America has serious health care problems, and as Paul Krugman makes clear in a recent column, serious cost control in the health care industry needs to be a top priority in reform. President Obama and Congressional Democrats seem poised to push for major health care reform in the upcoming months. One idea that politicians on neither the left nor the right will touch due to political sensibilities, however, could be the easiest way to save billions of dollars without affecting health care quality at all: legalizing euthanasia.
As every good CMCer with an understanding of economics should know, those with terminal illnesses are resource sinks for society. End of life care is incredibly expensive due to the frequency of hospitalizations, the increased need for specialists’ attention, etc. Those with terminal illnesses have even more expensive health care needs. Obviously, those in the final stages of a terminal illness are no longer in any position to contribute economically to society. Their continued existence may be personally meaningful to the those who love them, but from a economic perspective they are all cost and no benefit.
This idea is not new. The Netherlands, Switzerland, and Belgium all allow some form of legal euthanasia. Oregon’s Death with Dignity Act, which passed in 1994, allows those who have been diagnosed as being terminally ill to apply for assisted suicide. What is new is the massive number of baby boomers who are entering old age and straining America’s health care system with ever higher costs. Legalizing euthanasia at the federal level (or having the other state’s follow Oregon’s example) would allow millions of elderly Americans with terminal illnesses the option of ending their lives peacefully instead of suffering through the horrible pain and physical debilitations associated with prolonging life during a terminal condition. The supporters of Oregon’s campaign focused on this humanitarian argument. I would add that a proper conception of individual autonomy should also include the right to choose a painless death.
For the more utilitarian minded, however, consider this: a system of legalized euthanasia transfers medical resources from those who want to die to those who want to live. This Pareto improvement is especially clear philosophically when we consider that the government will undoubtedly play a larger role in America’s health care industry, which means that any money saved by allowing geezers to choose euthanasia frees up more health care dollars for the needy.
I know the arguments against legal euthanasia can seem convincing. Won’t we be embracing a culture of death? The short answer is no. The importance of the expressive function of the law is frequently overstated in euthanasia debates: I don’t think we have or are going to see profound cultural shifts in Oregon and select European countries because they have legal euthanasia. Alternatively, some argue that legal euthanasia will make those with terminal conditions feel pressured to end their lives early so as not to be a financial burden to their families? Sadly, this is already a reality and the only real solution would be a single-payer health care system that made families not financially responsible for their dying relatives. In the absence of a single-payer system, however, maybe the terminally ill really are justified in choosing euthanasia to spare their children bankruptcy. Regardless, I don’t see why the government is justified in making that choice for all terminally ill patients. To those with religious objections to euthanasia, all I can say is that many of us don’t share your comprehensive moral doctrine and would prefer to make the choice for ourselves.
Think about it: legal euthanasia is the ultimate cost control measure for the health care industry.