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Social welfare and the Affordable Care Act: Is it ever optimal to set aside comparative cost?

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  • Mortimer, Duncan
  • Peacock, Stuart

Abstract

The creation of the Patient-Centered Outcomes Research Institute (PCORI) under the Affordable Care Act has set comparative effectiveness research (CER) at centre stage of US health care reform. Comparative cost analysis has remained marginalised and it now appears unlikely that the PCORI will require comparative cost data to be collected as an essential component of CER. In this paper, we review the literature to identify ethical and distributional objectives that might motivate calls to set priorities without regard to comparative cost. We then present argument and evidence to consider whether there is any plausible set of objectives and constraints against which priorities can be set without reference to comparative cost. We conclude that – to set aside comparative cost even after accounting for ethical and distributional constraints – would be truly to act as if money is no object.

Suggested Citation

  • Mortimer, Duncan & Peacock, Stuart, 2012. "Social welfare and the Affordable Care Act: Is it ever optimal to set aside comparative cost?," Social Science & Medicine, Elsevier, vol. 75(7), pages 1156-1162.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:7:p:1156-1162
    DOI: 10.1016/j.socscimed.2012.05.019
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    References listed on IDEAS

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    1. Paul Dolan & Rebecca Shaw & Aki Tsuchiya & Alan Williams, 2005. "QALY maximisation and people's preferences: a methodological review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 197-208, February.
    2. Lancsar, Emily & Wildman, John & Donaldson, Cam & Ryan, Mandy & Baker, Rachel, 2011. "Deriving distributional weights for QALYs through discrete choice experiments," Journal of Health Economics, Elsevier, vol. 30(2), pages 466-478, March.
    3. Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November.
    4. Gold, Marthe Rachel & Franks, Peter & Siegelberg, Taryn & Sofaer, Shoshanna, 2007. "Does providing cost-effectiveness information change coverage priorities for citizens acting as social decision makers?," Health Policy, Elsevier, vol. 83(1), pages 65-72, September.
    5. Johannesson, Magnus & Weinstein, Milton C., 1993. "On the decision rules of cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 12(4), pages 459-467, December.
    6. Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Who cares about cost? Does economic analysis impose or reflect social values?," Health Policy, Elsevier, vol. 34(2), pages 79-94, November.
    7. Coast, Joanna & Smith, Richard D. & Lorgelly, Paula, 2008. "Welfarism, extra-welfarism and capability: The spread of ideas in health economics," Social Science & Medicine, Elsevier, vol. 67(7), pages 1190-1198, October.
    8. Mentzakis, Emmanouil & Stefanowska, Patricia & Hurley, Jeremiah, 2011. "A discrete choice experiment investigating preferences for funding drugs used to treat orphan diseases: an exploratory study," Health Economics, Policy and Law, Cambridge University Press, vol. 6(3), pages 405-433, July.
    9. repec:bla:econom:v:38:y:1971:i:151:p:295-303 is not listed on IDEAS
    10. Daniella Perlroth & Dana Goldman & Alan Garber, 2010. "The potential impact of comparative effectiveness research on U.S. Health Care expenditures," Demography, Springer;Population Association of America (PAA), vol. 47(1), pages 173-190, March.
    11. repec:bla:econom:v:36:y:1969:i:144:p:351-62 is not listed on IDEAS
    12. Coast, Joanna, 2009. "Maximisation in extra-welfarism: A critique of the current position in health economics," Social Science & Medicine, Elsevier, vol. 69(5), pages 786-792, September.
    13. Emmanouil Mentzakis & Patricia Stefanowska & Jeremiah Hurley, 2010. "A Discrete Choice Experiment Investigating Preferences for Funding Drugs Used to Treat Orphan Diseases," Centre for Health Economics and Policy Analysis Working Paper Series 2010-01, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    14. Birch, Stephen & Gafni, Amiram, 1993. "Changing the problem to fit the solution: Johannesson and Weinstein's (mis) application of economics to real world problems," Journal of Health Economics, Elsevier, vol. 12(4), pages 469-476, December.
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