What's Life Worth?
What is the economic value of life and health?
Pinning Down the Money Value of a Person’s Life, by Alex Berenson, NY Times: How much is your life worth? How about a year of life? How much is your vision worth? What about being pain-free? Able to walk unassisted? ... Unanswerable questions all. Or maybe not.
Economists ... are trying to answer ...[a] difficult question... — the price of health. The exercise has enormous real-world implications ... as health care technology becomes more expensive and health care spending becomes a bigger burden on companies, taxpayers and patients. The price of health is part of the calculus in determining whether a new medicine or treatment is worth the cost.
While making such determinations may seem unsavory, ... “The reality is we have to make these comparisons, and we either do them implicitly or explicitly,” said Dana Goldman, director of health economics at the RAND Corporation...
To make the process more explicit, economists want to compare the cost-effectiveness of different treatments in a single measurement, one that doctors and policy makers will trust enough to use.
So, how much is your life worth? You may think the answer is infinity, that no amount of money could compensate you for the loss of your life.
But people do put a price tag on their existence. Workers accept riskier jobs for higher pay, for example. And the rich tend to think their lives are worth more than poor people’s.
Studies of real-world situations produce relatively consistent results, suggesting that average Americans value a year of life at $100,000 to $300,000, said Peter J. Neumann ... at Tufts...
So a year of life is worth at least $100,000. But that figure only begins to answer the question of what health is worth. ... [M]ost medical care has a ... modest goal: back surgery is performed to relieve the pain..., and drugs are given to lift depression or end an asthma attack more quickly. Those treatments are meant to improve — not necessarily to save — lives. Can their value actually be compared?
Yes, say health care economists, who have created the “quality-adjusted life year.” The idea is that a year in perfect health is worth more — both to the patient and to society — than a year spent in pain, depression or a wheelchair. ...
Once they know how to rank the “costs” of various diseases, economists can determine the worthiness of a particular treatment. To do so, they use the “quality-adjusted life-year,” or QALY.
The idea of QALY is to put a value on treatments that may not save lives but improve them. For example, if a blind person’s quality of life is “worth” 0.75 points per year, a treatment that would restore him to perfect vision — and raise his quality of life to 1 per year — is worth 0.25 per year of life. If the person lived another 30 years, the treatment would be worth 7.5 QALYs, or 30 times 0.25. ...
In theory, QALYs offer a single figure that can measure value of every treatment, from drugs to surgeries to preventive care, like vaccines and cancer screenings.
Once they know how many QALYs a treatment is worth, economists can figure out its cost per QALY — the broadest measure of the cost-effectiveness of health care. ...
“When we go and buy health care, we have no idea how much health we’re going to get for a dollar,” said Dr. Goldman of RAND. “And if we had this just right, we’d know how much health we’re going to get. You’re not really interested in buying health care — you’re interested in buying health. That’s what this is trying to do.”
Still, Dr. Goldman said that using QALYs would work only if policy makers use them as guides and do not make decisions on the basis of efficiency. In some cases, like new cancer treatments, Americans simply do not want to consider cost, he said.
“They’re incredibly expensive and don’t work so well,” Dr. Goldman said of the cancer drugs. “But Americans have said they want these things. We like to do things for patients that are very vulnerable.”
[Update: I just remembered that I had a related post ready a few days ago, but never actually posted it - here's the original: Putting a Price Tag on Death, Scientific American - and a shortened version is in the post is below.]
The best general study I know of these issues is a a meta-analysis by Kip Viscusi and Joseph Aldy from The Journal of Risk and Uncertainty. Here are a few selections from the paper (which seems to steer away from the "single-measure" approach discussed in the NY Times article):
Introduction Individuals make decisions everyday that reflect how they value health and mortality risks, such as driving an automobile, smoking a cigarette, and eating a medium-rare hamburger. Many of these choices involve market decisions, such as the purchase of a hazardous product or working on a risky job. Because increases in health risks are undesirable, there must be some other aspect of the activity that makes it attractive. Using evidence on market choices that involve implicit tradeoffs between risk and money, economists have developed estimates of the value of a statistical life (VSL). This article provides a comprehensive review and evaluation of the dozens of such studies throughout the world that have been based on market decisions.
