Health Economy perverts Utilitarism

Utilitarianism is about judging actions according to utility or determining which actions have the greatest possible benefit for all. Utility is assessed in terms of people’s well-being, happiness or pleasure. The mathematical formula for calculating the greatest utility is the quality of life achieved by measures, e.g. expressed in quality of life per year (QALY) for as many people as possible.

The fact that this approach is arbitrary and empirically unprovable is one thing, because quality of life is not a measurable constant. Health economics perverts utilitarianism by reducing the effects of medical therapy to the utility (U) of the patient (E) in its already unrealistic and over-simplifying models (costs = K) and excluding the utility of the medical intervention for the relatives and the social and professional relationships (S) of the patient (E).

In 2022, 2232 articles were published under the keyword “QALY”. Medicine is therefore being intensively scrutinized by health economics. The overall effect of the QALY models is negative for medicine. Why?

The models have been reduced to the cost-effectiveness of U= K/Q(E): the models only take into account the QALY of the patients. The quality of life of relatives due to illnesses in the family and society are mathematically ignored, thus reducing the effect of medicine on the socially “isolated” patient. However, this is precisely not the assumption of utilitarianism. Utilitarianism wants to know the result of an effect on society as a whole, not just on the sick person. After all, the unhappiness of relatives because of the sick person in the family is a reduction in the greatest possible (utilitarian) happiness of as many people as possible and is therefore utilitarian relevant.

The models must be extended to the cost-effectiveness of U=K/Q(E+S+V). V is the social cost of a death, which according to the WHO is three times the GDP of a person per country per year. For Switzerland, this is 3×90,000 or CHF 270,000. The QALY of (S) is at least the QALY of (E), which doubles the U/Q. As a rule, the mathematical adjustments of the utilitarian QALY to the specifications of utilitarianism lead to the realization that medicine is generally cost-effective (costs/QALY <100,000 Fr or even return on investment), even for high-priced drugs.

On my behalf, the VEMS has drawn up a basic paper that clearly shows how utilitarianism, perverted by health economics, makes a cost-effective therapy appear cost-ineffective. This massive social intervention of health economics as a hidden implicit normativity exposes health economics as a socially destructive force.