6 ms·

I know it will sound unfeeling but I have to wonder why, in a world with billions of people, we would spend a million dollars to keep just one human alive?

• deleted 13y ago
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• fogleman 13y ago
  lolwut? For starters, a parent doesn't give a crap about those billions of people but would give their life for their own child.
• adamnemecek 13y ago
  Because one would hope that if the roles were reversed that s/he would get the same treatment.
• ForHackernews 13y ago
  Because part of what makes humans evolutionary successful is taking (sometimes drastic) steps to ensure the survival of the next generation. Maybe it isn't purely rational, but it's worked pretty well for us as a species.
• slucidi 13y ago
  Because money is a means to an end for people to live. Trading away a life to save a few dollars is missing the point.
  • conanbatt 13y ago
    Unless you use that million dollars to save way more people. Because, you can. Easy to save thousands with that kind of money.
• deleted 13y ago
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• PakG1 13y ago
  If it helps you to understand motivations, you can think of the motivations in terms of the prisoners dilemma. What is the morally correct thing to do is up to each individual involved in the situation though due the idea of fundamental human rights.
• smtddr 13y ago
  You are a perfect example of what I was just talking about less than an hour ago... https://news.ycombinator.com/item?id=7204058 https://news.ycombinator.com/item?id=7204058
• DrStalker 13y ago
  Start by figuring out the actual cost of the care in a sane health care system, rather than the inflated American price.
• MaysonL 13y ago
  With the cost of bullets so low, why don't we simply shoot a few of the extra ones?
• mikeash 13y ago
  All the other points about morality and such aside, a million dollars isn't even that much. Even from a pure cold-hearted rational perspective, the kid can be expected to contribute two or three times that much in economic activity over his life, so it's actually worth the money too.
  • dredmorbius 13y ago
    the kid can be expected to contribute two or three times that much Likely rather more than that. Your economic contribution isn't your lifetime earnings, but your lifetime value contribution. That's the productivity-of-labor side of the equation. Your salary/income is (generally) some small fraction of that. Look up revenues or profits at a company on a per-employee basis for a proxy of this.
  • w1ntermute 13y ago
    Right, it might make sense to save an infant (although it makes a lot more economic sense for women who cannot have healthy children to adopt instead). But the bigger question is why we spend so much money to prolong the life of someone who's in their 70s or 80s (and often suffering and in pain) for another couple of years, or even just months.
    • ars 13y ago
      That's part of what makes us human and not computers or animals. Some things are not rational yet we do them anyway.
      • w1ntermute 13y ago
        Human folly has lead to a variety of illogical practices, many of which have been stamped out over the centuries. There's no reason the same couldn't be done here.
  • rdtsc 13y ago
    > "isn't even that much" Especially coming from this clown, who, if had just paid that out of his annual salary would still have $10M left to party with.
• mjn 13y ago
  Given finite dollars to spend on healthcare, how to prioritize it is a fair question, though answering it ends up very emotionally and politically loaded. Just in terms of where the money goes, though, money spent on babies is not really a huge problem in the western world: the biggest part of our "heroic care" medical spending is in the last few months of life of elderly and/or terminally ill people. I don't know of a good way to solve it. I would like to prioritize solid evidence-based decisions as much as possible, but those have a tendency to come across as unfeeling, or worse (one might even gloss such decisions as amounting to "death panels"). I think part of it is that intellectually all of us agree that we cannot spend infinite resources on every possible health problem, but it's difficult to decide that this specific person should not be treated because it's "hopeless" (a gloss for "poor likelihood of success relative to costs"). That would mostly not be babies, but mostly would be a mixture of elderly people (prognosis for nearly anything declines with age) and people with terminal illnesses that are statistically very unlikely to be cured. But even still, difficult to stomach. In part, because it goes against the psychological messages we're sending at the same time, which is that people should never give up hope, etc. I don't actually know what I personally think about it, given some recent personal experience. One of my friends died a few weeks ago (in his early 30s) of melanoma, which was discovered in Stage 4, and treated unsuccessfully for about 9 months. The prognosis wasn't very good to begin with, given the advanced stage at discovery. Probably, this treatment had little statistical likelihood of success, though redeeming factors included: 1) at a young age, it was at least distinguishable from zero likelihood, and 2) it was part of a clinical trial, so may give some scientific information even if unsuccessful. However in a psychological sense both he and his friends/family seemed to benefit from the treatment, and would have been much less happy with a "not treatable" decision. Enough to be worth the cost, given the low odds of success? Difficult to say, and anyone who tried to say "no" would end up with a tough sell. And yet intellectually I obviously realize that if I were to advocate that we must "pull out the stops" to the maximum extent possible for every sick person, this isn't going to work under any economic system, whether it has a more right- or left-wing flavor.