These VSL estimates in turn provide governments with a reference point for assessing the benefits of risk reduction efforts. The long history of government risk policies ranges from the draining of swamps near ancient Rome to suppress malaria to the limits on air pollution in developed countries over the past 30 years (McNeill, 1976; OECD, 2001). All such policy choices ultimately involve a balancing of additional risk reduction and incremental costs.
The proper value of the risk reduction benefits for government policy is society’s willingness to pay for the benefits. In the case of mortality risk reduction, the benefit is the value of the reduced probability of death that is experienced by the affected population, not the value of the lives that have been saved ex post. The economic literature has focused on willingness-to-pay (willingness-to-accept) measures of mortality risk since Schelling’s (1968) discussion of the economics of life saving.
Most of this literature has concentrated on valuing mortality risk by estimating compensating differentials for on-the-job risk exposure in labor markets. ... In addition, economists have also investigated price-risk (price-safety) tradeoffs in product markets, such as for automobiles and fire alarms.
Use of the economic research on the value of mortality and injury risks in government policy evaluation has been a key benefit component of policy evaluations for a wide range of health, safety, and environmental policies. The policy use of risk valuations, however, has raised new questions about the appropriateness of these applications. How should policymakers reconcile the broad range of VSL estimates in the literature? Should the value of a statistical life vary by income? Should the VSL vary by the age distribution of the affected population? What other factors may influence the transfer of mortality risk valuation estimates from journal articles to policy evaluation in different contexts?
We begin our assessment of this literature with an overview of the hedonic wage methodology... Although there continue to be controversies regarding how best to isolate statistically the risk-money tradeoffs, the methodologies used in the various studies typically follow a common strategy of estimating the locus of market equilibria regarding money-risk tradeoffs...
Section 2 examines the extensive literature based on estimates using U.S. labor market data, which typically show a VSL in the range of $4 million to $9 million. These values are similar to those generated by U.S. product market and housing market studies... A parallel literature ... examines the implicit value of the risk of nonfatal injuries. These nonfatal risks are of interest in their own right and as a control for hazards other than mortality risks that could influence the VSL estimates.
Researchers subsequently have extended such analyses to other countries. ...[T]he general order of magnitude of these foreign VSL estimates tends to be similar to that in the United States. International estimates tend to be a bit lower than in the United States, as one would expect given the positive income elasticity with respect to the value of risks to one’s life.
A potentially fundamental concern with respect to use of VSL estimates in different contexts is how these values vary with income. ... Our meta-analyses of VSL estimates throughout the world ... imply point estimates of the income elasticity in the range of 0.5 to 0.6. ... Heterogeneity in VSL estimates based on union status ... and age ... indicate that the VSL not only varies by income but also across these important labor market dimensions. The existence of such heterogeneity provides a cautionary note for policy. While policymakers have relied on VSL estimates to an increasing degree in their benefit assessments, ... matching these values to the pertinent population at risk is often problematic, particularly for people at the extreme ends of the age distribution.
1. Estimating the value of a statistical life from labor markets ...
2. The value of a statistical life based on U.S. labor market studies ...
3. Evidence of the value of a statistical life from U.S. housing and product markets ...
4. The value of a statistical life based on non-U.S. labor market studies ...
5. The implicit value of a statistical injury: U.S. and international estimates Complementing the research on the returns to bearing fatal risks in the workplace, a significant number of studies have evaluated the risk premium associated with bearing nonfatal job risks. The hedonic labor market studies of nonfatal risk employ the same econometric approach as used for mortality risk. As discussed above, some studies that attempt to estimate jointly the effects of fatal and nonfatal risks on workers’ wages do not find significant effects of risk on wages for at least one of the risk measures. Fatal risk is highly correlated with nonfatal risk, so joint estimation may result in large standard errors due to collinearity...
