Can analysts provide better guidance to policymakers about the valuation of health effects? This paper argues that valuation questions usually cannot be easily sidestepped by the use of cost-effectiveness analysis. Valuations are implicit in the measures of program outcome that we use, as illustrated by an examination of a policy of maximizing discounted quality-adjusted life-years (QALYs). The paper concludes that surveys focused directly on the questions that health and safety policymakers face could be a most fruitful source of guidance.

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