Commonly in health economics and prioritisation (eg New Zealand’s Pharmaceutical Management Agency) you calculate the cost-effectiveness (eg cost per QALY) for a given medication, and then rank the desired medications from most to least cost-effective. You then take the budget, and distribute the funds from top until they run out. This is where your rule the line (bar). Nothing below gets funded unless more budget is allocated. If there are items below the bar worth doing then there is a funding constraint, if everything has been funded and there are leftover funds then there is a funding overhang. So it depends on how long the list of cost-effective desirable projects is as to whether there is a shortfall, right amount, or overhang, and that depends on people thinking up projects and adding them to the list. An ‘overhang’ probably stimulates more creativity and thought on potential projects.
But what determines what is ‘worth doing’ in those cases? You should be able to find ways to keep improving health, just at ever decreasing levels of cost-effectiveness.
Yes, absolutely, and in almost all cases in health the list of desirable things outstrips the funding bar. The ‘league table’ of interventions is longer than the fraction of them that are/can be funded. So in health there is basically never an overhang. The same will be true for EA/GCR/x-risk projects too. So I agree there is likely no ‘overhang’ there either. But it might be that all the possibly worthwhile projects are not yet listed on the ‘league table’ (whether explicitly or implicitly).
That’s true in theory. But in practice there are only a (small) finite number of items on the list (those that have been formally investigated with a cost-effectiveness analysis). So once those are all funded, then it would make sense to fund more cost-effectiveness analyses to grow the table. We don’t know how ‘worthwhile’ it is to fund most things, so they are not on the table.
Commonly in health economics and prioritisation (eg New Zealand’s Pharmaceutical Management Agency) you calculate the cost-effectiveness (eg cost per QALY) for a given medication, and then rank the desired medications from most to least cost-effective. You then take the budget, and distribute the funds from top until they run out. This is where your rule the line (bar). Nothing below gets funded unless more budget is allocated. If there are items below the bar worth doing then there is a funding constraint, if everything has been funded and there are leftover funds then there is a funding overhang. So it depends on how long the list of cost-effective desirable projects is as to whether there is a shortfall, right amount, or overhang, and that depends on people thinking up projects and adding them to the list. An ‘overhang’ probably stimulates more creativity and thought on potential projects.
But what determines what is ‘worth doing’ in those cases? You should be able to find ways to keep improving health, just at ever decreasing levels of cost-effectiveness.
Yes, absolutely, and in almost all cases in health the list of desirable things outstrips the funding bar. The ‘league table’ of interventions is longer than the fraction of them that are/can be funded. So in health there is basically never an overhang. The same will be true for EA/GCR/x-risk projects too. So I agree there is likely no ‘overhang’ there either. But it might be that all the possibly worthwhile projects are not yet listed on the ‘league table’ (whether explicitly or implicitly).
I don’t think there can ever be an overhang in that sense, since the point at which something is ‘worthwhile’ or not is arbitrary.
Let’s say all the worthwhile interventions produce 10 utils per dollar.
If you have enough money to cover all of those, now you can fund everything that produces 1 or more util per dollar.
Then after that you can fund everything that produces 0.1 util per dollar, then 0.01, and so on for ever.
That’s true in theory. But in practice there are only a (small) finite number of items on the list (those that have been formally investigated with a cost-effectiveness analysis). So once those are all funded, then it would make sense to fund more cost-effectiveness analyses to grow the table. We don’t know how ‘worthwhile’ it is to fund most things, so they are not on the table.