I agree it's not that simple, and finding better interventions in term of quality-adjusted life years seems really good! I'm not sure though how much elasticit

I agree it's not that simple, and finding better interventions in term of quality-adjusted life years seems really good! I'm not sure though how much elasticity there is in people's willingness to contribute more in response to more effective medical interventions. Setting a value on a life-year makes sense when choosing intervention, but individuals looking at their taxes or charitable contributions don't have a step-change reaction where they're happy to give without limits to the $X QALY opportunity until it becomes $X+1 I do think you have that budget in a very real sense, and I'm not sure I know exactly how sensitive it is to the effectiveness of the interventions, especially as you expand out. I'd argue that the current price of a life year still seems relatively cheap, but the healthcare system does not often complain from being inundated with too much funding.