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Author Topic: How much is a life worth?  (Read 1738 times)

Offline thedoc

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How much is a life worth?
« on: 28/05/2014 07:30:01 »
In the UK our National Health Service has limits on its budgets. How do we decide which treatments we can afford to offer?
Read a transcript of the interview by clicking here
or Listen to it now or [download as MP3]
« Last Edit: 28/05/2014 07:30:01 by _system »


 

Offline CliffordK

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Re: How much is a life worth?
« Reply #1 on: 28/05/2014 10:08:52 »
Quote
How much is a life worth?

It depends on whether it is your own life, or somebody else's life. 

It is difficult to put a 20,000/yr value on a life, especially with cancer where some patients will succumb to the cancer, and others may live long cancer-free lives. 

And, it is complicated.  There are some octogenarians who are destined to become centenarians, and a few will become supercentenarians.  Likewise, there are some 60 yr olds that won't reach their 65th birthday.  So, should one deny treatment for the 80 yr olds, but give it to the 60 yr olds?  What about the 80 yr old marathon runners?  Medical care for the last few years of life can cost more than the entire rest of a person's life.

Does one treat the people who have paid into the "system" every year, but used very little the same as those that have required tens of thousands of dollars of treatment every year in their life?  What about self-inflicted disease states such as alcohol induced cirrhosis?

 

Offline alancalverd

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Re: How much is a life worth?
« Reply #2 on: 29/05/2014 13:19:41 »
A remarkably complicated question!

There is good statistical evidence that a civilised population (Australia) spends about one sixth of GDP on health protection and treatment. Translating that to the UK suggests about 4,000 per year per capita. But we don't spend our entire lives being ill or in danger: maybe 2% of the population is significantly ill at any time, so perhaps we value an endangered life at 200,000 per annum. Say half of that is spent on treatment (2k per annum is roughly the NHS budget)  and half on prevention (road engineering, air traffic control....). Most people seem satisfied.

The problem arises, as always with statistics, when you try to particularise from the general. Given one quantum of cash, do you save a premature baby or a septuagenarian scientist? If the gamble works out OK, the prem baby could turn out to be the next Jesus or Einstein, but he is far more likely to become an average citizen or a lifetime burden on society, but the 70-year-old (a) feels some entitlement for having paid his taxes for the last 50 years (b) is of proven and calculable present worth and (c) is unlikely to last another 20 years, even as a burden.     

The 20k figure doesn't reflect the value of a life, but what society is prepared to shell out on average to give anyone an extra year of quality life - about 10 times the average contribution to a universal health service. The best figure for the value of a life is surely the average sum insured for the population: this represents what people are voluntarily (as distinct from tax) prepared to pay for in life insurance. I don't have (but would welcome) a good figure but my guess is around 50,000, given that many families only insure one or two breadwinners and AFAIK nobody will issue a policy on a 75 year old.
 

Offline CliffordK

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Re: How much is a life worth?
« Reply #3 on: 29/05/2014 18:20:33 »
You can't go with an "average" insurance payout, as averages consist of both low and high payments.  And, the payouts, of course, are based on cost, which is what is being controlled.

Your costs have multiple components.
Labor costs.
Facility costs.
Cost of medication, treatment, device, etc. 

There may be some treatments that become prohibitively expensive solely because of the extended time required in a medical facility.  For example, I'm seeing dialysis costing somewhere between $50,000 and $75,000 a year, largely due to being hooked up to a machine in a hospital for several hours a day, 3 days a week, every week. 

Other treatments like the next "wonder-pill" may be dirt cheap to make and administer, but the cost of R&D is also factored in.  By giving the NHS collective bargaining power, the UK can essentially say that the drug companies have no access to the whole country, or they can choose to sell the wonder pill at an amount the NHS deems fair.  That also often means that consumers in the USA without the same collective bargaining power of the UK, Canada, and elsewhere gets stuck with higher bills.

One also has to factor in the success rate.  Dialysis, while expensive, can essentially prolong life indefinitely for 99% of the patients.  Cancer treatments may be somewhat less efficacious.
 

Offline alancalverd

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Re: How much is a life worth?
« Reply #4 on: 29/05/2014 19:43:46 »
Confusion between what a tax-funded universal health service considers a reasonable cost for an average QALY, and what private individuals insure their or each other's lives for - i.e. the replacement value of a dead person. Interestingly, the two aren't an order of magnitude different.
 

Offline thedoc

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How much is a life worth?
« Reply #5 on: 30/05/2014 10:05:45 »
In the UK our National Health Service has limits on its budgets. How do we decide which treatments we can afford to offer?
Read a transcript of the interview by clicking here

or Listen to it now or [download as MP3]
« Last Edit: 30/05/2014 10:05:45 by _system »
 

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How much is a life worth?
« Reply #5 on: 30/05/2014 10:05:45 »

 

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