When you try to mix human morbidity and mortality with market economics, basically you just piss everyone off. I mean, if I want to be crass about it, I could ask you who's life you value more - your father or your son, your aunt or your niece? And how much money are you willing to pay to extend the life of any of these people. We are hesitant to ask these questions for good reason.
The NHS in the UK - whose low, low costs certain US political activists point to as proof public healthcare is not just better but cheaper - literally does this. There's a fixed amount they're willing to spend per expected year of healthy life saved, adjusted for quality of life during that time, and treatments that are expected to cost more than that aren't available on the NHS. This is surprisingly uncontroversial, possibly because the NHS as an institution is basically beyond questioning. However, the same reasoning was not applied in the UK over Covid; the mainstream consensus was that anyone who prioritised the economy over stopping Covid was an evil murderer, and every single Covid death that happened was caused by our government not stopping it.
Yes, any public healthcare system will obviously make these calculations. Private insurers also do this in the US however they are more limited in what they can do to control costs.
I suspect that because there is one universal system, people accept that they're all more or less bound by the same rules (I'm aware there is private care in the UK too), whereas in the US it can be pretty arbitrary as to who gets healthcare; obviously money helps but there are multiple single payer systems (lol) that some belong to also.
> the mainstream consensus was that anyone who prioritised the economy over stopping Covid was an evil murderer, and every single Covid death that happened was caused by our government not stopping it.
This poses a false dichotomy between strict lockdowns and economic growth. The UK had both bad death rates and a bad economic hit compared to other countries in europe. I think the conservatives tried to balance the short-term interests of the economy against case numbers, and ultimately ended up muddling about in the middle, which was why they ended up with the worst of both worlds.
The countries that did really well in the pandemic (east asian countries) typically went for what seemed like drastic measures in the early stages. As time went on, it's become apparent that their liberties, economies, and also case numbers were all far less impacted by the pandemic compared to western countries that had to go into emergency lockdowns as case counts soared out of control. Even in the limited context of western europe, one of the reasons why the UK had so many days in lockdown (more than France or Germany, often with more stringent rules, iirc) was because they prevaricated so much about bringing in lockdowns, then had to make them much tighter to compensate.
> The countries that did really well in the pandemic (east asian countries) typically went for what seemed like drastic measures in the early stages. As time went on, it's become apparent that their liberties, economies, and also case numbers were all far less impacted by the pandemic compared to western countries that had to go into emergency lockdowns as case counts soared out of control. Even in the limited context of western europe, one of the reasons why the UK had so many days in lockdown (more than France or Germany, often with more stringent rules, iirc) was because they prevaricated so much about bringing in lockdowns, then had to make them much tighter to compensate.
This raises an interesting point I hadn't considered; assuming that there will still be some transfer of the virus during lockdown (although presumably more limited) due to people still needing to go out to get food (or have food delivered, which still requires someone else going out), getting medical care, etc., the amount of time needed to stay in lockdown to lower the number of cases below a given threshold seem like it would grow in relation to the number of cases at the time lockdown was initiated. To make up some numbers, if the goal is to get the number of cases below 1% of the population, it's much easier to get there if you start the lockdown with only 2% of the country infected versus 5%. I don't have anywhere near the expertise to do even the most naive of calculations of how many extra days that would translate into in the real world, but given that I imagine the virus spreads faster than it goes away, it sounds like delaying by a certain amount of time would lead to _more_ than that amount of time needed to stay in lockdown. I wonder if the US had gone into lockdown at the beginning of March or even earlier, then the lockdown might have been shortened by months.
I imagine 'reluctant lockdowns' also create unclear messaging, so the general public is less likely to know or follow lockdown rules, making them less effective.
As I understand it, lockdowns were generally put in place to stop the hospital system from collapsing under the case load - so I imagine the higher the case count (which typically increases during the first weeks of the lockdown due to lead time) the more time you'd need to resupply, reorganize, process the patients coming through the system, etc.
You can't seriously claim that countries which imposed serious, long-lasting restrictions on the basic human right of freedom of assembly did "really well" in the pandemic. That's revisionist history.
Saving lives is not a valid justification. If you think it is, then why not impose a permanent police state? We could probably save some lives by giving police the power to search anywhere without a warrant.
