Tuesday, May 27, 2008
Does the Value of Life Exceed Fifty Thousand Dollars? by Legal Pub
What is the value of life? Ask a personal injury lawyer trying a wrongful death action and he will calculate a figure in excess of several million dollars based on life expectancy. An economist, hired by the defense, will quickly say such figures need to be discounted to the money's present value. Ask a criminal defendant and he may say the victim was worthless and deserved to die because it was self defense. Ask a spouse, lover or child and they may say no amount is ever enough. Ask Anthem and they will likely say without hesitation, $50,000 per year.
Is that cruel? Private and government-run health insurance plans routinely determine whether to cover a new medical procedure. The entity must calculate whether a treatment will guarantee one year of "quality life" for $50,000 or less. Cold, but factual.
Stanford Graduate School of Business has argued that the average value of a year of quality human life is actually closer to about $129,000. Kidney dialysis can be used as an example. Dialysis saves hundreds of thousands of Americans from renal failure while waiting for an organ transplant. Medicare has covered dialysis since 1972.
Should Medicare and/or the U.S. government use cost-effectiveness analysis in determining coverage of procedures? Canada, Britain and the Netherlands allocate health care based on cost-effectiveness and the $50,000 threshold. Our Medicare system decides whether a new technology is "medically necessary and appropriate." But at least one part of Medicare may be bankrupt by 2019. So should the medicare approach be reconsidered with cost as a factor? If the cost of a new technology is more than the monetary threshold, should Medicare not cover that new technology?
Assigning a dollar figure to Medicare patients' lives should not be taken for granted. However, while it seems very cold, a $500,000 death benefit is paid by our government to families when a soldier is killed in Iraq or Afghanistan. $500,000 seems like an arbitrary figure. Private health insurers make similar determinations as to what they will cover for customers, so why should medicare be different?
Researchers speculate that such a system for Medicare could result in the denial of life-saving treatment for many. Sounds awful. But what if they are terminally ill with another condition or suffering from severe dementia? Does that suddenly make a subjective decision or a decision based on objective criteria more appropriate? Readers, this is your cue to add comments where appropriate.