title: Who cares about cost? Does economic analysis impose or reflect social values?
abstract: In a two-stage survey, a cross-section of Australians were questioned about the importance of costs in setting priorities in health care. Generally, respondents felt that it is unfair to discriminate against patients who happen to have a high cost illness and that costs should therefore not be a major factor in prioritising. The majority maintained this view even when confronted with its implications in terms of the total number of people who could be treated and their own chance of receiving treatment if they fall ill. Their position cannot be discarded as irrational, as it is consistent with a defensible view of utility. However, the results suggest that the concern with allocative efficiency, as usually envisaged by the economists, is not shared by the general public and that the cost-effectiveness approach to assigning priorities in health care may be imposing an excessively simple value system upon resource allocation decision-making.
authors.affiliation: National Institute of Public Health, Oslo, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Nord
authors.forename: J
authors.initials: J
authors.lastname: Richardson
authors.forename: A
authors.initials: A
authors.lastname: Street
authors.forename: H
authors.initials: H
authors.lastname: Kuhse
authors.forename: P
authors.initials: P
authors.lastname: Singer
mesh_terms: D001294:Attitude to Health; D001315:Australia; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D015276:Health Care Rationing / Q000191:economics / Q000592:standards; D006291:Health Policy; D006292:Health Priorities / Q000191:economics*; D006801:Humans; D018579:Patient Selection; D011639:Public Opinion; D019057:Quality-Adjusted Life Years; D040841:Resource Allocation; D012945:Social Values; D011795:Surveys and Questionnaires