By Guthrie “Guff” Worth
To quote from a Washington notice: “Medicare officials say they will likely pay for a prostate cancer drug that expands life for about four months at a cost of $93,000 per patient.”
The drug apparently met the criteria of “reasonable and necessary medicine.” Medicare is not allowed to consider cost.
I think this is a precursor of many priority decisions that this country is going to have to face as medical care and social security problems develop.
Personally, I cannot conceive of a time when the last four months of one”s life is worth an additional drug cost of $93,000 (plus the other costs of care).
I would suspect that an advanced prostate cancer victim at the end of his life would be in such shape that hospice and pain management to make the end easier and the right of self termination would be more appropriate when funding is so limited.
Perhaps when the patient being treated is a researcher who will complete the development of a cancer cure in the last four months of his life the cost is justified, but I suspect that won”t happen.
I recognize that this is as much of a question of belief and of the state of mind of the patient as it is one of cost effectiveness, but the nation is going to have to consider some manner of Medicare limits if it is to maintain our present medical lifestyle.
I suspect that age, the present state of health (both mental and physical) and the potential nature and effectiveness of any proposed medical procedure and, of course, cost/benefit analysis. Not easy decisions. And the really nasty question: The recognition that all prospective patients are not equal, and the country will be benefited more by treating some patients than others when funds are limited is going to have to be faced. A lot of “bullets” are going to have to be bitten.
If our government had properly taken steps to tie in funding increases to spending forecasts in the past, we would not have this problem!
Guthrie “Guff” Worth
Lakeport
