Memo from To:
JOSHUA LEDERBERG Ken Arrow

JAN 5 971
Discounts and health.

Thank you for helping me clarify this analysis.
Your approach readily persuades me; I did not
have the experience to adopt it naturally.

What I think is an equivalent restatement is to
ask: What burden of debt, with accumulated in-
terest, would my descendant have wished me to
subscribe as an investement he would accept as
a fair bargain for the relief of his burden of
ill health.

I am still troubled by the difficulty that good
health is priceless, i.e., that in too many cases
no market exists for the purchase of freedom
from pain and anxiety, and the enjoyment of every
other good. So that any estimate based on
"productivity" is a lower bound.
Is it legitimate to add the price of medical ser-
vices to the residual burden of impaired produc-
tivity? I do so on the argument that ‘medicine!
pays for the alleviation of the more remediable
part of that burden, which would be much larger
if we did not buy medical service. But should
we then also add the additional cost of our in-
vestments in safety, for the prevention of en-
vironmental hazards? However, this would mostly
inflate the non-genetic component of ill health,
and probably have no bearing on the assessment
of radiation effects.

So many decisions in this field are "irrational
and based on imperfect information (or percep-
tion thereof-- like cost of smoking before a

Tung cancer is diagnosed) that I am not sure how
\ far to push the model.
NY duey grr. gene PROFESSOR JOSHUA LEDERBERG
Pe ’ Department of Genetics
dereussen of Thy

School of Medicine

' . . Stanford University
pager begidad Oe, California 94305
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