Economics and the Allocation of Resources to Improve Health

  • Marc J. Roberts
Part of the Philosophy and Medicine book series (PHME, volume 21)


This paper provides a review and critique of various ways in which economists have looked at the problem of allocating resources to health care. Three different perspectives that various economists have used at various times are considered: the so-called human capital view, that version of utilitarianism which leads to willingness to pay as the basis for life valuing, and cost-effectiveness analysis. My purpose is two-fold. First, I want to show that although all these ideas have been advanced within the same disciplinary tradition, they have quite different philosophical roots and justifications. They rely on and/or imply quite different views of the relationship between individuals and the state, and of the objectives at which the state is directed.


Human Capital Welfare Economic Social Welfare Function United States Today Resource Allocation Decision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. [1]
    Arrow, K.: 1963, Social Choice and Individual Values, 2nd edition, Yale University Press, New York.Google Scholar
  2. [2]
    Bentham, J.: ‘The Psychology of Economic Man’, in W. Stark (ed.), Jeremy Bentham’s Economic Writings, Vol 3, George Allen and Ltd., London.Google Scholar
  3. [3]
    Bergson, A.: 1938, ‘A Reformulation of Certain Aspects of Welfare Economics’, Quarterly Journal of Economics 52, 310–334.CrossRefGoogle Scholar
  4. [4]
    Bergson, A.: 1966, ‘On Social Welfare Once More’, in Essays in Normative Economics, Harvard University Press, Cambridge, Massachusetts, pp. 51–90.Google Scholar
  5. [5]
    Bunker, J. et al. (eds.): 1977, Costs, Risks, and Benefits of Surgery, Oxford University Press, Oxford.Google Scholar
  6. [6]
    Cassel, G.: 1935, On Quantative Thinking in Economics, Oxford University Press, Oxford.Google Scholar
  7. [7]
    Dublin, L. I. and Lotka, A. J.: 1930, The Money Value ofa Man, Ronald Press, New York.Google Scholar
  8. [8]
    Dupuit, J.: 1952 ‘On The Measurement of the Utility of Public Works’, International Economic Papers 2, 83–110.Google Scholar
  9. [9]
    Fanshel, S. and Bush, J. W.: 1970, ‘A Health Status Index and its Application’, Operations Research 18, 1021–66.CrossRefGoogle Scholar
  10. [10]
    Farr, W.: 1853, ‘The Income and Property Tax’, Journal ofthe Statistical Society of London 16, 1–44.CrossRefGoogle Scholar
  11. [11]
    Fein, R.: 1972, ‘On Achieving Access and Equity in Health Care’, Milbank Memorial Fund Quarterly50, 157–190.CrossRefGoogle Scholar
  12. [12]
    Fisher, I.: 1927, ‘A Statistical Method for Measuring “Marginal Utility” and Testing the Justice of a Progressive Income Tax’, in Economic Essays in Honor of John Bates Clark, Macmillan and Co., New York.Google Scholar
  13. [13]
    Fisher, I.: 1930, The Theory of Interest, MacMillan and Co., New York.Google Scholar
  14. [14]
    Goldsmith, S.: 1972, ‘The Status of Health Status Indicators’, Health Services Reports 87, 213–20.Google Scholar
  15. [15]
    Graaff, J.: 1957, Theoretical Welfare Economics, Cambridge University Press, Cambridge.Google Scholar
  16. [16]
    Hicks, J.: 1940, ‘The Valuation of Social Income’, Economica New Series 7, 105–124.Google Scholar
  17. [17]
    Kaldor, N.: 1939, ‘Welfare Propositions of Economics and Interpersonal Comparisons of Utility’, Economic Journal 49; 549–552.CrossRefGoogle Scholar
  18. [18]
    Landy, M., et al.: Beyond Pluralism: Lessons for Government Policy Making From the Environmental Protection Agency, unpublished manuscript.Google Scholar
  19. [19]
    Lipsey, R. G. and Lancaster, K.: ‘Welfare Economics and the Theory of the Second Best’, Review of Economic Studies 24, 11–23.Google Scholar
  20. [20]
    Little, I. M. D.: 1950, Welfare Economics, Oxford University Press, Oxford.Google Scholar
  21. [21]
    Little, I. M. D.: 1953, The Prince of Fuel, Oxford University Press, Oxford.Google Scholar
