions, then ranking of interventions requires ranking of health deficiencies. To rank health conditions in turn requires some way of making comparable the enormously heterogeneous health conditions in which people find themselves. This chapter asks how health economists assign values to health states and criticizes what it finds. It argues that health cannot literally be measured but that it can be valued in a variety of ways. It questions whether health conditions should be valued by the extent to which they satisfy population preferences, as determined by surveys of representative samples.