Bauer Daniel, Lakdawalla Darius, Reif Julian
University of Wisconsin-Madison.
University of Southern California and NBER.
J Public Econ. 2025 May;245. doi: 10.1016/j.jpubeco.2025.105346. Epub 2025 Apr 3.
We extend the conventional life-cycle framework for valuing health and longevity improvements to a stochastic setting with multiple health states and apply it to data on mortality, quality of life, labor earnings, and medical spending for adults with different comorbidities. We find that sick adults are willing to pay nearly twice as much per quality-adjusted life-year (QALY) to reduce mortality risk as healthy adults, and that reducing the risk of serious illness is valued similarly to reducing the risk of mild illness. Our results provide a rational explanation for why people oppose a single threshold value for rationing care and why they invest less in prevention than in treatment.
我们将用于评估健康和寿命改善的传统生命周期框架扩展到具有多种健康状态的随机环境中，并将其应用于不同合并症成年人的死亡率、生活质量、劳动收入和医疗支出数据。我们发现，患病成年人每质量调整生命年（QALY）为降低死亡风险愿意支付的费用几乎是健康成年人的两倍，并且降低重病风险与降低轻症风险的价值相近。我们的结果为人们为何反对单一的医疗资源分配阈值以及为何在预防方面的投资少于治疗提供了合理的解释。