31 studies from the U.S. labor market ... and 8 studies of labor markets outside of the United States ... have found statistically significant influences of nonfatal job risk on wages. ...
These value of statistical injury studies yield a wide range of estimates, reflecting both the differences in the risk measures used as well as whether mortality risk is included in the results. While several studies have very high values of injury, ... most studies have estimates in the range of $20,000–$70,000 per injury. ...
6. The effects of income on the value of a statistical life ...
7. The effects of union affiliation on the value of a statistical life ...
8. The effects of age on the value of a statistical life ...
9. The application of the value of a statistical life to public policy decisions ...
10. Conclusion For nearly thirty years, economists have attempted to infer individuals’ preferences over mortality and morbidity risk and income in labor and product markets. The substantial literature that has developed over that time has confirmed Adam Smith’s intuition about compensating differentials for occupational hazards in a significant and growing number of countries. In addition to evaluating various international labor markets, the literature has expanded to address a variety of econometric issues, morbidity risk premiums, and factors influencing mortality risk premiums such as union affiliation and age.
While the tradeoff estimates may vary significantly across studies, the value of a statistical life for prime-aged workers has a median value of about $7 million in the United States. Our meta-analysis characterizes some of the uncertainty in estimates of the value of a statistical life, and finds that the 95 percent confidence interval upper bounds can exceed the lower bounds by a factor of two or more. Other developed countries appear to have comparable VSLs, although some studies of the United Kingdom have found much larger risk premiums. Consistent with the fact that safety is a normal good, developing countries’ labor markets also have significant, but smaller, values of statistical life. Overall, our point estimates of the income elasticity of the value of a statistical life range from 0.5 to 0.6. Union members in U.S. labor markets appear to enjoy greater risk premiums than non-members, while the evidence in other developed countries is rather mixed. The theoretical and empirical literature indicates that the value of a statistical life decreases with age.
The estimates of the value of a statistical life can continue to serve as a critical input in benefit-cost analyses of proposed regulations and policies. Refining VSLs for the specific characteristics of the affected population at risk remains an important priority for the research community and the government agencies conducting these economic analyses. Improving the application of VSLs in this way can result in more informed government interventions to address market failures related to environmental, health, and safety mortality risks.
Appendix ...
[Here's the post related to the update above]:
Putting a Price on Grief
A new way to value loss of life:
Putting a Price Tag on Death, Scientific American: Economists say balancing the pain of loss with the right amount of money could lead to more rational court awards
If money could buy happiness, how much would it take to bring it back after the death of a partner, child or spouse? Most of us would be loathe to assign such a value, if not offended by the question, but two economists have attached such dollar values to deaths by comparing the way that lost loved ones lower scores on happiness surveys with the way that greater incomes boost scores. More than just a gruesome exercise, they say they hope it will provide courts with a way to more fairly award damages.
"It's a very black thing to talk about," says economist Andrew Oswald of the University of Warwick..., but courts regularly award damages to bereaved survivors after the death of a loved one. Such awards, however, are not necessarily based on well considered rules. In the U.K., the 1976 Fatal Accidents Act provides for a lump sum of $20,000 to a surviving spouse or the parents of a minor. Recent U.S. court cases have valued life at as much as $18 million or as little as $10,000, according to a 2005 study.
Looking for a more equitable way to assign damages, Oswald and Nattavudh Powdthavee of the University of London reviewed data collected from 10,000 Britons..., begun in 1991, which records major life events and includes questions designed to gauge overall mental health. They identified the amount of money, on average, that raised a person's mental health score by the same amount that a loved one's death lowered it.
They calculated that it would take $220,000 annually to raise someone's happiness to pre-death levels after a spouse dies, $118,000 for a child, $28,000 for a parent, $16,000 for a friend and only $2,000 for a sibling. Taking into account that some people might be harder hit than others could as much as double those amounts...
