August1991 Posted February 12, 2011 Report Share Posted February 12, 2011 Oscar Wilde wrote a novel (his only one) titled "The Picture of Dorian Gray". In the story, a painting of the main character appeared to age so that the main character never did. IOW, Dorian Gray had discovered the magic secret to eternal youth. Well, N. Gregory Mankiew used this idea to pose a good ethical question: Imagine that someone invented a (...) Dorian Gray pill, after the Oscar Wilde character. Every day that you take the Dorian Gray, you will not die, get sick, or even age. Absolutely guaranteed. The catch? A year’s supply costs $150,000.Anyone who is able to afford this new treatment can live forever. Certainly, Bill Gates can afford it. Most likely, thousands of upper-income Americans would gladly shell out $150,000 a year for immortality. Most Americans, however, would not be so lucky. Because the price of these new pills well exceeds average income, it would be impossible to provide them for everyone, even if all the economy’s resources were devoted to producing Dorian Gray tablets. So here is the hard question: How should we, as a society, decide who gets the benefits of this medical breakthrough? Are we going to be health care egalitarians and try to prohibit Bill Gates from using his wealth to outlive Joe Sixpack? Or are we going to learn to live (and die) with vast differences in health outcomes? Is there a middle way? NYT---- Make no mistake: Life is filled with such choices. If people believe that State Health Care somehow means that these choices don't exist, then they are naive. Canada's GDP is about $40,000 per person per year. If someone discovered a pill/mechanism to perpetuate life, but this pill cost $100,000 per person per year, what we would do as a society? Who should live? Is a State system of deciding any better than a private system? When the Titanic sank, it was women and children first. Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 12, 2011 Report Share Posted February 12, 2011 An important question, for sure, considering that technologies that can drastically extend life are soon to become a reality. Certainly, some people might have ethical issues with this decision. From my perspective, though, it is relatively straightforward. A society that tries to prohibit people that can afford an expensive health care treatment from obtaining it is a society that forces death upon people who need not die. Anyway, in Canada, if the government does not fund/provide a certain health care procedure, citizens are not barred from getting that procedure privately. There is no reason that a life-extending procedure should be treated differently. Additionally, there are economies of scale to think about: let the rich pay for their treatment by the millions, the industry will grow and come up with better ways of doing it, and costs will come down over time, allowing more and more of the population to have access. Quote Link to comment Share on other sites More sharing options...
August1991 Posted February 12, 2011 Author Report Share Posted February 12, 2011 Additionally, there are economies of scale to think about... Economies of scale? Yours is the false belief that the problem of choice does not exist. Bonam, according to you, centralized decisions would eliminate duplications. Everything is efficient if the power to decide is conentrated properly. Extreme federalists who want to make Ottawa, Ontario the centre of the universe and extreme Quebec nationalists who want to make Quebec an independent country would agree with you.Bonam, I wonder about your claim to "economies of scale... " Who should decide? Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 12, 2011 Report Share Posted February 12, 2011 Economies of scale? Yours is the false belief that the problem of choice does not exist. Bonam, according to you, centralized decisions would eliminate duplications. Everything is efficient if the power to decide is conentrated properly. Er what? Extreme federalists who want to make Ottawa, Ontario the centre of the universe and extreme Quebec nationalists who want to make Quebec an independent country would agree with you. Sorry, where did any of that come from? Bonam, I wonder about your claim to "economies of scale... " Who should decide? The market? Quote Link to comment Share on other sites More sharing options...
August1991 Posted February 12, 2011 Author Report Share Posted February 12, 2011 (edited) Er what?You state:Additionally, there are economies of scale to think about: let the rich pay for their treatment by the millions, the industry will grow and come up with better ways of doing it, and costs will come down over time, allowing more and more of the population to have access. IOW according to you Bonam, with time, this choice will not exist. The market will make everyone rich and we'll all live forever. ---- Bonam, that's not how the universe works, and it's certainly not how modern health care works. It is naive/foolish to believe that Canada's health system somehow removes the necessity of choice. IMHO, future technology will make these choices more dramatic, and make a State health system less sustainable. Here is the issue: How do we decide who lives? Edited February 12, 2011 by August1991 Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 12, 2011 Report Share Posted February 12, 2011 You state: IOW according to you Bonam, with time, this choice will not exist. The market will make everyone rich and we'll all live forever. Pretty much. Look at life expectancies in Western countries over the last few centuries: steadily increasing. That trend will only continue. Bonam, that's not how the universe works, and it's certainly not how modern health care works.It is naive/foolish to believe that Canada's health system somehow removes the necessity of choice. IMHO, future technology will make these choices more dramatic, and make a State health system less sustainable. Quite possible. Fortunately I live in the US now and will just buy it for money and not give a damn whether someone else can afford it or not Here is the issue: How do we decide who lives? People make their own choices in life and live with the consequences. Quote Link to comment Share on other sites More sharing options...
