In showing that there is currently no meaningful link between CBA and CEA, we have
also shown that CEA is not currently justifiable on strictly welfarist grounds. Instead, CEA
would seem to be justifiable only on non-welfarist grounds where the output of health
care is judged according to its contribution to health itself, rather than according to the
extent to which it contributes to overall welfare (as determined by individual preferences).
The normative justification for this focus on people’s objective needs rather than on their
subjective demands owes much to Sen’s (1980) concept of ‘basic capabilities’. Culyer
(1989) draws heavily on Sen when he argues that health is a crucial characteristic that is
important for people’s capability to ‘flourish’ as human beings