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Since the mid‐1980s the major players in US health care have argued that costs and benefits should underlie the allocation of health care resources. Looks at 30 cost benefit studies taken from the medical literature and examines five of them in depth, using the “depth hermeneutical” approach advocated by Thompson (1990). Concludes that cost benefit studies are about not only the co‐ordination of interests but also the obscuring and exclusion of other interests.

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