Friday, February 19, 2010


Megan McArdle on her Atlantic blog (embedded links added):
People under the age of 55 account for a very, very small proportion of deaths in this country. It's after 60 that you'd expect to be getting the largest mortality benefit from expanding insurance coverage. If switching people to government-run insurance at the age of 65 doesn't produce any measurable improvements in the mortality rate of a population with a high mortality rate that are large enough to show up in aggregate death statistics, then how big an effect could a national health care system for younger people have on mortality outcomes? Would it even register in the mortality statistics? Is this the right use of $163 billion? I mean, we can say that a policy is a success if it saves even one life, but it is not actually possible to run a country this way.


Whitehall said...

Mortality rates are therefore not the proper metric.

How about others?

Lost work days? The unemployed wouldn't count then would they?

Lost Democratic votes? Some people may be looking at it this way.

Infant mortality? Planned Parenthood offers an alternative.

Quality of life is hard to quantify but individuals know it when they see it.

Carl said...

Whitehall: The Levy & Meltzer study in the last embedded hyperlink focused on Medicare -- i.e., sample population mostly over 65 -- making differentiality mortality the most relevant metric. But, I welcome your analysis of a different approach should you want to post it in comments.

OBloodyHell said...

> Is this the right use of $163 billion? I mean, we can say that a policy is a success if it saves even one life, but it is not actually possible to run a country this way

As usual, libtards always make calculations in a vacuum, where lives saved are never balanced against whatever tradeoffs one had to make in order to save that life.

In reality, the calculus doesn't work that way. If you spend a billion dollars to save every child's life, pretty soon, you're guaranteed to wind up broke and destitute.

The optional wide-scale metric in this case is self-evident.

Man-lives -vs-man-lives.

If a person has a life span of 78 years, and the efforts in question save them at 60, then one could reasonably argue that I've saved 18 man years of life as a result.

So how to place a "value" on that? Is 18 man-years worth $10k? $100k? $1m?

"Oh, you can't place a value on human life!?!?"

Really? Why not?

Money is human time.

In order to create $1 of value, someone had to spend time doing whatever it took to do that thing of value, be it compose music, organize a pro soccer game, build a widget, or research a cure for the athletes foot.

In a base, simplistic calculus, if it took more than 18 man-years of valuable work to save those 18 years of life, then society is getting the short end of the deal and needs to say "no".

If, on average, it takes 12 minutes of human time to produce $1 of human wealth(per capita GDP/#minutes in one year, a crude but reasonable calculation), then we've associated an actual time-is-money metric. And now we can place an actual societal dollar value on that 18 years we've nominally saved -- $744k.

If society must spend more than $744k to add to that individual's lifespan, then it shouldn't be doing it, whatever "it" is.

Now, you can argue for a more complex metric that takes real personal production (what income decile is the person in?), and age(productivity tapers off in later years, usually), and any number of other things into account.

And/or you could apply a "normal curve" of wealth creation to an individual, which no-doubt center-loads the wealth created where it actually occurs, into one's so-called "productive" years, which usually tapers off a lot by one's 70s. This would substantially reduce that number, one can bet.

These enhanced metrics are a bit more heartless but probably more honestly accurate as to the honest societal valuation of those saved man-years.

That's not to suggest an individual should not apply whatever discretionary income they have towards extending their own life, or the life of a loved one.

But it does point up the limit of societal obligation in the balance.

Society itself owes you NOTHING but fair value for what you produce. Any other number for "humanitarian" reasons is non-obligatory, and cannot be justified on a large scale. You might choose to be humanitarian and save the starving victims in Haiti at a cost of 10x their lifelong social production, but society cannot afford to make that kind of expenditure on a vast scale, year in and year out. It's why so many libtard idealistic plans don't work, they don't have a suitable societal cost-benefit ratio. Their net effect will bankrupt society by paying more for something than the social worth of it.

This also does not take into account "quality of life" issues, but that's a can of worms that has massive repercussions to both sides of the argument, and so it best left for another time.