Page 113 - Petelin, Ana. 2020. Ed. Zdravje delovno aktivne populacije / Health of the Working-Age Population. Proceedings. Koper: University of Primorska Press.
P. 113
be such that the state is bound by ethics and justice to provide life exten- egalitarian distribution of health maintenance using technologies for life extension 111
sion unconditionally or is conditionally bound to do so. In our paper, we will
only talk about the first option, because the second option would require a dis-
cussion that would significantly exceed the limitations of this writing. Let us
first look at the specific conditions in which we claim that the state is obliged to
extend life unconditionally. We will also use an example to illustrate the con-
ditions. Some of the conditions for life extension must be: life extension tech-
nologies are easy to distribute, the cost is relatively low, efficiency is scientifi-
cally validated and quantified, the gain of extra healthy years of life is relatively
large, side effects are relatively negligible and people can freely choose wheth-
er or not to participate in life extension technologies. The key condition, how-
ever, is that after a certain number of years, when the program of free distri-
bution of life extension technologies begins, the state treasury has gained or at
least lost nothing financially with the costs of the program. By this, we mean
that if we add up the costs of these technologies and all the costs involved (bu-
reaucracy, distribution, control, awareness, the cost of waiting for the return of
state investment in the program), these are less than or equal to the inflow in-
to the state treasury because of the following things. Successful and effective
life extension technologies are pushing the ratio of healthy years of life to sick
years of life significantly in favour of healthy years. As a result, the costs the
public health system has with these people are much lower. People with longer
and healthier lives can work longer and thus pay taxes for longer. For exam-
ple, by looking after grandchildren and great-grandchildren, by being consult-
ants in companies and institutions, by workong in socially beneficial organiza-
tions they also benefit the society. A realistic example in which the state would
be unconditionally obliged to provide life extension is if we had evidence that
metformin is extremely effective. A multi-year study of TAME in the USA is
currently being prepared, which will scientifically study the effect of metform-
in on life expectancy and health on a very large sample of people (Tame trial,
2020). Metformin is exceptionally cheap due to the expired patent, 100 tablets
in Slovenia cost 5€ (Javna agencija RS, 2019). Realistically, we can imagine that
metformin will turn out to be a drug that statistically adds a few healthy years
of life to the average person. And from accurate data, we could calculate wheth-
er the state investment in the metformin program would be fully refunded or
not. The state would be conditionally obliged to prolong life if the total cost of
the life extension program was greater than the financial income from it. We
use the word conditionally because in this case it would be necessary to take
money away from other areas of the budget (health or overall), which would
mean setting priorities. For example, if metformin were very expensive and the
funds could only be drawn from the health fund, there could be a dilemma as
to whether the funds could be used for people who want to prolong their lives
or treat cancer.
We can argue for a practical defense of a situation in which certain condi-
tions are met, so that the provision of life extension can be described as uncon-
sion unconditionally or is conditionally bound to do so. In our paper, we will
only talk about the first option, because the second option would require a dis-
cussion that would significantly exceed the limitations of this writing. Let us
first look at the specific conditions in which we claim that the state is obliged to
extend life unconditionally. We will also use an example to illustrate the con-
ditions. Some of the conditions for life extension must be: life extension tech-
nologies are easy to distribute, the cost is relatively low, efficiency is scientifi-
cally validated and quantified, the gain of extra healthy years of life is relatively
large, side effects are relatively negligible and people can freely choose wheth-
er or not to participate in life extension technologies. The key condition, how-
ever, is that after a certain number of years, when the program of free distri-
bution of life extension technologies begins, the state treasury has gained or at
least lost nothing financially with the costs of the program. By this, we mean
that if we add up the costs of these technologies and all the costs involved (bu-
reaucracy, distribution, control, awareness, the cost of waiting for the return of
state investment in the program), these are less than or equal to the inflow in-
to the state treasury because of the following things. Successful and effective
life extension technologies are pushing the ratio of healthy years of life to sick
years of life significantly in favour of healthy years. As a result, the costs the
public health system has with these people are much lower. People with longer
and healthier lives can work longer and thus pay taxes for longer. For exam-
ple, by looking after grandchildren and great-grandchildren, by being consult-
ants in companies and institutions, by workong in socially beneficial organiza-
tions they also benefit the society. A realistic example in which the state would
be unconditionally obliged to provide life extension is if we had evidence that
metformin is extremely effective. A multi-year study of TAME in the USA is
currently being prepared, which will scientifically study the effect of metform-
in on life expectancy and health on a very large sample of people (Tame trial,
2020). Metformin is exceptionally cheap due to the expired patent, 100 tablets
in Slovenia cost 5€ (Javna agencija RS, 2019). Realistically, we can imagine that
metformin will turn out to be a drug that statistically adds a few healthy years
of life to the average person. And from accurate data, we could calculate wheth-
er the state investment in the metformin program would be fully refunded or
not. The state would be conditionally obliged to prolong life if the total cost of
the life extension program was greater than the financial income from it. We
use the word conditionally because in this case it would be necessary to take
money away from other areas of the budget (health or overall), which would
mean setting priorities. For example, if metformin were very expensive and the
funds could only be drawn from the health fund, there could be a dilemma as
to whether the funds could be used for people who want to prolong their lives
or treat cancer.
We can argue for a practical defense of a situation in which certain condi-
tions are met, so that the provision of life extension can be described as uncon-
