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Season 13 | Episode 3

Worth

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(Photo Credit: Paresh Gadjria/Flickr)

This episode, we make three earnest, possibly foolhardy, attempts to put a price on the priceless. We figure out the dollar value for an accidental death, another day of life, and the work of bats and bees as we try to keep our careful calculations from falling apart in the face of the realities of life, and love, and loss.

How Much Would You Pay For A Year Of Life?

Two years ago, a group of doctors did something unprecedented - they boycotted a cancer drug because it cost too much, given the benefit.

Comments [28]

How Much Does It Cost to Say "I'm Sorry"?

Gregory Johnsen, writer-at-large for BuzzFeed News leads Radiolab down a rabbit hole of United States' military condolence payments.

Comments [11]

How Do You Put a Price Tag On Nature?

What happens when humans figure out a cheaper, better way, to do something that nature had been doing for eons? 

Comments [10]

Comments [76]

Dan from California

The history of anglo Saxon culture includes weregild or "man price." This is how much money had to be paid for a death. It was historically stratified by social class. So killing a noble high born person required much more restitution than killing a peasant. We have decided in advanced democracies that people are equal and should be treated by the same formula, payment weighted by dependents. We legitimate our American hegemony on the model of the nation state and the ideals of universal rights. We like to claim that nations bargain with one another on a level field and within nations people should ideally be treated fairly by their own natuinal standards. What this means is nations are stratified. How much a citizen is worth is based on how much power you government has. For Afghanistan in this episode their government has basically no power, as the segment portrays the value if an Afghani life is a utilitarian calculation by Americans. There is not enough organized Afghani power to demand more. Just try to kill a European Union citizen as collateral damage and try to give them 2500 bucks. The price is not symbollic personally it is symbollic of national power.

May. 05 2016 09:11 AM
Heather from Texas

People in other countries want equal amounts of pay for lives as we give our own citizens, but that is not actually comparable. That would be if THEIR own country (for example, a country in the Middle East) were giving them (that country's citizens) repayment equal to what OUR country (America) gives its own citizens (Americans).
When terrorist attacks happen in the US, we give those amounts to our citizens even though the country whose citizens are at fault give them nothing.

Mar. 07 2016 10:41 AM

There are worse things than death. Most chemo treatments fall under this category. I am currently healing from a cancer surgery which found no metastases. It was a relief, but it got me thinking--what am I willing to endure, what am I willing to pay, just to live longer? And what would that extra time be like? The type of cancer I had was extremely fast-growing, and there are no effective treatments after about stage 2b. I was at stage 1b. So, I decided rather quickly that had they found any lymph node cancer cells at all, I would have opted out of chemo treatment and enjoyed the life I had left. I decided it quickly with that information. Other diagnoses, maybe diagnoses that have more ambiguous outcomes, well... I can see how that might have been a different decision, but, really, chemo...yuck. I'd rather avoid it if I could.

Oct. 13 2015 12:25 PM
Lawrence Weir from Sacramento

In the discussion about the hepatitis drug that costs $1,000 a day you should have mentioned that the executives of Gilead are highly compensated. The CEO receives over a billion dollars a year in salary and stock. His salary alone could pay for thousands of patients treatments. And by the way, he had nothing to do with the discovery of the drug. Gilead bought the company that discovered and developed the drug.

Sep. 02 2015 10:38 AM
MAO from New England

What a total load of crap!

May. 17 2015 11:40 AM

Being asked "what is one more day worth?" has fundamentally changed how I perceive my life. Hearing the podcast, I realised that if it were MY life, I would give everything I have for one more day. I'd probably just live that day as I would any other. What would be priceless is KNOWING it was your last day. I think that would really focus the mind and what is truly beautiful and wonderful about the world we live in.

Apr. 20 2015 02:48 AM
Jennifer Roberts from Montreal

One of the best things I've read that gives a broader take on value and commodification is Arjun Appadurai's introduction to The Social Life of Things. It's a bit dense, but it has deeply informed my thinking about value on so many levels. I highly recommend.
http://www.cambridge.org/cl/academic/subjects/anthropology/social-and-cultural-anthropology/social-life-things-commodities-cultural-perspective

Apr. 09 2015 11:56 AM
Toni L. Gatsby from NY

I personally believe that you cannot price someones life. One may own more objects than another, but that doesn't make their actual ability to live more precious than anyone else's. Even though many believe that how much money you have determines your worth, how one truly is on the inside is what really matters. I can see how many view money as a way of measuring how willing someone is to work and get down to buisness, but a majority of the wealthy were born into their fortunes. This fact means that the one who is left with the family money ultimitley did nothing to earn it; therefore, the allotment of someones life based primarily on money is not ethically correct or reliable.

Mar. 23 2015 10:41 PM
Dwight from Cleveland.

A better question would have been, "how much of a person's personal wealth is a year of life worth." Lets say you are worth $10 million. would a million be worth a year of life? Say everything you have to your name amounts to $1000, is $10 worth a year? Is you whole $1000 worth it? If you think more than $1000, who should be responsible for paying for it. In relation to the promise that "all mean are created equal" and of "life, liberty, and happiness" what is the governments responsibility to every citizen?

