= 27d567bc2d48d9f40e9ccc20ea370b15)
I wonder if people with ADHD experience less pain at having to leave what one is currently doing to make a decision.
Longevity Insurance
Let's say we (as a country) ban life insurance and health insurance as separate packages [1] and require them to be combined in something I'll call "Longevity Insurance". The idea is that as a person/consumer, you can buy a "life expectancy" of 75 years, or 90 years, or whatever. In addition, you specify a maximum dollar amount that the longevity insurance will ever pay out--say, $2 million. If you have any medical issues throughout your life, up to the life expectancy threshold, the insurance plan will pay for your expenses. If it fails to keep you consciously alive for the duration of your "life expectancy", then upon your death, the policy guarantees that the company will pay the full remaining amount to your next of kin.
As an example, suppose you (let's say you're a woman) had purchased a 75-year policy, but you had a car accident. The paramedics tried to save you, and the hospital bill came to $100k, but even after that noble effort, you still died. As a result, your husband and children get $1.9M. Alternatively, if in our hypothetical situation they succeed in resuscitating you, the company would keep the $1.9M for future medical bills, and, if they fulfill their promise of life expectancy, they pocket the remainder as profit on your 75th birthday.
It seems like this arrangement would put all of the right incentives [2] in place for both companies and individuals. Most individuals would want to avoid trivial medical expenses in order to maximize payout to family in case of accidental death. Companies would want to maximize health and longevity in order to profit from the end-of-life payout. And our society would have a way to rationally consider the value of life without resorting to arguments that essentially conclude "life is of infinite value," and in doing so, prevent sensible gerontological triage. To put it into perspective, it makes little sense that we spend $1M (as a society) trying to save a 92-year-old when that same amount could have saved 10 teenagers.
Longevity Insurance companies would be incentivized to become heavily involved in medical research that prevents disease, prolongs life, and keeps people healthy. I can imagine a whole array of things that make sense in this context. For example, it would be the right place to fund studies on genetics, it could be the right vehicle for getting 'free' immunizations, and it could even make public funding for "health insurance" easier to pass--simply set the bar low enough that everyone can agree on an age that society will extend a policy for. Do we all agree that everyone in our society should live to age 50? Super! The government will cover Longevity Insurance up to age 50.
[1] We could also just allow Longevity Insurance as a free-market alternative, but for the sake of argument, let's ban its competitors.
[2] The one incentive that Longevity Insurance does not seem to address well is the possibility of next-of-kin killing their loved one just prior to the end of an insurance policy. One option would be to require a one-year moratorium in the case where someone dies within a year of their policy ending. This would give time for an investigation before awarding large sums of money.
* crosspost from my blog, http://halfcupofsugar.com/longevity-insurance
Julian's comment is on point though. I've been involved with any number of charitable organizations where it is expected that people donate significant time for things like bake sales or craft fairs or dinners in order to raise money, where if you took the money raised minus costs divided by the total hours spent, people would have done better taking second jobs at McDonald's and donating the money.
Plus, we're often providing a product which wouldn't sell for that price on the open market, with custom driven largely by people's affinity for the organization raising the money.
All in all, fund-raisers that aren't either a good leisure activity for all involved, or relentlessly and professionally focused and profitable (i.e. don't encourage random volunteers -- only those with relevant marketable skills and make sure the venture would at least be break-even if you accounted for fair value of labor) are just a horrendous waste of resources. Just get people to write checks.
And yes I beat this drum at every socially appropriate opportunity for every charitable organization I'm associated with.
You might be underestimating the value of social involvement in your equation. If new people become involved in the organization as a result of a "fundraiser" then this may lead to a higher expected value than direct donation, all things being equal.
In response to
Dying Outside
FYI, there is a new report from the American Academy of Neurology out just today that offers new guidelines for the best treatments for ALS:
http://www.eurekalert.org/pub_releases/2009-10/aaon-ngi100609.php
Also in the news two days ago:
http://www.eurekalert.org/pub_releases/2009-10/uorm-csp101509.php
"Compound shows potential for slowing progression of ALS"
In response to
Dying Outside
FYI, there is a new report from the American Academy of Neurology out just today that offers new guidelines for the best treatments for ALS:
http://www.eurekalert.org/pub_releases/2009-10/aaon-ngi100609.php
= b715d02e85f7b3b4ae65ca3d3e450868)
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Interesting idea, but I see two problems :
"Most individuals would want to avoid trivial medical expenses" that's actually a huge problem. In our societies, people tend to postpone going to see doctors (because it costs money, even if most is paid back by social security (like it is here) or private insurances, and because it takes precious time). But for many disease, the earlier they get treated, the easier is the treatment. You have a small weird thing on your skin, you don't go see a doctor for that, and it happens to be a skin cancer and you die, or it happens to be a wart, and when you finally go see a doctor, it has multiplied and you may even have contaged someone else. The key for efficient healthcare is frequently going to the doctor to check you don't have anything. Maybe there could be a number of checks/examens that are not taken from your $2 millions ? A visit to the dentist and general practitioner for a checkup a year and a few things like that ?
You only consider "life", but not in which condition. So how does your mechanism handle issues like eyesight ? How does it handle artificial limbs for people who require them ? The interests of the person and of the insurance will be opposite in those issues - the insurance doesn't care if you're blind and limbless, as long as you're alive, but the person may prefer to be able to see and move around, even if it means a risk of dying earlier (surgery always has a risk).
Your second point is one I hadn't considered. I suppose for some conditions, there would be a correlation between lowered quality of life and early death, in which case a 'longevity insurance' company would calculate quality of life as a correlated factor of longevity. For example, blindness probably has a higher rate of accidental death, so there would be some incentive for the insurance company to help, but the incentive is not as strong as the individual's desire for the improved quality of life that sight would bring.
As an aside, it seems to me that evolution has factored these correlations in as well. We have two eyes, presumably, because an insurance policy against blindness improves the chance of procreation. Unfortunately, as individuals, we don't necessarily want to maximize posterity, but some unique mix of longevity and posterity.