The arbitrary economics of life and death

Posted by hans_casteels @hanscasteels, 3 days ago

It’s a peculiar thing, really—how life can be snuffed out in a school hallway for the price of a semi-automatic and a bad mood, yet salvaging a few extra months from metastatic cancer costs roughly the same as a small yacht. The value of human life is inversely proportional to how suddenly it's taken and directly proportional to how slowly it can be prolonged—preferably with side effects, paperwork, and the faint scent of hospital-grade despair.

The value of life, it seems, is determined by a system so arbitrary and surreal it would make Kafka weep into his mustache. One man is vaporized by a drone he never saw coming, his death unacknowledged by anyone but an algorithm and a quarterly defense budget. Another is kept barely alive by a rotating cast of specialists, medications, and billing codes—his existence meticulously prolonged not for meaning, but because the hospital hasn’t yet completed the correct insurance form. In this world, life is sacred, provided it's inconvenient, expensive, and stamped by at least three official seals.

On Monday, a child is gunned down in a school hallway with a weapon marketed like a sports car. By Tuesday, a pharmaceutical executive is celebrating the approval of a drug that extends the life of a man with metastatic prostate cancer by 4.2 months—for only $185,000. On Wednesday, Congress debates whether children deserve lunch. By Thursday, a hospital in Zurich offers cryogenic suspension to anyone willing to mortgage their second home. And by Friday, we’re all back to scrolling Instagram reels about green smoothies and the five habits of highly delusional optimists.

So what are we to make of this strange calculus? That life is simultaneously worthless and priceless? That it can be erased with a bullet or preserved with a billion-dollar pill? That a soldier in a trench in Donetsk dies anonymously for 40 feet of mud, while a man in Waterloo writes a memoir about 'beating cancer'—by outliving it six months?

Can we consider this question with the kind of moral detachment typically reserved for hedge fund managers and bioethicists?

1. Life Is Cheap When You're Selling It in Bulk
Mass death, it seems, has become the Costco of human experience. School shootings, bombed-out cities, opioid epidemics—these are industrial-scale operations. You don't weep for a statistic. You scroll past it. One thousand dead in Gaza? Two thousand in Mariupol? One child in Uvalde? We move on with the same numb efficiency we use to ignore spam emails or gym memberships.

The machinery of mass death is efficient, mechanized, and disturbingly democratic. It doesn't care about your 401k, your vegan diet, or your mindfulness journal. And it doesn’t charge you a co-pay. When you die in a war or a mass shooting, you don’t get billed afterward. There is, at least, that small mercy.

2. Life Is Priceless When You’re Buying It Back in Installments
Contrast this with the sick, the terminal, the hopeful. Here, life becomes a high-end boutique—no refunds, no exchanges, and definitely no price tags until you're halfway through checkout.

The prostate cancer patient doesn't die in a blaze of glory. He dies in beige hospital gowns, his dignity slowly bartered for modest survival gains and side effects that read like the script of a Kafka play. But, importantly, he dies expensively. Which means he matters. Or at least, his insurance does.

He is not a statistic. He is a patient. And patients, unlike victims, generate revenue.

3. The Tyranny of the Narrative
Mass shootings are senseless. But they are also narratively inconvenient. They interrupt brunch. They remind us that the idea of “life is sacred” has footnotes and exceptions, mostly printed in small, unreadable text. And we can conveniently dismiss the event, the unspeakable suffering of the next of kin of victims, with a cheap and gratuitous "though and prayers" bullshit remark

Cancer, on the other hand, offers a narrative arc: diagnosis, struggle, treatment, remission, relapse, death, preferably with inspirational piano music. It’s the hero’s journey for the pharmacologically subdued.

And stories sell. Not just to the public, but to the patient himself. He pays for the illusion of agency, for the story of "fighting." Never mind that the cancer does not care about his mindset, his diet, or his belief in positive energy. But hey, if you're going to die, you might as well die trying—preferably with branding and a GoFundMe page.

4. Death as Entertainment vs. Death as Industry
When we watch mass suffering on the news, it is framed like a thriller. Drones strike, sirens wail, reporters gesture solemnly in flak jackets. It’s fast, brutal, and broadcast-ready.

