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Rationale

Despite decades of research, education, and training of stakehol­ders, numerous opportunities remain for increasing the effective­ness, quality, efficiency, and fairness of health care financing and provision. Health economics has not been used to its full potential.

A3HE believes that reasons for this are attributable partly to stakeholders, but also to the conduct of health economics as a discipline. This, in turn, may reflect a problem of communicating new findings; but there is also reason to believe that influential parts of the discipline may be out of touch with society's values.

For example, many health economists broadly hold the belief that the principle objective of collectively financed health schemes ought to be the production of maximum health (usually conceptualized in terms of length and quality of life) from available resources. Empirical research has shown this assumption to be descriptively flawed. Applied health economics however has largely ignored this evidence, despite its far-reaching normative implications.

A3HE seeks to increase the correspondence between fundamental economic principles (such as the need to make choices when resources are limited and the unavoidability of opportunity costs) and evidence relating to social values.

In order to promote more policy-relevant health economic re­search, A3HE explicitly endorses an approach that will be characterized by theoretical and methodological pluralism, i.e., include the development of novel models and methods for the valuation of health and health care, for the analysis of social expectations and the specific problems associated with contexts and institutions.

This implies, inter alia, that analysts should not allow value judgements of the public to be overridden by assumptions reflecting analytical convenience. Value judgments, methodological choices, and their implications should always be explicit and transparent.

The utilitarian roots of the discipline have led many economists to share a strictly consequentialist belief system. This is not always congruent with the ethical foundations of health care provision and the needs and expectations of stakeholders. Yet good economic analysis is possible without a commitment to utilitarianism. The approach of A3HE is ethically eclectic. A3HE seeks to foster open scientific debate uninhibited by conventional preconceptions.