Drug and basically once the f.d.a. Approves a drug public insurance has to take it and then the private insurance companies just follow suit which means you get prescribe the drug and people pay for it and what does a drug cost that's the thing it costs roughly $30000.00 for the 3 month course. So so Leonards like wow that is expensive and there was already another drug on the market did the same thing and it cost half as much to put that in context this is just $1.00 drug that's a leaven $1000.00 a month a normal cancer patient might take dozens of drugs one needs growth factors to help support the white blood cell count which you sometimes need in chemo those can be $5000.00 every 2 to 3 weeks if you need antibiotics to treat infections those are cheap and then you need a pharmacist to prepare their labor intensive need to bring in equipment and needles to give it you need trained nurses to administer it you need doctors to take care of the patients and don't forget there's a cost for a cat scan or m.r.i. And then of course someone's got to pay for the real estate the heating the lights . None of those prices are figured into it Ok I'm just giving you the cost of the drug So Leonard calls up $1.00 of his colleagues my name is Peter Brock I'm a physician a Morris long Kettering Peter is the number cruncher of the group and Len grabbed him and ran him through all the data and we walked through the out of pocket expenses for Medicare beneficiaries if they don't have additional insurance $0.20 of every dollar they pay out of pocket they'd be paying something like $2000.00 out of pocket every month for just this drug $2200.00 if I remember the number correctly for a lot of Medicare patients that all of their money never mind other drugs that's when I thought we should go public with a Memorial Sloan Kettering they decided to boycott this drug. Now that is that. When you guys made that decision was that that feels like a big deal it did feel like a big deal and felt like a big enough deal that we decided to write the op ed piece in The New York Times they write an op ed in The Times that basically says look this is crazy $11000.00 a month for a drug that maybe gives you $42.00 more days of life is that worth it. We reached out to Santa Fe to talk about the price of Zaltrap and they declined to comment but in a statement that they released when this holds out track thing happened they said that they encourage so many costs for researching and developing and bringing a drug to market that that is what their pricing is based on Leonard doesn't disagree we need these companies they're the ones developing the drugs which aren't easy to develop if we talk about colon cancer he says for years there was only one drug on the market called 5 if you buy that he was patented in August of 1957 it was from 1957 until 1996 that a 2nd drug came along that's how long it takes to develop a good drug or in that interim there were over 70 drugs that were tried and failed like I don't get enough credit because that just astounded me it's very very hard and that according to Leonard is one of the reasons why prices are just going to keep going up but sooner or later the system is going to fall apart and at what point does society say there isn't an infinite number of dollars that we can commit to our health care system it's funny because I have the sort of interesting reaction to the word society 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 why is society involved because you're not paying. Someone else has to pay that obviously he says it's your insurance I mean say you're part of a policy that has $1000.00 members let's say that the premium for that is $100.00 so we had one $100.00 people we got ourselves out of $1000.00 Ok so we now have $100000.00 to take care of that that was in people that that money whatever amount of time if now $1.00 person comes up with a health care cost let's say it's for a month that is $100000.00 in that month everybody else is in trouble there's no money left. So they write this up bed saying that prices are too high and the drugs are not that great and sort of the next like notable wave is . $100.00 doctors get together and they cosign an editorial which basically says We totally agree with everything you guys are saying but we have an even bigger issue you know was out track we're talking about an expensive drug that maybe doesn't really do that much it's kind of easy even though it had never been done before to say we're not going to use this but what do you do when you have a really expensive drug but it's really really good it is at like a like a one day in the future we will face is going to question you know that is like a now today question. The most important new medicine approved this year everyone I talked to pointed me to this new drug Sovaldi It's known as Saval the food of all the many in the medical community are calling the new medication a blockbuster Saval the came on the market last December that's December 2013 correct this is Bruce Bruce Small I'm the editor of Commonwealth magazine he's written about civility and here's the basic story right. It is a drug that treats hepatitis c. Which is caused by a virus and the disease itself goes to work on your liver it inflames it it's scars it can cause liver. Cancer cirrhosis it can be fatal and for the longest time the treatments that they had just really weren't that great or they just had wretched side effects but along comes a Volt and it's a one pill 12 weeks you take it with some other antiviral meds it is a super simple treatment option and the side effects are very minimal and so a lot of doctors start to prescribe it in the 1st half of 201470000 people in the country in the United States were treated and it had a 95 percent rate of cure in other words we have direct was a radical that's very big but in fitting with our story this drug costs $1000.00 a pill. For like 11 pill that I take one a day. Or. 2 which angered a lot of people with hep c. In total it costs $84000.00 and if you think about the fact that in 2014 we know at least $70000.00 people got this drug then you're starting to talk about serious money wait I want to I just want to say that I can I just times doubt 70000 times 84000 and I got some There was 70 then it's 58 and then there's $70.00 which is like a bit $5000000000.00 yes. The big question