Akst: Determining the value of a life

Daniel Akst is a member of the Newsday editorial board.

See if you can imagine anything worse than this: You're moving your car in your own driveway when you back over a little bump.

But that bump turns out to be your infant son, who dies of his injuries. Now all you have to do is live with what you've done for the rest of your life.

I am a father, and so I wish I could say I was making this up. Unfortunately, this is what happened to a man right here on Long Island.

All of us can agree that no one should have to go through such a thing, which is why Congress passed a law in 2007 that will eventually require rearview cameras on new cars. The National Highway Traffic Safety Administration wants to impose this for all new cars starting Sept. 1, 2014.

The problem is, this will be expensive. The agency estimates that making cars with the necessary equipment will cost an extra $1.9 billion to $2.7 billion annually - the equivalent of a tax on cars, paid by consumers and car companies. The cameras will save - at best - 112 lives and 8,374 injuries yearly, the agency figures.

Combining all this into a single metric, NHTSA says the law will cost $11.8 million to $19.7 million per "equivalent life saved" - way more than the $6.1 million value it normally puts on a life. In other words, the law doesn't pay.

So is it a mistake? Well, the camera technology will probably get cheaper over time, lowering the cost. And I can't put a price on the pain we'll prevent in parents who might have run over their children. But perhaps someone should try, because it's amazing how much good you can do with money.

Scientists have tried to get a handle on this. Based on clever surveys and other techniques, researchers generally accept the value of $50,000 to $100,000 for a good year of life. And many health interventions clock in at way less - making them bargains.

In one study, flu shots for people ages 50 to 64 cost $34,000 per year of life saved. Antiretroviral therapy for people with HIV was around $30,000 for an extra good year.

Some efforts even saved money. In this category, according to a report from the Robert Wood Johnson Foundation, is immunization for childhood hepatitis A in parts of the United States where the disease is prevalent. I won't even get into what might be accomplished on behalf of Third World children for an absolute pittance.

It's a wonder we haven't gotten around to such things yet, given the evidence we can save lives at little or no cost. But it's human nature to move mountains to save some recognizable person; we care much less about any statistical "lives" whose faces we don't know.

Now, sooner or later in such discussions, we are all tempted to ask, "How can you put a value on a life?" But when we ask this, we are really asking two questions.

The harder one is, how do you arrive at a number? The answer is contentious, but government agencies and others do the best they can based on various factors, including how much extra people demand to be paid for doing risky jobs.

The second question is, "How can you possibly be so callous?" But putting a number on lives is the very opposite of callous.

Sometimes, for example, we do it because someone must be "compensated" for a loss, and while money can never make up for the death of a loved one, it's the best we can do.

More important, we try to put a number on the value of a life because resources are finite, and spending a lot of money to save just a few lives could mean the loss of many more that might have been saved by spending in other ways - however callous the calculation may seem.