Mar. 21 2015 10:46 AM
jo from Pittsburgh, Pa

Like many of your listeners, I am horrified that this conversation took place in a vacuum, not in the real world of profit and loss. It is revealing that the moment health can be monitized, you end up asking about the value of human life and human beings -- capitalism enables the objectification of nature, of other life on this planet, and even the survival of the planet itself. Only when we create medicare for all, remove the limit on income that can be taxed for social security, ;make the corporations pay their fair share (70%?) and make all health care private ventures non-profit, could we even begin to discuss how we allocate limited resources. Get it? Only with a mixed economy within the context of democratic socialism based on worker cooperatives can we even begin to seriously deal with these important questions.

Mar. 20 2015 11:51 AM
Michael M

The mother of all examples as far as economic value of nature goes is the oxygen that plants produce.

The oxygen in the air, unlike the nitrogen, is not the result of the earth simply existing, but the work of living organisms. 80% of all the oxygen comes from algae in the ocean, a really lot of biomass that produces a really lot of oxygen.

Then the next big producer are the rain-forests, then everything else is a distant third.

It allows you to simply exist, is free, and without it you'd die in a minute. How much would it suck if you had to pay for an oxygen utility, or had some giant solar powered oxygen generation machine.

Mar. 10 2015 04:05 PM
Mike

You missed a very important point in the segment about Sovaldi, which is that the "discovery" was heavily subsidized by the taxpayer via the NiH. In India, the generic costs far less than charged here in the US under our monopoly pricing system. In other words, we are being gouged for a drug we essentially made possible through government grants for basic research and development. Nice gig for the drug companies.

http://www.huffingtonpost.com/jeffrey-sachs/the-drug-that-is-bankrupt_b_6692340.html

Feb. 22 2015 06:22 PM
Michael Kemper from San Francisco

The very fact that such questions can be considered is evidence enough of the evil of capitalism which dictates that EVERYTHING has a monetary equivalence. EVERYTHING! Capitalism has managed to dehumanize all that it touches even those who imagine they are players in the game.

Feb. 21 2015 04:05 PM
Rosa Ballena from Chicago, IL

I was surprised and disappointed by this episode of radiolab.

The only worth money has is the worth people ascribe it. So, it's tiresome to keep talking about 'how much we would pay for a life', when there's no discussion about what prices mean or where they come from. It's as if we've gotten stuck discussing the small ins and outs of a mythical world, without ever once trying to dig deeper, and figure out what assumptions that world is based on.

Not to mention, it's no secret that pharmeceutical companies often make vast sums of money. Clearly, then, if we're saying that the prices they set are 'legitimate', we're also legitimating how today's economy works (one that devastates the environment, objectifies the natural world, alienates people from the existencial beauty of their lives, brings wealth to some, and impoverishes many).

Feb. 12 2015 09:34 PM

The economic perspective presented was interesting, but only a first step. It was an estimate of value given the current state of the world but not an analysis of possible alternatives, and so not a policy prescription. But it turns out general statements can be made pretty easily: 1) Ecology and Economics are both studies of systems far more complex than is manageable in any centralized fashion. 2) Because of this complexity there are possibilities of quickly escalating effects (black swans). 3) Therefore any cost benefit analysis that justifies severe ecological change (particularly if it affects a large area) should be viewed with an asymmetrically large amount of skepticism.

In other words, the idea that we can engineer the environment is a fatal conceit.

Feb. 11 2015 06:06 PM
Morrie in San Diego, Ca

Looks like normal corporate greed to me. The company that halved its price I am sure do not lose a dime, it just took a little longer to make all that profit. Your piece was interesting, but did not address what is enough profit for such items? Is 'what the market will bear' acceptable here? Why didn't you interview some medical ethicit's about this? Why not regulate this industry differently because of how this affects society? Arguments pro and con.

Feb. 07 2015 09:57 PM
Nick B from Brooklyn

"the way of industrialism is the way of the machine. to the industrial mind, a machine is not merely an instrument for doing work or amusing ourselves or making war; it is an explanation of the world and of life. because industrialism cannot understand living things except as machines, and can grant them no value that is not utilitarian, it conceives of farming and forestry as forms of mining; it cannot use the land without abusing it."
-wendell berry

Feb. 06 2015 04:38 PM
Alice A. Keats from The North Pole

It is sad now a days how people are slowly becoming less personalized and humanly. For example, students now a days are represented with numbers more so than names and personalities. Our student ID's determine who we are and we are nothing but a number to the school board and faculty. Also, the worth of the American dollar increases and decreases as the years go on. In northern states, money is valued at much less than those of their southern counterparts. A teacher living in the north would be waging approximately $70,000+ as a southern teacher would be earning no more than $50,000 a year. This is sad to see the polar opposite split for citizens of the US who are performing the same services.

Feb. 02 2015 07:22 PM
Dan Bert from Further

From the podcast: "So 1917. The Great War ramps up, so we start shipping young men over to Europe." The war started in August 1914. Before US troops reached combat in 1917, the war had claimed well over 10 million combined military and civilian casualties. How can Radiolab view almost 3 years of war preceding the US entry as happening before the war ramped up?

Feb. 02 2015 02:58 AM
Anna B. Silverstein

I believe that putting a price on ourselves, others, and nature serves mainly to open up a perspective. Until you think about what would you pay or what something is worth it's impossible to make a completely informed decision about many of those things. Also, on constantly debated subjects such as what to do with nature, having solid facts can create a solid argument based less on intrinsic values.

Jan. 31 2015 06:46 PM
Da Lagniappe

From my experience in Iraq while in the US Army if a civilian was killed by US or allied forces their family was given 50k USD. I am sure the numbers vary by location and year since the conflict has been going on for over a decade.

