What's a doctor worth? A lot, says Natasha Kerplunksy:
A dustman is worth £1m for cleaning up the rubbish, as far as I'm concerned, and a doctor is worth £20m for saving someone's life.
Are they really? NICE doesn't seem to think so. Researchers reckon (pdf) that it values a quality-adjusted life-year at a maximum of around £35,000. This is roughly consistent with the rule of thumb (pdf) that the value of a statistical life is 120 times GDP per head - £2.5m.
On this basis a doctor would have to save eight lives (at birth) a year to be worth £20m a year. More likely, he'd have to add just over 12 QALYs a week to do so.
Seems reasonable? Maybe not:
1. These are net requirements. In practice, doctors also reduce QALYs through sometimes fatal errors.
2. Successful medical interventions don't so much save lives as merely postpone death, sometimes for only a few painful months. This adds little to QALY. Much good doctoring, of course, consists in relieving discomfort or uncertainty, not prolonging life.
3. Even if doctors are worth £20m to us, there's no reason we should pay them this. For one thing, some of doctors' remuneration is non-monetary - job satisfaction and the like; you don't often find a doctor with a low sense of self-worth. And for another, doctors' pay depends upon the supply of them, not their "value." The benefit of doctors can take the form of consumer surplus, not necessarily their pay. It's a howling error to assume that people must be paid what they're worth.