However, GiveWell reports that decreased poverty is valued higher than improved health. I rely on literature estimates that value a QALY as 50% of GDP per capita of that nation.[i]
You can see the (perhaps outdated?) moral weights GiveWell used for comparing saving the life of children vs doubling someone’s income for a year. They assume value scales essentially logarithmically in income.
I would be careful about generalizing from that study, since it was done in Australia, where people are both wealthier and healthier. Decreasing marginal utility of income is typically assumed, whereas tying 1 QALY as equivalent to 50% of GDP per capita at all values would basically assume a constant marginal utility from income.
For example, passing a bill through a registered lobbying firm in the United States costs about $200,000/bill.
This seems surprisingly (perhaps suspiciously) cheap. I think the fact that the US just withdrew from it should also be taken as a sign that this particular bill couldn’t be passed unless the makeup people in government shifts enough away from the current makeup. Thankfully there’s an election coming up.
That is about $0.66 x 69.165 =$46 per statistical quality life (the life expectancy is India is 69.165 years[vi]).
I don’t think you should be multiplying by the life expectancy. You should be looking at the counterfactual impact of the trade policies. How long would these policies actually last before they would be overturned again? Or, would similar such policies be passed without our intervention soon anyway? If similar policies would pass within 5 years without our intervention anyway, then you’d only get an extra 5 years with the policy, and you’d multiply by 5 instead of 69.
The GiveWell’s moral weights are intriguing indeed. I used QALY as opposed to DALY intentionally, because I did not included the decreasing value of a life-year with increasing age (as is the case for DALY but not QALY).
Ah, I see! I cited the other study on the same topic. This one values life years in low- and middle-income countries. For Malawi (a least developed nation), the research estimates QALY as 1%–51% of GDP per capita. I took the upper boundary of 50%.
Woods, Beth, Paul Revill, Mark Sculpher, and Karl Claxton. “Country-Level Cost-Effectiveness Thresholds: Initial Estimates and the Need for Further Research.” Value in Health 19, no. 8 (December 2016): 929–35. https://doi.org/10.1016/j.jval.2016.02.017.
In Australia (based on the research I cited originally), I believe the QALY value was comparable to GDP per capita. Perhaps, based on the argument that the most poor people value other priorities more than personal health (e.g. protect animals by malaria nets as opposed to individuals), in poorer countries a QALY is valued less than annual income while in advanced economies QALY is valued about the same as GDP per capita.
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Yes, a more internationally focused U.S. administration, especially in the higher ranks, would benefit emerging economies.
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Yes, actually—thank you! This is a valid point. Rapidly developing India could lose its development status in, for example, 5 years anyway. In this case, after India’s industries develop to an internationally competitive level, other countries would be able to develop their economies through effectively preferential market access (relative to India) to the United States. I will look into the counterfactual more and let you know when it is revised!
Thanks for looking into this!
You can see the (perhaps outdated?) moral weights GiveWell used for comparing saving the life of children vs doubling someone’s income for a year. They assume value scales essentially logarithmically in income.
https://blog.givewell.org/2017/12/22/uncertain-cost-effectiveness-analysis/
https://blog.givewell.org/wp-content/uploads/2017/12/Fig1_StaffValues-2.png
I would be careful about generalizing from that study, since it was done in Australia, where people are both wealthier and healthier. Decreasing marginal utility of income is typically assumed, whereas tying 1 QALY as equivalent to 50% of GDP per capita at all values would basically assume a constant marginal utility from income.
This seems surprisingly (perhaps suspiciously) cheap. I think the fact that the US just withdrew from it should also be taken as a sign that this particular bill couldn’t be passed unless the makeup people in government shifts enough away from the current makeup. Thankfully there’s an election coming up.
I don’t think you should be multiplying by the life expectancy. You should be looking at the counterfactual impact of the trade policies. How long would these policies actually last before they would be overturned again? Or, would similar such policies be passed without our intervention soon anyway? If similar policies would pass within 5 years without our intervention anyway, then you’d only get an extra 5 years with the policy, and you’d multiply by 5 instead of 69.
Hello Michel,
The GiveWell’s moral weights are intriguing indeed. I used QALY as opposed to DALY intentionally, because I did not included the decreasing value of a life-year with increasing age (as is the case for DALY but not QALY).
Ah, I see! I cited the other study on the same topic. This one values life years in low- and middle-income countries. For Malawi (a least developed nation), the research estimates QALY as 1%–51% of GDP per capita. I took the upper boundary of 50%.
Woods, Beth, Paul Revill, Mark Sculpher, and Karl Claxton. “Country-Level Cost-Effectiveness Thresholds: Initial Estimates and the Need for Further Research.” Value in Health 19, no. 8 (December 2016): 929–35. https://doi.org/10.1016/j.jval.2016.02.017.
In Australia (based on the research I cited originally), I believe the QALY value was comparable to GDP per capita. Perhaps, based on the argument that the most poor people value other priorities more than personal health (e.g. protect animals by malaria nets as opposed to individuals), in poorer countries a QALY is valued less than annual income while in advanced economies QALY is valued about the same as GDP per capita.
-
Yes, a more internationally focused U.S. administration, especially in the higher ranks, would benefit emerging economies.
_
Yes, actually—thank you! This is a valid point. Rapidly developing India could lose its development status in, for example, 5 years anyway. In this case, after India’s industries develop to an internationally competitive level, other countries would be able to develop their economies through effectively preferential market access (relative to India) to the United States. I will look into the counterfactual more and let you know when it is revised!