In the UK there are fairly regular stories in the popular press about how somebody was denied expensive treatment that might have saved their life. 

We also, like Americans, get regular stories about how a soldier’s life might have been saved by expensive equipment like better air-support, transport helicopters or even better body-armour - this in spite of the fact that the American and British forces are already far, far better equipped than their enemies, and suffer a much lower casualty-rate in firefights. 

Again and again in the press, in the public consciousness, I see this indignant question being asked: “what price do you put on a life!?” 

It is the wrong question.  Life is not being priced at a certain level in either case.  There’s simply a limited amount of resources to go around and we live in a world where these resources are not distributed fairly or even intelligently, though in their own way institutions like hospitals and armies try to make the best of it.  Well, some of the time. 

If you take the “what price a life” question absolutely seriously and literally then you are committed to spending every dollar in the world to save the life of one terminally ill 80 year-old who fails to respond to treatment after treatment - until either something finally works or the money runs out. 

Our capitalist world is based on such a shaky philosophical foundation that it is important to step back and examine its role in a moral quandry instead of making judgements based on this shaky foundation.  Even if we are against capitalism, familiarity can still blind us, and we end up making an absurd case for limitless financial generosity that actually helps justify conservatism amd indifference - the conservatives get to play the ‘realists’. 

Primitive hunter-gatherers practiced infanticide when there was not enough food around to raise a new baby.  In our age we are insulated from such harsh choices yet the world itself has not changed - we just refuse to see.  The hunter-gatherers were not inhuman monsters; they presumably loved their children and worked in cooperative communities, but they had to face reality squarely, together, in order to survive.  They did not allow sentiment to cloud their judgement. 

I agree with Robinson: individuals should have a sense of the gravity of our shared struggle for survival.  If I fall gravely ill I should expect the same concern and assistance I would lend to another in the same predicament, but I should not expect to become the new centre of the universe, priority #1, even while in much of the rest of the world there are people suffering and dying for the lack of $5 medications. 

I don’t think that we have enough of a real sense of community and responsibility for necessary systems to work any more - everything’s based on coercion.  Gandhi had the right idea: if society is cellular then the small communities mind themselves and the national whole minds itself.  Like that old saying, “take care of the pennies and the pounds (£) take care of themselves”.

There is no such thing as risk-free and everything has a cost.  The government/insurance carriers want to get the most bang for their buck and this means analyzing the statistical risk value.  Currently, most insurance carriers allow one mammogram/year for a well-woman exam.  Under the new recommendations, it will no longer be part of a well-woman exam below age 50, but if the doctor recommends a mammogram for a younger woman, then it will be covered as per the insured’s policy.  The same will apply for the PSA test and other procedure that may now be included annually free under a wellness exam.

KDelphi, November 24 at 5:50 pm #

Lets get everyone covered first. This was a kindve odd time to come out with this, dont you think?
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You are absolutely right—I didn’t even consider those issues (betcha never thought I’d post THAT didja?)

Getting 50 million Americans coverage who don’t have it now IS the main point isn’t it?

a government run health care system will make this kind of rationing look like child’s play.  Believe me, I have lived in the UK, and it is only those with money who have the ability to access the better, and more timely, care.

And for the record, the US has by far the BEST health care system in world, bar none.  No one seriously questions that.  And it is provided a lot cheaper than many so called “single-payer” systems, run by governments.  Get the facts.

The “uproar” seems to be in the mainstream media only. You didnt even mention the “costs” of too much radiation and unnecessary treatment to individual human beings. Just because we CAN do it doesnt mean that we should.

As for rationing, (which we are already doing)I know many women who were sitting here saying, “Oh, so now I cant afford to get a mammogram until even later!” The media just talks as though everyone has access, as long as the “information is available”. If one does get diagnosed earl;y, good luck (unless you have Medicare of a gold plated plan) getting them to cover treatment, for all but removal..what good does it do to know, if you cant afford treatment?!

Lets get everyone covered first. This was a kindve odd time to come out with this, dont you think?

I don’t understand this latest opinion on the questionable necessity of mammograms prior to the age of 50 as in any way PREVENTING women from having them before the age of 50. (A run-of-the-mill health insurance policy - take a look - doesn’t cover all sorts of procedures.)

The ‘big’ picture is that we have the worst health-care system in the developed world and we pay twice the Western average to maintain that system. In the ‘developed’ world we’re talking various forms of single-payer systems, but since the health-care industry in this country won’t give up their pounds of flesh, we’re stuck with stuff like mammography tweaks.

Risk analysis can be sensible or it be simply a justification for rationing.

Example 1: Amniocentesis.  The risk of having amniocentesis done when a woman is under 35 is greater than the benefit, but the benefit increases when she’s over 35 to outweigh the risk.  This is sensible risk analysis.

Example 2: Gene Robinson’s example of mammography.  I know one friend’s wife died in her 40’s from breast cancer that was found too late.  Two years of expensive treatments to try to stop a Stage 4 level when it was found.  Earlier screening might have found it and saved her life.

Another friend is currently battling it, in her 40’s, and is winning because it was found early despite being a particularly nasty kind.  Her husband and kids would be looking at a terrible life without her.  The “cost-benefit analysis” ignores the fact that the COST to her is ultimate—her life, and the benefit to her is…NON-EXISTENT.  Yet she, too, is a citizen and a tax-payer and a teacher.

The new “standard” would have said she is disposable and should be allowed to die.
That’s not risk analysis—it’s rationing, the VERY thing the Republicans are using as one of their reasons to oppose ANY health care reform.