Social tariffs and democratic choice—Do population‐based health state values reflect the will of the people?
探讨健康技术经济评估中使用的社会关税（健康状态价值）不应仅视为操作定义，而应作为民主参与工具，并分析其对偏好汇总方法和纳入人群的影响。
In economic evaluations of health technologies, health outcomes are commonly measured in terms of quality-adjusted life years (QALYs). QALYs are the product of time and health-related quality of life. Health-related quality of life, in turn, is determined by a social tariff, which is supposed to reflect the public's preference over health states. This study argues that, because of the tariff's role in the societal decision-making process, it should not be understood as merely an operational (statistical) definition of health, but as a major instrument of democratic participation. I outline what implications this might have for both the method used to aggregate individual preferences, and the set of individuals whose preferences should count. Alternative tariff specifications and decision rules are explored, and future research directions are proposed.