Forests in the Inland West have been shaped by over a century of human migration and forest use. Relative forest health is still defined by human objectives in forest management. Economic analyses can help people understand the forest health implications of management choices between forest preservation, commodity production, or ecosystem management. Neo-classical microeconomics predictably casts the optimal forest health question as a cost-benefit trade-off even though valuation of forest health benefits must be inferred Alternative schools of thought, such as institutional economics, may reach different conclusions. Lack of public consensus on forest health objectives and acceptable remedies conflict with traditional deterministic analytic tools. An alternative planning approach that makes problem definition the focus of analysis may facilitate public forest health decisions.