is how states will pay for what could be upwards of and so we have a situation where states are basically having to ration day in Massachusetts most of the insurers currently are requiring liver damage before you can take the drug similar restrictions are happening in other states Florida it's happening in Oregon Illinois the doctor says the only option may be to wait until you're even sicker and then there's Arizona out of the entire state public insurance only approves 180 p. . Well for treatment Well just 180 just 180 now when I talked to a representative of the company that makes the track Greg Dalton vice president for corporate and medical fairs for Gillet sciences he says you've got to keep in mind this is not a chronic care situation this is a cure we're talking about 12 weeks of therapy period that's it and you're done and you've cured somebody so he says this is a one time deal like one time $84000.00 and then you're done think about all the years you'll live without having an illness then you'll see over a 20 year period the savings that will were crude to the system by having a patient cured of hepatitis c. He also said it's important to understand that every hepatitis c. Sufferer is not going to hit the system at the same time so all of the cost is spread out right which is totally true but I think there's like this bigger picture here and Bruce pointed out too it's sort of like a precursor of what could come because these companies are developing drugs all the time what if if you could get a drug but it was very expensive to treat diabetes. And then you're talking tens of millions of people in enormous segment of the population even if just a fraction of them want a drug that's a $1000.00 per day that's practically our entire us budget what do you do in that case a drug comes along like that and throws everything out of whack. This is the part where I really sort of got hooked in where it's like how do you answer this question is it that you know at a certain point you just draw a line and you say beyond this point. We're not paying beyond what point exactly I mean that's the hard part like how good does a treatment have to be for you to say this is worth the price that it's been set at don't think we have rejected out of hand but you know when I got into this pit with Leonard in the case of soundtrack they said All right 42 days that much money we're not going to do it but would it have. Been different if it was 50 days or 100 is that enough I'm sure you want to be talking in years but I guess the question is like what would be a is there a magic line for you. If I this is that I can't personally determine it for everybody but ultimately as a society we're going to have to reach an understanding of what that could point is what is one more year or one more month or one more day of life worth to was you know people like to say yeah so what's the value of a human life and the answer is Boy that's a complicated question but a really important one because nobody thinks it's infinite. Well I guess what is 42 days. What is $42.00 days mean in the sense of is that something that you'd pay $50000.00 for if you were I mean of course you would that it's like now I almost I have even asked the question but I don't know well I know I think it's a good question I think ethically it would be to the good of patients and doctors to have this conversation this is Susan Susan Gubar writer of living with cancer blog for The New York Times back in 2008 Susan went to the doctor kind of she hadn't been feeling well for a while they thought it was some sort of bowel issue but then the doctor walked into the room and said she had advanced stage of varying cancer most of hearing cancers are diagnosed at a late stage and it's it's basically incurable you're given a diagnosis of 3 to 5 years that is you go from having unlimited time in your mind to 3 to 5 years in like a doctor's visit Yeah it's it's a big shock you sort of enter his own. Well you're not quite aware of what you're doing. That day the day she was diagnosed she was told pack a bag get in a car and drive to Indianapolis you need surgery now so I went the next day to Indianapolis and the day after that I had the debulking surgery which takes out the ovaries and uterus in the follow him tubes in the spleen and sometimes the cervix and sometimes the appendix and whole balance are you serious Yeah it's called the Mother of All surgeries and then just like that she was doing multiple rounds of chemo chemicals that are used they destroy all quick growing cells so for example you have no hair no eyebrows no eyelashes that you know you also can I got terrible saws in my mouth I have no idea why but I know this happens to other people but yeah the other thing is this extreme fatigue and Susan who writes for a living couldn't even read I would look at the page and think had I turned to page . Chemotherapy it really is toxic to the spirit to the heart to the mind just the normal aspects of life feel polluted. Have you ever had to think about the cost I was never informed of the cost of any drug or any procedure I was given which really makes me think about how masked these costs are and would you want to be thinking about cost while you're going through it or is it better to just say here your treatment options these are statistical outcomes like pick one and then we'll deal with it on the other side I think this isn't a kind of unspoken agreement among everyone that the insurance company or Medicare is going to pay and if it's the government that means arch grandchildren are going and paying for all of this money so yes I guess to answer your question I think it would be healthier to know what these things cost on the other hand I have to say as a patient I was so traumatized I'm not sure I could have taken that information in I was thinking about your what what it's worth what's it worth a title and I was thinking that. The American individual istic optimistic response would be well whatever it takes whatever it takes life is worth it whatever it takes but whatever it takes will not cure my cancer. So I think this question changes when you have incurable cancer it becomes a different question which is when is enough enough. How rich she said that when is enough enough I was just I don't know that we're ready to say there's one magic line thrown back to