Allocating resources to health care: is the QALY (Quality Adjusted Life Year) a technical solution to a political problem?

The allocation of health care resources has always been and will remain a contentious issue. Classically, the arguments have been posed in terms of the "need" for health care and/or the "right" to treatment. More recently, there have been attempts to shape the debate in consequentialist terms, by introducing a composite outcome measure. In the United Kingdom, the QALY (Quality Adjusted Life Year) has been promoted enthusiastically. But, like many other such proposals, it is a dodo, and one that is potentially politically dangerous.