That being said, there really is no price. Even in the US accidental death payouts range from under a 100k to millions.

Jan. 31 2015 11:37 AM
Zakariya Hassouneh from oviedo fl

Wow, $30,000 for a 3 month period for just one pill, that is just ridiculous. I know people say their is no price tag on life, but if i was not financially stable i would not ask my family to pay that price and go in debt just so i can one more month, while their are also going to be other meds and doctors involved. Insurance is a good thing but sometimes insurance companies will back out on you and you will be stuck with the charges yourself. Im sure the drug took time and money to make but the price still seems outrageous, i have never heard of a medicine like this but it makes me believe that one day we will be able to find a cure for cancer.

Jan. 26 2015 09:00 PM
Virginia T. Ripley from Florida

You can't put a price on somebody's life. Every day is a gift that we should take full advantage of. I found this episode quite interesting and it was a interesting topic. I am all for medications being produced for good causes. I think it's great that we have the technology now in todays time to help people live longer.

Jan. 26 2015 08:36 PM
Justin

Very intresting thought about how much is a year of life worth, like that one man who got 20 years of behind bars and the state gave him 30k per year he was in jail. yes he wasnt dead during that time but those are still years this guy wont get back.

Jan. 22 2015 10:56 AM
Mia Belanger from oviedo, FL

I know people say there is no price on life, but I don't think it is that simple. Pharmacies that make drugs for people to live is a double-ended sword. You pay a high price to live one more day. The drug they talk about in this segment that has a 95% cure rate, I think is worth the $1000 a tablet. I don't want to sound like I don't care, but all the factors they mentioned that go into producing a drug like this makes you realize that there is a value on life in a way. It sucks.

Jan. 21 2015 02:23 PM
Alice H. Nash

There is no price you can put on a person's life. Each day there is a chance for something amazing to happen that are invaluable. I am torn between hating and loving pharmaceutical companies. I love the scientists who devote their lives to making these medicines that cure people and allow them to live longer. But I hate the business part of it. I hate that the companies take these cures and put a high price tag on them so they are not available to everyone. People seriously have their priorities screwed up.

Jan. 19 2015 09:53 PM
Milo C Rousseau from Florida

It's just weird trying to give monetary worth for things that really can't be given it. Although, in all 3 situations, there were serious practical applications for this "worth." I really don't know what value I would give to a year of life, or someone's death, or a marsh or bees. It's pretty clear though that we have no choice but to give these things value.

I really like these podcasts that tie stories together with a theme. IT makes them more interesting in my opinion.

Jan. 19 2015 09:24 PM
Clint from Riverton, Utah

What is the worth of saving a life to the pharmacist or researcher? How much are the doctors and researchers and pharmacists willing to sacrifice for the good of mankind? think this side of the argument needs to be highlighted equally. I appreciate immensely the efforts of our healthcare workers, and for that I am thinking we are undermining the potential for heroism within these workers when the "big" cure comes to us. Are these workers willing to have their pockets hurt, risk the success of their institution for the welfare of mankind? Millions of the common people could have their burdens lightened as well as the global economy as the healthcare workers took a portion of that burden by reducing the costs of medication.

Jan. 17 2015 04:52 PM
Ayn K. Melville

You CANNOT put a price on someone's life. Another year of life for some people could mean getting to walk their daughter down the aisle, or seeing the birth of their first grandchild; priceless moments that a lot of people would pay anything for. it's these moments that are worth the most to us but have no monetary value. Pharmaceutical companies are in the business to make money and make a name for themselves. Money has a different worth to everyone depending on the effort put forth to get it. $100,000 could be worth as much to a rich person as $20 is to someone who has nothing. So a year of life for the rich and poor has totally different values. It can also be looked at by who is sick and in need of the medication. Is it your elderly grandparent? Is it your 7 year-old child? Or is it you? another year for you may not be worth as much to you as your grandparents or your child. Odds are you'd offer everything you had to save your child but accept that there is nothing you can do to save yourself. A person's life has no price tag.

Jan. 13 2015 07:22 AM
Becky K. Woolf from Florida

I don't think many people really take time out of their day to sit and think about what or how much their life is worth. Healthy people, rather. When sickly, that is all you can think about.. the "should've, could've, and would've" of ones life. However, scientists are rational, intellectual thinkers. They tend to leave emotions out and only see what's needed to progress in their experiments whether its risking a life or handling money. I feel when and only when they become the patient, they then think "was it worth it?"

Jan. 13 2015 01:14 AM
Jane J. Asimov from florida

Putting a price on life is something I've never thought about. This video really got me think about the price of life. How much is to much? How much am I willing to pay? I think pharmaceutical are getting greedy. I understand that these scientists work really hard and need to make money when the drug they develop is successful but they need to realize who is on the other end of that drug. Sick and dying patients are the consumers. If the pharmaceutical brands keep this in mind and focus on saving lives and not being greedy they can be successful and help people.

Jan. 13 2015 12:52 AM
Jane J. Asimov from florida

Putting a price on life is something I've never thought about. This video really got me think about the price of life. How much is to much? How much am I willing to pay? I think pharmaceutical are getting greedy. I understand that these scientists work really hard and need to make money when the drug they develop is successful but they need to realize who is on the other end of that drug. Sick and dying patients are the consumers. If the pharmaceutical brands keep this in mind and focus on saving lives and not being greedy they can be successful and help people.

