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E-grāmata: Economics of Resource Allocation in Health Care: Cost-utility, social value, and fairness

(University of Regensburg, Germany)
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The question of how to allocate scarce medical resources has become an important public policy issue in recent decades. Cost-Utility Analysis is the most commonly used method for determining the allocation of these resources, but this book counters the argument that overcoming its inherent imbalances is simply a question of implementing methodological changes.The Economics of Resource-Allocation in Healthcare represents the first comprehensive analysis of equity weighting in health care resource allocation that offers a fundamental critique of its basic framework. It offers a heterodox account of health economics, putting the discourse on economic evaluation into it broader socio-political context. Such an approach broadens the debate on fairness in health economics and ties it in with deeper rooted problems in moral philosophy. Ultimately, this interdisciplinary study calls for the adoption of a fundamentally different paradigm to address the distribution of scarce medical resources.This book will be of interest to policy makers, health care professionals or Post-Graduate students looking to broaden their understanding of the economics of the healthcare system.
List of illustrations
ix
Acknowledgments xi
List of abbreviations
xiii
1 Introduction
1(6)
2 The utility concept in economics: from pleasure maximization to rational choice
7(53)
2.1 Introduction: the merits of a historical account
7(2)
2.2 The Jevonian revolution: the mechanics of utility and self-interest
9(14)
2.3 The ordinal revolution
23(16)
2.4 The formalist revolution and rational choice theory
39(7)
2.5 Preference and utility in modern economics
46(14)
3 On the rise, rationale, and authority of economic evaluation
60(28)
3.1 Introduction
60(1)
3.2 The market ideal and the evolution of health economics
61(9)
3.3 The raison d'etre of economic evaluations: mimicking markets
70(18)
4 The empirical failure of CUA and the approach of equity weighting
88(29)
4.1 Introduction
88(1)
4.2 Cost-utility analysis and its fairness issue
88(11)
4.3 Equity weighting: basic idea, normative claim, and state of the art
99(6)
4.4 Economic evaluation as applied consequentialism
105(12)
5 Values, weights, and trade-offs: the conception of choice in economics
117(34)
5.1 Introduction
117(1)
5.2 Choices in economics and the role of metaphors
117(4)
5.3 Social preferences and social value maximization
121(10)
5.4 Equity weights and representational consequentialism
131(10)
5.5 On the equity-efficiency trade-off, or whose benefit is it anyway?
141(10)
6 Inconsistencies in the determination and measurement of social values
151(35)
6.1 Introduction
151(1)
6.2 Preference anomalies in empirical studies
152(21)
6.3 Disability discrimination and the equal value of life approach
173(13)
7 On the normative status of empirically elicited prioritization preferences
186(17)
7.1 Introduction
186(1)
7.2 Two alleged dead-ends of the normative-theoretical discourse
187(4)
7.3 The role of empirical data within applied ethics
191(3)
7.4 On ethical expertise
194(3)
7.5 Respecting individual autonomy
197(6)
8 Conclusion
203(1)
Bibliography 204(26)
Index 230
Andrea Klonschinski is a postdoctoral research associate at the University of Kiel.