Putting a price on mental illness … and everything else

A recent article in The Economist on mental health research gave me pause for thought–made me even a bit worried. The article made a hard-headed business case for increased spending on mental health research. The costs of mental illness are high: “… 4% of GDP in lost productivity, disability benefits and health-care bills …” the article states. Spending on mental-health research, though, is paltry, with funding 150 times less per patient than more mainstream diseases like cancer. However, the returns from spending on mental health research are great, garnering a 37% return on investment.

In sum, mental illness incurs a cost to our society, and investing in its treatment is profitable. This is great, but it makes me wonder: What if it wasn’t
profitable?

Life: An economic unit of measurement

This reminds me of an experience from my days working in biotech. A company I worked with had developed a medical device capable of detecting certain types of cancers earlier than the current standard of care. Marketing the device presented unique challenges.

In the US, healthcare is profit driven. To encourage doctors to use our device, our sales-team had to create profit models showing how revenues the device earned would offset its cost. It had to add to the bottom line. In Canada, however, healthcare is paid for by the government, and is therefore cost driven–the goal being to reduce costs. We had trouble getting our device covered by provincial medical plans because–and I’m being dead serious here–using our device might lead patients to receive treatment sooner and live longer, creating more costs on the system.

The problem I see from my experience in biotech, as well as The Economist’s argument for the treatment of mental illness, is the value of human life is reduced to purely economic metrics. As such, the tragedy of mental illness is no more than the resultant loss of productivity. Citizens become either sources of revenue or costs that must be exploited or reduced. We live in a society where the value of a human is based on their net contribution to GDP.

But, how should a wise society measure human worth?

A society must be sustainable

I always feel disingenuous having these conversations. I teach university-level business, and I put considerable effort grinding into my students’ heads that they must calculate profitability of their options before choosing an action. I create the mindset I am criticizing, but do so for a good reason: if an organization loses money, it is not sustainable, and no one benefits.

Business disciplines teach us how to accomplish more with less, and how to use our resources to generate even more resources such that our organizations can grow and thrive. Business disciplines are a powerful tool that can increase the productivity of any venture; they help us marshal finite resources to achieve our ends.

Because we can apply business tools anywhere, we see them creeping into every crevice of our institutions, which itself needn’t be bad. But as a society, we have deemed ‘contribution to GDP’ as the ultimate goal of every institution. Universities are valued only for their ability to produce skilled labor. Hospital administrators consider metrics such as return-on-investment when assessing implementation of new healthcare innovations. Scientists must demonstrate clear economic applications of their research to increase their odds of getting funding. Treating the mentally ill becomes an issue of fixing non-functioning resources so we can once again deploy them productively.

If it is profitable, it has value. If it is not profitable, it is valueless.

Business disciplines provide powerful tools to us. But when I see we’ve quantified the value of a human life, and all our endeavors, using business metrics, I wonder if our tool has become our master. Are the objectives we currently use business tools to achieve what we truly value? A relentless focus on business metrics makes a society wealthy. Is it sufficient to make a society great?

I suggest a great society, rather than asking, “Is it profitable to help our people?”, would instead ask, “How can we help our people in a sustainable way?” Rather than using business metrics to determine what actions are worth pursuing, it uses its values to choose its actions, and then uses business disciplines to carry out those actions productively.

What do you think? How do we make a society great?

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