Chronic illness, by contrast, is boring. It unfolds slowly, in clinics and waiting rooms with bad lighting and worse coffee. But it is also more profitable. One does not build an economy on surprise shootings; one builds it on recurring appointments, proprietary medications, and patented devices that monitor your bowel habits in real time.

5. Because Hope Is the Most Lucrative Delusion of All
At the end of it all, perhaps we pay exorbitantly for life because it gives us the illusion that it matters. That it isn’t all chaos and entropy. That by spending $300,000 to live another year, we have somehow "beat the system." That the suffering was worth something. That our story, our little arc of inconvenience, had weight.

But the child who died in the school hallway had no such chance. No narrative arc. No $300,000 worth of experimental drugs. Just a final, brutal reminder that life is not sacred—it is situationally sacred. And situationally disposable.

So we live in a world where life is simultaneously a free-for-all and a Fortune 500 investment. Where you can die for nothing or live for everything—provided you can pay. It’s not moral. It’s not even logical.

But it is market-driven. And in late-stage capitalism, that's really all that counts.

Now, if you’ll excuse me, I need to refill my $14,000 prescription that may or may not extend my life by a season. Just long enough, I hope, to finish this sentence.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Excellent points, especially when you touch on the point (falsely?) attributed to Stalin: "One death is a tragedy; a million deaths are a statistic." 😕

That said, I'd counter that there *is* value in those initial short extensions of life for prostate cancer patients — assuming the patient gives genuinely-informed consent — because they're starting points. The reason some of us can live 10+ years of full, active life with stage-4 prostate cancer in 2025 is that people were willing to risk new, experimental treatments that offered only the faint hope of 10 more weeks or months back in 2005 or 2015, and the medical community learned from their experiences and refined the treatments.

Gentlemen of the past: over the span of years, from me to you, thank you for your courage. Your treatment choices weren't meaningless, even if they failed you. 🙇‍♂️

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@northoftheborder

Excellent points, especially when you touch on the point (falsely?) attributed to Stalin: "One death is a tragedy; a million deaths are a statistic." 😕

That said, I'd counter that there *is* value in those initial short extensions of life for prostate cancer patients — assuming the patient gives genuinely-informed consent — because they're starting points. The reason some of us can live 10+ years of full, active life with stage-4 prostate cancer in 2025 is that people were willing to risk new, experimental treatments that offered only the faint hope of 10 more weeks or months back in 2005 or 2015, and the medical community learned from their experiences and refined the treatments.

Gentlemen of the past: over the span of years, from me to you, thank you for your courage. Your treatment choices weren't meaningless, even if they failed you. 🙇‍♂️

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You’re absolutely right. We are the beneficiaries of the experiments and sacrifices of those before us. And although it doesn’t please me to be another sacrificial lamb, I hope that our journey makes future journeys less trying, more useful, and ultimately, more effective.

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@northoftheborder

Excellent points, especially when you touch on the point (falsely?) attributed to Stalin: "One death is a tragedy; a million deaths are a statistic." 😕

That said, I'd counter that there *is* value in those initial short extensions of life for prostate cancer patients — assuming the patient gives genuinely-informed consent — because they're starting points. The reason some of us can live 10+ years of full, active life with stage-4 prostate cancer in 2025 is that people were willing to risk new, experimental treatments that offered only the faint hope of 10 more weeks or months back in 2005 or 2015, and the medical community learned from their experiences and refined the treatments.

Gentlemen of the past: over the span of years, from me to you, thank you for your courage. Your treatment choices weren't meaningless, even if they failed you. 🙇‍♂️

Jump to this post

Excellent point. It's a small thing, but those treated before me with SBRT had to go through the process of making some kind of a body mold to hold them in place. I did not have to go through that because the technology improved. Since my treatment almost a year ago now, they're already finding MRI-guided radiation offers fewer side effects than CT-guided radiation, which is what I had. And it doesn't stop there. Research is underway showing that a supercollider can treat cancer better than current radiation treatments with even fewer side effects and in a single treatment lasting less than half a second (though it currently requires a gigantic building, much like the original IBM computers, the technology will eventually shrink). For those interested: https://en.as.com/latest_news/cancers-worst-nightmare-cerns-particle-accelerator-could-end-cancer-tumors-in-less-than-a-second-n-2/

