To Aggregate or Not to Aggregate

Abstract

AbstractThis chapter responds to the argument that health policy should not treat or prevent minor ailments when it might instead alleviate major illnesses, even if the treatment of minor ailments is more cost-effective. In addition to challenging the general view that small harms are not relevant to major harms, the chapter argues that minor health conditions, unlike small harms, pose risks of major harms, which makes ignoring them untenable. Discussion begins with a response to John Taurek’s argument against ever aggregating. That case faces serious objections, and it is not pertinent to questions concerning the allocation of health care. The chapter then presents the most plausible development of a partial aggregation view and discusses difficulties that require refinement of the partial aggregation view. It then offers three criticisms of the partial aggregation view. Finally, the chapter responds to the claim that despite its drawbacks, partial aggregation is superior to the aggregation implicit in cost-effective allocation.