"Where my health is concerned, cost is no ob ject." The reply of the penniless man to an expensive spe cialist reflects a moral question. Should the costs of health services be a significant consideration in deciding upon gov ernmental health policies and programs? The answer in my opinion is yes. Costs ought to be used in deciding the level of health activities versus other social goods and services, and in planning which health programs to support. The truly moral problem is not to distinguish between good and evil but rather to select appropriately among alternative goods. After argu ing that consideration of cost is a moral imperative, the useful ness of cost-benefit analysis in framing the right questions and in improving the chances of moving in directions of social improvement is urged, and some limitations are noted. Fi nally, examples of the use of cost-effectiveness analysis in studying problems of disease control and maternal and child health are given.