Posts Tagged 'cost effectiveness'

What’s rational?

A pretty sweet discussion is brewing between Alanna Shaikh and Isaac Holeman about global health programs which at first glance may seem to be completely irrational. A great example is Partners In Health who has flown patients with complex diseases such as cancer from Haiti to the US for treatment. This of course costs a lot of money, and one could argue may take funds away from more important broad-based public health interventions.

Alanna wants to consider alternatives:

How do we do it better? It’s not very realistic to argue that you should just ignore seriously ill people and spend the money on public health interventions. No human can do that….

You can’t ethically just take that cash and save fifty children from malaria or helminthes. But you can fly in a team of specialists or oncologists. You can most likely talk them into donating their time for the chance to help someone in a faraway location.

Isaac argues that creating compelling and heartening stories far outweighs the the actual costs:

I think a key issue at the heart of some such of programs is the balance between long term effectiveness and the fierce urgency of now. I agree that the programs she describes would play a very small role in an ideal global health care service, but ultimately what we need more than any specific program is for people to give a damn. Some people have excess resources; we need them to care enough that they are willing to share some of those resources with the rest of the human family. If irrational programs will occasionally inspire people, perhaps they are worth the cost.

I think that the real irrationality lies in the fact that we live in such a divided world that somehow it makes sense to us to spend tens of thousands of dollars a day providing life support to someone who is essentially dead but consider it irrational, not “cost effective” to spend the same on cancer treatment for a young Haitian woman. I think that it is irrational (and immoral) to weight the value of life differently based on color of skin or nation of origin. This means that it is our challenge to fight against the structures that keep resources in the hands of the wealthy and redouble our efforts to bring resources down the gradient of inequality.

Be sure to check out the comments sections on both Alanna’s and Isaac’s posts for some more great dialogue.


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