  • erichurkman 13y ago
    One huge thing that the average citizen can do is to write down (and properly file and certify, as needed) their end of life wishes. Too often it is that people end up in the later stages of their life (young or old) without formal directives as to their wishes. It then falls upon impassioned family members to make decisions: do they ventilate, for how long, and do they tube feed, and under what circumstances do they resuscitate? It is a discussion everyone should have with their family, _today_, before you or your loved ones are not lucid enough to make the call. I would love to see the healthcare space, along with the government, advocate for these difficult, yet vitally important, conversations.
• Edmond 13y ago
  Could be the next Einstein, in which case a million bucks is a pittance :) In all seriousness, it is a challenging question though. The issue of how to spend healthcare dollars wisely is one that as a country we are currently unwilling to address honestly.
  • dredmorbius 13y ago
    Could be the next Hitler, Stalin, Pol Pot, or Kissenger. It's all a crapshoot.
    • Edmond 13y ago
      agreed...but I am an optimist :)
• jtbigwoo 13y ago
  It's insurance. We pool together a bunch of people's money (plus money the company puts in on behalf of the people in this case). We say that some of them will cost a bunch and some of them next to nothing. With enough people, the costs average out and it should be manageable. Because AOL is self-insuring, they take the risk that the high cost folks will balance out the low cost folks. The answer to your question is simple. We pay $1,000,000 not to keep one person alive, but because that person is part of a risk pool which only works if it pays out when something catastrophic happens. The pool would quickly fall apart if it could say, "your parents paid in, but we don't think you're worth that much money." I'm not an expert, but I believe that Obamacare removed lifetime maximums and the ability to deny coverage based on preexisting conditions. Anderson is probably angry that his costs per individual aren't capped anymore. He happened to pick the least sympathetic way to get that message across.
  • yummyfajitas 13y ago
    It's Armstrong. Preexisting conditions and denying coverage has nothing whatsoever to do with corporate insurance, which already gives you coverage with preexisting conditions. AOL's insurance plans before Obamacare did not have lifetime caps (source: I worked at Patch). Most likely the added costs he is complaining about are caused by various low cost, high probability events that Obamacare mandates coverage of. When I worked there I had a cheap high deductible plan, which is the sort of thing Obamacare makes illegal.
• chris_wot 13y ago
  Yep. Sounds unfeeling. What if you were that "one person in a billion"? Or your own child?
  • icebraining 13y ago
    Do you give all your disposable income to poor kids? Why not - they could be your child! If parent sounds unfeeling, frankly your post sounds hypocritical. Everyone implicitly makes a decision on how much to give away vis-à-vis spending on less noble things. Parent's not a worse person for acknowledging it.
    • chris_wot 13y ago
      I am not, last time I checked, a nation state. Or a billion dollar corporation. FWIW, I do give a significant portion of my "disposable income" to World Vision. Be careful next time you call a stranger a hypocrite.
      • icebraining 13y ago
        It doesn't matter how much you give. If it's not all - and I have to admit I checked from your post history - you're still putting a limit on how much other people's children matter to you. I'm not accusing you of being a bad person or anything like that, I'm saying that is unfair to disparage RexRollman for voicing something we all effectively do.
        • chris_wot 13y ago
          I respectfully disagree. The reason I thought it was unfeeling was because he said that "I have to wonder why, in a world with billions of people, we would spend a million dollars to keep just one human alive?" It was the "we" part that got to me. We don't spend millions of dollars on every human, we (as a society) don't need to. But we do spend that on the few humans that it does cost millions to keep alive. There are a lot of research projects that costs millions of dollars to keep going, and often they find breakthroughs that influence other areas. And I wasn't really disparaging him. He said himself that he thought it might sound unfeeling. To me, it did.
• koenigdavidmj 13y ago
  The only people who suggest that are the people who are in the "allowed to survive" bucket.
• dominotw 13y ago
  To talk about it.
