We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

On the Standard Gamble

Frederick J. Zimmerman, PhD
Arch Pediatr Adolesc Med. 2003;157(3):225-227. doi:10.1001/archpedi.157.3.225.
Text Size: A A A
Published online


ONE OF THE MOST vexing yet important questions that health services researchers must collectively address is which medical care interventions should be offered to patients and in what quantities. This question is rendered more salient every year as health care consumes an ever-growing proportion of the national economic output and is allocated in ever more lopsided and arguably inequitable ways. Health care now accounts for more than 13% of the gross domestic product, and per-capita expenditures on health care in 2001 grew at 10%: a rate that far exceeded inflation.1 Most health economists agree that the reason for runaway costs is the increasing use of services and treatments, many of which are marginally effective at best. At the same time, 40 million Americans are uninsured. In effect, our society rations people rather than rationing care.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.

Schematic diagram of the standard gamble showing branching of options. The respondent sets the value of x so that he or she is indifferent between the gamble and the certainty of health state 1.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Utility function. As the number of goods increases, the person's sense of well-being increases, but less than proportionately to the increase in the number of goods.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

3 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic