It is widely agreed that cost-effectiveness analysis (CEA) could shed light on ways for the U.S. health care system to achieve better value. However, to date American policy makers have largely avoided using CEA and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of CEA in health and medicine, describes its promise for rational resource allocation, and discusses the n ... More

It is widely agreed that cost-effectiveness analysis (CEA) could shed light on ways for the U.S. health care system to achieve better value. However, to date American policy makers have largely avoided using CEA and researchers have devoted little attention to understanding why this is so. By considering the economic, social, legal, and ethical factors that contribute to the situation, and how they can be negotiated in the future, this book offers a unique perspective. It traces the roots of CEA in health and medicine, describes its promise for rational resource allocation, and discusses the nature of the opposition to it, using Medicare and the Oregon health plan as examples. In exploring the disconnection between the promise of CEA and the persist failure of rational intentions, the book seeks to find common ground and practical solutions.