Quantum
Matthew Parris almost gets this right. He’s talking about the price of a life, something we’ve got to take note of. Because, as we all know, economics tells us there are no solutions, there are only trade offs. Given that this is so we must be able to value the various things that go into the varied trade offs.
We convert all of those values to cash not because a life is actually worth cash. Nor because an unobstructed view of the South Downs is and so on. Rather, the conversion is so that we can do sums.
So, lockdown saves some number of lives at the cost of some amount of economy. And some amount of economy kills off lives by not having medical treatment, or food, or housing and so on. All of this is true and he’s quite right.
It’s this little bit that’s not quite right:
That, however, is not always how we act. Deep down, we know we can’t. The National Institute for Health and Care Excellence (Nice) uses quality adjusted life-years (Qalys) to compare the worth of medical procedures, treatments and drugs. One Qaly equals one year of perfect health (or two years of 50 per cent health, and so on). The NHS is said to regard a £30,000 Qaly as the upper limit for good value for money. Various government agencies use the value of a prevented fatality (VPF) to cost human life at £1.8 million per life saved.
NICE is simply an invented number. They’ve determined what we’re worth – how nice of them. But the £1.8 million, while it is indeed the number often used, isn’t a determination by the bureaucrats. Rather, it’s what we value a life at.
The method used is to look at what people actually do. That is, revealed preferences, not what people say of expressed preferences. How much are we willing to pay for a car that is a bit safer? How much jaywalking do we do, how much crossing only when the light says so? What can we find out about how we value the risk of death by watching what we do?
From that we can then calculate up that, on average, we ted to value a life at that £1.8 million. So, spending that to save a life is justified, spending more than that isn’t.
The point here being that it’s not really a determination of what a life is worth, it’s a calculation of what we all, on average, think a life is worth.
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The 1.8m for any average life makes a QUALY worth about £40k (£1.8m/(85/2)), not too far off the NIHCE £30k, which is in any event a "definitely worth it" boundary, not the absolute line. They will actually pay out for more expensive treatment, up to £50k per qualy, with argument.
"How much are we willing to pay for ..."
If it's a safer car you are talking about, how does the ordinary person decide? And having decided, can they actually afford that armoured Bentley?
You can tell that some people value their lives at very little. For example, if they don't get a tyre replaced immediately it reaches its safe limit. It also shows that they value the lives of other people at a lot less than your figure.
As well as a conversion to a cash equivalent, there is a political dimension. For example the media will screech "ONLY £1.8 MILLION?" SOmetimes decisions are taken on the basis of politics, not economics.
Politicians only ever make decisions based on politics.
"If it’s a safer car you are talking about, how does the ordinary person decide? And having decided, can they actually afford that armoured Bentley?"
They can't afford an armoured Bentley, but all those women driving Chelsea Tractors are definitely doing it because they perceive the risk to be lower.
Economics is a man made construct. Humans define it wholly. The "little bit" that you cutely refer to is not the only thing that's wrong. It's the whole "science." It is not a truth in and of itself. It is the set of game rules we have decided to apply. One could choose to make a human life priceless and work down from there. Adding human life as something that the game can decide a value for is silly at best. It is actually dangerous. It is precisely that "valuation" that leads to a huge number of problems, and assuming there should be some value is missing the point it seems.
Not really, no. Economics is a description of humans. Specifically, here, humans act as if they think a life is worth about £1.8 million. That's the whole base and aim of the calculation.
Yes, and the science is not the problem, but what we do about it. Once politicians obtain a number for the value of a human life, they can make "data-driven" decisions on having the government no longer serve certain constituents. A 1993 Hillary brainstorm was to curtail the disproportionate medical spending during the "last six months of life," however it was that she knew which those were.
And wouldn’t it be nice, if individuals in the UK could decide what their life was worth and be allowed to spend that, instead of NICE deciding for them. In other words, take away NHS State enforced monopoly and allow free market private sector insurance and provider competition so people could make their own choices. Now that would be nice.
Lockdown served to extend, not save, lives that were a cost; moribund people with one or more serious underlying medical condition requiring institutional support with neither hope nor expectation of recovery, but certain progressive deterioration to death.
And yes we did know that in March - the profile of those vulnerable evident from data from China & Italy. It was clearly stated a number of times, the number of deaths would be more evenly extended over time, rather than all at once. The so-called flattening the curve. But if you look at the curves for deaths, they are not flat: exponential rise, peak, gradual decline towards zero. The area before the peak = the area after the peak.
Additional costs, already extensively detailed, were incurred by lockdown. Who else other than lunatics would incur new costs to sustain and/or increase existing costs? Answer: politicians, but I am repeating myself.
Reality.
Worked like a charm; stretched "flu" season into June. (The current round of US mask mania has no point except to portray Trump America as dysfunctional and make us miserable enough to want a change.)
We are lucky our Public Health people didn't simply identify "lives that are a cost" and minister to Covid with euthanasia, justifying it "by the numbers."
It's not as simple as that. Lockdown reduced the number of young healthy people who died - possibly fewer than the number of deaths it postponed among elderly people with co-morbidities but we cannot actually know that since a large proportion of those elderly people who would have died without lockdown died anyway thanks to the NHS.
There was one interesting study that compared people's willingness to speed when speed limits were either increased (maybe the old 'double nickel') or removed in (IIRC) New Jersey; it compared the value of the time saved versus the increased risk of injury or death. They came out with a value of $2M USD. We were doing some work on a construction project that could have been undertaken in two different ways - one would present higher danger to workers; the other would present higher (although still very remote) risk of a catastrophic outcome. As Tim says, to do the sums (and of course, there were other factors involved, like construction quality, risk of delay, etc) we had to put a value on the lives at risk.
Our executive has strongly resisted that approach - no one wants to be the author (or recipient) of 'the Ford Pinto memo' - but understood that we had to use something. They agreed to $10M (CAD) on the basis that the US EPA uses a value of $7M (or did at the time), and the US Dept of Transportation values a life at $8M (ditto), and $10M CAD was in that range (we couldn't find any Canadian publications - no idea why not). They did this even though the EPA and DoT both admit that they inflate the value of a life to justify increasing their regulatory reach, not to attain the socially-optimum outcome.
Surely some lives are worth more than others. Is a scientist working on developing life saving treatments equal in their worth to society as that of a murderer? Of course they are not. Which isn't to suggest that treatments be withheld or granted on the basis of worth. A collective approach is illogical but has an advantage greater than logic, it avoids the truly terrifying possibility of a Chinese style social credit scheme being the determining factor in who gets what support and which treatment. Never-the-less some people's lives are worth a great deal more than 1.8 million and a good number are worth significantly less.
In the good old days, the problem of low-value lives was handled by the death penalty.
Though the Americans still seem to have plenty of ratbags despite having retained it.
@ Boganboy
pendantically they were high negative values