By Sean Sinclair
The Lancet, Volume 382, Issue 9909, Pages 1978 - 1979, 14 December 2013
In support of Richard Horton's idea that “economists have stripped morality from economics”, I identify two issues with health economics: first, the conservatism of positive economics (the descriptive branch), and second, the way values are illicitly transported from positive economics to normative economics (the prescriptive branch).
Positive economics takes some basic assumptions for granted, a priori. Most obviously, mainstream neoclassical economics starts with a default model of the citizen as Homo Economicus, an entirely self-interested being. When this model does not predict observed events, it is adjusted with additional assumptions, but not replaced entirely. Against this, David Parkin and colleagues (Oct 12) state that nowadays, empirical analysis dominates economics. However, recent introductory textbooks on health economics still propound a model of markets based on the concept of the utility-maximising individual. Therefore, theory change in economics does not come in the form of scientific revolutions on the scale we find in physics or chemistry, for which current mainstream theories would be barely recognisable to theoreticians of 150 or 200 years ago.
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