Colignatus, Thomas (2020): On the value of life.
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Abstract
The national budget affects life and death via its allocations in areas such as traffic safety, flood control, public health and the like. When the cost-effectiveness of an intervention is evaluated, common effect measures are the number of lives extended (saved) and the expected life-years gained. The latter are usually adjusted for quality of life, giving QALYs, and discounted. In models that support decision making on the national aggregates, the subjects can be reduced to representative agents that are scored only on these dimensions. The lives extended measure is impartial to age and sex. The life-years measures however are biased in age and sex, since young people have a higher life expectancy than the old and women have a higher life expectancy than men, and policy advice might reflect that bias. It seems advisable to devise a measure that is more impartial and fair with respect to the age groups and the sexes. An alternative is to value a single life at 100%, and to measure the life-years gain with respect to that 100%. In addition, rather than fine-tune policy with interpersonal utility comparisons, one could choose a utility norm for the representative agent. A possible norm for time preference and diminishing marginal utility of life is the square root. The square root is easier to communicate than logarithmic utility or some rate of discount, but has comparable effect. A life of 100 years then has value 10, a life of 25 years has value 5, so that by age 25 half of life is passed. The considerations of both 100% range and square root utility lead to the following age & sex adjusted gain measure. When a person has age a, experiences an event (accident, disease) with a life expectancy of d years, but might have an intervention such that the life expectancy could become e, then the current effect measures are the single life saved and the absolute life-years gain x = e - d, but the proposed compromise gain measure is g[x | a, d] = Sqrt[x] / Sqrt[a + d + x]. The square root gives the utility of the representative agent, g gives the impact for interpersonal comparison, and aggregate utility is found by summing the gi over the individuals i. For example, saving (from acute death, d = 0) a baby (a = 0) has the same value, namely 1, whether it is a boy (life expectancy at birth, x = 75.94) or girl (x = 80.71) (data Statistics Netherlands 2002). As another example, let the unit share s = x / (a + e) be 25% for one person and 81% for another person so that the last person would weigh more than three times as much in this respect. For above gain measure, g = Sqrt[s] and the weight ratio becomes 50% / 90%, so that the last person now weighs less than half so that there is more equality. The paper compares various gain measures within the context of social welfare maximization. The update in 2020 has a more explicit discussion of Fair Innings (FI) and Proportional Shortfall (PS), and it is shown in a better manner that the UnitSqrt can be an acceptable compromise.
Item Type: | MPRA Paper |
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Original Title: | On the value of life |
Language: | English |
Keywords: | social welfare, decision making, risk, health, quality of life, cost-effectiveness, discounting, fair innings, proportional shortfall, unitsqrt |
Subjects: | D - Microeconomics > D6 - Welfare Economics > D63 - Equity, Justice, Inequality, and Other Normative Criteria and Measurement H - Public Economics > H5 - National Government Expenditures and Related Policies > H51 - Government Expenditures and Health I - Health, Education, and Welfare > I1 - Health > I13 - Health Insurance, Public and Private I - Health, Education, and Welfare > I1 - Health > I14 - Health and Inequality J - Labor and Demographic Economics > J1 - Demographic Economics > J17 - Value of Life ; Forgone Income |
Item ID: | 102535 |
Depositing User: | Thomas Colignatus |
Date Deposited: | 26 Aug 2020 11:15 |
Last Modified: | 26 Aug 2020 11:15 |
References: | Colignatus is the name in science for Thomas Cool, econometrician (Groningen 1982) and teacher of mathematics (Leiden 2008) M.E. van den Akker-Van Marle, M. van Ballegooijen, G.J. van Oortmarssen, R. Boer, J.D.F. Habbema (2002), "Cost-effectiveness of cervical cancer screening: comparison of screening policies", Journal of the National Cancer Institute, 94:193-204 Barten, A. (1977), "The systems of consumer demand functions approach: A review", Econometrica, Vol 45, No 1 Bleichrodt, H., and M. Johannesson (1997), "Standard gamble, time trade-off and rating scale: experimental results on the ranking properties of QALYs", J. of Health Economics 16:155-175 Bodie, Z. and R. Merton (2000), "Finance", Prentice Hall Cairns, J.A. and M.J. van der Pol (1997), "Saving future lives. A comparison of three discounting models", Health Economics 6:341-350 Chapman, G.B. (2002), "Your money or your health: Time preference and trading money for health", Health Economics 401-416 Cohen B. J. (2003) , "Discounting in cost-utility analysis of healthcare interventions: reassessing current practice", Pharmacoeconomics. 