Trends in the Cost-Effectiveness of Federal Lifesaving Regulations, 1967–2024: The Triumph of Dr. John Morrall

Abstract Dr. John Morrall was a pioneer in the development of league tables that rank the cost-effectiveness of lifesaving federal regulations. Using Dr. Morrall’s methods, we developed a lifesaving league table for 2009–2024 and compared it to Dr. Morrall’s largest league table, which covered 1967–2001. Although the sample sizes in the two periods are relatively small and, therefore, limit statistically robust comparisons, we report suggestive evidence that the cost-effectiveness of federal lifesaving regulations has improved. The recent data reinforce Morrall’s observation that safety regulations tend to be more cost-effective than health regulations. We also verify a concern of some early critics of lifesaving league tables: as more of the non-lifesaving benefits of federal regulations are included in the ratios, the estimated cost-effectiveness improves. Finally, we describe some practical limitations of using benefit–cost analysis to achieve greater public protections at less cost and recommend that selection of regulatory alternatives be given more emphasis in the conduct of regulatory impact analysis.