• humannature 13y ago
  I am actually upvoting you. Why? because in today's "feel good" society no one wants to address a real world affecting everyone problem: overpopulation. and what to do about it?
• deleted 13y ago
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• staunch 13y ago
  I think it's cool Tim Armstrong asked this question on HN, even if did use an alias.
• rdtsc 13y ago
  > I know it will sound unfeeling Yap, it does > why, in a world with billions of people, we would spend a million dollars to keep just one human alive? Because part of what makes us, "us" is keeping one human alive. That one human, one baby is someone's baby. If it was your baby, wife, sister, friend, how quickly you'd tell the insurance company and hospital, nah, don't pay for it, let them die. You wouldn't have to pay. That is why you joined AOL maybe and have "great" insurance. For not having to go bankrupt or make such decisions in cases like this. I can see how someone in a poor country might be offended, but I am offended when a CEO who makes millions of dollars per year says that. Saving those 2 babies was just 15% of his annual salary. You can turn that question around and then ask: "I know it will sound unfeeling but I have to wonder why, in a world with billions of people, many making under $100/month, many sick and starving, we would, as a society even let one single CEO of some washed up Internet company that used to mail stupid cup coasters in CD form, make tens of millions of dollars / year?".
  • victorhooi 13y ago
    I think it's more a problem of prioritising finite resources. Pointing to his salary is just an ad hominem attack, and does nothing to progress the discussion. Basically, say you have a thousand employees and $5 million. If you spend $2 million on two of them, then it only leaves $3 million to spend on benefits for the remaining 998 employees. Like it or not, it's a zero sum game. It's a tricky ethical dilemma.
    • mgkimsal 13y ago
      And when you have extra profits of hundreds of millions, you can take a few extra of those millions and shore up the insurance coffers so that future outlier scenarios don't give people the option of scapegoating that section of the company first.
    • rdtsc 13y ago
      > Pointing to his salary is just an ad hominem attack ... and does nothing to progress the discussion. Isn't it the other side of the coin? I think it progresses the discussion pretty well. The profit pool a company makes is a finite resource. Let's talk about that then too if we are going to bring in logic fallacies and game theory into the game. So let's look at it this way -- You have a thousand employees and $5 million. And you spend $4 million as salary to the CEO and then spread around the rest to everyone else and it only leave $1 million for everyone else. It is a tricky dilemma? Or is it? What is the sum, for this "0 sum" game? Whoever set up that insurance pool might have been pretty incompetent and stupid for not accounting for such events. I am assuming there is no explosive epidemic of expensive-baby-threatening-diseases amongst AOL employee's families. So there is one person to fire on the spot during a "town hall meeting"
• fennecfoxen 13y ago
  Q: Would you consider working your rear end off for years on end to pay medical expenses necessary to save the life of some arbitrary human being halfway around the globe you've never met? Q2: Would you consider working your rear end off for years on end to pay medical expenses necessary to save the life of your own daughter? The reason AOL pays these expenses is the same reason it pays its own employees and the same reason those employees spend money on things like "television" and "dining out" and "silicon valley rent" instead of spending it on improving the fate of third world nations. People spend money on themselves and on people they care about!! There is more to life than the welfare state!! And it's a good thing, too, because taxation of an individual's economic output in favor of redistribution damages his incentives to work, and eventually you see the Laffer curve in action and the welfare state isn't doing as good a job of providing for peoples' welfare. (See also: abject failure of Communism, and associated famines).
  • jrockway 13y ago
    > taxation of an individual's economic output in favor of redistribution damages his incentives to work The part I keep increases my incentive to work. "You know, I really want that promotion, but since the government is going to take some percentage of the associated raise, fuck it, I quit," said no one ever.
    • fennecfoxen 13y ago
      [EDIT] I had a rant here, but I'm going to replace it with the blatantly obvious counterexample: working mothers. Consider working mothers in two-income families. Consider those who quit work to spend more time with the kids. Do you think that maybe there's one of these women who, if she were granted immunity from taxes and made an extra 50% in take-home pay, would choose differently? The rest of the reductio-ad-absurdam is left as an exercise to the reader. I'll remind the reader we seem to be dealing with a hypothetical redistribution of such a scope that we must lift the third world out of poverty before we can spend money on our own kid's cancer treatment or whatever.
      • jrockway 13y ago