Who cares about cost? Does economic analysis impose or reflect social values?

Erik Nord, Jeff Richardson, Andrew Street, Helga Kuhse, Peter Singer

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)79-94
Number of pages16
JournalHealth Policy
Issue number2
StatePublished - Nov 1995
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Health Policy


  • Cost-benefit
  • Equity egalitarian
  • Health economics
  • Priority
  • Quality Adjusted Life Year (QALY)


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