WHO CARES ABOUT COST - DOES ECONOMIC-ANALYSIS IMPOSE OR REFLECT SOCIAL VALUES

In a two-stage survey, a cross-section of Australians were questioned about the importance of costs in setting priorities in health care. Ge nerally, respondents felt that it is unfair to discriminate against pa tients who happen to have a high cost illness and that costs should th erefore 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 re ceiving 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 efficie ncy, as usually envisaged by the economists, is not shared by the gene ral public and that the cost-effectiveness approach to assigning prior ities in health care may be imposing an excessively simple value syste m upon resource allocation decision-making.