Cost-Effectiveness and
Non-Discrimination in Health Care

  • Must We Choose?

Rationing between health care needs is unavoidable. Such rationing ought to be morally justified. In order to be morally justified rationing must be nondiscriminatory and cost-effective. However, generally resources spent on old and disabled people are spent less cost-effectively, ceteris paribus, than resources spent on young and non-disabled people, since they can expect to enjoy fewer, extra quality adjusted (e.g., QALYs) life-years. Yet since giving lower priority to such groups can be discriminatory, we face a health care trilemma involving the following three claims:

1. A morally justified scheme of health care rationing does not discriminate against any groups (The Non-Discrimination Claim).

2. A morally justified scheme of health care rationing is cost-effective (The Cost-Effectiveness Claim).

3. A cost-effective health care rationing scheme discriminates against old people and disabled people (The Incompatibility Claim). 

This project explores how we should respond to the healthcare trilemma.

This research project is headed by Professor Kasper Lippert-Rasmussen and runs from 1.1.2020-31.1.2024.