Draft of May 2007; Please do not distribute without permission Valuing Health: A New Proposal

This paper sketches a new proposal for health measurement for the purpose of guiding allocations of health-related resources. Such a proposal might appear to be timed badly. Enormous resources have already gone into devising systems of generic health measurement. At least a half-dozen health measurement systems are in use,2 and over the past generation several other scales have been proposed. At this point, one might reasonably conclude that efforts should go toward consolidating this work and comparing the results of measurements employing these indexes rather than toward developing another way to measure health. Nevertheless, I shall sketch a new proposal, though one which is closely related to an old one, which was abandoned a generation ago. This proposal should make possible major improvements conceptually, ethically, and empirically. Before presenting and defending the proposal in sections 4 and 5, section 1 will clarify the specific purpose of health measurement in which I am interested and will lay out the standard structure of health measurement devoted to that purpose. Section 2 summarizes criticisms of the standard approach that I have presented elsewhere (Hausman 2006). Section 3 articulates constraints on the principles that should govern policy, at least in liberal democracies. Section