Health-health analysis - An alternative method for economic appraisal of health policy and safety regulation Some empirical Swedish estimates

Health-health analysis (HHA) focuses on statistical lives themselves as a numeraire. The underlying principle is that the expected gains in health and safety of reduced risks in one area may result in increasing risks somewhere else in society. By reducing one risk other risks may increase due to changed individual behaviour. In addition to this direct effect, another indirect effect will also be present. Expenditure on a particular health policy or safety regulation must be financed in one way or another. which will result in an opportunity cost or income effect leaving less resources for other health and safety promoting activities in society. Thus, we will have an effect that reduces safety and health benefits induced by that income loss. Whether the total net health effect from a specific safety regulation or health policy is positive or negative must be empirically analysed. One way of estimating the income loss that induces one death, which we call the value of an induced death (VOID), is to estimate it as a multiple of the traditional value to avert a statistical death, also named the value of a statistical life (VOSL). A contingent valuation (CV) study eliciting the willingness-to-pay (WTP) for reducing the overall risk of dying was performed as a postal questionnaire in Sweden in 1998. By use of data from this study, it was possible to estimate the VOID and the VOSL in Sweden amounting to SEK116 and SEK20.8 million respectively, indicating that the net health result confined to mortality effects, will be negative (more lives will be lost than saved) if a health policy or safety regulation will cost more than SEK116 million per life saved