Jan. 13 2015 12:51 AM
Alice Z. Lovecraft from Florida

It's odd to think how much life actually means to you. I tried to think of how much money a month would be worth for myself, but I have no idea. It's difficult to come close to any number. I'm unsure of how to judge something like that. I don't know how we could come up with something like that for healthcare. I worry that people will begin to change the amount per person based on their ethnicity, job, income and social standing. People might receive more money because they're a higher contributor to society and I can't tell if it's wrong. This made me question whether one life is really worth more than another.

Jan. 12 2015 05:25 PM
Luke from Canberra

Interestingly, the committee that decides which drugs should get listed on the Australian Pharmaceutical Benefits Scheme (which subsidises drugs - so that the most anyone pays is $36.90 for a prescription. Link: http://en.wikipedia.org/wiki/Pharmaceutical_Benefits_Scheme) decided that Sovaldi is too expensive for the government to subsidise.

Link to an article: http://www.canberratimes.com.au/federal-politics/political-news/the-miracle-cure-with-a-billiondollar-price-tag-20150112-12moah.html

Jan. 12 2015 04:36 PM
Rudyard L. Kevoac from Florida

The podcast was very interesting. While money has played an important role across modern history, it's amazing to think how far it has gone in determining human fortunes. Let's hope that no monetary catastrophes occur in the future. I'd hate to see what consequences a "currency disaster" would cause.

Jan. 12 2015 04:22 PM
Sherlock D. Whiler from United States

Just focusing on the dollar price for drugs, it is crazy. I think that these companies, focused on money, their greed really gets the best of them. They take advantage of people. Also, putting a price tag on life is really not possible. Knowing cancer and having a personal account of such a deadly disease, you don't really think long term, you think about short term. Just as cancer, you have to think about other diseases as well. Just the price of drugs alone to keep a person alive when sick is enough to empty someones pockets pretty quickly. Greed is never good.

Jan. 11 2015 09:01 PM
Antonia Neruda from Florida

I agree with this podcast. Worth can be time, money, or personal worth. Worth is interpreted differently by every person. Worth can mean a lot when it means you are a 37 year-old mother who has 4 kids and is dying, but she is able to live for one more month. Worth is a huge deal. I really liked this podcast. It was supported greatly by Molly, since she is a nurse for a hospital with old people. When it comes to money buying a drug to help someone live, money doesn't matter. What's worth the money is the time "bought" to live longer.

Jan. 11 2015 08:40 PM
Catniss J. Plath

After listening to Worth, its really interesting that a drug could cost so much for just a few extra days of life. Companies take advantage of these situations, raising prices on something that is priceless. Can you really put a price on an extra day of life and how far are we really willing to go?

Jan. 11 2015 07:33 PM
Diane Allen from Frederick, MD

On the segment asking questions regarding drug treatments and "How much is an extra 41 days of life worth?" you missed a few points:
(1) drug companies charge more for the same drugs in America than they do in Canada and Europe (countries with high GDPs that should be able to afford as much as we do) because these countries can collectively bargain to bring down the price of the drugs
(2) additionally, the 'dirty little secret' of drug research in America is this -- our government funds a lot of drug research. This money comes from our taxes and supports research that we then pay top dollar for -- you can almost look at it like this: US tax dollars are subsidizing low drug costs in other countries (since we aren't benefiting financially).
(3) Gilead's Hepatitis C drug Sovaldi brought in over $5 billion in the first year of sales. You let the Gilead spokesperson phrase the question in terms of "what did it mean to the individual to be cured of Hepatitis?". The business question is "What should be charged to recoup the development costs and make a modest profit? Pharmaceuticals are a business and industry profit standards for pharma companies are far higher than almost any other industry. I'll bet the answer isn't close to $5B. And if you think this probably doesn't hit home for me, let me tell you that it does. My father-in-law is an Egyptian citizen who contracted Hepatitis C from a dentist in Egypt who did not practice good hygiene between patients. He died in early 2014 from liver failure without ever having the option for Sovaldi because it was never presented as an alternative when he was undergoing the treatment that harmed his liver while it drove down the HepC viral load. I don't know whether or not the Egyptian doctors treating my father-in-law knew about Sovaldi at that time and I don't know if the healthcare system would have paid for an $84,000 treatment protocol. I do know that no one in the family (even combined) would have had the $84,000 for Sovaldi. It is also quite likely, that if the family had known of Sovaldi and was willing to beggar themselves to provide this treatment, that he would have refused. He was the type who would say "take the money and spend it on the kids (his grandchildren) or yourself, not me" whenever we tried to do something for him -- he was that type of guy. Still, I wish we had had the option and I wish that Gilead (and companies like them) made their calculations based on modest profits and not what they think insurance companies and wealthy governments will pay, because ultimately this particular drug is about a human life.

Jan. 11 2015 01:31 PM
Jim Chandler from Maine

Just listened to Worth and it raises many valuable issues. However you glossed over one very important aspect. Surely the drug company cannot justify billions of dollars of cost, even if you spread the cost over all its drugs to justify the high cost of the drug. Drug companies should also be held accountable for such high profit margins. Why do you think it was so easy for the company to drops its cost by 50% for fear of losing out. Also in this regard, how much of the basic research was funded with public funds, like NIH, for which the drug companies profit? There needs to be some limits to greed as well.

