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DanArmak comments on Rationality Quotes November 2012 - Less Wrong
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But the RoI for the patient himself is great. You present an argument against publicly funded research into heart transplants, but not against doing them at all.
If the patient is spending her own money, the RoI is still terrible compared to comparable interventions like hiring a personal trainer, diet coach, personal chef, etc. that could have forestalled the need for a heart transplant. Furthermore, the actually existing health infrastructure, particularly organ procurement, is so deeply entangled with the state, that it's difficult to speak meaningfully of strictly privately funded efforts.
Even having purchased all those, a person may need a heart transplant. Genes, disease, accidents, and nurture while young (and unable to choose one's own lifestyle) all strongly influence the eventual need for a heart transplant. So for many people, even a lot of lifetime investment into their health won't mean the RoI on a heart transplant will be bad.
Also, at the point where you choose whether to have a heart transplant, the RoI needs to be compared with other things you can do with that money during the time you have left to live without a transplant. If you have a lot of money, and the transplant improves your QALY, then the RoI is likely good.