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Apr 11, 2008

Aboriginal life expectancy: How much are we willing to pay to bridge the gap?

Can we - should we - place a value on an extra year of human life? ponders Gavin Mooney.


The Government’s commitment to closing the 17-year gap between Aboriginal life expectancy and that of other Australians by 2030 is very welcome, as is Rudd’s plan to monitor progress regularly. Perhaps the cost of bridging the gap doesn’t matter. It is an ethical issue and perhaps as such is beyond price. After all can we – should we – place a value on an extra year of human life?

As a society we do – or at least the Pharmaceutical Benefits Advisory Committee (PBAC) does on our behalf. The PBAC decides on behalf of government if a drug should be listed for taxpayer subsidy on the Pharmaceuticals Benefits Scheme and thereby made available at a reduced cost.

The judgment of whether or not to list for subsidy is reached on the basis of a number of factors, including the so-called “cost effectiveness” of a new drug compared to some existing drug. This “cost effectiveness” is often measured in terms of the extra cost per year of life extended.

It is grizzly arithmetic but one can see the logic. There is no explicit “cut-off” on the amount that the PBAC is willing to spend to extend a life for a year but the evidence from their decisions suggests that something like $40,000 is what they are prepared to say yes to.

If the Government is prepared to pay up to $40,000 on pharmaceuticals to extend an Australian’s life by one year, then not just logic but fairness and justice would suggest that they must be prepared to spend up to $40,000 to extend the life of an Aboriginal person by one year. So for 17 years, that would be $680,000.

There are about 500,000 Aboriginal people in Australia. Thus, the Government has agreed implicitly to pay up to $340 billion to bridge the gap.

If they were to say no to that, then they would be saying that Aboriginal lives are valued at less than average Australian lives.

They may not have to pay as much as $340 billion. But they have by implication indicated they are willing to pay up to this amount.

It’s time for Nicola Roxon to put her money where her commitment is.

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4 thoughts on “Aboriginal life expectancy: How much are we willing to pay to bridge the gap?

  1. Nick

    Poor old Professor Mooney, ignored over here in the west where he is rolled out at frequent intervals to repeat his mantra of “close the expensive doctor loving hospitals and spend all the money on preventive health”, seems to have found a new outlet. Same old, same old though, totally impractical tosh, too extreme to be seriously examined by the health system he despises. Maybe if he came up with practical, sensible, academically rigorous proposals he might merit his chair, and the airtime he craves.

  2. John T

    On the money, Garry. Might one of the few disinterested thinkers on aboriginality in Australian society please write here on the likely impact on health of winding down the “communities” and introducing young aboriginees into normal education, training, employment, income, and community life? As being proposed by Pearson et al; and in line with some emerging government and other seriously supported and structured arrangements for young aboriginees in their families, and boarding promising children in mainstream schools, and adolescents at comprehensive industrial and commercial centres offering real training. A long-haul task, but much more worthy of our wealthy and informed society than returning to the patronising “aboriginal development” models of the last 30 years.

  3. Steve Etherington

    Aboriginal people will continue to live short and brutish lives unless something like the 340 billion you calculate is used to move them into the workplace, or move the workplace to them. Its about jobs. All the other projects – housing, health and paternalistic controls over personal decision making are futile without giving people the essential personal freedoms of association, locality and personal income that we automatically have with our rights to work and access to work. It must be about jobs or we will simply waste another 340 billion. May God forgive us for the lives we will waste, and those we have already wasted by systematically excluding Aboriginal people from the workplace, and as a consequence, excluding their kids from the most fundamental human rights we insist on for non Aboriginal Australian children.

  4. Garry

    Perhaps we could also ask “what are aborigines prepared to do to bridge the gap.”

    We do need to remedy this situation, but more money alone will not do it.

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