On sufficiency

What Is Enough? Sufficiency, Justice, and Health

The capability approach is an alternative to welfarist and extra-welfarist approaches to health economic evaluations. Unfortunately, it is not so easy to put into practice. The chapter 15 of a book sheds some light on the issue.

The approach developed by us is based on an outcome called years of sufficient capability (YSC). Instead of focusing on the absolute gains of capability across a population (i.e., capability maximization), the YSC targets those who fall below a threshold level of sufficient capability, with the aim being to improve capability to sufficient levels for those who are “capability poor

These are the five capabilities of most importance:

Stability— “ability to feel settled and secure”
Attachment— “an ability to have love, friendship, and support”
Autonomy— “an ability to be independent”
Achievement— “an ability to achieve and progress in life”
Enjoyment— “an ability to experience enjoyment and pleasure”

However, at the end, the same question without easy answer:

 How to define a sufficient threshold of capability needs to be considered further. One approach would be to conduct qualitative research using participatory methods to assign a sufficient threshold for a given population.

Unfortunately the proposal of participatory methods and the measurement of capabilities is illusory, at least in my view.