The United States could save as many as 60,000 lives every year if the money now spent to promote health and safety were used in the most cost-effective ways. Currently, there is no relationship between cost-effectiveness and the health and safety measures actually implemented. For example:

• We spend $2.8 million a year to control emissions at phosphorus plants, but this saves at most one life every 10 years.
• Screening black newborns for sickle cell anemia costs only $236 for each year of life saved, but 20 percent of black babies are not screened.
• Taking away $45,000 of money spent on emission controls would have little effect on the life expectancy of phosphorus plant workers but could add 192 years of life overall to black newborns each year.

Public policy aimed at risk reduction is designed to prevent premature deaths, so one measure of success of a policy or regulation (also referred to as an "intervention") is the numbers of years of life saved. For example, if an intervention averts the premature death of someone who is 45 years old and allows that person to live to age 80, it saves 35 years of life. Dividing the total cost of an intervention by the number of years of life it saves gives the cost per year of life saved and demonstrates the cost-effectiveness.

An examination of 185 interventions, some fully implemented, some partially implemented and some not implemented at all, found that cost-effectiveness usually was not a consideration:

• The interventions cost about $21.4 billion per year and save about 592,000 years of life.

• If the same amount of money had been spent on the most cost-effective interventions, 1,230,000 years of life could have been saved - about 638,000 more years of life than under the status quo.

• That is the equivalent of 60,000 lives each year.

• The median regulation proposed by the Environmental Protection Agency costs about $7.6 million per year of life saved.

• The median regulation proposed by the Consumer Product Safety Commission costs only about $68,000 per year of life saved - less than one-one hundredth of the EPA regulation's cost.

Source: Tammy O. Tengs, "Dying Too Soon: How Cost-Effectiveness Analysis Can Save Lives," NCPA Policy Report No. 204, July 1996, National Center for Policy Analysis, 12770 Coit Rd., Suite 800, Dallas, TX 75251, (972) 386-6272.