Developing Welfare Indicators for Public Health Care Allocations: New methodological trends and Philosophical Perspectives


Alessandra Cenci


This article provides a philosophical view on the current state of the research in public health economics regarding methods to develop welfare indicators for allocation of resources in healthcare. In particular, the analysis deepens on latest advancements in the field namely the Cost-Values Analysis (CVA) and the Multidimensional First Order Dominance Approach (FOD). It elucidates which –methodological, normative, practical- insights they offer to measure well-being, health states, health inequalities when compared to conventional methods used to inform health care allocations such as the QALYs/DALYs (i.e. Quality adjusted life year/disability adjusted life year). In particular, the possibility of obtaining not only more efficient but also fairer allocations of healthcare and public health resources is seen as relying on the combined adoption of more objective/robust methods (e.g. FOD) and wide-ranging normative views within the contemporary egalitarian thinking (e.g. the Capability Approach). Both features are seen as pivotal for social justice in democratic settings.