2003,21(2):75-87 Cool, Th. (2001a, 2020), "The Economics Pack. Applications of Mathematica", Thomas Cool Consultancy & Econometrics, http://thomascool.eu/TheEconomicsPack/index.html. The software has been updated but the 2001a User Guide is “as is”. Colignatus, Th. (2001b, 2014), "Voting Theory for Democracy. Using The Economics Pack Applications of Mathematica for Direct Single Seat Elections", Thomas Cool Consultancy & Econometrics, http://thomascool.eu/Papers/VTFD/Index.html Colignatus, Th. (2003), "On the value of life”, working paper, https://ideas.repec.org/p/wpa/wuwppe/0310003.html Colignatus, Th. (2020a), “Covid-19 and the value of life”, https://boycottholland.wordpress.com/2020/03/31/covid-19-and-the-value-of-life/ Colignatus, Th. (2020b), “Redesign of the didactics of S(E)IR(D) -> SI(EY)A(CD) models of infectious epidemics”, https://zenodo.org/record/3894161 Ferrer Carbonell, A. (2003), "Quantitative analysis of well-being with economic applications", (17/01/03), Thesis 295, Tinbergen Institute, www.tinbergen.nl Gold, M., J. Siegel, L. Russell, M. Weinstein (1996), "Cost-effectiveness in health and medicine", Oxford Gold, Marthe, and David Stevenson, Dennis Fryback (2002), “HALYs and QALYs and DALYs, Oh My: Similarities and Differences in Summary Measures of Population Health”, Annu. Rev. Public Health 2002. 23:115–34 Grossman, M. (2000), "The human capital model", in A.J. Culyer and J.P. Newhouse, "Handbook of health economics", Volume 1A:347-408 Gyrd-Hansen, D. and J. Sogaard (1998), "Discounting life-years: Whither time preference ?", Health Economics 7:121-127 Hueting, R. (1991), "The use of the discount rate in cost-benefit analysis for different uses of a humid tropical forest area", Ecological Economics, 3, p43-57 Hueting, R. (1992), contribution in the discussion in "Committee of international development institutions on the environment (cidie): workshop on environmental and natural resource accounting, Summary Record, Nairobi, 24-26 February 1992", Environmental Economics Series Paper No. 3, United Nations Environment Programme (UNEP), see http://www.unep.org/unep/products/eeu/ecoserie/ecos3/ecos38.htm Hueting, R. and B. de Boer (2019), “National Accounts and environmentally Sustainable National Income”, Eburon Academic Publishers and University of Chicago Press, http://www.sni-hueting.info/EN/NA-eSNI/index.html Johannesson, M. (1992), "On the discounting of gained life-years in cost-effectiveness analysis", International Journal of Technology Asessment in Health Care, *:2, 359-364 Johannesson, M., J. Pliskin, M. Weinstein (1994), "A note on QALY's, time tradeoff, and discounting", Med. Decision Making 14:188-193 Jonkman, S.N., P.H.A.J.M. van Gelder, J.K. Vrijling (2003), "An overview of quantitative risk measures for loss of life and economic damage", Journal of Hazardous Materials A99, 1-30 Kahneman D., A.Tversky, P. Slovic (eds) (1982), "Judgment under uncertainty: Heuristics and biases", CUP Lipscomb, J., M.C. Weinstein, G.W. Torrance (1996), "Time preference", pp 214-246, in M.R. Gold, J.E. Siegel, L.B. Russell, M.C. Weinstein (eds) (1996), "Cost-effectiveness in health and medicine", Oxford Luenberger, D. (1998), "Investment Science", Oxford MacKeigan L.D., A. Gafni, B.J. O'Brien (2002), "Double discounting of QALYs", Health Econ. 2003 Feb,12(2):165-9. Manton, K, and E. Stallard (1988), "Chronic disease modelling", Charles Griffin & Co (UK), Oxford (USA) Mueller, D. (1989), "Public Choice II", Cambridge Murray CJ (1994), “Quantifying the burden of disease: the technical basis for disability-adjusted life years”, Bull World Health Organ. 1994,72(3):429-445. Nicolet, Anna, and Antoinette D I van Asselt, Karin M Vermeulen, Paul F M Krabbe (2020), “Value judgment of new medical treatments: Societal and patient perspectives to inform priority setting in The Netherlands”, PLoS One, 2020 Jul 9,15(7):e0235666. doi: 10.1371/journal.pone.0235666. Nord, E. (1992), "An alternative to QALYs: the saved young life equivalent (SAVE)", BMJ 305:875-7 Paulden, M. and Culyer, A.J. (2010), “Does cost-effectiveness analysis discriminate against patients with short life expectancy? : Matters of logic and matters of context. Working Paper”, CHE Research Paper . Centre for Health Economics, University of York , York, UK. Reckers-Droog, Vivian, and Job van Exel, Werner Brouwer (2019), “Equity Weights for Priority Setting in Healthcare: Severity, Age, or Both?”, Value in Health, Volume 22, Issue 12, P1441-1449, December 01, 2019, https://doi.org/10.1016/j.jval.2019.07.012 RIVM (2003), "Nuchter omgaan met risico's", RIVM rapport 251701047, Bilthoven, The Netherlands Rosenberg, L. (2002), "Exceptional economic returns on investments in medical research", speech for the Australian Society for Medical Research, at http://www.mja.com.au/public/issues/177_07_071002/ros10377_fm.html Rutten-van Molken, M., J. van Busschbach, F. Rutten (eds) (+/- 1999), "Van kosten tot effecten. Een handleiding vor evaluatiestudies in de gezondheidszorg", Elsevier Gezondheidszorg Wetering, EJ van de, and Stolk EA, van Exel NJ, Brouwer WB (2013), “Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall”, Eur J Health Econ. 2013,14(1):107-115. doi:10.1007/s10198-011-0346-7 Williams, A. (1997), “Intergenerational equity: an exploration of the ‘Fair Innings’ argument”, Health Economics 6, 117–32 Zorginstituut Nederland (ZIN) (2018a), “Ziektelast in de praktijk. De theorie en praktijk van het berekenen van ziektelast bij pakketbeoordelingen, https://www.zorginstituutnederland.nl/publicaties/rapport/2018/05/07/ziektelast-in-de-praktijk Zorginstituut Nederland (ZIN) (2018b), “Bijlage bij rapport ‘Ziektelast in de praktijk’: Samenvatting reacties externe partijen op concept rapport”, https://www.zorginstituutnederland.nl/publicaties/rapport/2018/05/07/ziektelast-in-de-praktijk |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/102535 |