title: Understanding Harris' understanding of CEA: is cost effective resource allocation undone?
abstract: We summarise and evaluate Harris' criticisms of cost-effectiveness analysis (CEA) and the alternative processes he commends to health care decision makers. In contrast to CEA, Harris' asserts that individuals have a right to life-saving treatment that cannot be denied on the basis of their capacity to benefit. We conclude that, whilst Harris' work has challenged the proponents of CEA and quality-adjusted life years to be explicit about the method's indirect discriminatory characteristics, his arguments ignore important questions about what 'lives saved' mean. Harris also attempts to avoid opportunity cost by advocating the same chance of treatment for every person desiring treatment. Using a simple example, we illustrate that an 'equal chances' lottery is not in the interest of any patient, as it reduces the chance of treatment for all patients by leaving some of the health budget unspent.
authors: School of Population Health, University of Auckland, New Zealand. r.edlin@auckland.ac.nz
authors: Richard
authors: R
authors: Edlin
authors: Christopher
authors: C
authors: McCabe
authors: Jeff
authors: J
authors: Round
authors: Judy
authors: J
authors: Wright
authors: Karl
authors: K
authors: Claxton
authors: Mark
authors: M
authors: Sculpher
authors: Richard
authors: R
authors: Cookson
mesh_terms: D003362:Cost-Benefit Analysis; D015276:Health Care Rationing / Q000191:economics* / Q000458:organization & administration*; D006801:Humans; D019057:Quality-Adjusted Life Years; D012935:Social Justice