What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Saturday, May 13, 2006

Whose Life Is Worth Saving?

Here is a new twist on the cost effectiveness scenario. Experts looking at the issue of a coming pandemic influenza have recommended that the ideal group to immunize and the group that should be immunized first in the event of a pandemic is the 18 to 30 year olds. Their rational is the following.
1) Society has invested considerable cost in getting them to the age of being productive.
2) They will be entering the work force and therefore will be the next-in-line tax payers for the longest expected period of time.
3) They should be the healthiest and therefore most likely to survive the influenza with the help of the immunization (notice, I did not say “benefit the most”)
4) They can work as the caregivers.
5) Saving lives in this group will prevent orphans that would need to be raised by the state.
Traditionally, the aged and the chronically ill are given preferential immunization. They argue that this is inappropriate and this group:
1) Are past their peak in productivity anyway.
2) Are less likely to survive even with immunization,
3) Will be less likely to be care givers to the influenza patients
4) Have contributed most of their life’s contribution already to society (taxes).
5) Have the least “life years” remaining.
Although the pediatric group will have many years to benefit, there will be additional costs to bring them to the age of “contribution”. All this deliberating was of course brought about by the following facts:
1) There will be a shortage of vaccine,
2) There will be delays in immunizing the populations of the world simply because of the enormity of the task, and the limitations in numbers of people available to do the immunization.
The obvious conclusion (in their minds), is there must be priorization to the immunization process to be cost effective and be for the “good of society as a whole”. So much for the idea that as a free society and in our health care system, we don’t make judgments as to relative values of human lives.

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