Eric Posner, a UC law professor..., says it is too early for courts to adopt Oswald and Powdthavee's method but notes that it may be less arbitrary than the existing way of assigning damages. "The courts ask juries to pick a number and they don't give juries a specific rule or principle for guiding their deliberations," he says. As a result, "it's either nothing or a very high number."
Social psychologist Jonathan Haidt of the University of Virginia says there is "so much more at stake when people suffer loss than simply the hit to their happiness." Actual suffering should factor into damage awards, he says, but so should other things such as feelings of outrage or injustice.
Oswald agrees that more research is needed before the findings should influence policy, but he stands by the concept. "Just because it's hard to value this subtle thing is no reason not to try to do the best in being fair to victim," he says. "We're trying to make it logical instead of random."
Posted by Mark Thoma on Monday, June 11, 2007 at 03:42 PM in Academic Papers, Economics, Methodology
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"The effects of union affiliation on the value of a statistical life ..."
"Union members in U.S. labor markets appear to enjoy greater risk premiums than non-members,"
Hmmm.
I used to be fairly familiar with the derivation and use of these kinds of estimates in a transporation safety context.
There's a critical distinction between the risk of an active agent and the background risk acceptable to a passive principal. The risks that a driver or pilot is willing to undertake are quite dramatically different from the passive background risk passengers are willing to accept; the risk that you will run into a car and the risk that a car will run into you, are perceived differently, and valued differently -- dramatically so. I imagine it is much the same "on the job".
In a transportation context, the temptation to do macabre cost-benefit analyses was fairly strong, but I think we did better looking for the frontier, where anamolous data indicated either that people were badly misperceiving risks, or investments and policy changes were needed to bring a situation up to standard.
It is neither humane nor rationally sensible to seek a static optimum; the operative question is where we should be investing to continue dynamic progress in increased safety or improved quality of life.
I suspect that health care policy could be improved by having better "quality-of-life" outcome data than the "saving lives" paradigm permits.
Posted by: Bruce Wilder | Link to comment | June 11, 2007 at 06:26 PM
Easy answer: As a best estimate, at the moment of death the future value of anyone's life is their present income measured into the future for their actuarial life-span, and corrected for inflation.
The cost of any health care service depends upon the country in which it is conducted. The point is to reduce the cost of such services across the board, not to show how a medicine/medical procedure can be cost-effective, because this latter is, also, country dependent.
So, replacing an American surgeon operating on a patient in America, with a surgeon doing the same surgery remotely employing robotic methods from New Delhi has an altogether different result one from the other.
Psstt ... that is precisely the direction in which the technology is heading. Replacing American surgical expertise with the same qualified expertise from any number of places around the world will reduce substantially American heath care costs.
When comes the day that consulting a GP will incur the same sort of savings? The fact that a GP is a "localized service" renders its dislocation abroad considerably more difficult. But, not impossible.
Posted by: Lafayette | Link to comment | June 11, 2007 at 09:21 PM
Here's something to consider in your calculus of life.
Thirty-seven years ago in April 1970, late on a Saturday night, and prior to Federal emergency medical care legislation, my father was transported to a California hospital. He'd had a massive heart attack.
The attack was at least the third he'd suffered over the course of twelve years. He was denied medical insurance in 1958 after his first one, so you know where this story is going.
The emergency room nurse, ignoring my assurances that the hospital would be paid, refused to treat him as he had no "proof of insurance." By the way, there was no physician on duty, in spite of the fact that the hospital was accredited by the American Hospital Association and an on-duty physician was a requirement for accredidation.
The duty nurse spoke with the physician by telephone. I learned later that, at the time of the telephone call, he was at a party several miles away. At any rate, he instructed her to have my father transported to the county hospital's charity ward, about thirty miles away. The doctor made a business decision based on hospital policy.
I asked the nurse to give me the telephone and I reminded the doctor that the county hospital was at least thirty minutes away and that, if my father died enroute, [DELETION].
