title: Fairness, public expenditure and the cost of new treatments in the UK.
abstract: Current differences in standards for allocating resources in the UK for, on the one hand, drugs and surgery, and on the other, chronic community and social care and social security lead to significant inequality. Using a case study of hypothetical patients, it can be shown that adoption of new treatments, at high cost, to make marginal improvements in well-being would lead to much greater spending on some patients than on others with similar problems from different causes. Inequality occurs because society tolerates tighter constraints on community and social care and social security than on acute care and drug budgets for new treatments. Resolution of the inequality would involve establishing fairly the resources to increase the welfare of patients with different chronic diseases to some target level of welfare. However, this would make overt the current rationing of community and social services and demonstrate the low levels of welfare of many with chronic diseases. Governments concerned with lower taxation might prefer to avoid exposing such issues.
authors.affiliation: National Economic Research Associates, London, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: West
mesh_terms: D002908:Chronic Disease / Q000628:therapy; D017048:Health Care Costs; D015276:Health Care Rationing / Q000592:standards*; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006801:Humans; D012935:Social Justice; D012944:Social Support; D006113:United Kingdom