A Million Dollars for an Extra Year of Life? ‘It’s my tax dollars!’
Tracy Morgan with her husband Mark before he died of brain cancer in 2011.
Paul Solman answers questions from the NewsHour audience on business and economic news on his Making Sen$e page. Here is Thursday’s query:
Name: Nancy Goodman
Comment: I feel terrible for the wife of the man with a brain tumor, but I also feel that the million dollars spent for his extra year of life could have been used a lot more productively. I’m not naive about the complexities about who makes such decisions, but it’s not “insurance or government money,” it’s my tax dollars!
Paul Solman: It’s brave of you to raise this issue, though a correction is in order: it was more than two years of extra life, not one. Actually, his prognosis was two to 12 months when he was diagnosed in Oct. 2009. So he beat the worst case by two years, the best case by one. But regardless, the same issue is raised: what is a year of life worth? Or two-and-a-half. I said in the story that to Mark Morgan’s wife Tracy, their time together was “priceless.” Political philosopher Michael Sandel has made the case here on the NewsHour that all life should be so considered. But I lean in the direction of your question, Nancy: could the money have been better spent, since there’s always an opportunity cost to resources? Or, to ask an even more provocative question, would the money have been spent had the rest of us not been forced to pay for it?
Defenders of the Affordable Care Act might say that’s why the law originally provided for payments to doctors for counseling patients on living wills and other end-of-life decisions. In light of Sarah Palin’s attack on this provision as “death panels,” however, it was removed from the Act. The Act’s defenders may not wish to address the issue you’re raising, Nancy, for fear of further antagonizing the Tea Party Right.
But the Morgans were a well educated, sophisticated couple. They almost surely considered their options honestly and carefully. They opted for as much time as money could buy. No small amount of it — $60,000 — was their own money. But most of it was not.
We can safely assume, then, that if they couldn’t have come up with a million dollars, they would have had to let Mark die. Would that have been OK with you? What if he’d been kept alive for ten years? Given the current estimate used by the government and courts of roughly $7 million per life, ten years would be worth something like one million dollars. (Look up the work of Vanderbilt University’s Kip Viscusi online for a fuller treatment of “VSL” — the value of a statistical life. The Wikipedia entry isn’t a bad place to start.
Yes, Mark Morgan’s best-case prognosis was for only one year. But he more than doubled that estimate. There must have been a non-zero probability that medical science would come up with some unanticipated cure.
Insurance is a pooling of resources to provide for risks. Do you not want insurance against medical catastrophe for your loved ones? Suppose you were in Tracy’s shoes? That’s the question we all have to ask, much as we may hate to.
As usual, look for a second post early this afternoon. But please don’t blame us if events or technology make that impossible. Meanwhile, let it be known that this entry is cross-posted on the Making Sen$e page, where correspondent Paul Solman answers your economic and business questions