The importance of quality of life in policy decisions

Abstract

The crucial policy decisions within the health care system are concerned with the setting of priorities. The need to set priorities arises from the fact that no country in the world, not even the richest, can afford to do all the things that it is now possible to do to improve the health of its citizens. In that situation, it is no longer sufficient, in the competition for resources, solely to show that a particular intervention is beneficial, though that still is (or should be) a necessary condition for funding. To be successful in that competition an intervention should be demonstrably more beneficial, per unit of resource used, than some minimum cut-off level. Rich countries can obviously afford to set that cut-off point further down the cost-effectiveness ratings than can poor countries, but what every country needs is a rank ordering of interventions by their cost-effectiveness, with those that yield the largest benefits per unit of resource to the forefront of the list, and those that are very costly in relation to their benefits placed at the rear of the queue. That is the rather stark nature of the policy problem we all face, though it presents itself various guises, according to context.