Radiolab: "Worth" (December 23, 2014)
Produced by WNYC Studios
Hosts: Jad Abumrad & Robert Krulwich

Overview

This episode of Radiolab dives deep into the concept of "worth." Through three distinct stories—a new cancer drug's controversial price tag, the U.S. practice of compensating civilian victims of war, and efforts to calculate nature's monetary value—the episode examines how we try (and fail) to put dollar figures on things that seem priceless: life, loss, and the natural world.

1. What’s a Life Worth? (00:56–45:46)

Cancer Drugs and the Cost of Time

(Main contributors: Producers Molly Webster, Dr. Leonard Saltz, Dr. Peter Bach, Bruce Mohl, patients, public interviewees, Susan Gubar)

The Question:

The segment explores skyrocketing cancer drug prices and the moral, economic, and societal dilemmas of valuing "an extra month of life," centering around two drugs: Zaltrap (for cancer) and Sovaldi (for hepatitis C).

Key Points & Insights:

• Cancer Drug Prices Soar

  • Dr. Leonard Saltz (Memorial Sloan Kettering):
    “We have drugs out there that are many hundreds of dollars per pill.” (04:10)
  • Zaltrap, newly approved in 2012, offered a median of 1.4 extra months of life—at a cost of $30,000 for a three-month course ($11,000/month).

• Pseudo-Precision in Medicine

  • On survival data:
    “I could show you some graphs ... showing survival curves calculated out to two decimal places in terms of months ... that's a little over seven hours. ... It’s pseudo precision.” – Dr. Saltz (07:49–08:04)

• Boycott and the Market’s Response

  • Sloan Kettering doctors publicly rejected Zaltrap, leading to a dramatic 50% price cut nationwide.

• Society’s Stake

  • “Why is society involved in my conversation with my doctor ... about if I want to take this drug, that may give me another month and a half of life?” – Producer (18:23)
  • Insurance means the public and employers pay, not just the patient.
    “If now one person comes up with a health care cost ... that is $100,000 in that month, everybody else is in trouble.” – Dr. Peter Bach (20:57)

• The High Cost of Cures

  • Sovaldi, a new hepatitis C drug: considered a cure (95%+ effective), cost $1,000 per pill, $84,000 per patient.
    • States began to ration the cure, requiring some patients to become sicker before approval.

• Who Decides the Value?

  • No clear consensus, even from patients or the public.
  • The World Health Organization suggests a year of life is worth 1-3x GDP per capita ($50,000–$150,000 in the US), but this lacks legal binding.

Notable Quotes:

• “What is a year of life worth? … That’s deep.” – Random public interviewee (32:20)
• “There are things you just can’t put a price on, but no one thinks it’s infinite.” – Dr. Saltz (38:38)
• “The American individualistic, optimistic response would be, ‘whatever it takes.’ … But whatever it takes will not cure my cancer. So … it becomes a different question, which is: when is enough enough?” – Susan Gubar, cancer patient and NYT columnist (44:10)

Memorable Moments:

• Producer Molly Webster's random Times Square interviews reveal most people need to know the context (age, quality of life, etc.) before trying to set a price on a year of life.
• Susan Gubar’s personal narrative of a terminal illness highlights the emotional complexities behind these big-picture questions.

2. What’s an Apology Worth? (45:50–01:24:18)

The Price of Civilian Lives in War

(Main contributors: Matt Kielty, Gregory Johnsen, Prof. John Witt, Marla Keenan, US military lawyers, victims and survivors in Yemen)

The Question:

After a U.S. drone strike accidentally killed wedding celebrants in Yemen, how does the U.S. (and other states) compensate for the loss of civilian life? What does payment accomplish, and what is its value?

Key Points & Insights:

• Yemen Drone Strike:

  • December 12, 2013, a drone strike on a wedding convoy killed 12 civilians. Survivors took victims’ bodies to a public square in protest.
    “An American drone killed these. It was a massacre.” – Local Yemeni man (50:30)

• History of Compensation:

  • In WWI, General Pershing began a formal cash-based system for compensating civilian victims—borrowed from the British.
  • The U.S. developed a habit of paying "condolence payments," except in “combat situations,” leading to tricky legal lines with modern warfare.

• How Much Is Paid?