That's the point. If you consider hours spent in lockdown per-capita, even a country like China, an authoritarian police state, did less harm to the liberties of their citizens than countries like the UK, France or Germany with their pandemic response.
That's without bring up countries like Japan, South Korea, or Australia, all of which are liberal democracies.
Well now you're just making things up. UK, France, and Germany did harm to civil liberties but nowhere near as bad as China. They still have entire cities under strict lockdowns right now!
I didn't downvote, but the UK was middle of the pack amongst European countries in terms of Covid deaths and economic damage. It's just our media focused on anything that'd make us look worse, like comparing total deaths without adjusting for population size or cherry-picking specific time periods to yell about. Also, pretty much the whole of Europe pursued very similar policies so that comparison isn't going to tell you much anyway.
>I mean, if I want to be crass about it, I could ask you who's life you value more - your father or your son, your aunt or your niece?
That's an incredibly easy one, if I had kids it would be my kids over my parents, and I'm certain my parents would agree and be willing to sacrifice themselves to save their grandkids if it truly came to that. The fact that this apparently isn't the default moral calculus for most people (as shown by the pandemic response) is deeply troubling to me.
Also an extremely easy answer for me to choose the future over the past. There was no reason my grandpa should have been getting dialysis paid for by taxpayers at the age of 93. For years. Give him access to assisted suicide and invest that money into the nation’s children.
And while it is probably easier to talk the talk than walk the walk, I do not want a dime spent on me once I am chronically unable to do simple tasks myself. If I need 24/7 care, then I like to think I will opt to take myself out.
So your grandfather lived for years after the age of 93 with the help of basic, modern medicine. Yet you feel that his medical care was a significant share of society's resources. Dialysis costs between $30K and $90K per year (in the US) depending on type of treatment.
In 2019, the Federal budget outlays were $4.4 Trillion dollars. State expenditures were another $2.3T. Total US wealth was roughly $96T.
I think we can afford to give dialysis to anyone who needs it.
It's part of the societal contract, though: Why would I rip myself a new one for a country that hands out suicide pills or lets me die in agony because some kid on the other side of the country doesn't get free healthy food from their school, if the resources for universal healthcare are there, but are not distributed equally?
Old people vote. Kids by definition don't (and parents of kids that can't afford healthcare are also less likely to vote).
See this is where the hypotheticals go. Let's say your grandpa doesn't want to do the assisted suicide thing. Are you willing to "withdraw care" (the medical term for when doctors kill people on purpose) or even take more active measures? I know the arithmetic is pretty obvious but as you say walking the walk is something different entirely.
If the question is would I want a significant share of society’s resources to not go towards extending the life of a 93 year old, then my answer is no.
Of course, I would not want society to force anyone to accept assisted suicide (which would not really be suicide).
Ok, what if we tell the grandparent that we'll take half of their expected costs for care and give that to their grandchildren's college funds if they go through with the suicide? Is that an acceptable compromise or horrible dystopian bargain? Basically it's the trolley problem in that there are endless hypotheticals you can construct to determine your values, but as I said it can get pretty distasteful.
I do not think it would be useful for a society to specifically allocate the resources saved by not extending a 90 year old’s life specifically to their grandkids.
Society already triages resources for various populations. It is not like the government throws unlimited money at old people to get all the gold plated healthcare they need. It is allocated roughly based on how rich you are, with poor people getting less care via reduced Medicaid reimbursements and a million other ways to price discriminate recipients.
If anything, this opaque maze of who does and does not get a share of society’s resources is worse than a transparent policy.
Yea, but that isn’t rhe choice. It’s about quality of life, not life itself. Ask your teenager if they are willing to let grandma choke to death or spend two years with just family, and rhe answer will be different.
As the song goes, "if you choose not to decide, you still have made a choice". The fact that we've steadfastly refused to verbalize the implicit choices that have been made doesn't change anything about what was actually done.
The government already has these answers. There is a value assigned to life per year it could be extended. For some reason that was thrown out the window for covid.
tl;dr, if memory serves correctly, it's about 60k GBP per full health year left. So 2 years at 50% health is 1 full health year, with formulas to tell you what 50% health means exactly.
I don't know of other countries that make this calculation so explicitly.