The doctor asked me to give the telephone to the nurse, and she instructed him to admit my father immediately and begin a course of treatment. He would be enroute to the hospital.
If you were that doctor, what was my father's life worth to YOU that night? If you used your imagination to formulate the answer, you're probably right.
Postscript: The bill was paid by cashier's check two weeks later on the day of his release. One week after that I received a $4.50 bill for one soft drink, which was not included in the final billing and marked "Past Due." I returned the bill personally to the hospital's controller, who was aware of the situation, and told her, "Go #&$k yourself." My father lived another two years and completed another seven paintings.
Posted by: mp | Link to comment | June 11, 2007 at 11:58 PM
The whole notion of the QALY and trying to find a metric for an impairment vs. a "whole" state seems totally bogus. The example above discusses the value of giving a blind person sight. In one of Oliver Sacks' books, they did that for someone who had been blind all his life. He didn't like seeing and had the operation reversed. I also recall reading of a case of a man who was totally color blind. It turns out that the lack of color vision gave him far greater acuity of distance vision. He similarly was very unhappy with the results of a procedure to give him color vision and had it reversed.
What if someone has a minor impairment, say that restricts one's mobility in a minor way (you can walk a half a mile at a moderate pace without incident, but more will create inflammation). If you are a normal person, that would be a nuisance, but you might not warrant it to be worth the risk and recovery time of an operation. But if you were a serious athlete, you'd have the procedure in a heartbeat. So the value of getting from an "impaired" to an "unimpaired" state is very personal, and therefore awfully difficult to subject to statistical analysis across populations (unless you do a lot of research, and even then, subjective reporting is notoriously unreliable).
Posted by: archer | Link to comment | June 12, 2007 at 12:06 AM
Lafayette...
Lafayette - is that meant to be a serious answer? What about a housewife or a student? The value of someone is purely measured by the income they earn. That is market fundamentalism gone crazy. So when I am about to retire you can kill me without conscience?
Posted by: reason | Link to comment | June 12, 2007 at 12:36 AM
The value of human life can't be measured in terms of money. Each life is worth an infinite amount of money. Unfortunately, there is not an infinite amount of money to work with. We need to figure out how many resources as a nation we can reasonably allocate to health care, and then figure out the most efficient way to utilize the resources.
Help as many people as we can to live long, healthy lives while still leaving enough resources for housing, food, etc... Of course, finite resources means that any practices that inefficiently waste health care resources will kill people. Creating maximum efficiency in health care is literally a matter of life or death for many people. When all the resources are used up, no further health care can be provided.
Posted by: Outside the Box | Link to comment | June 12, 2007 at 01:26 AM
"Creating maximum efficiency in health care is literally a matter of life or death for many people. When all the resources are used up, no further health care can be provided."
Completely meaningless; though of course I have run out of aspirin and wonder whether that last aspirin was the last aspirin in the world. Remind me of all the ways I can over-use even squander health care resources this summer.
Still, we will be directly spending $622 billion on defense in the coming year and I am dreadfully worried about running out of defense resources.
Posted by: anne | Link to comment | June 12, 2007 at 02:09 AM
Notice the nuttiness of Fred Thompson's pitch to conservatives. We need smaller government, lower taxes and a bigger defense budget....
http://www.nytimes.com/2007/06/03/us/politics/03fred.html?ex=1338523200&en=f6039efca3d1fa42&ei=5090&partner=rssuserland&emc=rss
He was short on specifics, offering instead a broad conservative approach toward smaller government, lower taxes and a bigger defense budget....
[We will "use up" resources then for health care while resources for defense do not matter, especially as we are lowering taxes while increasing defense to have a smaller government. Repeat a few times, and it even makes a bizarre sort of sense.]
Posted by: anne | Link to comment | June 12, 2007 at 02:16 AM
Japan is an aging society, far more than we are, and Japan is somehow able to afford health care for all with minimal fuss, while we have been cutting Medicaid assistance for pregnant women in Mississippi, infant mortality rising as a result, and we are supposed to worry about using up resources. Where is my aspirin, Oliver?
