Olympic medals or long life: what’s the bottom line?
Authors: Craig R Mitton, H Dele Davies and Cam Donaldson
Published online: 21 June 2004
Craig R Mitton,* H Dele Davies,† Cam Donaldson‡
* Assistant Professor, Department of Health Care and Epidemiology, University of British Columbia, 4480 Oak Street, E414 A, Vancouver, BC V6H3V4, Canada; † Professor, Pediatrics and Human Development, Michigan State University, USA; ‡ Professor, School of Population and Health Sciences and Business School, University of Newcastle, UK. cmittonATcw.bc.ca
In reply: We thank Orchard and Finch for their letter about our article comparing spending on the Sydney Olympics to expenditure on healthcare for Australia, Canada and Britain.1 The reason we “singled out elite athlete funding” was simply to choose a high profile expenditure as an illustration that government does indeed make decisions about priorities with the limited societal resources available. While we would strongly agree, and in fact state, that “spending more on athletics may improve the health of the population”,1 the necessary public debate about how societal resources should be best spent is lacking.
In our view, such a debate should be informed by the costs and wide-ranging benefits of government expenditure and be based on clearly articulated public values. Contrary to the claim that we “ignore the concept of efficiency”, it is precisely here, when costs and benefits of alternative claims on limited resources are explicitly compared (both within healthcare and across government sectors), that the notion of efficiency is addressed.2 Upstream investment in promotional activities may well be an appropriate way to spend health and non-health dollars — let’s just make these choices, and the underlying values, explicit.
References
- Mitton CR, Davies HD, Donaldson CR. Olympic medals or long life: what’s the bottom line? Med J Aust 2004; 180: 71-73. <eMJA full text>
- Weinstein M, Stason W. Foundations of cost-effectiveness analysis for health and medical practices. N Engl J Med 1977: 296; 716-721. CBBIJCDH