  • Common U.S. condolence payments: $2,500 for a life, $1,500–2,500 for property.
    “I can’t get over ... $2,500 seems like just such a nominal amount.” – Matt Kielty (01:14:31)
  • For 9/11 victims: payouts ranged from $250,000 to nearly $7 million.

• Purpose of Payment:

  • It's less about compensation, more about acknowledgment, apology, and explanation—making amends.
  • “It’s the apology and the explanation that matter to you. … That’s why we call it amends, making amends.” – Marla Keenan (01:18:39)

Notable Quotes:

• “[Condolence payment is] an occasion for you to say, like, not just ‘I'm sorry,’ but here's what happened.” – Marla Keenan (01:19:15)
• “There are desperate effort[s] to find some common language between the party paying and the victim. Some Esperanto for communicating the meaning of what's happened in a language that the other side knows matters.” – John Witt (01:22:23)

Memorable Moments:

• In Yemen, Abdullah al-Taisi, whose son was killed, ultimately received $30,000, far more than average—but there's no way to express meaningful remorse or make up for the loss:
  “How you can persuade someone who lost his son ... if the payment was equal?” (01:23:32)

3. Pricing Nature: The Value of Ecosystem Services

(01:24:20–end, ~01:55:10)

Bat Dollars, Bee Lessons, and the Economics of the Environment

(Contributors: Carl Zimmer, Robert Costanza, Glenn-Marie Lange, Adam Welchel, Matt Kielty, Simon Adler, J.B. MacKinnon)

The Question:

Can (or should) we quantify the economic value of nature? Is it dangerous—or necessary—to price the invaluable?

Key Points & Insights:

• Bat Pest Control:

  • Bats save South Texas cotton farmers ~$700,000 per year by eating pests (out of $4-5 million of production).
  • Nature’s “hidden” value often uncounted and underappreciated.

• Global Nature’s Value:

  • Economist Robert Costanza, via massive Excel, calculates global ecosystem services at $142.7 trillion/year—more than all the world’s GDP.

• Salt Marsh Fieldwork (with Simon Adler):

  • Each ecosystem service (cleaning water, feeding fish, ecotourism, etc.) can be calculated per-acre. Example:
    “Flood control, water supply protection, pollution control … about $31.22 per hectare per year.” – Adam Welchel (01:31:06)

• Danger of Economic Valuation:

  • “The real danger is that we actually succeed—that we convince people that nature is valuable because it makes money, and then we're really in trouble in the many instances where it doesn’t make us money.” – Doug McCauley (01:39:14)

• The Parable of the Bees (Mao County, China):

  • Apple producers, having lost bees to habitat loss and pesticides, hand-pollinate blossoms—at first increasing yields.
  • As wages rise, hand pollination can’t compete; without bees, they could be facing total collapse.

• Limits to Quantification:

  • “If you lose the bees … you cannot bring them back.” – Glenn-Marie Lange (01:51:34)
  • Economic value is volatile and doesn’t account for ecological irreversibility.

Notable Quotes:

• “If you only measure things economically, ... we might conclude that ... some ecological processes just aren't necessary. ... But what about when values change?” – J.B. MacKinnon (01:48:48)
• “You have to have a lot of numbers in your head, but here’s what I like about this idea ... when you put a number on a bee or a bat or a marsh, it’s like an attempt to force a kind of long-term thinking.” – Jad Abumrad (01:52:24)

Memorable Moments:

• Real-world consequences of treating ecosystem services as commodities: "If you go business-y on nature ... and you’re wrong, there are irreversibilities.” – Glenn-Marie Lange (01:52:56)
• Final reflection on the loss of biodiversity as a loss to human imagination:
  “All this diversity ... is an extension of our own brains ... when we draw down on that pool ... we deeply impoverish ourselves ... in a sense we are doing harm to our own ability to think and to dream.” – J.B. MacKinnon (01:53:32)

Timestamps for Key Segments

• Cancer Drug Dilemma: 00:56–45:46
• Compensation in War and the Value of a Life: 45:50–01:24:18
• Valuing Nature: 01:24:20–end (~01:55:10)

Conclusion

"Worth" presents no easy answers, but instead offers many angles from which to contemplate value. Whether it’s time gained or lost, lives destroyed or spared, or the unseen services of nature, assigning a dollar figure rarely tells the whole story. The episode leaves listeners with the challenge: Can value be meaningfully measured? And if not, what—if anything—should take its place?