In his recent post on Slate, the intrepid Jacob Weisberg eagerly plays the death card in order to excoriate Republican presidential nominees for their incoherent and cowardly opposition to ObamaCare in the latest primary debate. The hypothetical that we have to address is this:  what should be done with a person without insurance who suffers catastrophic illness, which requires six months of intensive care? Should that person be allowed to die or should that person be supplied that care at public expense under, of course, ObamaCare?

One telling illustration about this example is that Weisberg does not tell us whether the individual who receives this care lives or dies when the treatment is over.  If we assume the latter, the initial question is whether intensive care at, say, $10,000 to $20,000 per day represents the best use of social resources.  A bit of simple arithmetic says that society has spent $1.83 million to $3.66 million on a venture that may well have kept this person alive in a comatose state or have subjected him to repeated invasive treatments when hospice care may well have been preferable. Alternatively, that person could have lived, but we do not know in what kind of state or how much money it will take to sustain him.  In this instance, we might derive somewhat greater benefits, but only at a far greater cost. 

The only alternative that is not covered by Weisberg's hypothetical is a case in which intervention is really cost effective: the use of a single day in the intensive care unit that results in keeping a person who suffers from a sudden injury alive so that he or she can return to a normal life thereafter.  The hard question therefore is why is it so apparent to Weisberg or anyone else, that letting a grievously ill person die is the wrong alternative for a society that is determined to make its health care dollars go as far as they want.  Weisberg never addresses this question in a coherent fashion because he is innocent of the notion that high levels of health care expenditures on one individual could exhaust resources that could have enabled many other individuals to survive.  It is just irresponsible to ignore the hard question of scarcity in asking how to set social priorities.

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