A news story today concerned prostate cancer, and especially, the amount of federal funding that goes to prostate cancer research. Evidently, prostate cancer gets about $80 million in research funding each year, and kills about 41,000 men. Breast cancer gets $550 million in annual funding, and kills about 45,000. AIDS gets $1.6 billion in funding, and kills about 51,000.
The point was made in this report that breast cancer research is better funded because women have organized and lobbied to get that funding. And of course AIDS has been the focus of intensive organizing and lobbying.
Now, all of these clearly merit research. But it is insane to allocate research dollars based on the group that makes the most noise. This started me thinking “there’s got to be a better way.”
So here’s my idea. First, we assign an economic value to one year of an average person’s life. Statisticians have some number that they use. I’m not sure what that number is. Let’s use $40,000, because it is a nice, round number. I readily admit that this is a crass way of looking at things, but it leads to a model that has a lot of explanatory power, so please hold your nose and continue.
Next, figure the average age of the victims, then substract that from the average lifespan. Multiply that by the number of victims each year, and then multiply that by $40,000. That is the economic potential lost to the disease each year.
For example, using prostate cancer for the moment, let’s say as a guesstimate that the average age at which men die of it is 65, and the average male lifespan is 75. On average, each victim has lost ten years. This yields the following:
10 years x $40,000/person/year x 41,000 people
= $16.4 billion in lost economic potential
Now figure this for all diseases, and you have an index of awfulness, or to look at it another way, a way of determining how much research money various diseases should get. This is based on something objective, not lobbying clout. I hasten to add that I am not suggesting we spend $16.4 billion per year on prostate cancer research; all I am saying is that given a certain reserve of money available for medical research is, this gives us a way to divide it up equitably. Although it is somewhat outside the scope of this topic, it could also be used to help indicate whether that pool is too big or too small.
So far so good. We can take this approach much further, though. According to this logic, AIDS would obviously get more money than prostate cancer or breast cancer, because it kills more people, and they tend to die at a younger age. But there’s another factor: AIDS is communicable. The fact that one AIDS carrier can pass the disease on to any number of other people needs to be accounted for. Again, we can estimate the average number of people that will catch HIV from one carrier, when those cases will mature into AIDS, the average lifespan for someone with AIDS, and work all these into the calculations. Admittedly, there is a lot of room for arguing over what those numbers might be, but if the basic premise is accepted, at least we are arguing over relatively objective data.
Another way to extend this is to apply it to diseases that don’t kill people. For example, if salmonella poisoning knocks 2,000 people out of commission each year, for an average of one week each, that is
1/52nd of a year x $40,000/person/year x 2,000 people
= $1,538,461 in lost economic potential
Of course, it costs a certain amount of money to treat each of those people. The way economic growth is currently measured, that is actually considered a good thing. This is kind of crazy, and for our purposes, let’s just pretend that spending money to cure a disease is less desirable than spending less money preventing it. Suppose that it costs $300 per case to treat salmonella poisoning. That’s 2,000 people x $300 per person, or $600,000. So add that to the lost economic potential. So we can extend this general approach to account for the relative cost of treating diseases (in fact, this will work with fatal diseases as well as minor ones). We could say that if we could prevent all those salmonella outbreaks for less than 2.1 million dollars, it would be worth it.
To be sure, I have oversimplified the matter here. There would no doubt be numerous variables involved in any such calculations. But the general approach is sound. Oregon uses a similar rational scheme for rationing medicare.