公平的寿命?全生命周期风险降低的功利主义与优先主义价值

Fair innings? The utilitarian and prioritarian value of risk reduction over a whole lifetime

Journal of Health Economics · 2020
被引 41
人大 AABS 3

中文导读

利用终身效用模型,研究功利主义和优先主义社会福利函数下降低死亡风险的社会价值,发现优先主义为公共卫生中的“公平寿命”概念提供了经济学基础,即年轻人应优先于处境相似的老年人,且收入不影响优先性。

Abstract

The social value of risk reduction (SVRR) is the marginal social value of reducing an individual's fatality risk, as measured by some social welfare function (SWF). This Article investigates SVRR, using a lifetime utility model in which individuals are differentiated by age, lifetime income profile, and lifetime risk profile. We consider both the utilitarian SWF and a "prioritarian" SWF, which applies a strictly increasing and strictly concave transformation to individual utility. We show that the prioritarian SVRR provides a rigorous basis in economic theory for the "fair innings" concept, proposed in the public health literature: as between an older individual and a similarly situated younger individual (one with the same income and risk profile), a risk reduction for the younger individual is accorded greater social weight even if the gains to expected lifetime utility are equal. The comparative statics of prioritarian and utilitarian SVRRs with respect to age, and to (past, present, and future) income and baseline survival probability, are significantly different from the conventional value per statistical life (VSL). Our empirical simulation based upon the U.S. population survival curve and income distribution shows that prioritarian SVRRs with a moderate degree of concavity in the transformation function conform to widely held views regarding lifesaving policies: the young should take priority but income should make no difference.

公平寿命功利主义优先主义终身风险降低