Friday, July 30, 2010

A PRICE on delaying death?

This is a HUGE topic........Can you "put a price on delaying death?" There is a revolutionary drug that may cost $93,000 to add FOUR MONTHS to the life of prostate cancer patients. This drug has very little side effects, by the way...patients are comfortable until the end, apparently. Here's an important snippet (in italics) from the article, though I hope you read the whole thing, it's not long and it's fascinating:

An estimated 200,000 new cases of prostate cancer will be diagnosed in 2010, according to the National Cancer Institute. While only a fraction of these cases will ever become eligible for treatment with Provenge, the potential burden on Medicare funds is sizable.

Currently, Medicare is not allowed to deny a treatment based on cost alone, but in the coming years, "it will be difficult to sustain coverage of these very costly procedures considering the Medicare program is facing a huge long-term deficit," David Howard, assistant professor in the department of Health Policy and Management at Emory's Rollins School of Public Health, says.

"Ten years, 20 years down the road, Congress is going to have to rewrite the law to allow cost to play into coverage decisions."

UHOH. Congress will decide? And, this drug may also be effective for BREAST CANCER.

CAN we put a price on life? Can we pay these huge prices for four months more life?

WHAT DO YOU THINK? It's a HUGE topic and I hope we can get some good input here..thanks.



Anonymous said...

That's the real problem with government run health care. The government isn't willing to spend money on costly new treatments, period.

Always On Watch said...

Have you seen this chart about ObamaKare?

Always On Watch said...

I know from personal experience how difficult it is to fight the health-insurance industry when trying to get certain benefits listed on the insurance policy.

Can you imagine how difficult ObamaKare is going to make such fighting back? The bigger the bureaucracy, the more difficult the battle!

JINGOIST said...

These are VERY good questions Z. Unfortunately we are "BLESSED" to ask them concerning the treatment of other people because of our gd collective payment of those bills!!!!!

Imagine if bill payment worked in accordance with Natural Law, where market forces and pressures ONLY dictated the prices of medicines, and people who still couldn't afford those medicines went to their church or private charity--or drug company to pay the fee.

This discussion would be where it rightly belongs,,.,with the friends and family.

We are living the socialist alternative to Natural Law--and it's VILE!!

Linda said...

All I know, is, my hubs is taking the new cyberknife treatment for prostate cancer. I don't know for sure how much it costs, but I've heard $20,000 for each one. He is taking the last one today...PTL, for a total of 5. I am so glad we are on Medicare. We've always had health insurance, most of the time, self pay. Our last self pay policy was MAJOR MEDICAL only, with a $10,000 deductible, and then 80/20.

As I've said, the day we reached 65, we were covered by MC. We've never had anyone knock on our door with a 'better policy'. We don't have a choice!

The drug companies need to bring the cost of the drugs down. You know they make lots of profits.

Ducky's here said...

Not much of a capitalist, Linda?

Linda said...

Ducky, I am a capitalist! We just didn't have a choice when we turned 65. I am all for making as much money as you can, just not at the expense of others. We've been very fortunate all of our lives that we've been able to pay our bills, and have a little left over!

Speedy G said...

Not much of a capitalist, Linda?

Having been forced to pay 16% of ones income to Social Security for the better part of fifty years makes one a Socialist when they go to finally collect?


Chuck said...

Z the question on whether extending a life for 4 months is worth $93,00 is a tough one.

What is life worth?

Does it matter who's life it is? Often these cases are easier to dismiss if you do not know the person, if it is a nameless somebody else. If it is a family member, then $93G is a small price to pay for 4 months.

I am against using cost to determine care options. The hospital I work for is the "Charity hospital" for the city. We provide a lot of unfunded care and I am proud of that fact. We intentionally do not ask about insurance while caring for the patient in the ER, it just isn't relevant to us.

I think what is more likely to happen with rationing down the road is looking at life style choices (except homosexuality, of course). I think we may see a time, not in the distant future, when people that are smokers may not get treatment for ailments caused by smoking for instance. A simple example may be that they will not give a smoker a lung transplant. Things like this are already happening and will likely increase.

I can't say I entirely disagree with this to some extent. Again though, it is not an easy question.

Opus #6 said...

Won't this drug go generic in a number of years, lowering the price?

The Born Again American said...

I'm probably going to catch some flack for this, but why not wait until you've figured out when they only have four months to live, then you tell them they're goinng to die tomorrow, but you have this magic pill that's going to give them another four months... Give them sugar pills and they spend there last four months thinking they've cheated death...


Have a field day Ducky, I hope your head explodes over that one...

Karen Howes said...

Personally, if I were dying, I wouldn't see much point in extending my life for four months, especially if I were suffering. But the point is that this should be available, patients should choose, and that the gov't should have no say in it.

Anonymous said...

I completely agree with Karen’s statement (above). We cannot escape the inevitable, even though we do wish to delay it for as long as possible. For me, the question is whether I want to spend so much money for a marginal benefit. Would living four additional months be worth the cost to me, to my family, to my thousands of readers? Should I go kicking, screaming, and whining … or should I simply accede to the dictates of nature; go quietly with dignity?