August1991 Posted February 12, 2011 Author Report Share Posted February 12, 2011 (edited) Quite possible. Fortunately I live in the US now and will just buy it for money and not give a damn whether someone else can afford it or not ... People make their own choices in life and live with the consequences. So, what do you think of Medicare/Medicaid? These entitlement programs make the US federal budget unsustainable.How old are you Bonam? And how rich are you? Edited February 12, 2011 by August1991 Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 12, 2011 Report Share Posted February 12, 2011 So, what do you think of Medicare/Medicaid? These entitlement programs make the US federal budget unsustainable. Obviously, in the context of the US economy, something will eventually have to be done about the cost of health care. How old are you Bonam? Young enough to be pretty sure I'll live forever Quote Link to comment Share on other sites More sharing options...
bloodyminded Posted February 12, 2011 Report Share Posted February 12, 2011 Economies of scale? Yours is the false belief that the problem of choice does not exist. Bonam, according to you, centralized decisions would eliminate duplications. Everything is efficient if the power to decide is conentrated properly. Extreme federalists who want to make Ottawa, Ontario the centre of the universe and extreme Quebec nationalists who want to make Quebec an independent country would agree with you. Bonam, I wonder about your claim to "economies of scale... " Who should decide? I'm not seeing how this relates in any way to Bonam's remarks. Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 12, 2011 Report Share Posted February 12, 2011 I'm not seeing how this relates in any way to Bonam's remarks. Yeah it left me scratching my head too. Quote Link to comment Share on other sites More sharing options...
Oleg Bach Posted February 12, 2011 Report Share Posted February 12, 2011 There was a guy I met who started an exclusive health palace called The Kings Health Centre...eventually..this private upscale facility collapsed when the founder filled a suit case with 30 million in cash and split the country...A week ago I noticed that the building had been taken over by a faction of the law society and the place is an exclusive healing centre for lawyers - I am sure they have all the life extention stuff that we are no privy to as usual...It bugs me though - I was hoping to out live every lawyer on the planet..But as I see..they are desperately using every scientific means available to out live persons like me...so it is a battle between the spiritual health care...and material health care - I believe I will win this one...Imagine - a world without lawyers...why that would be heaven! Quote Link to comment Share on other sites More sharing options...
betsy Posted February 13, 2011 Report Share Posted February 13, 2011 Make no mistake: Life is filled with such choices. If people believe that State Health Care somehow means that these choices don't exist, then they are naive. Canada's GDP is about $40,000 per person per year. If someone discovered a pill/mechanism to perpetuate life, but this pill cost $100,000 per person per year, what we would do as a society? Who should live? Is a State system of deciding any better than a private system? When the Titanic sank, it was women and children first. I saw tv W5 segment about a guy (can't remember name) who got cancer. A pill that's supposed to increase his chances of survival was just too expensive for healthcare to provide. He died. I don't have anything against anyone taking the Dorian pill if they can afford it....as long as we, the taxpayers, don't have to pay for it. I can't afford that! I'll just shrug it off and continue living what's left of my life. Quote Link to comment Share on other sites More sharing options...
August1991 Posted February 18, 2011 Author Report Share Posted February 18, 2011 Obviously, in the context of the US economy, something will eventually have to be done about the cost of health care.Bonam, I agree. And not only "in the context of the US economy".I could care less who will pay for your future health care. My question is who will provide for your future health care? Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 18, 2011 Report Share Posted February 18, 2011 My question is who will provide for your future health care? Probably doctors, nurses, and technical and support staff, just as now? Further in the future, probably automated systems will play a greater and greater role. Quote Link to comment Share on other sites More sharing options...
August1991 Posted February 18, 2011 Author Report Share Posted February 18, 2011 Probably doctors, nurses, and technical and support staff, just as now? Further in the future, probably automated systems will play a greater and greater role. But why would these people do this?---- In life, we must make choices. Technology will make us richer overall, but it will also make these choices harder. The stakes will be higher. I think that "State Health Care" is a false sense of security. Life itself imposes choices. Risk is inevitable. The State is a chimera of security, zero-risk. Quote Link to comment Share on other sites More sharing options...
Bonam Posted February 18, 2011 Report Share Posted February 18, 2011 But why would these people do this? Cause that will be their job? I.e., they will make their livelihood by providing such services, as they do now. In life, we must make choices. Technology will make us richer overall, but it will also make these choices harder. The stakes will be higher. Certainly. I think that "State Health Care" is a false sense of security. Life itself imposes choices. Risk is inevitable. The State is a chimera of security, zero-risk. Yup, I agree. Quote Link to comment Share on other sites More sharing options...
August1991 Posted February 27, 2014 Author Report Share Posted February 27, 2014 Bump. Shouls we all pay through our taxes for insulin? Quote Link to comment Share on other sites More sharing options...