this conversation that I had with Leonard Salter he was saying that we have to look at everything in terms of value before we figure out what we're willing to pay we have to think about what we are paying for yeah I don't think we know what for Susan you know 6 years ago she decided that she was going to get chemotherapy because in part it would be more time with her daughters Yeah but I think with changed by the treatment too for now Susan's cancer is basically under control because she's on this new drug for 2 and 2 years and now a month and I am counting. Have been alive without arm occurrence without the cancer growing by taking these pills every day. But when these drugs stop working and I've been told they will stop working. I'm not sure I would want to go back to chemotherapy. But I think I suspect I don't know until I get their. News from Molly Webster we want to thank Stephen Hall when I mentioned Susan Gubar his book called Memoirs of a deep bulked woman and thanks also to Dr told one day for all his help radio continue in a moment you have 2 messages. This is true small Radio Lab is supported in part by the Alford Sloan Foundation has prevented. Find out. More information about Sloan had. Loaned out or video or add to the you hand why. Tied to Jordan yards from Chicago Illinois pretty lab supported by Indy indeed employees who post a job in the screener questions and 0 in on a shortlist of screen candidates using an online dashboard for info at Indeed dot com Last hired. By This is Kim Brinkerhoff coming from Pleasanton California Radio Lab is supported by constant contact their admission features automatically send welcome in Berkeley nerds as well as auto responders when users taken action more Akron see contact dot com. 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I am javelin Ron I'm Robert Krulwich This is Radio Lab And today well we're still on the subject of worth but this is a totally different take Yeah and this comes from our producer Matt Keelty and starts with Buzz Feed writer Gregory Johnsen So Ok maybe you should start with what has now become sort of the infamous wedding wedding drone strike is that I was that sort of where it started for you yes so this strike happens in a very rugged part of Yemen it's Thursday morning summer 12th 2013 and early that morning in a small village a group of guys roughly 50 to 60 people including a soon to be married man Palin a bunch of cars and they start driving this is the convoy the wedding convoy now in the lead car of this convoy was this man our share of the $150.00 is named is that Mohammed l.t.c. . We spoke to him through an interpreter in Yemen and. A Doolittle me it was his neighbor who was the groom to be married that day of a German Hunter How do women because and so they were all driving up to the bride's village. Said they got there little before noon it launch recited what in poems after lunch they grab the bride and they start driving back to the groom's village for the actual wedding ceremony. Gonna bite at their. Ability said that ever since they left that morning through lodge all day long they heard this. Humming a sort of metallic whirring this metallic thumping overhead no one in the conflict see it but they knew what it was a drone. That some saw and hearing all the day is nothing new for people in rural parts of Yemen by this point they don't think anything of it it's common to hear those sounds Yeah if you usually hear it there so you keep trying to basically if you can imagine it they're sort of winding through these Wadi as these desert mountainous places I don't I don't know the road he said Montanus they're all strung out on this rotted out little dirt track 11 cars single file finally they reach this little clearing. Up near the top of this cliff where they all slowed down and started to bunch together because apparently then I went into one of the cars they got in a flat there how do you want some guys got out fixed it got back in their cars and right at that moment the sound shifts somehow and then. The missiles start. 4 of them in quick succession the shrapnel is just flying everywhere in a blink. It's over people are trying to figure out what has happened all the screaming there's fires that are burning in and. Out of. His car was torn up he had shrapnel in his face was in his face one you mean earlier sorry and in the right hand left fi. In the back. Of the mob going to and he says that once he saw there was smoke and the 1st thought was Where's my son and knowledge of the mob going to who he was that he was looking for his son his son was there yeah a young man who'd been a few cars back from the 4th car on board and he was married with 2 boys and one daughter Dilla said he could move so he got his car and stumbled back toward the 4th car a lot of you can say that much if I'm going. To find his son. Said they found him just next to the car. For years. After you know he didn't talk to him just he looked at him and just. So there are 12 dead and typically what happens in Yemen is that as soon as someone is killed they're very very very shortly thereafter what happens here is something different. Now I don't know the people in the convoy take the bodies of the dead and they take them back to rather this big town near where the drone strike occurred there's a video I have that's what you hear and receive some men take these 12 dead bodies and they lined them up in the street on this bright blue tarp and they sort of wrap them in these cheap blankets and so there's just a huge crowd that just gathers around and at a certain point this very tiny very very leathery old Yemeni who's sort of holding on to the back of a pickup with one on. He stands over the dead sort of swaying over the bodies and just lecturing the crowd on what happened he's just screaming at them and so. You can hear his voice. Start to go hoarse What are the words and I'm not sure if you need screening in American drone killed these it was a massacre these people are on their way to the wedding why did this happen with longer than Europe. 