Posted by: anne | Link to comment | June 12, 2007 at 02:21 AM
You buying aspirin is actually an example of an efficient market mediated transaction. The final customer bought a product with her own money that she valued from a market provider with competition. If all health care decisions were as market oriented as this one, health care would be much more efficient.
You are certainly correct that every resource wasted on Iraq is a resource that cannot be used to research an inexpensive cure for some dread disease. Wasting tax resources anywhere in the budget ultimately costs lives, as the resources cannot then be used to help people that need it.
Posted by: Outside the Box | Link to comment | June 12, 2007 at 02:25 AM
Japan uses their resources more efficiently than we do. We waste vast health care resources on special interest group pork. That is why we don't have enough resources left to help more people.
Posted by: Outside the Box | Link to comment | June 12, 2007 at 02:30 AM
Nonsense; absolute nonsense. I really must find ways to waste more health care resources, just for spite. We can afford the destruction of Iraq, is that wasteful enough by the way? No; only health care is wasteful. My next paper will be "the final aspirin." Use an aspirin this morning and poorer families in Mississippi must do without.
Posted by: anne | Link to comment | June 12, 2007 at 02:45 AM
Clever response, as far as it goes, actually.
"Your buying aspirin is actually an example of an efficient market mediated transaction. The final customer bought a product with her own money that she valued from a market provider with competition. If all health care decisions were as market oriented as this one, health care would be much more efficient."
We may be arguing similarly, but I am stressing the resources are there in a relative sense while you are stressing increasingly responsible use of resources. Yes; I understand.
Posted by: anne | Link to comment | June 12, 2007 at 02:51 AM
Yes; I understand the concern with mis-pricing and mis-use of health care resources, and even that such resources are finite when alternative needs are considered. But, I wish to emphasize the need to use presently available resources equitably rather than swing to discussions of rationing health care when rationing is not necessary nationally unless our values deem so.
Posted by: anne | Link to comment | June 12, 2007 at 02:57 AM
I don't mean to be rude, but, you know, there are thousands of juries doing *exactly this* every single workday. Legal publishers do gather their verdicts together in reports. It shouldn't be too difficult to generate a value based on actual outcomes.
Posted by: ndd | Link to comment | June 12, 2007 at 04:40 AM
Yes, it is the manner in which the court today accepts reparation in case of incompetence. One may ask for treble damages in some states, but the basis of the calculation is as I have described it.
What is your method?
No, of course not.
But, as I said, an estimation in many instances IS NECESSARY and this is an actuarial means of calculating one. And, it is used widely. (Of course, in the US, punitive damages are what count.) It repairs the damage to those who would have depended upon the person's income by means of its restitution.
Now, if you have another, better one; let's see it.
NB: I remember one case that calculated the services of a housewife by employing the cost of hired help for the services a housewife performed. It comes to a considerable amount of money annually, and the calculation did not include "marital satisfaction".
Posted by: Lafayette | Link to comment | June 12, 2007 at 08:07 AM
I've been through the workers' compensation system in CA and they are way ahead of you folks. They have the value of a finger, an ear, a toe, etc, etc, etc, figured out down to the penny. It's a farce at best, and to many it's a disaster. Retraining monies have been cut drastically. Not only that but you MUST have a lawyer to negotiate the system successfully.
And if you are 'lucky' enough to win an award, you face a lifetime of insurance company fights over who is responsible for a particular treatment i.e. how does counseling relate to your loss of both legs? or why does neck surgery relate to your neck injury?...... everything is a fight.
Expand Medicare to all health care. One payer. Fighting one payer is SO much easier than fighting two.
And I agree, the 'pork' at all levels uses more resources than inappropriate patient/client use.
