Comments on: Dedicated Ventilators?

By: Dreamer

Dreamer — Sat, 26 Jan 2008 21:27:38 +0000

Here is a creative solution.

This project is being worked on. The Pandemic Ventilator Project ( http://www.panvent.blogspot.com/ ) has already produced a workable prototype that can be made from readily available parts in an emergency. A second more sophisticated design that can meet the acquisition guidelines of the AARC (American Association of Respiratory Care) http://www.aarc.org/resources/vent_guidelines.pdf. is currently being developed.

This is not the first time homebuilt ventilators have been required to save lives in an epidemic. Look here to see examples of home built ventilators made in the 1940s and 50s to combat the polio epidemic.

http://www.ncl.ac.uk/nsa/vent.htm

The Pandemic Ventilator Project

http://www.panvent.blogspot.com/

By: Adam

Adam — Wed, 15 Mar 2006 05:30:11 +0000

You’re free to sell your house as you like. (Although, I’ll humbly suggest that you might sell it for $200,000, and donate to Oxfam yourself, perhaps getting a substantial tax benefit.)

When you suggest imposing taxes, then I am no longer free to invest my money as I see fit, and that, and further inefficiencies should be considered more carefully than what you personally choose to do.

By: Puzzled

Puzzled — Tue, 14 Mar 2006 18:04:25 +0000

One more response, then I will let you have the last word. But your switch to contracts does not really help you. In a world with multiple suppliers of ventilator technology, anyone who in essence doubles the price of their ventilator will see sales disappear. Every potential purchaser will go buy from the supplier who is offering ventilators at the normal, lower price. Indeed, that is why taxation has to be done at the governmental level. If not, the “tax” just looks like a price increase, and competitors undercut it.

I do not mean here to beat you up, by the way. This is a great topic and a worthwhile discussion in which to engage. I do mean, however, to push you to do even better in your posts. As I say, blogs are not an excuse to drop the ball; here, you ought to be bringing sophisticated analysis to bear, albeit in engaging prose and with oh-so-pretty pictures.

By: Frank

Frank — Tue, 14 Mar 2006 17:57:57 +0000

one last thought–i assume you’d defend my right to sell my house for, say, $100,000, with the requirement that the buyer also donate $100,000 to Oxfam. I don’t see how this is different.

By: Frank

Frank — Tue, 14 Mar 2006 17:54:40 +0000

Puzzled, your points are certainly economically sophisticated, but politically naive. The NYT article made it clear that this is not a priority for the government right now. In the face of government lethargy, creative private solutions are necessary. Would you be comforted if this were just done by an association of hospitals, via contracts, rather than being thought of as a “tax”? I know that’s a dirty word to many…so just think of it as a contract between the hospitals and the people who buy the ventilators.

By: Puzzled

Puzzled — Tue, 14 Mar 2006 17:34:30 +0000

Sadly, I think you just proved my point. Your response is not a response. The commenters above are telling you that we can achieve the exact same health outcomes in multiple ways: we can raise the money by taxing health care, we can raise it by taxing income, and so on. That is important because taxation has enormous efficiency implications, and we want to tax in ways that minimize those problems.

Your response doesn’t speak to this issue. It seems instead to imagine that we are arguing about outcomes (how much health care to the poor, how much to the wealthy, and so on) when instead the criticisms here are about method. Why tax only one item (very very inefficient, most likely) when we can fund the same end result by taxing more strategically?

ps. Blogs aren’t lectures, true; but that’s no excuse for sloppy thinking. Besides, it’s likely that more people read this blog than read your scholarship (or Dan’s, or mine.) So we should strive to get things right.

By: Frank

Frank — Tue, 14 Mar 2006 17:21:15 +0000

Puzzled–well, this is a blog, not a tutorial or lecture. If I were really serious about making the point, I’d direct people to Daniel Callahan’s books on the topic, the extensive literature on rationing, etc. But anyway, here’s the core quote:

Individuals, too, are obliged to rethink the ways they invest (directly and indirectly) in the projects of negative immortality [i.e., the indefinite evasion of death]. One strategy would be to match whatever one spends on extra-ordinary medical technologies with donations to assure that poorer people get access to ordinary medical technologies. Since the distinction between the ordinary and the extraordinary is difficult to apply in practice, a more reliable heuristic would be comparative evaluation of insurance payments. In other words, a person genuine-ly concerned about the potential of new technologies to advance inequality of life chances would try to match whatever they spent above the average on health insurance with donations to insure those without coverage.

One might object: why scrutinize health care expenditures so carefully? Even if we follow liberal theorists and accept a public duty to assure that all persons meet a certain baseline of care, why should our contribution to this goal be tied to our own health expenditures? Shouldn’t people match, say, what they spend on entertain-ment, with expenditures for the poor?

These difficult questions challenge the heuristics proposed above. Nevertheless, health care is an area in which we need to be concerned, not only with assuring everyone a certain baseline of care, but also with assuring that levels of care in general do not diverge too far from a norm. As “boutique” medical practices become more common, already existing medical resources are being allocated away from those who cannot afford them in order to provide “deluxe” care for the wealthy.

Regenerative medicine threatens to further inure the comparatively wealthy to the claims of the poorest by rendering their lives qualitatively different. Most other expenditures (such as those on entertainment) are methods of dealing with (or distracting oneself from) a common human fate of mortality. The new technologies of negative immortality are methods of escaping this fate, and thus may erode the bonds of empathy upon which the moral psychology of distributive justice is premised [unless they also help finance health care for the disadvantaged.]

By: Puzzled

Puzzled — Tue, 14 Mar 2006 17:14:29 +0000

Please don’t just cite your own papers as a response to what reads to be devastating criticisms of your blog post. Your post looks like it makes an enormous error: you tax ventilators exclusively, rather than spreading the tax in a more efficient way. If you have a response, give it. But to just link to your paper is lame. Who would bother to read your long-ish paper on this subject if your 3-paragraph summary has such a huge and obvious hole?

By: Frank

Frank — Tue, 14 Mar 2006 16:48:02 +0000

Adam, that’s a very good point re taxing only health care…I actually try to address it in my piece on stem cell research…pages 117-188 of this pdf:

http://law.shu.edu/faculty/fulltime_faculty/pasquafa/pasquale_stem_cell.pdf

By: Adam

Adam — Tue, 14 Mar 2006 16:42:02 +0000

John,

There’s a nearly infinite number of things to tax. For example, we could tax blog postings, and use the money to buy ventilators. Then some folks could buy ventilators who could not if we tax them at 100%. That would seem superior to letting the old people die because they can afford one ventilator, but not two.

By: John

John — Tue, 14 Mar 2006 06:27:09 +0000

You let the old people die first, then the sickest, then the youngest. It seems pretty simple to me.

By: Adam

Adam — Tue, 14 Mar 2006 06:24:49 +0000

I think you’re being overly flippant about adding a 100% tax to ventilators. Why not just raise taxes across the board, rather than taxing health care?