Valuing Health: Well-Being, Freedom, and Suffering

Hardcover | April 21, 2015

byDaniel M. Hausman

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In Valuing Health Daniel M. Hausman provides a philosophically sophisticated overview of generic health measurement that suggests improvements in standard methods and proposes a radical alternative. He shows how to avoid relying on surveys and instead evaluate health states directly. Hausmangoes on to tackle the deep problems of evaluation, offering an account of fundamental evaluation that does not presuppose the assignment of values to the properties and consequences of alternatives.After discussing the purposes of generic health measurement, Hausman defends a naturalistic concept of health and its relations to measures such as quality-adjusted life-years (QALYs) and disability-adjusted life years (DALYs). In examining current health-measurement systems, Valuing Healthclarifies their value commitments and the objections to relying on preference surveys to assign values to health states. Relying on an interpretation of liberal political philosophy, Hausman argues that the public value of health states should be understood in terms of the activity limits andsuffering that health states impose.Hausman also addresses the moral conundrums that arise when policy-makers attempt to employ the values of health states to estimate the health benefits of alternative policies and to adopt the most cost-effective. He concludes with a general discussion of the difficulties of combiningconsequentialist and non-consequentialist moral considerations in policy-making.

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In Valuing Health Daniel M. Hausman provides a philosophically sophisticated overview of generic health measurement that suggests improvements in standard methods and proposes a radical alternative. He shows how to avoid relying on surveys and instead evaluate health states directly. Hausmangoes on to tackle the deep problems of evalua...

Daniel M. Hausman is the Herbert A. Simon and Hilldale Professor of Philosophy at the University of Wisconsin-Madison. A founding editor of Economics and Philosophy, his research has centered on epistemological, metaphysical, and ethical issues at the boundaries between economics and philosophy. His most recent book is Preference, Valu...

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Format:HardcoverDimensions:288 pages, 9.29 × 6.42 × 1.1 inPublished:April 21, 2015Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0190233184

ISBN - 13:9780190233181

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Table of Contents

IntroductionAcknowledgments1. Why Measure Health?1.1 Clinical and research uses1.2 Epidemiological or demographic uses1.3 Allocational use1.4 What a generic health measure should be2. Health2.1 Functional efficiency2.2 Pathological vs. healthy part function2.3 Should generic health measures quantify theoretical health?2.4 Functional efficiency without statistical normality2.5 Tentative Conclusions3. Normative Conceptions of Health and its Measurement3.1 Evaluative views of health3.2 Criticism of evaluative theories3.3 Concepts of health and generic health measurement3.4 Conclusions4. Can Health Be Measured?4.1 Measuring overall functional efficiency4.2 What measurement requires4.3 Categorizing health states4.4 Is the "at least as healthy as" relation complete?4.5 Does the value of health reflect the quantity of health?5. Health Measurement Systems5.1 Quality and disability weights5.2 Health-related quality of life (HRQoL)5.3 Assigning disability weights in GBD 20105.4 GBD 2010: Interpreting the paired comparisons5.5 Conclusions: Why are health economists measuring attitudes?6. Well-Being and the Value of Health6.1 Well-being and the value of life6.2 Theories of well-being6.3 Can the value of health states be measured?6.4 Measuring average and standard values of health states6.5 What good are average or standard health-state values?7. Preferences7.1 What do economists take preferences to be?7.2 Preference and well-being: evaluative competence and the evidential view7.3 Preferences and other attitudes7.4 Preferences, attitudes, and feelings7.5 Can health be measured by preferences?8. Valuing Health by Eliciting Preferences8.1 Critique of preference elicitation practices8.2 Preference measurement and cognitive limits8.3 Whose preferences?8.4 Averaging8.5 Why rely on informants to value health states?8.6 Conclusions9. Health and Happiness9.1 Dolan and Kahneman's argument for subjective evaluation9.2 Subjective evaluation9.3 What matters, mood or subjective appraisal?9.4 Subjective evaluation of health9.5 Conclusions10. Qualms about Valuing Health by Well-Being10.1 Well-being and the value of health10.2 Can well-being be measured?10.3 Subjective experiences as a measure of well-being10.4 Measuring well-being by preferences11. What Makes Well-Being Measurable?11.1 Fundamental evaluation and Hume's position11.2 A more thoroughgoing subjectivist response and its problems11.3 What makes states of affairs better for people?12. Should Health Be Valued by its Contribution to Well-Being?12.1 The pitfalls and advantages of valuing health by its impact on well-being12.2 How else can health be valued?12.3 Is a scalar measure needed?12.4 Should health states be valued by their contribution to well-being?13. The Public Value of Health13.1 The "social value" of health states13.2 Liberalism and the value of health13.3 The two dimensions of the public value of health13.4 Public vs. private value and liberal state policy13.5 Conclusion: the public value of health14. Measuring the Public Value of Health States14.1 Ordering distress14.2 Ordering activity limitations14.3 Classifying health states for public evaluation14.4 Valuing limitation/distress pairs14.5 Conclusions: public evaluation15. Putting Health Measures to Work: Population Health and Cost-effectiveness15.1 Cost-effectiveness analysis15.2 Technical problems and conceptual problems in measuring effectiveness15.3 Should effectiveness be measured by increases in well-being or health?15.4 Further normative questions concerning what to measure15.5 Moral objections to rationing by cost-effectiveness and the relevance of public values15.6 Conclusions16. How Health Policy Should Meet the Ethical Challenges16.1 Can the fair chances objection be justified?16.2 Severity: compassion and priority16.3 Non-aggreggation: respect or compassion16.4 Discrimination and fairness16.5 Rationing fairly and humanely16.6 Freedom, fairness, compassion, and markets17. Restricted Consequentialism and Public Policy17.1 Restricted consequentialism17.2 Coping with the measurement demands of restricted consequentialism17.3 Why not just ask?17.4 Conclusions17.5 A brief recapReferences

Editorial Reviews

"In this enjoyable and superbly readable book Hausman distinguishes between measuring health and measuring the value of health, and argues that the value of health should be judged by its contribution to well-being, suggesting ways in which current instruments can be refined in order to do somore accurately. A second vital distinction concerns the private value of health to an individual, and its public value, which should inform health-related resource allocation. Hausman's proposal draws on the theory of 'liberal facilitation' in which the state's main role in relation to health is toprovide people with opportunities and to exercise compassion for their suffering. His sketch of a resource allocation mechanism devised on this basis will be a focus of debate for many years to come. This book cements Hausman's standing as one of the leading philosophers of health of our time." --Jonathan Wolff, University College London