THE SIGNIFICANCE OF AGE AND DURATION OF EFFECT IN SOCIAL EVALUATION OF HEALTH-CARE

To give priority to the young over the elderly has been labelled 'agei sm'. People who express 'ageist' preferences may feel that, all else e qual, an individual has greater right to enjoy additional life years t he fewer life years he or she has already had. We shall refer to this as egalitarian ageism. They may also emphasise the greater expected du ration of health benefits in young people that derives from their grea ter life expectancy. We may call this utilitarian ageism. Both these f orms of ageism were observed in an empirical study of social preferenc es in Australia. The study lends some support to the assumptions in th e QALY approach that duration of benefits, and hence old age, should c ount in prioritising at the budget level in health care.