Jan. 11 2015 12:16 AM
Alexis DiBlanda

This is really interesting. How can we really determine the value of a human life? Does it have a fixed value? Or does it only based on how much people are willing to pay? These are such tough questions.

Jan. 09 2015 05:12 PM
MD

My guy reaction is that the narrative of this show (admittedly the first 15min) is fairly conservative by not considering things like nationalizing certain pharma companies, or offering extremely generous incentives to companies for solving certainly problems which still keep people working on things but which frames pharma as a public good which should be folded into the common wealth.

Jan. 05 2015 09:24 PM
Charles

Great episode. Really enjoyed listening to it. Keep up the good work.
My other recent favorited: haunted and juicervos

Jan. 05 2015 10:22 AM
Erin from London

"What's society doing at a conversation between me and my doctor?" I'm sorry but only an American could say something so colossally idiotic.

The suggestion is that there exists some point or points at which we aren't enmeshed in society, its structures, institutions, and values. If you and your doctor are using language to communicate, you're already participating in society, and that's without taking into consideration the various government subsidies in play for those receiving medical care as well as for medical R&D and for care providers.

If Americans had a bit better understanding of how we are quite literally all in this together, then perhaps they would demand a more humane health care system that didn't operate on sheer profit motive.

I left the US several years ago and have been happily living in a country that considers health care a basic human right. The national health service isn't perfect, but it provides quality health care to everyone, for free. The government uses its bargaining power to lower drug costs, offering, in exchange, exclusive use of a specific drug in the national system, or other attractive terms. This is what government-run health care can offer, in contrast to a health care system run by private insurance companies and drug companies.

Jan. 05 2015 05:15 AM
Alex from NYC

Here's another way to think about the worth of nature:

Within vegetarian thought, beings (such as plants, humans, and other animals) deserve rights according to their capacity, so "because animals have the capacity to suffer, they have the right not to suffer." (But because animals don't think logically, they don't command the right to vote.)

So when you're talking about nature, why not just think about their capacity to live, and their right to do so?

More vegetarian thinking: if another being cannot talk, then I will project my understanding of my worth into those beings' own self-representation, and treat them as I would myself, so: "I can't communicate with fish, but if I was them, would I want a human to eat me, or destroy my home?" The obvious answer is no.

As a side note, once you come up with the value of a human life, what is the value of our rights, such as the right to privacy, to assembly, or to freedom of religion?

Jan. 03 2015 09:43 PM
johnsenn from norway

Dear Radio lab.
Thanks for the thought provoking shows.

Ultimately the money issue comes to this:

If there is not a 'physical' thershold of production whereby a drug cannot be produced fast enough to meet the number of requests. Eg: adding factories/labs/equipment/raw materials to produce the drug in the first place. Or for that matter there is not enough doctors, nurses, hospitals to perform an time consuming procedure then there is a physical limitation on the healthcare system.

If its just a matter of paying for the treatment: Then the money is not an issue.

If the US government (or any government that issues its own currency) can at the stroke of kayboard deposit billions of dollars into the balance sheets of commercial/federal banks then it can also do exactly the same for funding any given treatment or any given drug. Especially if there are not supply constraints.

I think the show fell a bit short (usually radio lab gets to the bottom of everything ;) in exploring how a fiat moneatry system actually operates and the mechanics available to a currency issuing government such that the worst case scenario of a diabetes cure costing thousands per person multiplied by millions becomes a whole lot less problematic.

Jan. 03 2015 06:17 AM
Damon from California

Sadly, Radiolab continues to slide towards non-relevance. Aside from Jad Abumrad's completely casual, continual and distracting use of profanity, this episode itself has dubious worth.

Nature has its own inherent worth. So rather than discuss the subjective dollar value, why not illuminate some of the tremendously valuable things occurring in nature that most people don't know? For example, a deeper dive into the micro-ecology of the Salt Marsh would help folks understand the value in protecting them.

The height of irony is Jad opening the podcast with a plea for crowd-sourcing dollars. Assuming Radiolab has value itself, prove it by obtaining a sponsor to underwrite your expenses.

Jan. 02 2015 05:36 PM
Tony Peterson from Arizona

This was crazy, my mom has been blogging about Harvoni the 1,000$ a pill drug she hasn't even finished the 12 week treatment and has tested negative for Hepatitis-C. She's had it for 30 years and is also currently in chemo-therapy for multiple-myeloma.

Blog on Harvoni - http://mayhollenback.com

Jan. 02 2015 04:00 PM
Duke of York from Dallastown, Pa.

Oh my. What is happening to my Radiolab? Yet another snoozer. I couldn't get through the whole show either. Subject was worthy of a Freakanomics podcast, not Radiolab. Oh well.

Dec. 31 2014 12:23 PM
Mjae from Albuquerque

The fictional version of this Radiolab episode is perfectly encapsulated in this award-winning short story by Daniel Abraham: "The Cambist and Lord Iron." http://www.lightspeedmagazine.com/fiction/the-cambist-and-lord-iron-a-fairy-tale-of-economics/

“The measure of a thing’s worth is what you can purchase with it... You have a strange way of looking at things... To hear you speak, the baker buys my five shillings with his bread.”

“And how is that wrong, my lord?” the cambist asked.

“And then the wineseller buys the coins from him with a glass of wine. So why not buy the bread with the wine? If they’re worth the same?”

“You could, my lord,” Olaf said. “You can express anything in terms of anything else, my lord. How many lemon tarts is a horse worth? How many newspapers equate to a good dinner? It isn’t harder to determine than some number of rubles for another number of yen, if you know the trick of it.”

