How Can Life Savings
Be Estimated
Daily Observer
According to the Department of Health Education and Welfare (HEW, now
The text also states that: low-income
families and racial minorities (Swedes? Finns? Jews?) receive a greater
proportion of their care through hospital outpatient facilities than
physicians’ offices.
HMO subscribers spent fewer days in hospitals but more time in doctors’
offices.
The cancer death rate decreased for those under 45 from 21 to 14 per
100,000 between 1950 and 1976.
Life expectancy increased 2 years and infant mortality decreased about
one percent since 1970.
So the gist of the 500 page report is that we should spend less on
health, but the health of the nation is not improving. HEW wants more
productivity from health “providers”. A health “provider” is a doctor or nurse
or the laundry-man that services the hospital. But let’s just talk about
doctors and nurses, those in whose hands the life of the patients rests. That
life is the measure of increased productivity. For the critically ill many
man-hours devoted by doctors and nurses may be applied to the saving of only
one life. Be it the life of a derelict or a criminal, saving that life is a
product of medical care.
Thousands of man-hours devoted to saving one life is not really
efficient as measured in balance sheets or cost accounting manuals. Spending
hundreds of thousands of dollars to rescue a man lost at sea is also cost-inefficient.
But there are certain situations in which life is considered so sacred that no
effort is too great o too costly.
We all know that our salvation ultimately is through decency, sharing,
volunteerism and self-sacrifice. And we all know that these values cannot be
measured or economically assessed. Yet the woods are filled with social
scientists writing learned papers about cost-risk benefits of this procedure or
that, and value-cost ratios and other nonsense which is diabolical only because
there are those in government who believe that the mystery of life can be
dovetailed into a national budget.
One can only say to HEW that you are trying to measure the
immeasurable. Each of us has a value system which individualizes life in
general and life in particular. A nation has the right to add up the cost of
saving life (medical care, health care, environmental care) but has not the
right to determine the cost of life itself. We can measure the cost of
destroying life (war, auto deaths) and even the cost of saving life measured
against the money the saved life will cost us in the future, but we can’t
measure that worth of that ephemeral substance, life itself. We must treat life
as our national resource. It is fragile, and must be treated gently and tenderly,
but not fiscally.
Somehow or other the partnership of the people, its health
professionals, government and other forces have evolved a system of top quality
medical care. The only threat to that system comes from those who wish to
curtail it, to ration the high quality of health care available.
Thus when it is stated that we need increased productivity in health it
con only mean that we want more services produced by fewer people, and that
just isn’t the way the practice of medicine works. Automation in a factory
saves labor. Automation in medicine increases the concentration of goods and
care applied to a single patient; increases the number of people who must watch
over the machines; encourages survival (and
added cost) of patients that otherwise wold have died; and thus drives up labor
costs and by herd measures decreases productivity. Thus the only way to
increase productivity in this setting is to ration care. And that is the
message coming out of