How Much is a Life Worth?

How Much is a Life Worth?

Life is priceless - or is it? There’s an unspoken rule amongst society in general that a life is worth saving no matter the price. In reality, there are costs to bringing forth and maintaining a person’s life. But then we also have to ask the question: whose life is worth saving?

Determining the quality of life is a complicated ethical issue that not many have the answer to and is still being debated today. The most complex of which arise in cases such as the termination of a pregnancy or in competent/incompetent adults. With a pregnancy, it is deemed a candidate for termination if the quality of life for the fetus is expected to be low from an abnormality or otherwise. This type of decision is based more on the biological facts rather than a potentially lived life. However, it is even more complicated by the fact that society generally views fetuses as having limited moral status. In the case of competent or incompetent adults, their interests are prioritized and there is respect for the life they have lived, but it is also acknowledged that perhaps their current quality of life may not be worth prolonging. On the other hand, there are those with depression who have suicidal ideations, but this does not necessarily mean that their life should end. [1]

When it comes to the actual costs of prolonging a person’s life, the American healthcare system turns a blind eye to it. It is a worthy cause, but at some point it is only going to hurt our pockets. Oftentimes, patients are uninformed of the costs and what is covered by insurance [2]. In 2009, the United States spent $2.5 trillion in health care, which was 17.6 percent of the GDP. By 2019, it is predicted to increase to $4.5 trillion, or 20 percent of the GDP. Much of these costs can be attributed to single treatment plans that cost tens of thousands to hundreds of thousands of dollars per patient. Cancer treatments range from $50,000 to $130,000 for a course of treatment that more than 600,000 patients are eligible for. Heart failure is treated with drugs far less expensive, but is more commonly experienced by the general population. Additionally, HIV-positive patients are sustained by three or four drug combinations that cost about $35,000 per person per year [3].  Other countries such as the United Kingdom, which has a nationalized health care system, control the amount of money spent on life-saving drugs based on analyses conducted by the National Institute for Health and Clinical Excellence [4]. It compares the health benefits of the drugs versus the cost using a measurement called the “quality-adjusted life year” (QALY) [5]. For the most part, it supports interventions that will offer another year of good quality life for less than $30,000 to $50,000. The FDA, on the other hand, only evaluates drugs for their safety and effectiveness and not their costs [4].

Drug pricing often has little correlation with the drug’s effectiveness. However, the price of living longer is only increasing. Pharmaceutical companies contribute to most of the outrageous drug costs due to the costs associated with research, development, and bringing a drug to market [6]. Lately, the pharmaceutical industry has tarnished its reputation first with Martin Shkreli, former CEO of Turing Pharmaceuticals, and Zaltrap, a colorectal cancer drug. In both instances, the respective companies overpriced a drug that made it unreasonably difficult for anyone to afford. Many in the medical community have become critical of these companies’ pricing policies [7].

The other side of the conversation lies in determining who is worth funding and how much more time we can afford for those with these debilitating diseases. In 1972, Congress made amendments to Medicare that essentially provided full funding for dialysis or kidney transplants for patients with end-stage renal failure no matter employment or insurance status. It was believed that the program would cost a maximum of $500 million in the next 20 years, but in 2009, the actual cost of the program was found to be $31 billion, which was sustaining 480,000 lives. In this case, we can argue that those with cancer should also receive equal coverage, but unfortunately do not receive such even with an insurance plan [3]. In 2013, it cost cancer patients on average $207,000 for another year of life [6]. How much are we, as a society, willing to spend for someone or ourselves to live another two, three, or four years?  

As uncomfortable as it may be, we are forced to put a price tag on life when it comes to healthcare. Healthcare is expensive and is increasing with every year that goes by. With limited resources and funding, society is faced with the moral and practical question of whether prolonging people’s lives is worth it. At the forefront of this controversy is drug and treatment pricing. The medical community relies heavily on the pharmaceutical industry to supply effective drugs for patients, but oftentimes it is difficult to afford due to sketchy pricing policies. It is also evident that the rules and regulations in place also treat patients differently. Depending on the treatment and disease, patients may or may not be guaranteed coverage. Although the American healthcare system was built upon the ideal that life is priceless, we have found that it indeed does have a price.

References:

  1. Farsides, B. and Dunlop, R.J. “Is there such a thing as a life not worth living?” BMJ. 16 Jun 2001. 

  2. Gubar, S. “Pricing a Year of Life” The New York Times. 5 May 2016. 

  3. Fleck, Ph.D., L.M. “What Is a Life Worth?” AMA Journal of Ethics. Apr 2011. 

  4. Schaffer, A. “The Cost of Life” MIT Technology Review. 19 Apr 2011. 

  5. Cook, C. “How much is year of life worth?” BBC News. 29 Aug 2014. 

  6. Robbins, R. “How much is an extra month of life worth?” Stat News. 25 Feb 2016. 

  7. LaMattina, J. “When It Comes To Cancer Drugs, What Is a Year of Life Worth?” Forbes. 9 Oct 2015. 

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