It's painfully telling that we (or at least some of us) somehow consider the effort in keeping a person alive an "investment" that must be "earned back".
We a species have finite resources and can't sink all of them into every patient. Every time we treat or don't treat someone (and it's not possible to treat everyone of everything), we're making implicit statement in the form of a mathematical inequality about how we value money against human life and quality of life. The question here is whether these statements about how life balances against resources are self-consistent or not. And if they're not consistent, then that means you can re-arrange your decisions to save more lives at the same cost, or alternatively save the same number of lives at less cost. The route the NIH apparently went was to try to make their decisions consistent by explicitly giving a dollar value to a year of human life.
>We a species have finite resources and can't sink all of them into every patient. Every time we treat or don't treat someone (and it's not possible to treat everyone of everything), we're making implicit statement in the form of a mathematical inequality about how we value money against human life and quality of life.
We spend more on dog food than we do on millions of patients.
So, no, it's not a question of "finite resources".
Or, rather, it would be, if we were anywhere near exhausting our resources.
Treating the cost of saving a life as a cost is a completely different question than treating it as an investment. Human lives have value, in and of themselves, irrespective of whether or not sinking some number of dollars into extending them can — let alone should — be "earned back".
Whatever you call it, the value that patient N derives from cost C needs to be compared to the value that patient N+1 would derive from that same cost C.
When the NIH (or equivalent) turn that into a C/expected number of years, they're doing a scarce resource allocation problem. Unless you have infinite resources to give every patient every available treatment, you have to do allocation somehow.
Giving a 10-year old a treatment that you'd deny a 90-year old seems perfectly sane and rational to me.
I can't tell if you're agreeing with the concept and just disagreeing with the terminology, or if you believe there's a fundamentally better way?
