When Life is at Stake, Money Should Not be a Consideration

That is what Garrett Shakespeare is saying. He has a rare blood disease that can be treated, but the cost of the needed drugs is $500,000 each year. He is 22 years old, and if he lives a normal life, he should live another 70 years, so he is telling Canadians that they have a moral obligation to provide him with $35 million to let him live.

The problem with the argument that "you can't put a price on a life" is that in the real world, decisions have costs. Take the above story, but change $500,000 into $1 trillion. Should Canadian taxpayer spend $1 trillion per year to save one BC man? Should they spend $35 trillion over the next 70 years? That would represents 75% of the total national income. So all 34 million Canadians should literally starve to death, homeless, cold so that one man can treat his rare blood disease? That is utter nonsense.

The reality is that life and death decisions do hinge on economics and wealth. I'm a big supporter of the Canadian health plan, but if we look at it as a pot of money, I would rather spend it where you get the biggest bang for the buck. I'm not big on providing elaborate and expensive life saving operations for those in their 80s. On the other hand, I'm all for giving those very same operations to children. Why? The benefit to a kid of 12 is another 80 years of life. The benefit for an 87 year old. Maybe another 5 years.

Sadly, the New Democrat Party has stepped and argued that the medical plan should pay for this treatment adding the classic statement "you can't put a price on a life". But that just shows that the NDP has no understanding of economics and reality. Get a grip. Yes, we should help as many people as we can and our socialized medicine is a gem that should be protected and even extended, but not mindlessly ignorantly and without concern for costs. That way lies economic calamity! Socialized medicine works only if bureaucrats are diligent in helping to buy the best medicine possible for the greatest number of people and obtaining the best benefit. It shouldn't be idiotically thrown to the wind to save hopeless cases or sad cases where the cost is simply prohibitive. Realism is essential.

Here is a Province newspaper article about Garrett Shakespeare and his sad medical situation:

If Garrett Shakespeare wants to live a full life, the cost will be approximately $500,000 a year.

Shakespeare has an extremely rare and deadly disease that attacks his red blood cells. There is a potential cure, and it's approved by the Canadian government.

But Shakespeare can't afford the treatment.

Paroxysmal nocturnal hemoglobinuria is a potentially fatal blood disorder usually managed with blood transfusions, but Shakespeare, 22, said his doctors advised against that treatment.

"My particular count of bad cells is so high that a transfusion wouldn't be very effective," he said before heading to his job as a lifeguard and swimming coach.

Shakespeare, who lives in North Vancouver, said he's hoping to be treated with infusions of eculizumab, more commonly known as Soliris, a treatment he said might be a miracle drug.

"I would love to get some of that," he said, his voice perking up at the mention of the drug.

The treatment was approved in Canada two years ago, but the price tag has put it out of reach for Shakespeare, who has dealt with PNH since he was a child.

For an example of this principle in the US, Oregon's public health plan has a prioritized list which captures economic reality:

The Prioritized List emphasizes prevention and patient education. In general, services that help prevent illness are nearer to the beginning of the list (also referred to as “higher
on the list”) than services that treat illness after it occurs. Treatment of advanced cancers, for instance, has a lower priority on the list than regular checkups, in the belief that early detection or lifestyle changes may reduce the frequency of cancers that become untreatable.

The Health Services Commission (HSC), in hearings over more than 18 months involving more than 25,000 volunteer hours, originally devised a list of health services ranked by clinical effectiveness and value to society. Actuaries determined how much it would cost to provide the services on the list. Combined, these pieces of information indicate the value of the health service relative to the cost of providing the service.

Fanatics who say that "health care is a right" would denounce this. But in the real world money is scarce and what we pay for has to be prioritized. It is a tragedy if somebody has paroxysmal nocturnal hemoglobinuria, but it is a tragedy if you slip and fall, hit your head, have a concussion that kills you. Life is full of "unfair" facts. We make do as best we can with our lot in life.

Where I draw the line is with billionaires and millionaires telling the bottom 90% of society that schools must be shut down, police services curtailed, firehouses closed because "there isn't enough money" and "taxes are too high". For those who want to be morally outraged, I suggest they direct their anger toward the ultra-rich who during the last 30 years have severed their connection with the rest of society and demand that they be treated like royalty beyond the reach of "the common law".

If I have a choice between helping a kid get a good education and an old person live another 6 months, I go with the kid. In my morals, anything else is cruel and wasteful.