Posted by: jean | Link to comment | June 12, 2007 at 10:25 AM
The life insurance industry has been studying the value of a human life for over one hundred years. The strategies for these valuations may be as complex as a six page formula or as simple as a multiple of annual income based upon the individual's age. If you are really interested I can refer you to volumes of theories and formulas.
Posted by: little john | Link to comment | June 12, 2007 at 11:50 AM
Of course. What do you expect of private practice system of medical care? It's a business highly prone to litigation - America is proof-positive.
What did you think? That health care insurance would bend over backwards to help the insured? How naive. That is not how you meet your profit targets in the insurance business.
Besides, given the skyrocketing costs, prolonged litigation is the preferred mechanism for cost avoidance - and that does not include medical tort. (This latter is a case particular to the US. Most European courts are (1) not trial by jury in tort cases, so treble damages are not hallucinatory and (2) in a smaller medical profession it is almost impossible to find a doctor who will testify against another doctor.)
Health Care, I never tire of repeating, is NOT A BUSINESS, it is public service. It is an EXPENSIVE public service, but certainly affordable in a country that can spend trillions on a useless war in the Middle East. As for medical tort, set up some binding system of arbitration regulated by law. A good number of lawyers will have to go back to teaching law for a living.
Get your priorities right, and all the rest will fall into place.
Posted by: Lafayette | Link to comment | June 12, 2007 at 11:16 PM
Thank you, but I suggest such is not the issue. We all know what actuarial tables are employed to do.
The subject at hand is the value, within a health care context, of the loss of life and limb. And, who should pay.
I suggest that, in this context, that health care is like national defense. We should all pay by means of taxation and all be covered regardless of the medical circumstance - but most importantly, that the costs of health care by based upon a more fundamentally fair compensation for the services offered.
Presently, health insurance is paid for by the employer. How does the employer recuperate that cost? In pricing products/services accordingly. So, high health care costs go directly into making American commerce and trade non-competitive. You looking for a culprit on which to blame the dislocation of American un- and semi-skilled jobs? Start here.
Extending coverage to the uninsured, this upcoming presidential election's favorite topic, will NOT - by waving some magic wand - solve the problem. The problem is that health care costs are exorbitantly expensive and have been made such by the medical lobby (the AMA). An alternative must be found.
Why is schooling (for all) both public and private? Why is health care not? Extend Medicaid upwards to all and then manage it properly! (One person out of six, who is employed, has no medical insurance for them or their family. And, those employed illegally have none whatsoever as well.)
(This may require increased taxes, but what is the price of good health care for all if costs are managed properly? Less than what we are paying presently.)
Of course, if you have some better solution, then you are welcome to post it. Otherwise, please, let's stop the whining.
Posted by: Lafayette | Link to comment | June 12, 2007 at 11:41 PM
Lafayette:
Medicare for all.
Let the insurance companies insure cosmetic surgery.
I believe we are on the same page.
Posted by: jean | Link to comment | June 13, 2007 at 10:02 AM
I happened to be listening to public radio when I heard what I have heard or read before but not paid much attention to, though I will now. I heard that American photographers in Iraq are being increasingly restricted is what can be portrayed.
Posted by: anne | Link to comment | June 13, 2007 at 06:23 PM
http://www.nytimes.com/2007/02/03/opinion/l03military.html
The Photograph of a Dying Soldier
To the Editor:
I am writing to express my profound disappointment in The New York Times's decision to publish a photograph of a mortally wounded American soldier.
Not only are the photograph and video offensive, the clear depiction is also directly counter to the written agreement made by the reporter and the photographer before publication.
The article that accompanied the photograph and Web site video, " 'Man Down': When One Bullet Alters Everything," by the reporter, Damien Cave, and the photographer, Robert Nickelsberg, was a story of soldiers operating in and around Haifa Street in Baghdad.
This story can and should be told. That is not in question. What is disturbing to me personally and, more important, to the family of the soldier depicted in the photograph and the video, is that the young man who so valiantly gave his life in the service of others was displayed for the entire world to see in the gravest condition and in such a fashion as to elicit horror at its sight.
