QUALITY ENHANCED LIFE DAYS

Quality Adjusted Life Years (QALY) is typically defined as perfect health years. McIlvaine has supplemented this term with a new term which reflects life enhancement beyond perfect health. A jail inmate may be in perfect physical health and generate one QALY each year. However, the average individual is enjoying life to an extent greater than the jail inmate. This enhancement factor is a key element in decision making.

The average U.S. 35 year old can expect to live 42 additional years while maintaining an average lifestyle. However, with maximum risk avoidance he could be expected to add another 15 years. He would gain these additional years by never traveling or mingling with other people. He would maintain a rigid diet and otherwise follow a course of action to maximize life.

Few would choose to add 15 years in exchange for this monastic lifestyle. The result is that individuals are constantly choosing to take risks that statistically reduce their life in terms of quantity for a perceived increase in quality. These life enhancements are described as the Quality Enhanced Life Years (QELY). It is useful to divide Quality Enhanced Life Years (QELY) into days thereby creating QELD.  All sustainability options can be rated in terms of number of QELD gained or lost.

QELD can be determined for all sustainability activities including improved working conditions for employees, charitable contributions, or more frequent information for investors. The QELD is the number of days of life the beneficiaries would be willing to sacrifice for the gain.

Here is a chart of Quality Enhanced Life Years for various different individuals.

The zero risk taker never leaves his property and lives to be 95. The effective risk taker enjoys each life year 1.4 times as much because of the risk. So even though he becomes disabled for a few years and dies at age 84, he still generates 108 Quality Enhanced Life Years. The ineffective risk taker does not do any better than the zero risk taker. The race car driver lives in the fast lane for a relatively short number of years and ends up with the lowest number of enhanced years.

The reason that this approach is potentially important is that it allows a rational comparison of any of life’s decisions. It allows us to address questions such as the threat to survival of the snail darter or the polar bear. It allows us to resolve the argument of whether nature should be untouched regardless of the impact on humanity.

If enough people feel their life quality is greatly enhanced by the protection of a specific wilderness area regardless of any human activity in that area, then that enhancement has to be added to the Quality Adjusted Life Years. However, there needs to be the realization that the cost per additional QELD gained from the protection of the wilderness area may be more than other options.

Examples of Use

An individual decides to drive to a basketball game and will spend ½ day driving each way. He has to determine whether the life enhancement or increase in quality exceeds the decrease in quantity.

The decision to travel round trip of one day to see a basketball game indicates that the QELD value is more than 1. How much farther would the individual be willing to travel to see that game in full knowledge that statistically his life would be reduced one day for each day traveled? If he believes that he would be willing to sacrifice 6 days of life for this experience, then the enhancement factor is 6. By taking the trip he gains 5 QELD. (6 QELD due to the enhancement less one day actually lost at the end of life.)

Basketball Trip

A company wants to know whether to buy a painting for $10,000 and donate it to the local art museum or to give a similar amount to a charity which is saving lives in Africa. Assume that a life from starvation can be saved by just an investment of $500/yr. Therefore, $365 X $10,000/$500  = 7300.

The painting will benefit local residents. The donation to the charity would benefit people in under developed countries. Since the U.S. generally applies a 99.9 percent tribal discount to foreign aid vs. domestic expenditures, then the painting has to generate 7.3 QELD . At a QELD value of $273/day in the U.S. you would only need to ascertain that 37 people would be willing to give up a day of their lives to view this painting or that 888 people would be willing to give up an hour of their life to view the painting.

The average visitor is already traveling an hour or more to the museum. So we have established a willingness to sacrifice one hour of  life for the general experience. Lets say that there are 100 paintings of equal interest. Then you need to establish that 88,800 visitors are willing to give up an hour of their lives to visit the museum and see this and the other 99 paintings. Since the painting will be on display for many years it is possible that 5,320,000 people will receive enjoyment from viewing it. Therefore only one minute of life quality enhancement needs to be justified for each.

The above example is for the analysis of a single event. But a slightly different approach can be used to calculate QELD  for continuous impact. Assume an individual would give up one hour of life each day just to live in a much nicer house. Over 20 years this will generate 1/24 x 365 x 20 = 304 QELD.  At a value of $273/QELD this is $82,992. If there are 4 people enjoying the nicer house then it is worth an additional $332,000 in cost over the 20 years.

Better working conditions: There is a movement to force U.S. companies to adopt better working conditions in their off shore manufacturing facilities. This is a morally justifiable cause. The problem is to make sure that the people affected are being helped in the most beneficial manner.

Assume a worker in a poor country experiences a life quality enhancement due to better working conditions that is worth one percent of life quantity. He would trade 0.3 years of his life (109 QELD) to work under better conditions for the next 30 years. But if he is going home at night to no electricity or running water, is the better working conditions the highest priority? He might gladly trade a year of his life for electricity and running water for the next 30 years.

You also have the question of the high risk of disease and other life shortening factors in poor countries. If the money spent on improved working conditions were spent on health care the investment might be better.  You only have to justify a life extension of more than 0.3 years.