Snarky History of Health Economics QOTD

In general, applied fields get less than their fair share of attention from historians and sociologists. This is especially true of economics. STS scholars have done a bit better – especially with finance – but historians of economics probably publish ten articles on Adam Smith for every one on labor economics or development or… One nice exception to the rule is Evelyn Forget’s (2004) HOPE piece on the history of health economics.*

Forget argues that health economics has a past but not yet a history. This past stretches all the way back to William Petty, who considered the costs of the plague:

100,000 persons dying of the Plague, above the ordinary number, is near 7 million pounds loss to the Kingdom: . . . how well might 70,000 pounds have been bestowed in preventing this Centuple loss?

In a lovely footnote, Forget (2004: 619) explains a bit of Petty’s analysis:

Petty valued an Englishman at 69 pounds and a Frenchman at 60 pounds. He allowed that the latter may be an underestimate because he could buy an Algerian slave for 60 pounds. This latter statement is what health economists refer to as “sensitivity analysis.”

Oh, snap! The article goes on to offer multiple accounts of the intellectual history of “QALYs” – quality adjusted life years, or how health economists try to figure out the utility of different interventions, and the justification for QALYs based on (a misreading of) developments in theoretical welfare economics. Recommended, if that’s your sort of thing though still a bit too focused on the big theoretical developments for my taste and not as much on applied economics actually being applied!

*As an aside, “Forget” has to be one of the best possible historian last names!

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