This photograph will be the last of this man that his family will ever see. Further, it will cause unnecessary worry among the families of other soldiers who fear that the last they see of their loved ones will be in a New York Times photograph lying grievously wounded and dying.
To achieve a mutually agreed upon standard of working together, all reporters and photographers are required to sign the Multinational Forces-Iraq News Media Ground Rules. In it, they agree to the following:
"Media will not be prohibited from covering casualties provided the following conditions are adhered to: (a) Names, video, identifiable written/oral descriptions or identifiable photographs of wounded service member will not be released without the service member's prior written consent."
No such consent was sought or provided.
All of us bear a responsibility to provide for the dignity of our service members in combat. This soldier and his family deserved better.
(Lt. Gen.) Raymond T. Odierno
Cmdr., Multinational Corps-Iraq
Camp Victory, Iraq, Feb. 2, 2007
Posted by: anne | Link to comment | June 13, 2007 at 06:23 PM
http://www.nytimes.com/2007/01/29/world/middleeast/29haifa.html?ex=1327726800&en=03a1dca5752b0c8e&ei=5090&partner=rssuserland&emc=rss
January 29, 2007
'Man Down': When One Bullet Alters Everything
By DAMIEN CAVE
BAGHDAD — Staff Sgt. Hector Leija scanned the kitchen, searching for illegal weapons. One wall away, in an apartment next door, a scared Shiite family huddled around a space heater, cradling an infant.
It was after 9 a.m. on Wednesday, on Haifa Street in central Baghdad, and the crack-crack of machine-gun fire had been rattling since dawn. More than a thousand American and Iraqi troops had come to this warren of high rises and hovels to disrupt the growing nest of Sunni and Shiite fighters battling for control of the area.
The joint military effort has been billed as the first step toward an Iraqi takeover of security. But this morning, in the two dark, third-floor apartments on Haifa Street, that promise seemed distant. What was close, and painfully real, was the cost of an escalating street fight that had trapped American soldiers and Iraqi bystanders between warring sects.
And as with so many days here, a bullet changed everything.
It started at 9:15 a.m.
"Help!" came the shout. "Man down."
"Sergeant Leija got hit in the head," yelled Specialist Evan Woollis, 25, his voice carrying into the apartment with the Iraqi family. The soldiers from the sergeant's platoon, part of the Third Stryker Brigade Combat Team, rushed from one apartment to the other.
In the narrow kitchen, a single bullet hole could be seen in a tinted glass window facing north.
The platoon's leader, Sgt. First Class Marc Biletski, ordered his men to get down, away from every window, and to pull Sergeant Leija out of the kitchen and into the living room.
"O.K., everybody, let's relax," Sergeant Biletski said. But he was shaking from his shoulder to his hand.
Relaxing was just not possible. Fifteen feet of floor and a three-inch-high metal doorjamb stood between where Sergeant Leija fell and the living room, out of the line of fire. Gunshots popped in bursts, their source obscured by echoes off the concrete buildings.
"Don't freak out on me, Doc," Sergeant Biletski shouted to the platoon medic, Pfc. Aaron Barnum, who was frantically yanking at Sergeant Leija's flak jacket to take the weight off his chest. "Don't freak out." ...
Posted by: anne | Link to comment | June 13, 2007 at 06:24 PM
Yes; photographers must now sign an agreement with the American military that wounded soldiers are not to be photgraphed unless the wounded soldier has in advance given written permission to the photographer. "Shut the eyes of the dead, not to embarrass anyone."
Posted by: anne | Link to comment | June 13, 2007 at 06:25 PM
Everyone should have to look. Men, women, even children. Everyone. They should have to watch someone bleed out while they beg for mom or dad. If they had to look, if they had to beg someone close to them not to die, they wouldn't be so god-damned eager and willing to buy into all of this political crap. And that's all it is. Crap.
Posted by: mp | Link to comment | June 13, 2007 at 11:31 PM