6 was going to was going to do was. Why did they target this this convoy Well according to the u.s. Government they had received intel that on that day in this convoy was an al Qaeda operative name Shoki all about Danny who apparently had been planning attacks against the u.s. That's why they took the shot and in fact they say that he was wounded in this in this wedding convoy strike and do we have any reason to. Believe that I have no reason to believe it spent weeks in Yemen talked to survivors of the drone strike talk to people who were there no one knows this guy great Says the guy isn't really a member of either the tribes that were involved in the wedding and so to him it makes no sense that he would be there to him this was a terrible mistake. But what really got me interested in Craig's reporting is that he goes really deep into the question of like how do you repair something like this when you have 2 totally different cultures with 2 different traditions how do you find a way to try to make this right and the talent he can think can you know I mean to historical do soldiers have an obligation to repair the damage they do no there's no obligation but what's happened is we've actually created an obligation for ourselves when Americans have Yeah and there's a there's a great law professor at Yale. And there is last name is his wit it's John wit that's me we ended up checking down John to talk about how the us 1st started to try to right the wrongs in war that starts with General Pershing and World War one . So 1705 was the Great War ramps up so we start shipping young men. Back over to Europe the end of the specifically France and in charge of these men was a man named John j. The commander of American forces on the Western Front stern man handsome mustache bit of a maverick gentle person is your nickname was was black jack and when he 1st arrives in France with his troops Gen by check Pershing he's got this problem which is that he has jeeps built in America. By Oh So World War One is the 1st war in which the us is shipping a lot of automobiles more than 100000 British soldiers to drive cars trucks jeeps and ships a really great they get his men from one place to another to bury. I don't know by say but they also run into French farmers chickens and cows children sometimes just the farmers themselves sometimes it was probably just ordinary car accidents and sometimes no doubt a little French one was involved so this is person's problem he's trying to run a war overseas and it wasn't any good for him to have grumpy civilians at his rear and so Pershing has an idea he will use cash money to right our wrongs once he goes to Congress and begs for a statute and Congress obliges really quickly there's no sign this is a controversial thing but it is a genuinely new thing because for the 1st time in the history of war as far as we could tell you had a state compensating individuals usually it states state here you have state individuals and so the us government starts systematically pain money for the loss of a non American life in war. How much of what she said I don't know actually surprisingly hard to find documentation mentioning specific amounts but whatever the amounts were it seems to afford a. Person right in his biography that the swift and prompt settlement of claims had a great effect upon the people. In this is a museum here that like this is what we would do with a drone strike victims we talked about that we pay them money well it's actually it's a it's a bit trickier than that because the thing that Pershing got in World War one it came with a catch and that is that there's a combat exclusion and he's just walked in that's Gregory Johnsen and what he means is that this law basically what it said is that will pay your claims if it didn't happen on the field of battle and it was in a combat situation there was combat and it was on the field of battle then tough luck that's just war so if u.s. Soldiers were driving to a fight and they ran their car into somebody and they damage that car killed that person those people would not be able to get compensation whereas if the u.s. Soldiers were driving to a bar and got in an accident they would be able to get compensation but the problem is. Getting the least counterinsurgency or civilians are suddenly in the middle of the fray trying to have been. Killed as many as 557 and their civilians during a this is in a way the story of modern warfare. Getting. President Karzai says he's delivering his final warning to the u.s. After us your story killed the one that is doesn't mothers and children by the time we get to Afghanistan and Iraq the fighting is happening in the cities so there's no difference really between the battlefield and where people live and so the line between what's combat related what's not combat related it starts to get blurry and so in 2003 and Iraq there were actually people lining up you know there were civilian. Terry operation centers people started lining up outside of that he's saying My family has been harmed I want help how many people do you remember if I had to guess it was you know maybe around 80 people or so that's a ton of people yeah that's John Tracy he was a military lawyer in Iraq in 2003 and before him by the Kenyan I'm managing director of Center for civilians in conflict so when they came with a complaint what sort is it like you ran over my chicken or you knocked out my window you know much more serious I think of cluster bombs during the shock and awe campaign one of the types of bombs that we were using or the Air Force was using what they call cluster munitions basically John's Air Force planes would fly over these targets and drop hundreds and hundreds of these tiny little bombs smaller than a Coke can and a lot of them would land in maybe a parking lot or a field and they wouldn't explode so on a number of occasions you'd have mostly it was kids right because the kids would see it and they didn't know any better it would just run over and kick it in then that's when it would explode I had a lot of those close to a dozen and so that was a that was a difficult one because it's combat because they are force dropped it because they were you know bombing the city but at the same time days weeks even months have gone by and this thing is just sitting in the ground couldn't we say it's not combat and this was a real question that John had to ask his boss and then his boss as his boss they eventually sent the question up to the Army claims service and they said no if it's combat meaning they're not going to pay basically like we are in an in an armed conflict and this was an unfortunate incident but