Dec. 31 2014 11:13 AM
Owen from United States

So, the cost of human existence?

I really enjoyed the topic of Worth, and the translation of worth into ecological and environmental values. But one idea I mull over often is the idea of "Cost" in a more philosophical and metaphorical term. I often wonder, what is the cost of my existence, on a bit by bit, day by day, action by action basis. As humans, I feel as if we are producing less and less for our ecosystem both nature and psychological, and I'd just like to know the math behind what it costs the world for me to wake up in the morning to an electric alarm clock, turn up the heat a little, walk down a paved sidewalk in my shoes, eat lunch, etc. What do all my small actions add up to in cost similar to how you researched the worth of ecosystems.

In short. What does it cost to be a human on the smallest and largest scales? Is that cost increasing? And do any of these ideas of cost, cross over into phycological human interactions with each other?

Dec. 31 2014 10:13 AM
Keith from Maryland

Shouldn't we start this conversation by discussing what a dollar, or a hundred dollars, or a thousand dollars represents in effort? If I'm going to make a decision about whether an extra year of my life is worth $100,000 I want to know the level of effort to provide that money. Does that factor in or is my reasoning unsound?

Dec. 30 2014 03:34 PM

We can calculate the actual cost to manufacture a pill with a $1,000 price tag, and unfortunately without doing that first, the discussion is nearly pointless. So let's do that.

Dec. 30 2014 07:40 AM
Ricky from Houston

Outside of the purely economic debate, there's a much better way to phrase the "what is a year of life worth". Rather than asking someone to monetize their OWN life (as everyone is assuming) ask them what they'd pay for an extra year of life for their spouse, their child, their parent. The numbers would be much higher & all those people that wouldn't give much for another year of their own life might pay massive sums to save a dying child. This is the context that medical treatments and care are taken. For example, your frugal Grandfather didn't get that expensive surgery because he wants to live a little bit longer as much as Grandma and his children, and his grandchildren want him to be around longer.

Dec. 29 2014 02:15 PM
quinn from radiolab

I am really starting to hate the U.S government.

Dec. 29 2014 11:29 AM

when the segment of drugs came I had the deep feeling of frustration....this was the first time in many many years since i listen to radiolab that my position and the narrator position was on totally opposite sides of the scale...i felt so frustrated...when the question of worth is perceived from market position (which is bulshit...arbitrary, and doesn't have anything to do with real costs) but it is in fact added value....and this has to do with capitalistic system america is operation in...I dont want to be communist here...
but i was also surprised Robert Krulwich didnt react to this...whom I consider a soulful man :) ...love the show...been listening it for years from Bosnia and Herzegovina....but really had a urge for the first time to react to the usually extraordinary show! love you guys <3

Dec. 28 2014 05:32 PM
Rob nanansns

Agree w mike from Dallas - the production was awful. Incredibly distracting, almost unlistenable. The topic was interesting, but nothing really new was discussed. Also, having the narrator drop profanity bombs ("holy shit!") in background is amateurish. Act like a pro. The narrator is not the story. The story is the story.

Dec. 28 2014 03:34 PM
Dan from Missouri

I find it hard to believe that if the US government could know that there was an al-Qaeda operative in the wedding convoy, they could not know that it was a wedding convoy. To say this was a "mistake" seems really misrepresentative and typical of US propaganda. It's obvious they knew it was a wedding convoy and decided that killing everyone in it to get to one person was worth it. That doesn't make it a mistake, it makes it mass murder. Also, the US is not at war with Yemen and thus these drone strikes are really very illegal under international law. You all did such a great job with the show on the Authorization to Use Military Force, and this attack is that in action.

Dec. 27 2014 09:48 AM
A man from Fint, MI, USA

Here, here "Spartacus from Santa Fe", well said and without distraction.

The movement of the center of popular thought has shifted so far right that even a well done piece with great collective social implications fails to consider one of the most fundamental dictums of investigation, cui bono.

Dec. 27 2014 09:47 AM
Spartacus from Santa Fe

What I find missing in the discussion of pharmaceutical costs is the question of whom is profiting, and by how much. After all, it is not simply the development cost of pharmaceuticals that figure into final product costs -it is also the expectation among executives and share holders that they will be enriched simply by their position in the organization or in the market. Lots and lots of hand-wringing about valuing the life of the infirm, and no consideration of the outrageous enrichment of a very few at the expense of individuals and society both. By failing to look into this part of the equation, Radiolab tacitly supports the currently popular notion that concentration of wealth in the economic system is not subject to question. I for one am very very disappointed that this critical factor was ignored in the segment.

Dec. 26 2014 11:42 PM
Max Zarayan from San Jose, California, USA

Great podcast. Very timely and important topic. The cost of medicine, not just medication, is growing at a rate far greater than any other metric. A national or perhaps even international level discussion needs to happen to address it.

There is one problem with the "worth" question. It has to do how the cost is scaled. In the case of Sovaldi, you have a drug that cost over $2.5B, and is used at a rate of say 100,000 patients and a per patient cost of $84K. That's a yearly revenue of $8.4B. Since it cures the disease, it should have a diminishing return over the years. While one may consider this rate of return a bit excessive, it's still a far cry to extend the argument to say diabetes medication. In the case of diabetes, you're talking about 2-3 million people. If you assume that the development cost of the miracle diabetes medication may cost similarly in the few billion range, the same type of return rate would mean the drug would cost a few thousand dollars. After all the cost of producing and distribution of the drug is minimal.

