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> I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists

> I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own. Like the UK NHS's NICE? "The UK’s National Institute for Health and Care Excellence (NICE) is responsible for conducting health technology assessment (HTA) on behalf of the National Health Service (NHS). In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness (AfR)—and one substantive—an ‘ethics of opportunity costs’ (EOC) that rests primarily on the notion of allocative efficiency."[0] "NICE’s use of ICERs, quality-adjusted life-years (QALYs) and the cost-effectiveness threshold as its preferred tools for decision-making, with some allowance for relevant social and ethical values, has been consistent since the institute’s inception"[0] and as Karol Sikora said: "QALY [is] not a perfect metric, but it’s the best we’ve got" "[NICE] guidelines are based on the best available evidence. Our recommendations are put together by experts, people using services, carers and the public"[1][2] Sounds not unlike what you suggested ... and yet they've consistently used 'value for money' measures such as QALY. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ [1] https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/how-we-develop-nice-guidelines https://www.nice.org.uk/about/what-we-do/our-programmes/nice... [2] https://www.nice.org.uk/process/pmg20/chapter/introduction#who-is-involved https://www.nice.org.uk/process/pmg20/chapter/introduction#w...

stevenAthompson 3y ago
Systems like this are necessary primarily because these programs are given lower priority than other government spending. If I were in charge the queen would've been buried in a pine box, and the money wasted on her funeral would've gone towards life saving medical treatments. Any system that prioritizes anything above human health is fundamentally broken, and that's not the SME's fault. That said, the world is finite and tough decisions do still need to be made. In those cases I would defer to the SME's. If they still thought a system like the above was necessary after being fully funded I would accept that, despite it being distasteful to me.

stevenAthompson 3y ago

Systems like this are necessary primarily because these programs are given lower priority than other government spending. If I were in charge the queen would've been buried in a pine box, and the money wasted on her funeral would've gone towards life saving medical treatments. Any system that prioritizes anything above human health is fundamentally broken, and that's not the SME's fault. That said, the world is finite and tough decisions do still need to be made. In those cases I would defer to the SME's. If they still thought a system like the above was necessary after being fully funded I would accept that, despite it being distasteful to me.