This paper reports the results of a Fall 2005 survey of US health economists, the first in over 18 years. Where appropriate, the results are compared with the earlier findings of Feldman and Morrisey (J. Health Politics Policy Law 1990; 15(3):627-646). The paper describes the demographics and training of health economists. It also describes how employers view the substitutability between a Ph.D. in economics and a Ph.D. in health services research, which is a key question because self-identified health economists increasingly include health services researchers trained in schools of public health or medicine. This study also reports the expectations of various, employers of health economists regarding external grant and contract support. It also reports health economists' perceptions of the processes that allocate resources and recognition: promotion review, journal refereeing, and grant review. Copyright © 2007 John Wiley & Sons, Ltd.