6 ms·

The NHS approach of putting monetary value on a year of life and comparing the drug costs to that is a good approach to reducing the spend on tired old bod's.

to3m 11y ago
"Tired old bods". Will you feel the same when (touch wood) you reach such an advanced age? :)
- hessenwolf 11y ago
  Yes. Hopefully euthanasia will be a thing should I reach the decrepit stage. One last party (perhaps with a bit of morphine), followed by drifting to an infinite sleep... sounds fairly dignified.
  - soaringmonchi 11y ago
    Sorry, but this sounds a bit short-sighted. While nobody should be sentenced to suffer severe pain for the rest of his life, just because your body isn't as capable as it used to be doesn't necessarily mean that you want to end your life. Often there will be people that you will leave behind and you certainly don't want to explain them that it's your decision to do just that. On top of that, this is also dangerous from a social perspective where people could get a feeling that they are supposed to go once there is nothing they can contribute to society anymore. We should rather focus on allowing making "regular" dying more dignified rather than promoting euthanasia.
    - hessenwolf 11y ago
      I do think it should be a personal decision. Also, euthanasia is certainly not preventable (I think of a certain gentleman that took the bottom of the river approach). I have seen a few old people live beyond their time and wait for death though. It is quite harsh and undignified. "I am just so tired and I want to go."
coldtea 11y ago
There's nothing about "wired new bod's" that makes them more worthy of being alive...
- spacehome 11y ago
  I agree with you completely. While I'm not totally on board with what the NIH is described as doing, what you say is not against what the parent said. The issue is that new bods are very likely to have a lot more useful year left, which counts in the equations. Let's say the NIH values a year of life at X. There is a 90 year old and a 10 year old who need the same treatment that costs 10X. We should be much more willing to give the treatment to the 10 year old because he has a much better chance of 'earning back the investment', whereas statistically, the 90 year old is overwhelmingly likely to die in the next 10 years.
  - Qwertious 11y ago
    Strictly speaking, if it costs 10x then the 10 year old will have to live to 110, whereas the 90 year old need only live to 100 to "earn back the investment". So, your maths is incorrect, try "5x the cost". But I take your point.
    - rosser 11y ago
      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".
      - spacehome 11y ago
        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.
pc86 11y ago
It is beyond offensive to imply that 60 year old individual is worth less to society than a 30 year old individual, and that there are life-saving measures appropriate for the latter that are too costly for the former.
- DiabloD3 11y ago
  I don't know why this comment is being downvoted. If medicine still advances at the rate it is now, by the time we will be 60, the average old age will be in the 100s.
  - hessenwolf 11y ago
    Due to "rectangularisation of the survival curve", probably not (there appears to be a max age of around 110). Current rates are 3 months more life expectancy per calendar year. However, in the US and various other places the improvement is seriously wobbling due to wobbly bellies.
- hessenwolf 11y ago
  Let's say the treatment guarantees until life expectancy of 88, ignoring a few details. Do we say that 28 years of life is worth the same as 58 years of life, keeping in mind budget is fixed?
- IkmoIkmo 11y ago
  I mostly disagree although I understand and appreciate the sentiment of your post. You have to consider first of all that we're working with scarce resources. When we're not, it's not even an issue to compare two lives if you can save them both. But in the case that there are limited resources and you happen to have to choose between focusing on two different groups of people and make that tradeoff, you inevitably have to base your decision on something. Now if you have a 15 year old kid and an 80 year old person, and both are dying from some preventable disease at a rate of 1% per year, and you have a scarce budget to focus on researching one particular disease, which one do you choose to focus on? Well flipping a coin is probably shit. But making a ranking based on qualify adjusted life years[0] probably makes more sense. Of course it's not perfect, but it's not beyond offensive if you ask me to go about reasoning like this to partially inform policy decisions. [0]https://en.wikipedia.org/wiki/Quality-adjusted_life_year https://en.wikipedia.org/wiki/Quality-adjusted_life_year

to3m 11y ago

"Tired old bods". Will you feel the same when (touch wood) you reach such an advanced age? :)

hessenwolf 11y ago
Yes. Hopefully euthanasia will be a thing should I reach the decrepit stage. One last party (perhaps with a bit of morphine), followed by drifting to an infinite sleep... sounds fairly dignified.
- soaringmonchi 11y ago
  Sorry, but this sounds a bit short-sighted. While nobody should be sentenced to suffer severe pain for the rest of his life, just because your body isn't as capable as it used to be doesn't necessarily mean that you want to end your life. Often there will be people that you will leave behind and you certainly don't want to explain them that it's your decision to do just that. On top of that, this is also dangerous from a social perspective where people could get a feeling that they are supposed to go once there is nothing they can contribute to society anymore. We should rather focus on allowing making "regular" dying more dignified rather than promoting euthanasia.
  - hessenwolf 11y ago
    I do think it should be a personal decision. Also, euthanasia is certainly not preventable (I think of a certain gentleman that took the bottom of the river approach). I have seen a few old people live beyond their time and wait for death though. It is quite harsh and undignified. "I am just so tired and I want to go."

coldtea 11y ago

There's nothing about "wired new bod's" that makes them more worthy of being alive...

spacehome 11y ago
I agree with you completely. While I'm not totally on board with what the NIH is described as doing, what you say is not against what the parent said. The issue is that new bods are very likely to have a lot more useful year left, which counts in the equations. Let's say the NIH values a year of life at X. There is a 90 year old and a 10 year old who need the same treatment that costs 10X. We should be much more willing to give the treatment to the 10 year old because he has a much better chance of 'earning back the investment', whereas statistically, the 90 year old is overwhelmingly likely to die in the next 10 years.
- Qwertious 11y ago
  Strictly speaking, if it costs 10x then the 10 year old will have to live to 110, whereas the 90 year old need only live to 100 to "earn back the investment". So, your maths is incorrect, try "5x the cost". But I take your point.
  - rosser 11y ago
    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".
    - spacehome 11y ago
      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.

pc86 11y ago

It is beyond offensive to imply that 60 year old individual is worth less to society than a 30 year old individual, and that there are life-saving measures appropriate for the latter that are too costly for the former.

DiabloD3 11y ago
I don't know why this comment is being downvoted. If medicine still advances at the rate it is now, by the time we will be 60, the average old age will be in the 100s.
- hessenwolf 11y ago
  Due to "rectangularisation of the survival curve", probably not (there appears to be a max age of around 110). Current rates are 3 months more life expectancy per calendar year. However, in the US and various other places the improvement is seriously wobbling due to wobbly bellies.
hessenwolf 11y ago
Let's say the treatment guarantees until life expectancy of 88, ignoring a few details. Do we say that 28 years of life is worth the same as 58 years of life, keeping in mind budget is fixed?
IkmoIkmo 11y ago
I mostly disagree although I understand and appreciate the sentiment of your post. You have to consider first of all that we're working with scarce resources. When we're not, it's not even an issue to compare two lives if you can save them both. But in the case that there are limited resources and you happen to have to choose between focusing on two different groups of people and make that tradeoff, you inevitably have to base your decision on something. Now if you have a 15 year old kid and an 80 year old person, and both are dying from some preventable disease at a rate of 1% per year, and you have a scarce budget to focus on researching one particular disease, which one do you choose to focus on? Well flipping a coin is probably shit. But making a ranking based on qualify adjusted life years[0] probably makes more sense. Of course it's not perfect, but it's not beyond offensive if you ask me to go about reasoning like this to partially inform policy decisions. [0]https://en.wikipedia.org/wiki/Quality-adjusted_life_year https://en.wikipedia.org/wiki/Quality-adjusted_life_year