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Put a price on life

We can hate the virus. We can fear the virus. We can scream at the virus. We can weep before the virus. But we should also love the virus.

And that’s because the COVID-19 virus will force this country to finally have a real conversation about health care and, as result, we may elect to improve the system we have.

For decades, this country has refused to put a pricetag on life and, in this refusal, we have created a monstrously expensive, overly complicated health care system that consistently has delivered poor public health outcomes.

It’s our fault. We refuse to say how much this country is willing to spend to save grandmother’s life or, for that matter, any life. In that refusal, we give power to hospitals, doctors and insurance companies. They decide, not us, what gets spent on health care. The results have been cataclysmic.

The virus, however, is changing how we view health care. It is forcing us to connect dollars and lives in new ways.

Let’s consider the case of Wisconsin. On March 24, Gov. Tony Evers issued Executive Order No. 12 which instituted Safer at Home social isolation rules, closing schools and non-essential businesses, including bars, restaurants and hair salons. The order had an immediate impact on the economy.

The state Department of Revenue now predicts state tax revenues will fall from $17.3 billion in 2019 to an estimated $15.7 billion this year, a nine percent drop. If the state’s general economy shrinks by this same percentage, it means the Wisconsin Gross Domestic Product will plummet in 2020 by $30.6 billion or $588 million a week.

This weekly figure is, we can say, the cost of Safer at Home. But what did it buy?

The Wisconsin Department of Health Services tells us. The department reports that before Safer at Home, COVID-19 infections in Wisconsin doubled every three days, but, after Safer at Home was put in place, the doubling slowed to every 12 days. In flattening the curve, the department said, Safer at Home has saved between 300 and 1,400 lives.

These lives saved are precious, certainly, but, in truth, not priceless. Government and business price lives all of the time. The Environmental Protection Agency, for example, prices one life at $10 million. This is not an arbitrary number, but, instead, is based on labor premiums paid coal miners for the risks they take on the job.

So, let’s do the math. Safer at Home saved between 300 and 1,400 lives in three weeks. Each life is worth $10 million. In keeping people alive, Wisconsin benefited. The monetary value of that benefi t is between $3 billion and $14 billion. The cost of Safer at Home is $588 million a week. The three week cost is $1.8 billion. The bottom line? Safer at Home is good public health policy. It pays off. It’s worth it. It gets a thumbs up.

The state, following the nation, is twisted up in a debate over when COVID-19 lockdown orders like Safer at Home should end. Opponents want the isolation orders halted immediately, claiming that people need to work and businesses need to stay open. Gov. Evers has responded with the Badger Bounce Back plan that would open up businesses based on whether the state sees fewer COVID-19 cases.

This disagreement will likely turn into a miserable, political debate that will divide the population and solve nothing. Instead, we should do the math. We should agree that we need Safer at Home when the benefits of the shutdown exceed the costs, but also agree that the program should be relaxed when costs exceed benefi ts. Now, is this cold blooded and heartless? No, it’s basic public health policy, and it’s a far better approach than having an ugly, bitter wrangle between Gov. Evers and Republicans, including the Trump-supporting libertarian crowd that has made headlines in recent days.

We can move forward on the COVID-19 pandemic by putting a cost on life. We can save lives in practical ways, being cost effective in our approach.

But there is no reason we need to stop here. If this nation can handle COVID-19 through a public health approach, it can also take on the mess that is our entire national health care system where we spend more than any other country on the plant, but have mediocre public health. To move forward, however, we need to take one crucial step. We need to put a price on life.