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@scottbeammeup

Excellent point. It's a small thing, but those treated before me with SBRT had to go through the process of making some kind of a body mold to hold them in place. I did not have to go through that because the technology improved. Since my treatment almost a year ago now, they're already finding MRI-guided radiation offers fewer side effects than CT-guided radiation, which is what I had. And it doesn't stop there. Research is underway showing that a supercollider can treat cancer better than current radiation treatments with even fewer side effects and in a single treatment lasting less than half a second (though it currently requires a gigantic building, much like the original IBM computers, the technology will eventually shrink). For those interested: https://en.as.com/latest_news/cancers-worst-nightmare-cerns-particle-accelerator-could-end-cancer-tumors-in-less-than-a-second-n-2/

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Interestingly, while I didn't have to use a body mold for the 20 rounds of SBRT to my prostate, I *did* have to use a custom-made, cage-style head mask to immobilise my head and neck during the earlier 5 rounds of post-op SBRT to my middle spine. It's a lot like the mask that Hannibal Lecter wears in Silence of the Lambs, and probably about as comfortable. 😕

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Wow. A very intense read.

Just yesterday I received, I hope, my very last out-of-pocket bill for a medical procedure (I'm on Medicare now). It was a $300 bill for my share of my last $13,000 Lupron last December.

In my case, since my diagnosis 5 years ago, I find my life to be very valuable, I'm extremely busy doing positive activities, and I feel pretty good. I think that somewhere down the road, when I start to actually suffer from cancer, that will mark a new "stage" for me, and I'll certainly start questioning values.

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@bluegill

Wow. A very intense read.

Just yesterday I received, I hope, my very last out-of-pocket bill for a medical procedure (I'm on Medicare now). It was a $300 bill for my share of my last $13,000 Lupron last December.

In my case, since my diagnosis 5 years ago, I find my life to be very valuable, I'm extremely busy doing positive activities, and I feel pretty good. I think that somewhere down the road, when I start to actually suffer from cancer, that will mark a new "stage" for me, and I'll certainly start questioning values.

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I'm so glad to hear how well things are going for you. ❤️

I have to admit, though, that my jaw dropped when I saw that they billed your insurer US $13,000 for a simple Lupron shot. That's insane! Your $300 co-pay alone would have covered almost half the total cost here, assuming CA $800 (US $575) for the Lupron itself and maybe $50 (?) to administer the shot, unless there's something major I'm missing.

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Hmmm….couldn’t help but notice a few allusions to a war in Ukraine. Is someone breakfast scrolling war images?
Next we’ll be hearing about your favorite Netflix show😘…

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@northoftheborder

Interestingly, while I didn't have to use a body mold for the 20 rounds of SBRT to my prostate, I *did* have to use a custom-made, cage-style head mask to immobilise my head and neck during the earlier 5 rounds of post-op SBRT to my middle spine. It's a lot like the mask that Hannibal Lecter wears in Silence of the Lambs, and probably about as comfortable. 😕

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Did you look at the technician and say "the lambs, Clarice" 😃. But seriously, I'm really hoping for the day when one of my descendants can video chat with their boss and say "I won't be in this morning, I'm getting treated for cancer, but I'll be better by this afternoon so will see you around 1."

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@scottbeammeup

Did you look at the technician and say "the lambs, Clarice" 😃. But seriously, I'm really hoping for the day when one of my descendants can video chat with their boss and say "I won't be in this morning, I'm getting treated for cancer, but I'll be better by this afternoon so will see you around 1."

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Exactly — ~10 years from now: "It's so ANNOYING that I have to take 2 hours off work and drive 20 km to get the injection that cures my stage-4 cancer forever. Why can't researchers make this easier? Nobody cares!"

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@northoftheborder

Exactly — ~10 years from now: "It's so ANNOYING that I have to take 2 hours off work and drive 20 km to get the injection that cures my stage-4 cancer forever. Why can't researchers make this easier? Nobody cares!"

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ahahahaaaaa, this is a good one : ))) !!!!

Sooo true XP !!!

North :), I really appreciate your optimism and upbeat and hopeful attitude, especially after all that you had to endure. Perhaps your user name should be a "North Star" ; ).

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