Your last point strikes me as a truism and distraction. The question is what motivates overall QALY maximization. Parent’s point was that resources should be used where they can most effectively increase QALY, and that possibly comes down to both intrinsic motivation (I don’t need it, they need it, it just fits nicely) and extrinsic motivation (direct reward through hard-wired empathy and social reward through philanthropy meme).
Your last point strikes me as a truism and distraction. The question is what motivates overall QALY maximization. Parent’s point was that resources should be used where they can most effectively increase QALY, and that possibly comes down to both intrinsic motivation (I don’t need it, they need it, it just fits nicely) and extrinsic motivation (direct reward through hard-wired empathy and social reward through philanthropy meme).