Editorials

Can an economic case be made for investing in health?

BMJ 1998; 316 doi: http://dx.doi.org/10.1136/bmj.316.7147.1762 (Published 13 June 1998) Cite this as: BMJ 1998;316:1762

No, but it's the wrong question

  1. Charles Normand, Professor of health policy
  1. London School of Hygiene and Tropical Medicine, London WC1E 7HT

    Social insurance for health services grew out of voluntary schemes to ensure access to care for workers, especially to provide treatment for industrial injuries.1 At least part of the reason was a desire to help workers back to work. Implicit in some of the pronouncements from the World Bank is a belief that health services in developing countries should be used to treat and thus restore the productivity of workers. 2 3 Increasing output can be used as one measure of benefits in cost benefit analysis,4 but this gets no mention in some recent texts on health economics,5 and it is now rare to value benefits in economic evaluation in terms of improved productivity. As government services are increasingly being judged on their ability to contribute to economic growth—for example, crudely testable skills seem …

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