an incident that happened during a lawful combat operation and therefore we're sorry. And that's basically it so I said no to a lot of people and so like in World War one with General Pershing military officers they started lobbying their bosses for an expanded system so they could start making more payments and eventually the military does expand it and how much are they paying Well I haven't like the u.s. Military hasn't given me access to a database or anything like that but through for years and and interviews I've seen different numbers of this is that in 2006 the seal you filed for a request and eventually got their hands on hundreds of claims files and in those files what you see are a bunch of different numbers but one that comes up again and again $2500.25 baht a large Now someone like John could have paid more but that meant they'd have to run the claim up the chain of command Exactly so it's almost like there were these scenes 2500 for a life 1500 for property damage and then eventually the property damage amount got raised to 2500 is as well and that that didn't make any sense to me that somebody could get so much for a Toyota Corolla but you were you were just going at the same amount for a loss of life like I can't get over I mean $2500.00 seems like just such a nominal amount in the practicality of that money of like if you were to kill someone who is the the breadwinner of the family but we're not actually trying to pay full compensation right like we're not trying to say we think if this 20 year old man had lived to be the average age in Afghanistan that he you know that it would have been 60843 dollars right like that's not the thing but if you ever you know we had people who were killed here in attack the federal government is one step closer to cutting its 1st checks to families of those killed and injured on September 11th and those people have been compensated the levels of compensation to the New York victims is is pretty high the range of payments for death claim ranged anywhere from $250000.00 to just under $7000000.00 Do you notice that. I do. I do but that's a very different type of monetary payment Well yes and no Essentially it's a person's life and yeah I mean I think there's an argument to be made that there's an empathy in the number that you come up with in the amount that you pay for someone's life I totally get what you're saying the $2500.00 I think it's any amount of money if I told you $10.00 would you feel better about it I mean a little bit better u.n. I think so Ken what does it get you though in the end $10000.00 doesn't buy anything more back than what you lost I don't know what that doesn't get to exactly in Afghanistan but my assumption is that it gets you a lot more than 2500 but does that really help you is that really what you want is the money unimportance you really sounds like the money's really I'm not a victim so I don't know that I can answer that to me if it happened at this point told us a story about how before she got into this line of work I had several friends who were journalists one of those friends was a man named Chris Hondros you know he's a photojournalist he was a photojournalist and back in 2007 Chris was on assignment in Libya moving with a rebel group when they were fired upon and Chris was killed yeah. And while this is when she found out that it happened I wanted someone to explain to me why that happened I mean. I didn't want to turn to explain I think you know like I knew his family was going to give me money I knew that these guys shot a rocket propelled grenade at him we're going to care no one is going to explain but I wanted that. And the money then becomes an occasion for you say like not just I'm sorry but here's what happened it's the here's what happened part I think it's the token that's given with the apology and with the explanation but it's the apology and explanation that matter to you yeah that's why we call it and then making amends. One of the things that is true of money damages generally is there there are desperate effort to find some common language between the party paying and the and the victim some Esperanto for communicating the meaning of what's happened in the language of the other side knows matters that's how John would put. But the problem is in order for that Esperanto to work it has to say the same meaning to both sides which for John Tracy it wasn't really about the money at all or not just about the money it was as much about the armful of that the money was in or that there was a real person there to hand it to them I wasn't the one who read their house I wasn't the one who killed their daughter but most of them they you know just wanted to look at somebody who's in a uniform and say you really messed with my life. And that opportunity is exactly what Abdul l.t.c. Moment to him a letter battle of the will never get the. Son was killed by a drone He never stop or aided by a man who never meet on behalf of the country that still doesn't admit it was a mistake and so the money he got. My McAfee which in the end he says was the equivalent of $30000.00 u.s. Dollars way more than anyone got in Iraq or Afghanistan still all he can do without anything else to go on is just compare amounts. Of monogamy and I don't understand until my point and then I'm going to. Have you walk out on our Congress. Or he can accept that only. If. It gets the you know the you know like the payment you quote to those you know. To like in America how you can be say someone who lost his son for example if the payment was if the payment was equal Yeah. Producer Matthew Kielty Radiolab return in a moment by this is Midge lotto from Kalamazoo Michigan Radio Lab disappointed by Progressive Insurance offering snapshot a device designed to reward safe drivers learn more after aggressive dot com or 1800 progressive Now that's progress. P.b.s. Public Radio is supported by Lloyd pest control proud sponsors of one book one San Diego Loyd pest control offers termite solutions and a defense against ants fleas and spiders they can be reached at 1800 bad bugs or online at bad bugs dot com sun powered by stellar solar now offering the industry's 1st 400 watt home solar panels the Sun Power a serious 400 watt panels part of the equinoxes them with built in micro inverters learn more about this new solar technology at stellar solar dot net. Every single person gets angry at some point but who actually gets to express it who gets to be angry with power who gets to be angry with recognition who gets to be angry with accolades ideas on the different sides of anger that's next time on the Ted Radio Hour from n.p.r. . Saturday at 1 pm Sunday at 9 am m k p.b.s. . 