How Much Is A Human Life Worth?
In today's environment, where jobs are being cut,
families are scrounging to get by, public assistance programs are being
cut, and personal net worths have suffered a severe hit, President
Obama is pushing health care reform. I certainly agree that something
has to be done. Exactly what is a debate for another day. What I want
to write about is something that I thought about while shaking my head
at the mobs yelling about "death panels" and "rationing".
Of
course, any organized insurance plan has a list of things that they
will pay for. In the private insurance field, it's called a formulary.
If your preferred pill is on the formulary, they will pay X amount per
prescription. If your pill is not on that list, they usually won't pay
a dime.
This list of drugs and treatments is
put together by people in meeting rooms in some corporate office
somewhere. Typically they are experts in the part of the list they are
involved with. Cardiologists work on the heart pill section, while
Oncologists work on the cancer pill section, and so forth. At some
point, there are pills and treatments that they look at and say "No, we
won't pay for that." So, when your doctor prescribes that pill or
treatment and you try to get your insurance company to pay for it, they
will say "No, we won't pay for that."
This is
the same situation that Democrats have proposed and have been accused
of putting together "death panels", while Republicans have been telling
people to "die as quickly as possible." I don't see the big deal with
the Democrats plan because it is exactly what exists in the private
insurance sector today. Big companies like United Healthcare and Blue
Cross Blue Shield, as well as the small ones, have panels of people
that decide what they will and will not pay for. I guess, in a sense,
they all have death panels.
I don't blame
insurance companies, though, because it's necessary for a company to
decide what it will and will not pay for. It is much easier to
determine what their claim costs will be so they can charge an
appropriate premium to the insureds. They can't have Joe Blow
submitting a claim for a $1 million stop smoking patch developed by his
uncle Billy and be expected to pay for it. The company would quickly
go out of business.
However, the difficult
part comes in when the medical experts must sit down and parse hundreds
of different drug treatments and medical procedures to decide which
ones are the most likely to be the best treatment option for the most
people. Some are no-brainers. Applying raw pickles to your left butt
cheek will not cure cancer. Reducing blood pressure will reduce the
risk of stroke. Simple.
But what about the
thousands of variations between? At some point, they have to say "No"
to a variation that will be the best treatment option for someone, but
not the best treatment option for most people. Only by reducing the
number of options can an insurance company successfully negotiate
reduced rates for medicines, equipment, and treatments. Those
economies of scale help to keep insurance rates down for their clients.
What
they are really looking at is cost to benefit ratios. How much does it
cost versus how much benefit will be received. When you look at
hundreds or thousands of patients, it's easier to think of the numbers
in chances. Drug A will cure disease X 99% of the time. Drug B will
cure disease X 75% of the time. No brainer? For the big numbers,
sure. But what about that 1% of people who may die while taking Drug
A? What if they would have been cured under Drug B? Does the cost to
benefit ratio make sense if you know that not paying for Drug B will
kill 1% of the people?
People die every day
because they could not afford to pay for the medical treatment they
needed. People who would have been cured if they only had the money to
pay for the treatment. However, they didn't have the money, so their
option was to die.
Now, with the government
considering a public health option, many people will believe that the
government will pay for any and all medicines or treatments when they
get sick. Should a public health option pass, they will be sorely
upset to find that to be inaccurate. They'll believe that the
government has plenty of money to spend, so they should get any
treatment needed; or more accurately, they think they should get any
treatment requested. However, a panel will decide what treatments
will be paid for and which treatments will not. This is simply to
control costs. Some will say this is unfair. Some will say they are
murdering people who are too poor to pay for treatment and relied on
the government in the first place.
So, in a round-about way, this led me to begin to consider: How much is a life worth?
Say
you were in a doctor's office one day and a nurse approached you.
Suppose that she told you that the person next to you had a fatal
disease, but a treatment was available. There was a single pill they
could take that was 100% effective at curing the illness. However,
they needed you to decide if the government (i.e. taxpayers) was going
to pick up the tab. Some silly government regulation requires you to
okay the expenditure (suspend logic for a moment. Imagine you're in
Congress). The cost of the pill would be divided by the number of
taxpayers and each person would pay an equal share on their next tax
year filing. Sounds fair to me.
So, how much is this magic pill? It's $100.
Duh, give me the pen. No brainer, right? Sure.
What about $1,000? Sure.
What about $100,000. Well, okay. Spread out across all taxpayers, that's not that much.
What
about $1,000,000? See where this is going? A cool million could do a
lot of different things, but perhaps the person's life is worth it.
It's a guaranteed cure, so I'd probably sign.
What
about $1,000,000,000 (a billion dollars). That could really help a lot
of people, instead of just one. I don't know if I'd sign.
What
about $1,000,000,000,000 (a trillion dollars). I'm pretty sure I
wouldn't sign. First, that's a lot of money that each taxpayer is
going to have to pay. Assuming 200,000,000 taxpayers (two hundred
million), that would be an extra $50,000 in taxes for each taxpayer.
I'm sure most of the taxpayers couldn't afford such a financial hit.
How would you explain to them that they needed to fork out $50,000 for
this stranger?
So, this exercise simply asks the question: How much is a life worth?
The answer is: I don't know for sure, but a human life does seem to have a price tag - at least for me.
What about for you? What do you think a human life is worth?
Mark

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