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生命的价值能用金钱来衡量吗?

Can We Put a Price Tag on a Life?
生命的价值能用金钱来衡量吗?

Can we measure the cost of hundreds of thousands of dead?

数十万人死亡的代价,该如何衡量?

President Trump and leading business figures are increasingly questioning the wisdom of a prolonged shutdown of the American economy — already putting millions out of work — to curb the spread of the coronavirus pandemic.

特朗普总统和商界领袖们越来越多地质疑,为遏制新型冠状病毒的蔓延而让美国经济长期停摆是否明智——这种停滞已经让数百万人失去了工作。

“Our people want to return to work,” Mr. Trump declared Tuesday on Twitter, adding, “THE CURE CANNOT BE WORSE (by far) THAN THE PROBLEM!”

“我们的人民希望重返工作岗位,”特朗普周二在Twitter上宣称。他还说,“对策不应该比问题更糟(糟很多)!”
 

曼哈顿休南区一条安静的马路。纽约州已下令关闭所有非必要的商铺。

In essence, he was raising an issue that economists have long grappled with: How can a society assess the trade-off between economic well-being and health?

从本质上讲,他提出了经济学家长久以来努力解决的问题:一个社会如何评估经济福祉和健康之间的取舍?

“Economists should be doing this cost-benefit analysis,” said Walter Scheidel, an economic historian at Stanford University. “Why is nobody putting some numbers on the economic costs of a monthlong or a yearlong shutdown against the lives saved? The whole discipline is well equipped for it. But there is some reluctance for people to stick their neck out.”

“经济学家应该进行这种成本效益分析,”斯坦福大学(Stanford University)经济历史学家沃尔特·沙伊德尔(Walter Scheidel)说。“为什么没有人在一个月或一年的停摆带来的经济代价和由此拯救的生命之间做一个量化对比?整个学科完全有能力这么做。但大家还是不愿意冒这个险。”

Some economists who support lifting the current restrictions on economic activity say governors and even the Trump administration have not sufficiently assessed the costs and benefits of those restrictions.

一些支持取消当前经济活动限制的经济学家表示,州长乃至特朗普政府都没有对这些限制的成本和效益做出充分评估。

“We put a lot of weight on saving lives,” said Casey Mulligan, a University of Chicago economist who spent a year as chief economist on Mr. Trump’s Council of Economic Advisers. “But it’s not the only consideration. That’s why we don’t shut down the economy every flu season. They’re ignoring the costs of what they’re doing. They also have very little clue how many lives they’re saving.”

“我们非常重视拯救生命,”芝加哥大学(University Of Chicago)经济学家凯西·马利根(Casey Mulligan)说,他曾在特朗普的经济顾问委员会(Council of Economic Advisers)担任过一年的首席经济学家。“但这不是唯一的考量。这就是为什么每次到了流感季,我们不会让经济停摆的原因。他们忽略了做事的代价。同时他们对能拯救多少生命也毫无概念。”

There is, however, a widespread consensus among economists and public health experts that lifting the restrictions would impose huge costs in additional lives lost to the virus — and deliver little lasting benefit to the economy.

不过,经济学家和公共卫生专家倒是普遍认为,取消这些限制将使更多的人死于这种病毒,付出巨大的代价,而且几乎不会给经济带来什么长期的好处。

“It’s useful to adopt the cost-benefit frame, but the moment you do that, the outcomes are so overwhelming that you don’t need to fill in the details to know what to do,” said Justin Wolfers, an economist at the University of Michigan.

密歇根大学(University Of Michigan)的经济学家贾斯汀·沃尔弗斯(Justin Wolfers)表示:“引入成本效益框架是有帮助的,不过一旦你这样做了,得到的结果将是压倒性的,你无需更多细节就知道该怎么做。”

The only case in which the benefits of lifting restrictions outweigh the costs in lost lives, Mr. Wolfers said, would be if “the epidemiologists are lying to us about people dying.”

沃尔弗斯说,只有在一种情况下,解除限制的好处会超过失去生命的代价,那就是“流行病学家在死亡的问题上对我们撒谎了”。

Weighing economic costs against human lives will inevitably seem crass. But societies also value things like jobs, food and money to pay the bills — as well as the ability to deal with other needs and prevent unrelated misfortunes.

权衡人类生命的经济成本似乎不可避免地显得愚蠢。但是,社会也重视工作、食物和支付账单的钱等事物,以及满足其他需求和防止不相关的不幸的能力。

“Making people poorer has health consequences as well,” said Kip Viscusi, an economist at Vanderbilt University who has spent his career using economic techniques to assess the costs and benefits of government regulations.

