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.
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.