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They're doing things for example cotton farms in South Texas so that you know the farmers are doing their thing like this guy James Parker plan their cotton they're collecting it off farm about 526700 acres of cotton so say 2000 bales they're doing what farmers do I spend a lot of time on the tractor and. Check your water every morning every evening Meanwhile they have all this extra help in the air yes they have bats how many bacteria out there you really don't know one all around the bats eat 2 thirds of their own weight in sex every night and they. All kind of bugs a whole bunch of pests that would otherwise be eating the cock and now a few years ago when John Westfall did a calculation he came out of my farm and did a study each year the farmers collectively they make about 4 or 5000000. Dollars off these farms question was how much of this was because of the bats because you know bats are natural pesticides you know the more they spray and here's what the scientists figured out out of 45000000 dollars It was around $700000.00 that you could ascribe to the bats it does give you a glimpse at the kind of scale of value economic value that nature has that we generally just totally ignore but we talk to a guy who didn't ignore it when he was Robert Christan So in fact he took this way of thinking to the absolute limit Yes So the question was what's about you have all of these ecosystem services globally all the services on earth we tried to synthesize all of the studies that had been done around the country in the world like the bats study except they didn't just look at cotton farms they looked at tropical forests rivers and lakes coral reefs coastal wetlands in the wetland the ocean with temperate for as you know it goes on and on grasslands it's it's kind of the Excel spreadsheet from how you can get tricky so fans and his colleagues took all these different studies some of them together did a bunch and. Came up with a number which in today's dollars is $142.00 trillion dollars. Per year of services that's more than the gross national product of the world let me ask you like I get I get the way this would work with a bat like the bats eating the box but like how do you do it with like a like a field or something like How do you can figure out what the services are well for example a salt marsh. And we are in the one. You're in the water what is it a salt marshes that like the floor salty and suddenly don't know what a salt marshes salt marshes are wetlands that are on the coast got it you know we're standing in about a foot of water here were quickly approaching high tide Lisa and one of our producers Simon Adler to a nearby salt marsh to talk to this guy my name is Adam Whelchel and I'm a director of science for the Nature Conservancy here in Connecticut and then I'm gave Simon a kind of inventory ism of the services provided by coastal salt marshes it's a stream of goods and services are being provided over time one of the things it does is it takes water that's coming in from inland and that's laden with all sorts of pollutants all sorts of bad stuff the so Marshall trapped that water so the pollutants settle and then very often the marsh grass will suck up that water into the roots and clean it up so you could ask very simply how much would you have to spend to keep your water that clean Well there is one other study I want Adam Walsh said that scientists in New England have already figured that out for flood control water supply protection pollution controls roughly about $31.22 per hectare per year then you've got to add the value of all the plants that be deficient and end up on our dinner plate a $138.00 annually per acre then there are the bird watchers that my latte support local economy $490.00 per hectare the list goes on and on and on and on you get kind of obsessed with it you start like you start becoming an accountant and writing down numbers just seriously and. And it gets you to think about nature in a different way than you had before there's this galling element or this aspect like when I 1st came across at this point our producer Tim Howard jumped into the interview and you'll also hear our producer on Wheeler in just a 2nd I do feel like in an example at the salt marsh which cleans water that's all reliant on people being there that need the water so if you didn't have people there does that Saltmarsh cease to have any value but Tim Haven't you ever had a conversation with somebody who just like if you make the a static argument which is that nature should be should be preserved for its own sake there's a whole category of humanity just doesn't respond to that argument if this becomes a way to talk across the aisle but it does still feel like it demotes something of infinite value to something of a paid leave it can really be infinite value I mean like a mother's love you don't think your mother's love is priceless I mean you know Ok I totally accept that there is this sort of priceless aspect of nature but if you are in the government in a very poor country you have some tough choices to make if somebody comes to you and says Ok you've got these lovely mangroves now turns out that that this sort of setting where the mangoes are is the perfect place for shrimp aquaculture we're going to put in these farms we're going to grow shrimp you are going to get millions and millions of dollars in tax revenue if you're thinking about the the welfare of all the people in your country that might be a really powerful argument now into that kind of a discussion you can bring in the fact that these men grows are sitting there doing all sorts of incredibly valuable things in fact they've done these kind of calculations and in some cases the services that mangroves provide are 4 times more valuable than what you could get out with shrimp is it a hypothetical situation you know that's a no so if you are asked this is going. Marie Lang she's an environmental economist for the World Bank and she says very often she finds