[ericflo]

> Viewing this after-the-fact leads one astray, into thinking there is some problem with the system

> The answer is probably that this drug doesn't make economic sense

You don't see it? The problem with the system is that we let economics drive these decisions.

[SilasX]

What would it look like for economics not to “drive decisions”? Spend unbounded money to save each life? That doesn’t make sense either.

What decision mechanism do yo prefer, and how would it work differently here? Why would that outcome be better?

Remember, even the much-lauded European health care systems didn’t feel it passed the cost benefit test, and they’re supposed to be the model of “not letting people die for lack of money”.

Rejecting economic thinking doesn’t suddenly solve the problem of opportunity costs and trade offs.

[ericflo]

You quoted me, but missed the important word - these decisions. It's a tragedy of the commons type thing, and we can carve out specific solutions to that, as we do for these types of situations. Where the European healthcare bureaucracy draws their specific moral lines has no bearing on my overall argument.

[SilasX]

But what is “these” and why would the same points not apply?

The fewer people that are suffering a given disease, the lower return to curing it. Moralizing doesn’t change that; it just means you’re willing to prioritize it over cures that help more people.

Yes, creation of disease cures is a tragedy of the commons, but the point is that there are worse tragedies of the commons. What consistent, defensible decision procedure favors a different response to this one?

[ericflo]

It seems we agree in principle on tragedies of commons - that in edge cases where normal rules of economics produce lethal externalities, we should intervene.

My original comment was simply pointing out that it is not inconsistent to blame the system for these lethal externalities.

Where and how we draw the lines on where to break from economic decisionmaking and into moral decisionmaking is a way, way bigger topic.

[SilasX]

I'm sorry, but no, you don't have a basis for concluding that from my responses or the thread.

In my previous comment, I just explained to you why -- even accepting that there are these disease victims you want to care for -- you still wouldn't necessarily have a justification for allocating resources toward a cure for this disease. After all, there are far worse tragedies of the commons: diseases that affect far more people, and that even European governments believe merit a higher priority.

To wave a wand and say "oh, we should throw money at this rare disease", you're saying "we should throw less money at the things that are impacting far more people". (Or, worse, you're saying we should throw unbounded money at all problems, the very charge I originally made!)

And you still haven't even explained under what criteria you would do anything differently, let alone why those criteria would be any better.

So no, you don't get to claim a moral high ground, or that "economic thinking" led to the wrong decision. Not when you can't even explain what exactly the moral error is, or why.

[infinite8s]

Economics drives all decisions. Economics is ultimately about allocation of a finite set of resources.

[umanwizard]

Okay. Let's say you were the dictator of the world. What model not involving "economics" would you propose for deciding how many resources to assign to which medical research projects?