Just a thought.

Dec. 26 2014 07:51 PM
Kris Alman MD from Portland, Oregon

Stupendous topic! The price of drugs will continue to skyrocket because pharmaceutical companies charge what the market will bear. There is no correlation to the costs of research & development. The rationale for Sovaldi is that the costs for liver transplants are averted with a cure.

How do can these companies claim this? This research was funded by the very same drug companies that make these claims! There is no long-term research to support a "cure" as the drug has not been around long enough.

Furthermore, obscuring the price of healthcare means that we agree to pay whatever the market will bear--and blame the insurance companies for not paying.

The cost-benefit of treatments at end-of-life is not contemplated in ways that address quality of remaining life. I am so glad you recommended Atul Gawande's new book, "Being Mortal."

This is a political problem where we are held hostage by capitalist greed... and it will spiral out-of-control if secret TransPacific Partnership and Transatlantic Trade and Investment Partnership treaties (intellectual property chapters) are fast tracked through Congress. Learn more at Public Citizen.

Dec. 26 2014 05:39 PM
Rama Ganesan from United States

Actually, the cost of drug development and marketing has been calculated. I just looked it up. It costs $2.6 B to bring a new drug to market. http://csdd.tufts.edu/news/complete_story/pr_tufts_csdd_2014_cost_study

Dec. 26 2014 03:42 PM
Uli from London

Intense story telling here. One of the best episodes yet. Really tough questions, pressing. Thanks for pressing.

Dec. 26 2014 01:30 PM
Knotts from Western PA

Speaking of "worth": You read in the newspapers that "so-and-so is WORTH X billion dollars". The language we use equates the worth of a human being with their money. And by extension, their worthiness. Thus an impoverished person is worthless, according to common language usage promoted by the media. A wealthy person is to be celebrated for their wealth, regardless how that wealth came to him, or what is done with it. A young person might unconsciously absorb this message, and compare their career choices accordingly. Executives of finance hold greed dear, as a cherished moral value. It's a damaging word.

It is time we changed the language. So-and-so is sitting on X billion. So-and-so commands X billion in personal wealth. Or how about simply, "has".

Dec. 26 2014 10:26 AM
Cycledoc from Everson, WA

In fact, other countries have figured out how to somewhat control drug costs. They spend less and get similar medical outcomes. The U.S. leads the world in medical expenditures and in the cost of patented medications. Simply by reviewing cost/efficacy and negotiating with drug companies, prices overseas are significantly less than we pay here.

Our expenditure on healthcare/capita is 1.5 to 2 times that of other countries. We're the only country in the industrialized world that has people going bankrupt from health care costs. Why? You tell me.

www.medicynic.com

Dec. 26 2014 07:47 AM
Jan Luszczek from USA

Prices of drugs could be controlled through good old market forces if drugs had to strive for approval based on shown effectiveness AND price. Let's say we put a ceiling on ALL drug expenditures at x% of GDP. Then split that drug budget proportionally to illnesses, their prevalence and their severity. We would end up with x amount of dollars to treat Hepatitis C and y amount of dollars to treat ovarian cancer. The drug companies would have to propose products that meet those budgets and are an improvement over existing treatments. In that system Sovaldi could well be approved despite high price, but the cancer drug that gives the patient additional 42 days would have to be priced accordingly to be approved.

Dec. 25 2014 10:23 PM
Nancy from Choteau Montana

I once worked as a paralegal and this episode struck me as weird because it failed completely to address the very rigorous workers compensation system in this country that makes value decisions on human worth every day. Certainly the basis is income potential (that's what the 911 commission did). What is a hand loss to an electrician, a leg lost to a construction worker versus an office worker, it's all there in writing every day. Life too is given a value. My dismay comes from what the drug companies make if they are successful, where does that money go, it's all in a fog of "research." What is that but people using materials and spending time. When the commentator said that the one drug brought in billions, I am outraged. Prove to me, that making that drug cost billions. No way. The fact that the drug company can cut the price 50 percent reveals the unfairness. This also highlights the issue of end of life issues versus cures and I am all for that debate.

Dec. 25 2014 12:41 PM
LIstener in NYC from NYC

Small nit. The Jeep didn't exist until World War II: http://en.wikipedia.org/wiki/Jeep#Development

Dec. 25 2014 11:30 AM
Douglas B from Pennsylvania

I would like to respond to the discussion about drug prices, and the value of life, ie another year. I have dealt with these issues in a sense for many years, since I am a pharmacist, but also I have a degree in Finance, and to top this all off, I have significant experience working in hospitals and cancer treatment centers.

In a way, the amount we are willing to pay for another year is very individual. To illustrate this, lets take a average person who earns $50,000 per year, no insurance. Lets say, over a 40 year career, this person saves $1,000,000. He has a wife and 2 children. If he retires, and is suddenly presented with a diagnosis, that requires a $1,000,000 expenditure to live another month, I am certain he will decline. Would he spend all his money he saved for him, and his family for 1 extra month? Very doubtful.

