Peter Singer on Health Care Rationing

By Conor Clarke

I started reading Peter Singer's big New York Times Magazine piece on health-care rationing expecting to be at least a little annoyed by the time I got to the end. But it didn't happen! I agree with most of what Singer -- the famed utilitarian -- has to say, largely because Singer doesn't say a whole lot about the specifics of the current health care debate, and because his general points seem pretty obvious and anodyne. Mostly, we learn that it is both necessary and difficult to set an implicit dollar value on human life when allocating scarce goods and services that increase safety or improve longevity. Swell.

But I do think the piece has one especially strong argument against the idea that "rationing" is something unethical or un-American or just downright Canadian. And that is Singer's description of what our government already does:

If the Department of Transportation [followed the principle that it was impossible to put a dollar value on human life] it would exhaust its entire budget on road safety. Fortunately the department sets a limit on how much it is willing to pay to save one human life. In 2008 that limit was $5.8 million. Other government agencies do the same. Last year the Consumer Product Safety Commission considered a proposal to make mattresses less likely to catch fire. Information from the industry suggested that the new standard would cost $343 million to implement, but the Consumer Product Safety Commission calculated that it would save 270 lives a year and since it valued a human life at around $5 million, that made the new standard a good value. If we are going to have consumer-safety regulation at all, we need some idea of how much safety is worth buying. Like health care bureaucrats, consumer-safety bureaucrats sometimes decide that saving a human life is not worth the expense. Twenty years ago, the National Research Council, an arm of the National Academy of Sciences, examined a proposal for installing seat belts in all school buses. It estimated that doing so would save, on average, one life per year, at a cost of $40 million. After that, support for the proposal faded away. So why is it that those who accept that we put a price on life when it comes to consumer safety refuse to accept it when it comes to health care?

Why indeed?