No matter what I finally decided, it should be my decision —mine alone. But you see we have faced this problem for quite some time now. Whether we are discussing a private health care policy or one run by the government, a bureaucrat decides whether we live or die based on cost-benefit analysis. If you think your HMO made some unpopular decisions in the past, just wait until ObamaCare starts making them for you. I never thought I’d see the day when long lines of Americans would be forming to get into Canada’s health care system.

Z said...

AOW, I can't look!
Signed, your friend the ostrich.
And no, there will not be a battle...the laws will just say "Die" (but we can't say that because the leftwingers will accuse us of suggesting Obama wants us to do, of course)

Anonymous, there were those who've suggested that American companies will not be able to produce the great medicines they have over the years and they're up there with Germany right now in this case. I think this is almost the worst part of Obama's package...there won't be the money for R&D, for example. said "where market forces and pressures ONLY dictated the prices of medicines" COULD this work?

Linda, profit is good but there has to be a way around these things. I hope your husband's doing really well. xx

Born Again, odd you should say that. My cousin died recently, five years after being diagnosed with cancer and BEING TOLD SHE HAD FIVE YEARS. She practically died on the anniversary of the diagnosis. We must be careful what we let our body hear, so to speak.

Karen, I agree...this particular treatment is apparently comfortable, but that doesn't mean the pain from the illness isn't there, come to think of it. you're right.

Mustang ..thousands of readers should BE so lucky to read YOU, believe me. :-) And that's the truth.
You say "My decision, mine alone" and then the question comes "If you can't afford the cost of this procedure, then what?" Devil's advocate here.

Ducky's here said...

ooops, Heather accused me of being an instigator. Now, I take Heather seriously.

There is a predictable flow here.
The right is quick to complain about rationing in countries they perceive as "socialized" regardless of whether health care delivery is owned by the state or not.
Then we get the anticipated argument that the market should determine the delivery of this drug but with no hint that implies rationing. So one of the central issues is neatly avoided.

Then we have the sentiment that the price should come down. But the right has resisted ideas like importation from Canada and any restrictions on drug company profits.
What you'll get is the standard argument that they need the money for new drug development even though the majors spend twice as much on advertising as the do on R&D. Ever think about those ads where they tell you to go complain to your doctor if he isn't medicating you.
So they push a lot of product but the price doesn't come down. Interesting. Where were you all when Bush and Billy Tauzin were giving Pharma a nice big kiss with the prescription drub addition to Medicare that we can't pay for and just like Obamacare does NOTHING to limit costs?
Try to limit costs and you'll be right there complaining about government meddling. Bit of a standoff.

Sister of a friend is a intensive care ward nutritionist and she could go through Howard Dean's ideas chapter and verse and he made a lot of sense. But that's past and gone.
And we sure can't talk about end of life decisions without euthanasia charges. Maybe even get some bimbo talking about death panels.

But it's all Obama's fault.

Z said...

Ducky, you needed Heather to tell you you're an instigator? WOW.

Your generalizations about Bush, me and my commenters, etc., is silly.
"Gee, I LOVED everything BUSH DID!, DIDN"T Y'ALL?" :-)

I keep telling you we aren't monolithic like the leftwingers...we have differing's only since the left maligned the Right enough thru our schools and media that people stopped listening and...look what's happened.

I'll let others respond handily to your snide jibes....

Anonymous said...

Devils Advocate ... If you can't afford the cost of the procedure, you die. This happens every single day in this country and throughout the world. There is no guarantee for longivity; there is no entitlement to a long, healthy life.

Z said...

Mustang..very true. thanks.
I suppose your comment says all about this topic in a nutshell, doesn't it.

I'll be back later on amongst yourselves!

Ducky's here said...

What if the "procedure" is an inexpensive inoculation that prevents diarrhea in a child? Those deaths happen all the time.

Just throwing everyone in for the tender ministrations of the market may be convenient for deflecting the morality inherent in the question of equitable distribution but it is no answer.

It's just Ayn Rand trying to hide her clown suit.

Anonymous said...

What if the "procedure" is an inexpensive inoculation that prevents diarrhea in a child? Those deaths happen all the time.

Yes they do, Ducky.

Now before you dismiss one inoculation as a relatively inexpensive cost, understand that the vaccine itself is a resource and all resources are limited. The fewer resources there are, the more expensive they become. So how many millions of people are you suggesting need this inexpensive inoculation? And how many smallpox, measles, chicken pox, tuberculosis, influenza, and HIV inoculations? Americans and Europeans have been paying for these things for a long time.

You know, we have had a Peace Corps in this country for a very long time now. One wonders why we aren’t making advances throughout the world. I mean, besides the petty warlords who routinely receive arms and munitions from unprincipled arms dealers, and dismissing the stupidity of do-gooders like Michael Jackson’s “We are the World” concert tour which did not put a bowl of porridge in the hands of one hungry child, how shall “we” address all the problems in the world?

