PubMed · 15720863
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Ivor Slickand. 2005. "You cannot be serious".. https://doi.org/10.1783/0000000052972744
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An individual assessing a risky job can be understood as a public good. He and each of his valued relationships place a demand for the preservation of his life and health for which he accepts a responsibility to preserve. Additional demands generally do not deplete his capacity for beneficial relationships, hence, they are nonrival. It follows that the more extensive are his relationships the greater is his social capital. Although a common metric to compare and aggregate such relationships is not practical, the paper demonstrates that the common social capital indicators can yield qualitative predictions on changes in risky behaviors in the context of conventional value of life models familiar within health economics. The individual will change his behavior toward risk upon experiencing an exogenous change in his social capital: when he marries, has children, acquires friends, or experiences a more socially active community. The empirical sections of the paper show this prediction to conform well to prior studies of micro data as well as to original empirical analysis of aggregate data.
In an earlier article in Health Economics, Salomon and Murray argue that by applying maximum likelihood techniques to predetermined functional forms and to a data set where a number of health states are valued by means of four standard valuation techniques, underlying 'pure' valuations of health may be teased out, together with estimates of parametric relationships between these 'pure' valuations and valuations based on the four standard techniques. We argue below that 'pure' valuations of health are ordinal rather than cardinal and that the 'pure' values that result from the multi-method approach give a false impression of being cardinal. They are therefore not usable as weights for life years. In the unlikely event that the authors should be able to demonstrate cardinality in 'pure' valuations of health, it must be possible to have subjects express these valuations directly, in which case there seems to be no need for the indirect multi-method approach.
The conventional time trade off (TTO) method relies on fundamentally different procedures to assess states better than and worse than dead. Arbitrary transformation mechanisms are then applied to worse than dead scores in order to achieve symmetry with those rated as better than dead. We use a 'life profile' approach along with a ranking procedure in order to show how states rated worse than dead may be assessed in exactly the same manner as better than dead scores. We then explore a common issue associated with states worse than dead that has received some attention recently: maximal endurable time. Our results showed that, although the severe health state was commonly rated as worse than dead, there were relatively few respondents that exhibited MET preferences. We discuss the implications of our findings for the use of the TTO method in deriving values for states that are worse than dead.