Instructions: In 1500-2000 words, answer one of the following questions. Papers must use a recognized citation system – e.g. Chicago or MLA – and must be double-spaced throughout.

1. The U.S. Department of Housing and Urban Development (HUD) is proposing a rule requiring each public housing agency (PHA) administering public housing to implement a smoke-free policy, affecting over 700,000 units. According to the proposed rule, each PHA must implement a smoke-free policy for all indoor areas – i.e. a policy prohibiting lit tobacco products in all living units, indoor common areas, and PHA administrative office buildings. HUD has conducted a cost-benefit analysis and found that this policy is likely to be net beneficial under reasonable assumptions. What is cost-benefit analysis? Why might government agencies be justified in using this decision procedure to evaluate policies and regulations? Assuming HUD’s smoke-free policy – compared to the status quo and other possible policies – offers the greatest net benefit, is this sufficient reason to conclude that HUD should enact it? That is, should cost-benefit analysis be used as the sole criterion for deciding regulatory questions like this? Why or why not? If not, should HUD enact its proposed rule anyway? Why or why not?

2. Suppose you are a policymaker responsible for allocating resources and setting spending priorities for North Carolina’s Medicaid program. You’ve been granted an extra $20,000,000, and with this funding, you can either:

1. Offer 50 children/year a highly effective live-saving treatment for pediatric cancer, yielding 3750 total QALYs, or
2. Offer 25,000 adults suffering from mild depression* a highly effective course of psychotherapy – e.g. talk therapy – yielding 25,000 QALYs.

* Adults with mild depression can typically manage their day-to-day activities, but usually with little enjoyment. They may also experience symptoms such as difficulty sleeping, difficulty focusing, tiredness, negative thoughts, and feelings of sadness, among others.

What is cost-effectiveness analysis? What is the motivation for using cost-effectiveness analysis to prioritize healthcare services? How would you decide this question if you employed cost-effectiveness analysis? Is cost-effectiveness analysis a just procedure for prioritizing health care services? Why or why not? Does priority to the worse off offer a more just approach to the prioritization of health care services for Medicaid recipients? Why or why not? If so, which version of priority to the worse off is most defensible? Why? Be sure to defend your answer.

3. Many policymakers argue that citizens’ wellbeing, not GDP, should be the principal standard of policy evaluation. Supposing that they are correct that some policy areas should be evaluated in this way, which conception of wellbeing – hedonism, preference satisfaction, or objective list/the capabilities approach – should they employ? Why? What is wrong with the alternatives? Your essay should briefly define and explain each of these approaches to wellbeing. Additionally, you should feel free to limit the scope of your argument in a number of ways. For example, you might argue that a particular approach is best for a particular area of policy – e.g. calculating QALYs or conducting cost-benefit analyses – but leave open the question of which approach is suitable for other areas. Similarly, if you are lacking for space, you might limit yourself to showing that one particular approach is superior to another, thus not discussing a third alternative approach.

Evaluation Guidelines

The purpose of this paper is for you to provide a reasoned defense of a position on the above question. Your paper will be evaluated in accordance with the following guidelines:

1. Thesis: Does the paper advance a clearly formulated thesis? Is the scope of the thesis appropriate? Or, does the paper set out to accomplish too much or too little?

2. Understanding and Reconstruction of Text/Positions/Arguments: Does the paper demonstrate a comprehensive understanding of the text/arguments/positions under discussion? Does the paper support its interpretation of the text by appeal to textual evidence? Does the paper reconstruct the positions/arguments under discussion in a systematic way, making clear the way in which the different components of the argument/position fit together? Or, does the paper only present a superficial understanding of the text/arguments/position? Is the paper fair to the positions/arguments under discussion by reconstructing them charitably? Or, does the paper reconstruct the arguments in a way that fails to recognize their strength.

3. Strength of Argumentation: Does the paper present strong arguments to support its thesis? Does the paper consider possible objections to its position? Or, does the paper present arguments that invite immediate objections or that commit fallacies? Do the thesis and arguments of the paper consider the complexity of the issue under discussion? Or, does the paper advance claims that are overbroad or too general?

4. Organization: Is the paper well organized? Is its structure apparent to the reader? Does the paper proceed in a rational fashion? Does the paper contain a helpful introduction and conclusion?

5. Clarity of Expression: Is the paper clear? Does the paper use simple language and grammatical sentence structure? Does the paper define the concepts that it introduces?