This paper considers the question of what ought to be valued in the context of measuring the
outcomes of healthcare interventions. The answer is discrete health states in the case of the
quality-adjusted life-year (QALY) model and an entire health profile in the case of the
healthy-years equivalent (HYE) approach. How well the weighted average of values attached
to the former approximates the overall value attached to the latter depends on the validity of
the assumptions of the QALY model. The paper considers some of the empirical literature relating
to them. One of the most important assumptions, which from the limited evidence available
appears not to hold, is additive separability. However, it is argued that violation of this
assumption does not in itself invalidate the QALY approach, since in some circumstances it
might be more appropriate to elicit the value of a health state independently of the states that
succeed it. Investigation into this issue is identified as one of the key areas where future
research efforts should be directed.