One of the most valuable things the health economist does for us is to challenge us. Why should we not attempt to obtain the most good for a given expenditure, or spend least in order to achieve a given good? Is this not the most responsible approach to dispensing funds which (in the NHS) may be public property, all-too-scarce, and held in stewardship for the relief of suffering and disability? What could be more moral than trying to make these funds work hardest for us?