Putting a dollar value on life? Governments are already doing it


But $ 100,000 to $ 200,000 has become the standard range endorsed by many health economists. In addition to reflecting the ideas of experts, “this range builds on the experience of working with decision-makers to manage the budgetary impact of health care,” said Christopher McCabe, executive director and CEO of the Institute. of Health Economics from Alberta, Canada.

Regardless of the value, no threshold is explicitly applied to health care coverage decisions in the United States. Allowing others to decide what care is worth paying for and what is not seems unpleasant or unfair.

We tend to value treatments that help those near death, spending more on them than on treatments for others who ultimately save more lives. It also reflects values ​​that are difficult to translate into mathematics.

“All the ways of deciding how to use collective resources discriminate against someone,” said Mr. McCabe. “The best we can hope for is to make these decisions through a transparent process. A fundamental problem in the United States is that there is no agreement on this process.

Many countries and organizations that use cost-effective healthcare recognize and rise to this challenge. For example, the National Institute for Health and Care Excellence in Great Britain is more likely to recommend coverage for treatment if it costs less than £ 20,000 to £ 30,000 (equivalent to $ 25,000 to $ 37,000) per additional year of life it provides (adjusted for quality of life). But this is not a hard and fast rule. The body also consider other The factors, including the disease and the population it treats, the level of evidence of effectiveness and the availability of alternative treatments, among others.

Likewise, the Institute for Clinical and Economic Review – a private nonprofit group in the United States that assesses the effectiveness and value of health treatments – considers cost-effectiveness as well as a range of contextual factors that such an analysis is likely to miss. To further ensure that all values ​​are taken into account, the two groups hold open meetings and invite comments on the draft documents.

Reflecting the fact that there is no “right” price for a life, there is no one and right way to combine all of these factors and perspectives. But deliberating openly and allowing public comment helps reconcile our personal feeling that we want unlimited health care for ourselves with the collective compulsion that there are limits to what society can afford.

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