This argument is a moral event horizon and the problem should be resolved by other means.
Once one decides to ration healthcare based on estimated remaining QALY, the same logic says we shouldn’t subsidize, e.g., healthcare for people who suffer from cystic fibrosis, or HIV, or aggressive cancers, or. . .
Or if you’d rather, there are millions of children without healthcare in the United states. Would you forgo your access to healthcare for them?
> $365 billion of it went for end-of-life care. [1]
That’s all? Musk alone is worth twice that, and who knows how many QALYs he has left but it can’t be that many. He seems pretty miserable most of the time.
> Once one decides to ration healthcare based on estimated remaining QALY, the same logic says we shouldn’t subsidize, e.g., healthcare for people who suffer from cystic fibrosis, or HIV, or aggressive cancers, or. . .
Those are risks. Risks are insurable. However, death is a certainty. It is very reasonable to discuss what we believe society should subsidize for end-of-life care as it will impact everybody, myself included.
> Or if you’d rather, there are millions of children without healthcare in the United states. Would you forgo your access to healthcare for them?
I don't see what pediatrics has to do with end-of-life care in the context we are discussing (Medicare), but I would much rather subsidize pediatrics than elder care.
> That’s all? Musk alone is worth twice that, and who knows how many QALYs he has left but it can’t be that many. He seems pretty miserable most of the time.
Musk is worth 244B [1]. Even if we could tax wealth 100% into cash, we would fully exhaust the wealth of the 25 wealthiest American families within 7 years. These expenses, however, will likely continue for the next ~20 years. We need to discuss benefit cuts or tax hikes on the American population writ large.
> Once one decides to ration healthcare based on estimated remaining QALY, the same logic says we shouldn’t subsidize, e.g., healthcare for people who suffer from cystic fibrosis, or HIV, or aggressive cancers, or. . .
Not everybody gets cystic fibrosis, or HIV, or aggressive cancers. These are a risk. That is fundamentally an insurable risk. However, we will all die. No matter how much money is spent, death comes for us all in old age. Discussing how much is an appropriate cost for end-of-life care when aged is very much a societal question.
> Or if you’d rather, there are millions of children without healthcare in the United states. Would you forgo your access to healthcare for them?
This remains a question, even in Europe. See [1] for a discussion as early as 2000 regarding rationing in the NHS.
> That’s all? Musk alone is worth twice that, and who knows how many QALYs he has left but it can’t be that many. He seems pretty miserable most of the time.
That is a cost each year, and Musk is currently at 244B [2]. We have roughly 20 years of this level of spending or greater. Even if we assumed we could tax Musk 100% (which isn't practically possible because who liquidates his positions), where do you propose to acquire that level of ongoing cashflow? Within 7 years, we would fully exhaust the wealth of the 25 wealthiest American families, even at 100% tax rate. End-of-life care is mind-bogglingly expensive for the United States economy. This either needs to be a tax hike which realistically will it everybody or a benefits cut.
This argument is a moral event horizon and the problem should be resolved by other means.
Once one decides to ration healthcare based on estimated remaining QALY, the same logic says we shouldn’t subsidize, e.g., healthcare for people who suffer from cystic fibrosis, or HIV, or aggressive cancers, or. . .
Or if you’d rather, there are millions of children without healthcare in the United states. Would you forgo your access to healthcare for them?
> $365 billion of it went for end-of-life care. [1]
That’s all? Musk alone is worth twice that, and who knows how many QALYs he has left but it can’t be that many. He seems pretty miserable most of the time.