Should the Value of Future Health Benefits Be Time-Discounted?

Paul T. Menzel

in Prevention vs. Treatment

Published in print December 2011 | ISBN: 9780199837373
Published online January 2012 | e-ISBN: 9780199919499 | DOI:
Should the Value of Future Health Benefits Be Time-Discounted?

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The chapter provides a comprehensive normative assessment of discounting future health benefits back to present value in the same manner and degree as monetary costs and benefits, a practice that often significantly disadvantages prevention in cost-effectiveness analysis. I conclude that even when the often powerful reasons articulated in economics are accounted for, the moral case for a general practice of uniform discounting is very weak. The route to this conclusion involves (1) drawing a distinction between two different kinds of time-preference judgments, about individual utility and about social value; (2) comparing money and health in respect to characteristics that generate change in value over time; (3) examining relevant segments of the empirical data on time-preference; (4) assessing two moral arguments that ground the practice of discounting in individual utility time-preference, (5) addressing the Keeler-Cretin paradox that differential discounting encounters, (6) assessing the effect on discounting of placing monetary values on life and health, and (7) evaluating the degree to which a moral justification of discounting can rely on empirical preferences.

Keywords: discounting; time preference; individual utility; social value; monetary value of life; health benefits; prevention; treatment

Chapter.  13329 words. 

Subjects: Moral Philosophy

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