Health Care and Public Policy
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Health Care and Public Policy

David Reisman

Health Care and Public Policy is a comprehensive and intelligible cross-disciplinary account of the objectives of health care policy (medical, social, economic) and of the policy-tools that government can employ (cost–benefit analysis, entry barriers, competition) in order to ensure that scarce resources are not wasted nor needy social groups deprived of basic and affordable care.
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Chapter 5: The Value of Life

David Reisman


Medicine is about the quantity and quality of human life. Economics is about the dispassionate comparison of the costs and benefits. There is little love lost between the two disciplines. There was little love there in the first place. In terms of ethics, there is an instinctive revulsion towards any policy that would reduce the sanctity of human life to pecuniary measurement and the rate of return. Life is the fulfilment of potential. Life is a human right. Policymakers, however, must live in the real world. Resources are finite and priorities must be assigned: ‘Choices must be made and every choice necessarily reflects a set of values. These values underlie all implicit and explicit weighing of costs and benefits. Because resources are scarce relative to wants, we do not have the option of evaluating or not evaluating. The only option is whether to evaluate explicitly, systematically, and openly, as economics forces us to do, or whether to evaluate implicitly, haphazardly, and secretly, as has been done so often in the past’ (Fuchs, 1983: 48). No decent person would say that economic tradeoffs should be the only criteria. What most decent people would, however, say is that more information rather than less is essential if a democratic society is to get the policy-mix that best suits its tastes and preferences. This chapter is concerned with the economic value of a human life. It follows the three groupings that were identified in chapter 3 to show that to satisfy Jack will often...

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