Now if we change the scenario to an insurance question, the answer starts to become clearer. With insurance, the above example question would never need to be asked. Lets say this and every individual can buy insurance, like any other insurance, that has differing limits. For example, one insurance costs $100 per month and guarantees a payout of $100,000 if a catastrophic illness happens. Or for $250 per month the limit is $250.000. Now in our example we know out patient makes $50,000 per year, how much insurance would he or could he afford? Well he makes about $4500 a month, and that needs to cover many things, it seems at most he might decide to may 10 to 20%, ie $450 to $900 per month, which at most would get him $900,000 worth of insurance. While these numbers are made up, if such a market existed, the numbers would become elucidated.

This is the system we currently have, even though as a society we don't want to admit it. We buy the insurance, and before obama care there were lifetime limits, now under obama care, I am not sure. But in a macro sense, there are limits. If these limits were elucidated, the questions presented in the show would have clear answers. The system is currently careening toward these limits for multiple reasons, which is a whole other discussion, but with the developing societal scenario, these limites will probably become necessary in the next 5 or 10 years.

A big part of the reason this is happening, is that drug development is becoming a higher and higher risk endeavor. As the costs go up, and the number of new drugs goes down, the price put forth by the drug companies is skyrocketing. The "societal obligation" of the drug companies to put forth a reasonable price for a drug is being unmasked as a one way agreement that drug companies are no longer willing to honor. As this occurs, the distortions presented in the system are being taken advantage of, ie one additional month of life for $100,000. Once game theory is applied to the pricing of drugs, then the goal is to get a drug that shows even the most marginal of improvements, and charge exorbitant prices,

Dec. 25 2014 08:30 AM
Liz Alva Rosa from United States

As uncomfortable as it is, it is important to discuss the cost of health care. Our resources are limited and we need to have these difficult discussions. Especially with end of life care.
I was very disappointed that you did not address the idea that drug companies have carte blanche to charge whatever they want. For sick people these drugs are not a choice. Most other countries in the world negotiate with US drug companies for a better deal. The US does not. As a society we need to address this issue and put a stop to it.

Dec. 24 2014 05:06 PM
Michael from Dallas

Stylistic comment here: Good God, do you have to edit the program in such a way that you have that horrendous rat-a-tat ping pong style of narration:
Doctor: The cost is
Narrator: ...$22,000
Doctor: ...dollars.

It's horrific. Especially when the narrator has a good strong voice and the doctors in the early part of the show were soft spoken. I don't mind the style when you are doing this to clarify a statement but these short one and two word back-and-forths are distracting as hell. If it is only a one or two word edit then just tell us what the doctor said and move the story along.

Finally, I get that you audience may speak using terms like "like" and "totally" but that just slows the show down when the narrator does it.

I'm sorry, but the subject deserves more tightness.

Now I will go back to being a curmudgeon.

Dec. 24 2014 04:55 PM
Andrea from Indianapolis

Interesting episode, as always.
I was a little disturbed by the abstractness of the issue of compensating families of victims of American military action abroad. What is the buying power of $2500 in Iraq or $30,000 in Yemen? Could it put an orphaned child through college, for example? I appreciate that there is a symbolic component to the compensation, but the dollar amount must matter to some of the families. In the story, we only heard from one person in this situation and I'm not convinced your conclusion is valid.

I also want to respond to the reference to the debate around the legalization of same-sex marriage in California, where a number value was placed on the revenue that legalization would bring into the state. The speakers stated that's not what most people think about when they think about legalizing gay marriage. Here in Indiana same-sex marriage was legalized this fall by federal court order. But early in the year, an amendment to the state constitution that would have defined marriage as only between one man and one woman was debated in the state legislature. The economic argument- that the state would lose skilled workers and therefore revenue to more open-minded states came up again and again. (The amendment did not pass because the two houses disagreed over whether to include civil unions in the ban).

Unfortunately, these are the arguments that win. Governments will take steps to slow climate change when they believe the cost of not taking those steps outways the cost of taking them.

Dec. 24 2014 04:34 PM
ricecaek

The decision’s fairly easy when individuals asked that they must pay for such expense. It’s extremely unfair to have the masses to pay the ever increasingly high insurance premium which reach to the point of unaffordable to the masses so just few people can have all the treatment. That’s the reason why so many don’t buy into the insurance scheme.

People must take individual responsibility to take care their own health first in their life. Education system must add to educate people about their body and their self healthcare as primary education. They can't just abuse themselves and let others or the system to fix the mess. Your person is your own sole responsibility. People must made to know that Life and death are the package deal to be a human.

Dec. 24 2014 12:45 PM
karlem

This is the first time I could not even finish an episode of Radiolab. I can't believe you are using MONEY to put a value to people and not questioning the value we give money in the first place. Very disappointing.

Dec. 24 2014 09:17 AM
Kieron from Yorkshire

That's it?

You're just going to end it there?

I concede that all ideas are drawn from nature, so we need to factor all intellectual property into the value of nature, but what then?

You mention irreversibility, then point out a value we take from nature that doesn't suffer from it.

Where's the discussion on accounting for opportunity/replacement cost when discussing the importance of nature?
________

Also I'm surprised that you didn't contrast Nature against Art when your counterpoint to nature's utilitarian value is nature's importance as an aesthetic feature.

Art is all about aesthetic, yet I don't see people campaigning to protect every cast-off doodle or rubbish painting.

Art is protected when we put a price tag on it. If nature is art then isn't that a stronger argument for putting a value on nature.

There can be no new works of Picasso, there's the allegory of the irreversible damage that can be done to nature, yet we have allowed 99% of art wither and decay to nothing.

If we want to understand how to value nature we can understand how we value art.

Dec. 24 2014 06:02 AM

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