herself in exactly this kind of conversation particularly you know I work for the World Bank So our primary clients are our governments Philippines Vietnam and when you're talking to a minister of finance is saying you know what you were I know jobs are jobs but you need those marshes they have value they'll say well yeah that's true but that means I'm going to have to reduce the money that I put into the education budget so you've got to really make a strong argument about the benefits and that's really where the rubber hits the road well I mean that said here's the counter argument it comes from Doug Macaulay in a college at the University of California Santa Barbara the real danger is that we actually succeed that we we convince people that nature is valuable because it makes money and then where we're really in trouble in the many instances where it doesn't make us money what do you do in a situation he says where say a bunch of rivers are running dry and they're quote depreciating in value you know by the same logic that you train me to think with we should go out and liquidate these natural assets makes me feel really uncomfortable on the other hand I want to say that when you don't put a value on these services basically they don't get counted they get implicitly assigned a value of 0 according to Glenn Marie leg and as we were debating this going back and forth back and forth we bumped into a story about what happens when all of these value of nature ideas are let loose into a world fruits and trees and human uncertainty. The parable of the beans we heard this 1st from writer j.b. MacKinnon who says the story begins and now counted in central China rural area fairly remote lush green mountains filled with apple orchards and orchard ing was the main business and according to j.b. In the 1990 s. The wild bees of Mao County slowly started to disappear. And there's a few different reasons given for that could. In the destruction of the habitat that the bees nested in the heavy honey harvesting that wasn't leaving enough food for the bees but the prevailing theory is actually an economic one because in the 1990 s. As China was shifting to a market based economy album producers were under pressure to produce more apples so they started spraying pesticides probably it was a constellation of all of those things in a few others and result is to be stopped by using in my county which if you are an apple farmer that's a disaster as bees travel from flower to flower in search of nectar they are there dusted with Paul in which is the means by which flowers engage in sexual intercourse so if you don't have the bees making the birds and the bees on the blossoms then then you don't get fur to have flowers to turn into to turn into for and obviously if you're a fruit farmer and you have no fruit to sell you have no income. So what do you do your novel farmer and you don't have bees then you need to find some other way to pollinate the flowers. And I guess they concluded Well we'll have to do it ourselves by hand in mentoring Chaney's we say fan so it basically that means a manual for the nation. This is how I'm a correspondent in China Polish French newspaper a couple years ago you heard about the apple farmers in Mal county so he flies to chane do an infant hop in a car and we drive for like 5 or 6 hours and see if we reach a. Tiny little village and we actually saw it at the well you know it's a foreigner in the trees like on the trees struggling up on these often thin and spindly branches men and women that I've seen in photos in any Harold and his friend took pictures and if you look at those pictures you'll see the farmers holding little brushes little pollen brush that they've constructed using things like chopsticks and chicken feathers and Sigur. At filters I may have a little bottle of pollen and then what they do they dip the brush into the bottle and they paint the flower blossom with the pollen they dip the brush back into the pollen of the paint the next floor blossom again in the Depression by going again and they paint again in the debate again and hundreds and hundreds of flowers Portree what a pain in the ass that sounds like now the image of this of these Chinese orchardist standing up in the spindly trees traveled around the world through environmental circles and it the message that it seemed to send was that you know this is what happens if you if you lose biodiversity you end up standing in the trees doing the job that the bees used to do on the wing for free for free those people are just like human beings then this guy enters the story this is in son Chen Yeah human being 4 years ago he traveled to Mao county to do a sort of economic analysis of just how much the loss of the bees was hurting the farmers of Mao County but what he discovered weirdly was that the trees were producing more apples than ever more production. Nation. Be punished and what's really people were doing it better than the bees had been doing it yes a lot better for production went up 30 percent that's what the farmers told us when checked because I think hemp pollination can pints most orally they can pine that every flower and beast don't pollinated flower bees are a little bit. They're a little bit uneven when. They don't like it it's called it I like it of it's damp they don't like it if it's windy but you send people out there and tell them to pollinate every damn block. And they're going to do it and there is the additional benefit of the people you paid to go to the bar they buy groceries they spend those earnings in their local communities in a way that obviously is never did so here you had this. Whole story that was supposed to be about how important the bees are parable of biodiversity it turns out maybe the lesson is just the opposite that actually we don't need to be right. But there's one more chapter to the story Harold to both told us that when he visited Nan Chan I talked with one farmer his name. Is 38 and he said in his opinion for the nation. These appear you know a few years apparently as China's economy has continued to grow workers have started demanding better pay the wages are getting so high. That the farmers have to employ to help them basically it's not efficient economically to do the intonation anymore that's what's a lot of farmers say this now they're likely thinking we need peace