Re: risk abatement options (response to Tschaeche)

[BLHamrick@aol.com]

In a message dated 02/15/2000 10:41:14 AM Pacific Standard Time, 
Andrew_Karam@URMC.Rochester.edu writes:

<< Another approach might also prove of interest to you.  Taking Tammy Tengs'
 paper on the cost-effectiveness of over 500 types of life-saving
 interventions, you can make a very good case that spending, say, $100
 million to address a "problem" that will affect only a few people is not
 effective and will actually cost lives.  For example, there are many
 programs (including childhood immunization programs) that operate at a net
 savings to society because these people require fewer emergency room visits
 and miss less work.  Putting $100 million into safer roads in the community
 will also save more lives, as will using it to upgrade emergency response
 vehicles or any of a number of other areas.  In addition, other work cited
 in the New England Journal of Medicine has shown that every (about) $10
 million in costs distributed across society results in one additional death
 because that is money taken from taxpayers (or ratepayers, or whatever) that
 is not available for, say, new snow tires, better foods, vitamins, and so
 forth.
 
 Putting these together, I have argued that, by insisting a large amount of
 money be spent on reducing a very small risk, these funds are being removed
 from other, better uses that could save many more lives. >>

You make some excellent points, and bring up two issues about which the 
public is sorely undereducated.  One, is the issue of cost-benefit.  I know 
many well-educated people who find it completely disdainful to "put a price 
on a human life."  There needs to be a better way to "sell" this concept.  If 
you ask, for example, is it reasonable to spend a hundred million dollars to 
save one life?  You will likely find there are a substantial number of people 
who are literally horrified that you would suggest that a human life has some 
"monetary value."  (Disclaimer:  Please don't confuse the messenger with the 
message...I understand the benefits and realities of cost-benefit analyses).  
For this reason, I think it may be beneficial to approach this as more of a 
"balancing" analysis...That is, rather than equate lives to money...equate 
lives saved by spending money one way to lives saved by spending money in 
another way...so that the idea is more palatable.

The second issue is that of where the money really comes from...I have 
repeatedly heard diatribes wherein the person will say, "the government has 
to do something about [fill in the risk]," with little or no recognition that 
the government will be spending that person's money, and yours, and mine.  
The public too often seems to think that "the government" should do 
something, however costly, without any acknowledgement that "the government" 
is spending taxpayer money...."The government" is not some independent 
profit-generating entity (please argue this statement on the TaxRelief 
listserver)...And, for that matter, the public needs to recognize that 
forcing a corporation to expend vast dollars to reduce perceived or actual 
(but vanishingly small) risk does not generally mean the CEOs will be cutting 
short their Mediterranean vacation, but that the product cost will increase 
to cover the expenses, and Joe Citizen will still end up paying for it.  I 
think this message can be delivered in a fairly simple and effective way to 
the public, and because it involves "their money," they will be more inclined 
to think twice.

Barbara L. Hamrick
BLHamrick@aol.com
************************************************************************
The RADSAFE Frequently Asked Questions list, archives and subscription
information can be accessed at http://www.ehs.uiuc.edu/~rad/radsafe.html