范德比尔特大学(Vanderbilt University)的经济学家基普·维斯库西(Kip Viscusi)表示:“让人变穷也会对健康造成影响。”维斯库西在他的学术生涯中一直利用经济方法来评估政府监管的成本和收益。

Jobless people sometimes commit suicide. The poor are likelier to die if they get sick. Mr. Viscusi estimates that across the population, every loss of income of $100 million in the economy causes one additional death.

失业者有时会自杀。如果穷人生病,他们死亡的可能性会更大。维斯库西估计,在整个人口中,经济每损失1亿美元的收入,就会导致一起额外的死亡。

Government agencies calculate these trade-offs regularly. The Environmental Protection Agency, for instance, has established a cost of about $9.5 million per life saved as a benchmark for determining whether to clean up a toxic waste site.

政府机构定期计算这样的取舍。例如,美国环护署(Environmental Protection Agency)设定了一个标准,每拯救一个生命的成本约为950万美元,将其作为是否清理有毒废物场地的决定基准。

Other agencies use similar values to assess whether to invest in reducing accidents at an intersection or to tighten safety standards in a workplace. The Department of Agriculture has a calculator to estimate the economic costs — medical care, premature deaths, productivity loss from nonfatal cases — of food-borne disease.

其他机构使用类似的方法进行量化评估,以决定是投资减少十字路口的事故,还是加强工作场所的安全标准。农业部有一个计算标准,用来估计食源性疾病的经济成本——医疗保健、过早死亡、非致命病例造成的生产力损失。

Now, some economists have decided to stick their necks out and apply this thinking to the coronavirus pandemic.

现在,一些经济学家决定冒险把这种想法应用到冠状病毒大流行上。

In a paper released on Monday, Martin S. Eichenbaum and Sergio Rebelo of Northwestern University, with Mathias Trabandt of the Free University in Berlin, used the E.P.A.’s number to figure the optimal way to slow the spread of the disease without economic costs that exceed the benefits.

在周一发布的一篇论文中,西北大学(Northwestern University)的马丁·S·埃辛鲍姆(Martin S. Eichenbaum)和塞尔吉奥·雷贝洛(Sergio Rebelo),以及柏林自由大学(Free University)的马蒂亚斯·特拉班特(Mathias Trabandt)使用了美国环保署的数字,分析在不造成经济成本超过收益的情况下减缓疾病传播的最佳方法。

The economy would contract sharply even without a government-imposed lockdown as people chose to stay away from workplaces and stores, hoping to prevent contagion. In that case of voluntary isolation, Mr. Eichenbaum and his colleagues estimated that U.S. consumer demand would decline by $800 billion in 2020, or about 5.5 percent.

即使没有政府强制的封锁,经济也会急剧收缩,因为人们为防止传染,会选择远离工作场所和商店。在这种情况下,埃辛鲍姆和同事们估计,到2020年,美国的消费者需求将减少8000亿美元,降幅约5.5%。

Based on epidemiological projections, as the virus ran unchecked, it would quickly expand to infect somewhat over half the population before herd immunity would slow its course. Assuming a death rate of about 1 percent of those infected, about 1.7 million Americans would die within a year.

根据流行病学预测,当病毒不受控制地传播时会迅速扩大,感染半数以上的人口,然后群体免疫才会减缓其进程。假设感染者的死亡率为1%,那么大约170万美国人将在一年内死亡。

A policy to contain the virus by reducing economic activity would slow the progression of the virus and reduce the death rate, but it would also impose a greater economic cost.

通过减少经济活动来遏制病毒的政策,可以减缓病毒发展并降低死亡率,但它也将带来更大的经济代价。

Mr. Eichenbaum and his colleagues say the “optimal” policy — assessing economic losses alongside lives — requires restrictions that slow the economy substantially. Under their approach, the decline in consumption in 2020 more than doubles, to $1.8 trillion, but the deaths drop by half a million people. That would amount to $2 million in lost economic activity per life saved.

埃辛鲍姆及同事们说,既考虑经济损失又考虑生命的“最优”政策需要实施一些大大减缓经济增长的限制措施。按照他们的评估方法,2020年,消费下降超过一倍,达到1.8万亿美元,但死亡人数减少了50万人。这相当于每挽救一条生命就损失200万美元的经济活动。

In this instance, “you want to make the recession worse,” Mr. Eichenbaum said. But an important corollary is that there are limits to the sacrifice: Beyond a certain point, it would not be worth it to lose more economic activity in order to save more people.

在这种情况下,“你需要让经济衰退变得更糟,”埃辛鲍姆说。但一个重要的推论是,这种牺牲是有限度的:超过某个限度,为了拯救更多的人而失去更多经济活动就不值得了。

The model, he noted, is heavily dependent on the assumptions that go into it, meant to convey the magnitude of the trade-offs. And the economists are still tweaking. The cost-benefit ratio will change if one considers that the health system might become overwhelmed by Covid-19 cases, increasing mortality rates. That would justify a more aggressive lockdown that ramped up more quickly.

