 There are at least two reasons why health technology assessment, HTA, agencies need to seek process-based backslash XA0 solutions to support the legitimacy of health care resource allocation, i.e. I, and pluralistic societies, the existence backslash XA0 of often conflicting and incommensurable claims, i.e. the fragmentation of value, and the lack of a broadly backslash XA0 accepted, ethically defensible analytical framework, and, i.e. the well-documented loopholes of the conventional backslash XA0 logic of cost-effectiveness, i.e., with its reductionist concept of allocative efficiency, which fails to reflect the backslash XA0 distributive dimension of resource allocation decisions in collectively financed health schemes. This article was authored by Michael Schlander.