Aboriginal life expectancy: How much are we willing to pay to bridge the gap?
By Gavin Mooney, Professor of Health Economics at Curtin University|
Apr 11, 2008 12:00AM |EMAIL|PRINT
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.