A Response to Alan Williams

Abstract

In his reply to the author's criticism of QALYs, Williams claims that the QALY methodology attempts to clarify the issues involved in priority-setting in health care by introducing a formal model of the process. The author argues that Williams' approach is obfuscatory rather than clarificatory and that his model is promotional rather than analytical, and suggests that part of the problem is in Williams' failure to understand the nature of a democratic political process.