Measuring elusive benefits: on the value of health

Can analysts provide better guidance to policymakers about the valuation of health effects? This paper argues that valuation questions usually cannot be easily sidestepped by the use of cost-effectiveness analysis. Valuations are implicit in the measures of program outcome that we use, as illustrated by an examination of a policy of maximizing discounted quality-adjusted life-years (QALYs). The paper concludes that surveys focused directly on the questions that health and safety policymakers face could be a most fruitful source of guidance.