Abstract
This article is part of a research project which seeks to draw on the methods and tools put forward by Michel Foucault to shed light on all areas of discussion concerning the economic assessment of health. It examines the epistemological basis of preference elicitation methods, based on welfare economics, which are used today to assess the benefits of health care. To do so, this research draws on Foucault’s episteme set out in The Order of things. More specifically the article considers that the rejection of interpersonal comparisons that foreshadowed the marginalist revolution and the transition to ordinal measures of utility during the 19th century can be explained by the shift from the classical episteme to a modern episteme. The question of the cardinal or ordinal measurement of utility is central to the economic assessment of health care. Indeed, the methods for valuing health benefits, especially using QALYs, are similar to cardinal measures, in contrast to the paradigm of the welfare economics of which they are meant to be part.