GostHacked Posted February 27, 2014 Report Share Posted February 27, 2014 Here is the issue: How do we decide who lives? The rich and the powerful will be making those decisions for the rest of us. Kind of like how they do it now. Quote Link to comment Share on other sites More sharing options...
Shady Posted February 27, 2014 Report Share Posted February 27, 2014 Initially the cost for said pill or mechanism may be $100,000 dollars. But eventually, as more companies began to provide this service, the cost would drop significantly. So I think the overall question of who should live or die would become moot once this particular industry became more mature. Quote Link to comment Share on other sites More sharing options...
idealisttotheend Posted February 28, 2014 Report Share Posted February 28, 2014 (edited) Bump. Shouls we all pay through our taxes for insulin? Of course, the alternative is to pay though our wallets for insulin, and pay more. Or to die because we can't pay at all individually. Or to go broke, medical costs are the number one cause of bankruptcy in the United States. Medical ethics/decision making is clearly the highest priority for our society as new technologies become available. How do we decide who lives? We can't do it now when it comes to what treatments we should provide the old or chronically ill etc. Look at India and China where the simple technology of sex revealing ultrasound and the combination of a millennium old cultural practice that families of females pay dowries to families of males (plus the usual misogyny) has led to a 60-40 male to female birth split and the countries to try and ban that one simple technology: sex revealing ultrasounds, never mind sex selection abortions. I fear that an inability to raise taxes will lead medical costs to be privatized in Canada which will then make it simple like in the States; if you are rich you live and live well, be poor and you die, or live poorly healthwise. This is consistent with corporatism replacing democracy, and corporatism being the "rule of none," no one will decide, just if you have enough money you can pay. Edited February 28, 2014 by idealisttotheend Quote Link to comment Share on other sites More sharing options...
August1991 Posted March 1, 2014 Author Report Share Posted March 1, 2014 Initially the cost for said pill or mechanism may be $100,000 dollars. But eventually, as more companies began to provide this service, the cost would drop significantly. So I think the overall question of who should live or die would become moot once this particular industry became more mature.Shady, you're an American idealist/idiot. Shady: "We'll all live forever!" (Shady, are you from California?) ---- Back in the real world, circa 21st century, not everyone can live forever. So, "who" gets to live? Rich people? I disagree. Aside from their wealth, I bet that Justin Trudeau and David Suzuki know how to contact doctors when a critical issue affects their family. Quote Link to comment Share on other sites More sharing options...
bush_cheney2004 Posted March 5, 2014 Report Share Posted March 5, 2014 Yes...the rich and powerful will get to decide, because they have the resources to exchange for such specialized services. Item: A girl in Ontario is currently fighting for provincial approval of a cystic-fibrosis drug that costs about $350,000 per year. The province won't pay until a better price is negotiated with the pharma supplier. Pay the price.....or not ? http://news.nationalpost.com/2014/03/03/twelve-year-old-girl-with-rare-disease-pleads-for-ontario-to-fund-life-saving-drug-that-costs-350000-a-year/ Quote Link to comment Share on other sites More sharing options...
August1991 Posted March 6, 2014 Author Report Share Posted March 6, 2014 (edited) Yes...the rich and powerful will get to decide Wait a second. Rich and powerful? What happens if a "rich" parent confronts a "powerful" parent to give a Dorian Gray pill to a dying child? Do both parents get a pill? ---- BC, my question in the OP was more mundane. If a Dorian Gray pill costs $200 and you need one every day, then that's about $60,000 a year. (Mankiew used a larger number, but he's American.) IOW, it requires more than GDP per capita to keep you alive. Do the math. If the pill costs $60,000 and let's say Canadian GDP per capita is $50,000 then someone must be working to keep someone else alive. But more, there's not enough to keep everyone alive. Someone must die. With or without State health insurance, we (collectively) will have to make a choice: if the pill of eternal life costs more than GDP per capita, who gets the pill of eternal life? The "rich" or the "powerful"? Edited March 6, 2014 by August1991 Quote Link to comment Share on other sites More sharing options...
bush_cheney2004 Posted March 6, 2014 Report Share Posted March 6, 2014 Wait a second. Rich and powerful? Yes, but not because a life wants to be saved or extended, but because those with the service and/or pills will demand payment. Life comes and goes every day, but Dorian Gray pills are rare. Pay up or die on schedule. Quote Link to comment Share on other sites More sharing options...
August1991 Posted March 6, 2014 Author Report Share Posted March 6, 2014 (edited) BC, Bill Gates is rich. Vladimir Putin is powerful. Given that a Dorian Gray pill exists, in which society would you (a mere mortal) prefer to live? A society where Gates wins? Or a society where Putin is the winner, top dog? Edited March 6, 2014 by August1991 Quote Link to comment Share on other sites More sharing options...
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