Health Care Thought Experiment

In the July 19, 2009 NYT Magazine was an article by the utilitarian philosopher, Peter Singer. Singer asserted in the article that health care should be rationed.

He begins the article with this hypothetical situation. Suppose you have advanced kidney cancer. Within the next year or two, it will kill you. Suppose there is a drug that will slow the spread of the cancer to the point that you might live an extra six months. But, the drug costs more than $50,000. Is the potential extra time alive worth the cost? Singer supposes that, if you had the money, you would probably pay for the drug.

He then alters the scenario. Suppose it is not you with the cancer, but some stranger who is covered by your health insurance. If this stranger gets the drug, and if others with the same diagnosis do as well, your premiums will increase. Do you still think the drug is worth it? But, suppose, the drug costs $1,000,000 or $10,000,000? Is there any monetary cost at which you would say the drug is not worth the possible extra 6 months - whether for yourself or anyone else?

Let me add some other variables. Suppose as a result of providing the drug, even at $50,000, the health insurance carrier raises its rates so much that the company for which you work and through which you have coverage drops all of its insurance coverage. Or, suppose the carrier tells your company to fire you or anyone else who used the drug. Would you still take the drug? Would you support having it available to anyone else?

What is the ethical decision in this case?