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Oh boy, yet another "actshually" filled with emotions that supposed to give "another view". You precisely know what Emanuel and Lee mean when they quanyify tha

Oh boy, yet another "actshually" filled with emotions that supposed to give "another view". You precisely know what Emanuel and Lee mean when they quanyify that someone with 25 years is a greater loss than someone with 60 years. This emotional story about grandmother does nothing to change their statement.

wyattpeak 6y ago
That's not the point that the article takes issue with. Not the difference in time, which the author acknowledges is important, but the classification of those later years as being inherently less valuable than the younger ones.
- vixen99 6y ago
  Surely, this evaluation relates to the public sphere perspective. Along with insurance companies, every single relevant government action that requires estimations of life value, tacitly or explicitly agrees that later years are indeed less valuable than the younger ones and likely, always will. NICE - the UK medical board that decides which medicines can be used in the NHS, constantly makes calculations on quality of life for all ages. This is inevitable if public funds are involved. In the private sphere, it’s a completely different matter. This seemingly 'uncaring' stance only applies where public decisions are involved. No reason for this evaluation to necessarily work at a personal level if the state (taxpayer) does not pay for it.
- tomatocracy 6y ago
  It's not later years per se but level of health which is adjusted for. We tend to think of this in terms of whether we should extend life with poor years or not but if you think about treatments or devices which won't extend life but might well have a dramatic effect on level of health, mobility etc during those years then it becomes clearer why this is an important consideration. I think most people would say that in a resource constrained world there still ought to be room to fund those things.
- incrudible 6y ago
  The problem is that insurances pool everyones money for treatment. No death can be prevented, only deferred. Is it justified to extend the life of a terminal cancer patient for another miserable few months with chemotherapy, at full cost to everyone else in the pool? I dare say not, and QUALY is the measure we use to calculate this, imperfect as it may be. It also is worth noting that QUALY is not conditioned on worker productivity, as suggested in the article.
  - ntsplnkv2 6y ago
    Everyone wants their grandma to get the most treatment possible, just no one else's. When it's "society" - people will say we're spending too much money. When the shoe is on their foot, people won't like it and say they "deserve the best care." > for another miserable few months with chemotherapy, My grandfather hated chemo. But he did it for those few more months - and he got to see my cousin get married. How do you account for this? You can't.
    - incrudible 6y ago
      Indeed, you can not emotionally account for individual tragedies or circumstances with a statistical measure. Unfortunately, somebody has to financially account for it, because as I said, this is a pool of money that everyone chips into. If you are willing to pay extra, or out of pocket, to have your life extended to the absolute limits, that is fine with me, but please do not push this attitude as the “morally right one” unto everyone else.
      - ntsplnkv2 6y ago
        > but please do not push this attitude as the “morally right one” unto everyone else. I will push whatever I want to, thank you. Insurance is supposed to provide healthcare. It isn't supposed to judge what is a good life. I shouldn't have to pay extra for care that I was always paying for because you're mad your rates went up. Don't like it, don't buy the care. Ridiculous assumption to let society decide when people should live and die. It's also unnecessary to. On the populations we are talking about, individual cases like people living long on chemo in miserable lives to die are counteracted by people who died way younger. It's easy to calculate the risk and spread that among insurance holders.

wyattpeak 6y ago

That's not the point that the article takes issue with. Not the difference in time, which the author acknowledges is important, but the classification of those later years as being inherently less valuable than the younger ones.

vixen99 6y ago
Surely, this evaluation relates to the public sphere perspective. Along with insurance companies, every single relevant government action that requires estimations of life value, tacitly or explicitly agrees that later years are indeed less valuable than the younger ones and likely, always will. NICE - the UK medical board that decides which medicines can be used in the NHS, constantly makes calculations on quality of life for all ages. This is inevitable if public funds are involved. In the private sphere, it’s a completely different matter. This seemingly 'uncaring' stance only applies where public decisions are involved. No reason for this evaluation to necessarily work at a personal level if the state (taxpayer) does not pay for it.
tomatocracy 6y ago
It's not later years per se but level of health which is adjusted for. We tend to think of this in terms of whether we should extend life with poor years or not but if you think about treatments or devices which won't extend life but might well have a dramatic effect on level of health, mobility etc during those years then it becomes clearer why this is an important consideration. I think most people would say that in a resource constrained world there still ought to be room to fund those things.
incrudible 6y ago
The problem is that insurances pool everyones money for treatment. No death can be prevented, only deferred. Is it justified to extend the life of a terminal cancer patient for another miserable few months with chemotherapy, at full cost to everyone else in the pool? I dare say not, and QUALY is the measure we use to calculate this, imperfect as it may be. It also is worth noting that QUALY is not conditioned on worker productivity, as suggested in the article.
- ntsplnkv2 6y ago
  Everyone wants their grandma to get the most treatment possible, just no one else's. When it's "society" - people will say we're spending too much money. When the shoe is on their foot, people won't like it and say they "deserve the best care." > for another miserable few months with chemotherapy, My grandfather hated chemo. But he did it for those few more months - and he got to see my cousin get married. How do you account for this? You can't.
  - incrudible 6y ago
    Indeed, you can not emotionally account for individual tragedies or circumstances with a statistical measure. Unfortunately, somebody has to financially account for it, because as I said, this is a pool of money that everyone chips into. If you are willing to pay extra, or out of pocket, to have your life extended to the absolute limits, that is fine with me, but please do not push this attitude as the “morally right one” unto everyone else.
    - ntsplnkv2 6y ago
      > but please do not push this attitude as the “morally right one” unto everyone else. I will push whatever I want to, thank you. Insurance is supposed to provide healthcare. It isn't supposed to judge what is a good life. I shouldn't have to pay extra for care that I was always paying for because you're mad your rates went up. Don't like it, don't buy the care. Ridiculous assumption to let society decide when people should live and die. It's also unnecessary to. On the populations we are talking about, individual cases like people living long on chemo in miserable lives to die are counteracted by people who died way younger. It's easy to calculate the risk and spread that among insurance holders.