back right yeah problem is there are no bees in those villages anymore. Here's swear that story. Leaves me thinking that economics is just not a good way to go putting a value even of even a precise and thoughtful value want to be on the pound of pesticides you do it and you think you're smart but then the value changes the bees go from being worth a lot to being worth nothing to being worth everything all within a few years all right you know he's a book is a dumb when I know I'm in love I want to argue the other side no where in the story did someone walk into the middle of the proceedings and say you know what do you have value here is the number in fact you know Caro when we were talking to him told us you know there'd been estimates that the value of the pollination that comes from wild b. Is $190000000000.00 So that's globally right but still there was nobody in the room giving that kind of number so the bees were inherently valued at 0 but remember bees are value to 0 only until humans get valued more than bees go down because go I get have a lot of the numbers in your head but here's what I like about this idea is that when you put a number on a beer a bat or a. Marsh It's like an attempt to force a kind of long term thinking you can't just say don't do that I mean it's the thing that like conservation to say Don't don't don't but if you say don't do that because here is the value the loss you're going to yeah here's the last one that actually gives the whole precautionary don't think some teeth except for this that if you go business see nature and you're wrong there are irreversibility That's how environmental economist Glen Marie Lange puts And this is one of the differences between nature ecosystems and what we produce you smash your car Henry someone can build a new one if you lose that be many instances you cannot bring them back so the question we got to is is there another way to think about the value of nature I mean a way that's not economic and therefore short sighted and all about us but also not simply about the a statics in the beauty because that can be sort of limiting to is there another way the best I was able to do thinking about this writer j.b. MacKinnon again was when it struck me that all of this diversity that's out there all this biological diversity all these wonderful and amazing and alien things that other species can do is like an extension of our own brain and there's so much imagination out there that we simply could not come up with on our own that we can think of it as as a pool of imagination and creativity from which we as humans are able to draw and that when we draw down on that on that pool of creativity and imagination we we deeply impoverished ourselves you know in a sense we are we are doing harm to our own ability to think and to enter into dream. J.b. MacKinnon's book is called the one secure world he's written many but this one is my fave do. Thanks to Carl Zimmer reporting in The New York Times on this topic is really what got us launched into this whole thing and what got us through this whole thing is Simon Adler whose production assistant was invaluable thank you and thank you guys for listening I'm Jeff and I remember growing We'll see you next that. Is supported by Rancho Laporta a health resort 45 minutes from San Diego 34 and 7 night winter vacation packages include fitness classes hiking mindfulness and Cullen area adventures Rancho Laporta dot com Thank you for listening to and supporting San Diego's n.p.r. Station k p.b.s. San Diego k 206 AC lawyer k.q. Vo Calexico where news matters from the k p b s traffic center earlier accident north as Boulevard has the freeway backed up from a much worse here your stop and go from before last pull gets down to the 78 then again traffic from point say to Santa Fe drive that's now one hour and 15 minutes from before last pull this down to Del Mar else where the freeways are moving along in pretty good shape make a lasting impact on our community with a gift to k. P.b.s. Through your will trust or retirement plan. Dot org slash plan giving to learn more I'm going for k. P.b.s. . This. Is the Ted Radio Hour. Each week groundbreaking Ted talks to. Ted Technology Entertainment Design design does that really would stem from never known delivered at Ted conferences around the world gift of the human imagination we've had to believe in impossible from this true nature of reality beckons. Just beyond those talks those ideas adapted for radio. From n.p.r. . I'm Guy Roz coming up who gets to be angry there is a sweet spot for anger is a wonderful sign and terrible strategy anger can alert us to injustice and then energize us to respond to that injustice I don't mean hostility resentment hatred I think about passion this episode rethinking anger 1st this news. Live from n.p.r. News in Washington I'm Barbara Kline Turkey warns it will resume its military operation against Kurdish militants in northeast Syria if they don't completely leave the border region as N.P.R.'s Peter Kenyon reports the Kurds are required to withdraw under a u.s. Brokered cease fire arrangement under an agreement hammered out an awkward Thursday the y.p. G. Forces were given 120 hours to leave the area where Turkey wants to establish a safe zone president rigid tape aired on adds that Turkish forces will not be withdrawing from northern Syria one is insisted Turkey will not accept what he called a terror chord or along its border NATO Secretary-General un Stoltenberg called for deescalation a northeastern Syria Friday calling the situation fragile and difficult the cease fire largely held Friday despite some reports of shelling around the Syrian town of Ras aligned Peter Kenyon n.p.r. News Istanbul British Prime Minister Boris Johnson has failed in his attempt to get a Breck's it deal passed by today Teri Schultz reports the European Union is waiting to hear what happens next European Commission spokeswoman mean under a of a says the British government must inform Brussels as soon as possible how it intends to move forward now that the agreement remains in limbo prime minister Johnson had asked lawmakers to pass the deal today but parliamentarians voted to 1st and match new laws necessary to implement the agreement with the e.u. And then vote on the overall agreement Tuesday that kicks in the Bene Act which requires Johnson to ask for a.