他指出,这个模型在很大程度上依赖于其中的假设,它是为了表达取舍的量级。经济学家们仍在作调整。如果考虑到医疗系统可能会被Covid-19的病例压垮,从而增加死亡率,那么成本效益比将会改变,因此会有必要以更快的速度实施更剧烈的封锁措施。

It comes down to what a life is worth.

归根结底,这是在衡量生命的价值。

In the 1960s, a Nobel Prize laureate in economics, Thomas C. Schelling, proposed letting people price their own lives. Observing how much they were willing to spend to reduce their odds of death — by buying a bicycle helmet, driving within the speed limit, refusing to buy a house near a toxic-waste site or demanding a higher wage for a more dangerous job — government agencies could compute a price tag.

1960年代,诺贝尔经济学奖得主托马斯·C·谢林(Thomas C. Schelling)提出让人们为自己的生命定价。通过观察人们愿意花多少钱来减少死亡率——购买自行车头盔、在限速范围内行驶、拒绝购买附近存在有毒废料的房屋,或者做工资更高、风险更大的工作——政府机构可以计算出一个标价。

That can lead to some strange numbers, though. As Peter Singer, the Australian ethical philosopher, noted, you can save a life in poor countries with $2,000 or $3,000, and many of those lives are still allowed to be lost. “If you compare that with $9 million,” he said, “it’s crazy.”

不过,这可能会导致一些奇怪的数字。正如澳大利亚伦理哲学家彼得·辛格(Peter Singer)所指出的,在贫穷国家,两三千美元就能挽救一条生命,然而他们仍然任由许多人死去。“和900万美元比起来,”他说,“简直不可思议。”

The discussion gets even more touchy when one considers the age profile of the dead. It raises the question: Is saving the life of an 80-year-old as valuable as saving the life of a baby?

再纳入死者的年龄,讨论会变得更加敏感。它提出了一个问题:拯救一个80岁老人的生命,和拯救一个婴儿的生命,有同等的价值吗?

Cass Sunstein, a legal scholar who worked for the Obama administration, heading the White House office in charge of these valuations, once proposed focusing government policies on saving years of life rather than lives, as is customary in other countries.

曾为奥巴马政府工作的法律学者凯斯·桑斯坦(Cass Sunstein)是白宫负责这类评估的办公室主任,他曾提议将政府政策的重点放在拯救生命时长上,而不是像其他国家的惯例那样,仅仅关注生命本身。

“A program that saves younger people is better, in this sense, than an otherwise identical program that saves older people,” he wrote.

“从这个意义上说,一个拯救年轻人的项目,比另一个同样的拯救老年人的项目更好,”他写道。

In the George W. Bush administration, the E.P.A. tried to move in Mr. Sunstein’s preferred direction. To calculate the costs and benefits of legislation regulating soot emissions from power plants, it had to figure out the value of reducing premature mortality. Rather than evaluate every life saved at $6.1 million, as it had done in the past, it applied an age discount: People over 70 were worth only 67 percent of the lives of younger people.

在乔治·W·布什(George W. Bush)政府时期,美国环保署曾试图朝着桑斯坦喜欢的方向前进。为了计算监管发电厂烟尘排放的立法的成本和收益,它必须计算出降低过早死亡率的价值。它没有像过去那样,为每拯救一条生命估价610万美元,而是采用了年龄折扣:70岁以上的人只占年轻人生命价值的67%。

The backlash by AARP and others was fierce. And the agency dropped the idea. “E.P.A. will not, I repeat, not use an age-adjusted analysis in decision making,” pleaded Christine Todd Whitman, the E.P.A. administrator at the time. Yet by putting the same price on all lives, the agency implicitly devalued young people’s remaining years.

美国退休人员协会(AARP)等机构对此强烈反对。于是美国环保署放弃了这个想法。“我再说一遍,美国环保署不会在做决定时使用年龄调整分析,”当时的环保署负责人克里斯汀·托德·惠特曼(Christine Todd Whitman)辩称。然而,在对所有人的生命一视同仁的同时,该机构无形中造成了年轻人剩余生命的贬值。

Covid-19 seems to be much more lethal for older people, whatever their economic worth. But Mr. Trump declared Tuesday that even while those most at risk are safeguarded, the economy could be “raring to go” within three weeks. “Seniors will be watched over protectively & lovingly,” he said on Twitter. “We can do two things together.”

无论老年人的经济价值如何,Covid-19对他们来说似乎更致命。但特朗普周二宣布,在面临最大风险的人得到保护的同时,经济在未来三周内也会是“蓄势待发”的状态。“老年人将受到保护和关爱,”他在Twitter上写道。“我们可以同时做到两件事。”
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