This paper analyses National Health Service R&D as a Samuelsonian public good. It also identifies other characteristics of NHS R&D: supplier-induced demand; information asymmetries; jointness in production of R&D, medical education and health care; multiplicity in research funding sources;...

It is frequently claimed that social justice requires that some goods – medical care is a frequently cited example – be distributed according to “need”. The most common justification for adoption of this principle is the cause of inequality: the principles of “distribution according to...

In a recently published monograph of the INstitute of Economic Affairs by Dr David Green entitled Which Doctor?, the argument is made that the ills of the NHS can all at root be laid at the door of one professionally regulated froup: the doctors, and that, if only this encumbrance could be...

There has been a vigorous dispute about quality adjusted life years (QALYs) and it has been argued that they are an inappropriate measure of patient utility and that a more efficient approach is to measure outcomes in terms of health year equivalents (HYEs). This paper explores the theoretical...

This Discussion Paper argues that the government has been right both in its rejection of market solutions to health insurance and in its injection of competition into provider markets. The particular advantages of the latter are that the collective expression of demand is maintained, with...

Most people agree that equity has something to do with equality – but equality of what? This paper discusses five relevant “respects” according to which horizontal or vertical equity for individuals or groups of people might be achieved: marginal willingness to pay, per capita expenditure,...

In this paper, I shall take a restricted view of the scope and limits of health economics, concentrating on that area which has, in Europe at least, been expandtng fastest in the last decade or so. I am going to focus, as implied in all I have said so far, on economic appraisal in health care. I...

Four distributional principles for the allocation of health care resources are discussed: equal expenditures per capita, proportionality to need, proportionality to endowment health status, and proportionality to capacity to benefit. They are compared with another process, concept of equity,...

This paper is the text of the 1994 Francis Fraser Lecture given at the Royal College of Physicians on 2 June 1994. It presents the outcome of the consultation exercise conducted by the taskforce on R&D in the NHS chaired by Professor Culyer and identifies the principle problems currently...