So much of medicine is probabilistic. If you wanted to really cut costs, you’d take a coldly statistical view of the whole thing, with those who ended up on the wrong side of the numbers regrettable sacrifices. As a society, we’re not ready or willing to do that — and rightly so. But this is the essential conflict: politicians and hospital administrators look at the global budget, while doctors and patients look at the individual’s health. The latter militates for constantly seeking the lowest possible error, the former for going with the statistics and saving money where you can.
He should read the chapter, “Dollars and Decisions,” in Crisis of Abundance.
So, if there were a procedure that cost $10 million, and it could reduce the probability that Ezra would get cancer by one ten thousandth of one percent, would Ezra spend that money? Or would he say that “society” is obligated to spend that money?
I am sorry, but there really are cost-benefit trade-offs in medical care. You can hide your head in the sand and pretend that they do not exist, but in the end they are going to have to be made somehow.
