Mar
5
Health Care and the Cost of Time, from Paolo Pezutti
March 5, 2010 |
I came across this article on Bloomberg:
"End-of-Life Warning at $618,616 Makes Me Wonder Was It Worth It" by Amanda Bennett
It is the story of a wife who assisted her husband through a long story of pain, hope and money spent to prolong life as much as possible. It is interesting how time has a different value when you realize your life is coming to an end, and when you understand time has become a scarce resource.
Rocky Humbert comments:
Using 2005 data from the March of Dimes, the average pre-term birth costs $51,600 and the first-year medical costs are also about 10x greater for a premature birth versus a full-term birth. This is a lot of money because pre-term babies make up over 12% of American newborns. Amazingly a 2-pound baby now has a 95% probability to live a full and happy life. (Admittedly, some of these babies are permanently impaired and cost fortunes in lifetime medical costs.) Nonetheless, forty years ago, the probability of survival of a 2-pound infant was close to nil.
I bring this up because I like to focus on the positive, and truly amazing advancements in medicine have been achieved over the past decades. Polio, anyone? One of these "expensive" pre-term or in-vitro babies may be the next Einstein, and far be it from me to argue for "pulling the plug" on Einsten at age 0 or Einstein at age 100. Theoretical analysis ignores the infant mortality side of the spectrum. If one can theorize immortality, one should also theorize about the extraordinary efforts and money to reduce infant mortality and increase fertility. Why should one assume that an immortal man does not father hundreds of children? And why cannot elderly women have more children too? Hence rather than reaching the conclusion that the ratio of elderly/young would be unsustainable, one might reach the conclusion that the overall population would grow uncontrollably– perhaps with Malthusian consequences. Which of course argues that we need more Einsteins…
Nick White responds:
One needs only to consider that the march of mankind over the past 6,000 years has been generally forward. Hence if one extrapolates this trend, one is likely to conclude that as human population grows (ceteris paribis), there is more good than evil. A triumph of the optimists…I'm not so sure on this one.
Generally forward? Well, yes. But that neatly sweeps under the carpet vast swathes of humanity who may be net no better off (or possibly worse) than they might have been 6,000 years ago. Certainly, for everyone on this list, life is many orders of magnitude brighter than it was all those generations ago. Yet, overall, I would argue there's quite a bit of skew in the distribution of benefit; largely depends on what region of the world you're in and what ethnic group you hail from.
Is there more good than evil? I think this is another proximate vs. ultimate causes issue. I would argue that rational self interest (ie "greed") provides many collateral benefits– but is that intrinsically "good", and who decides? That depends, inter alia, on one's theology (or lack thereof). Generally speaking I'm short human motives, but long on some of the products of those motives!
Economically speaking, I think the progressive pattern you've identified is perhaps something approximating an unintentional Nash Equilibrium– society at wide has benefited as people have done what was best for themselves in the context of their group….but, on average, I think many people were out for their own end. (nb: of course, your example of Salk etc is duly noted, and there are numerous examples of truly beneficent altruism amongst the pantheon of social contributors) All said and done, I think Gekko sums up my position best, and I think it does capture the evolutionary spirit. It's just the side effects one must pay heed to and much of the colorful debate on this list goes back and forth on that very point; we all agree on capitalism– some of us disagree on appropriate social conscience.
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