  22. [22]
    MacIntyre, A.: 1981, After Virtue, University of Notre Dame Press, Notre Dame, Indiana.Google Scholar
  23. [23]
    Marshall, A.: 1890, Principles of Economics, MacMillan and Co., London.Google Scholar
  24. [24]
    Miller, J. E.: 1970, ‘An Indicator to Aid Management in Assigning Program Priorities’, Public Health Reports 85, 725–31.CrossRefGoogle Scholar
  25. [25]
    Mishan, E. J.: 1965, ‘A Survey of Welfare Economics 1939–1959’, in Surveys of Economic Theory 1, St. Martins, New York, pp. 154–222.Google Scholar
  26. [26]
    Mishan, E. J.: 1971, ‘Evaluation of Life and Limb: A Theoretical Approach’, Journal of Political Economy 79, 687–705.CrossRefGoogle Scholar
  27. [27]
    O’Donnell, T. F. et al.: 1980, ‘The Economic Impact of Acute Variceal Bleeding: Cost-Effectiveness Implications for Medical and Surgical Therapy’, Surgery 88, 693–701.Google Scholar
  28. [28]
    Pareto, V.: 1897, Cours d’Economic Politique Professé à la Université Lausanne, F. Rouge, Lausanne.Google Scholar
  29. [29]
    Petty, Sir W.: 1699, Political Arithmetick, Robert Clavael, London.Google Scholar
  30. [30]
    President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: 1983, Securing Access to Health Care, Volume One: Report, U.S. Government Printing Office, Washington D.C.Google Scholar
  31. [31]
    Prest, A. R. and Turvey, R.: 1966, ‘Cost Benefit Analysis: A Survey’, in Surveys of Economic Theory 3, St. Martins Press, New York, pp. 155–207.Google Scholar
  32. [32]
    Rice, D.: 1967, ‘Estimating the Cost of Illness’, American Journal of Public Health 57, 424–440.CrossRefGoogle Scholar
  33. [33]
    Rice, D. and Cooper, E.: 1967, ‘The Economic Value of Human Life’, American Journal of Public Health 57, 1954–1956.CrossRefGoogle Scholar
  34. [34]
    Roberts, S. D. et al.: 1980, ‘Cost Effective Care of End Stage Renal Disease: A Billion Dollar Question’, Internal Medicine 92, 943–48.Google Scholar
  35. [35]
    Samuelson, P. A.: 1947, Foundations of Economic Analysis, Harvard University Press, Cambridge, Massachusetts.Google Scholar
  36. [36]
    Samuelson, P.: 1950, ‘Evaluation of Real National Income’, Oxford Economic Papers, New Series2, 1–40.Google Scholar
  37. [37]
    Sandel, M. J.: 1982, Liberalism and the Limits of Justice, Harvard University Press, Cambridge, Massachusetts.Google Scholar
  38. [38]
    Schelling, P. C.: 1968, ‘The Life you Save May be Your Own’, in S. B. Chase, Jr. (ed.), Problems in Public Expenditure Analysis, Brookings Institution, Washington, D.C., pp. 127–163.Google Scholar
  39. [39]
    Scitovsky, T.: 1941, ‘A Note on Welfare Propositions in Economics’, Review of Economic Studies 9, 77–88.CrossRefGoogle Scholar
  40. [40]
    Stokey, E. and Zeckhauser, R.: 1978, A Primer for Policy Analysis, W. W. Norton, New York.Google Scholar
  41. [41]
    Thaler and Rosen: 1976, ‘The Value of Saving a Life: Evidence from the Labor Market,’ in N. Terleckyz (ed.), NBER Studies in Income and Wealth, Number 40, Columbia University Press, New York.Google Scholar
  42. [42]
    Walzer, M.: 1983, Spheres of Justice, Basic Books, Inc., New York.Google Scholar
  43. [43]
    Wennberg, J. and Gittlesohn, A.: 1982, ‘Variations in Medical Care Among Small Areas’, Scientific American 246, 120–134.CrossRefGoogle Scholar
  44. [44]
    Wicksteed, P. H.: 1979, ‘The Scope and Method of Political Economy’, Economic Journal24, 1–23.CrossRefGoogle Scholar
  45. [45]
    Williams, B: 1985, Ethics and the Limits of Philosophy, Harvard University Press, Cambridge.Google Scholar
  46. [46]
    Zeckhauser, R. and Shepard, D.: 1976, ‘Where Now for Saving Lives’, Law and Contemporary Problems 40, 4–45.CrossRefGoogle Scholar

Copyright information

© D. Reidel Publishing Company 1986

Authors and Affiliations

  • Marc J. Roberts
    • 1
  1. 1.School of Public HealthHarvard UniversityCambridgeUSA

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