Today, people continue to crap upstream from others who rely on that water for drinking and cooking. Shall we simply inoculate these people and feel as though we’ve really accomplished something, or should we try to teach them about hygiene? Where are all these leftist universities who could be stepping up to help in matters of hygiene, agriculture, and animal husbandry —but who would rather just talk shit and do nothing substantial to help those who really need it?

And while politicians visit third and fourth world cesspools and pledge x amount of dollars in HIV medications and research, millions of people die because of horrendous conditions that mostly relate to over population, the predominance of Islam, and ignorance.

Meanwhile, as the US pours billions of dollars into countries like Haiti, Chili, and Turkey (an Islamacist state sponsor of terror), our states are on the verge of bankruptcy, our homeless number in the millions, our children go to sleep at night hungry and undernourished, our senior citizens are living on a fixed income, illegal aliens demand their fair share of our limited resources, and the leftists in government have driven our debt into the trillions. And for all the good things America does throughout the world, it is never enough and it is impossible for the left to hate America more. Makes you wonder, doesn’t it?

Ducky's here said...

Now let's assume the drug company did this on it's own and without any assistance from the NIH or state funded universities or the like.

They have a budget to recoup. The article states that it's over a billion over several years. Now t give them of reasonable ROR over time how do they seek payment.

1. Assume insurance companies pay? Up go your premiums. This method has problems and possibly insufficient assurance to make that big an investment.

2. Market it to the wealthy self insured and hope The Vulgar Pigboy and a lot of oil shieks get advanced prostate cancer. Maybe. It puts us into a pretty ugly state of competition.

3. Count on the government to pay for treatment. This isn't a bad deal potentially. Get a number of nations to go along and spread out the cost so that the company makes a decent ROR and continue the research for other forms of cancer with the longer term prospect being much cheaper treatment.

That may be too optimistic but it is something that option two is guaranteed never to achieve so we might want to see if it can be made workable.

cube said...

Unless Omabacare can be derailed, there will be unbelievable rationing for health care in this country. Just look at the UK and see the horror stories. Is that what we want? I don't think so.

Anonymous said...

When the Salk vaccine was developed, and available, no one asked, how much does it cost?

Everyone took their children, post haste to get the shot. Polio was beaten, almost in one fell swoop.

Did we care about how much it cost? Hell no. I realize that was a contagious disease and it was a no brainer, but, cost didn't matter. To this day, I have no idea what it cost to innoculate millions of people and I don't care how much it cost.

So, while this new vaccine is presented as for prostate cancer, it could lead to new miracles in treating any manner of cancers. This discovery is a first in treating cancer because it is a vaccine. Plus the cost would eventually come down, as it is used over time for more and more people.

Personally, if this were Mr. Pris who had prostate cancer, I'd spend our savings, or take out a loan on our home, to keep him alive.

What I'm saying is, I'd want the decision, not some bureaucrat weighing the value of his life, and that's where we're headed.

When a life comes down to numbers, each of us is no more than a statistic.

I do not relish being reduced to a cost effective statistic, and more than that, that one I love is a number to be erased without our having anything to say about it.


Ducky's here said...

Polio is a pretty good example. As a nation we funded the research with a significant portion coming from the March of Dimes.

Salk and Sabine didn't have private patents to the vaccines, yeah collectively we got it done.

Kapital didn't enter the picture.

Unlike smallpox it hasn't quite been eradicated but the WHO (part of the dreaded U.N.) has come close to the success they had with smallpox.

Anonymous said...

"Unlike smallpox it hasn't quite been eradicated but the WHO (part of the dreaded U.N.) has come close to the success they had with smallpox."

Well, if the UN stuck to eliminating epidemics, or contagious diseases which devastate all manner of peoples in the world, that would be one thing, but when it becomes political, and has the power to hold people hostage to their commands, that's another.

Inhibiting people's freedom of choice, in what they eat, or cultural habits, it is no longer charity, but dictatorship.

In the case of Polio, the March of Dimes was a huge success thanks to private donations, and I might add, freely given. This was possible because the people of America rose to the occasion as they always do.

This was at a time when the free market was the rule, before the entitlement mentality we have now. Polio was of epidemic proportions, and the government wasn't the bloated bureaucracy it is today.

People are less likely to give, when the government pays for things. The attitude becomes, "let the government do it, we pay taxes don't we?" In fact the Obama administration has opted to eliminate tax exemption for charity donations. Why?

Chuck: "A simple example may be that they will not give a smoker a lung transplant. Things like this are already happening and will likely increase."

I'm a smoker, however I'm not overweight. Should I take the position that if you're fat, you shouldn't receive care for a heart problem? Diabetes? Knee replacements etc.?

If a person is a vegetarian, should he take the position if one eat's meat, he shouldn't receive care for arteriosclerosis? Heart bypass procedure?

If one exercises regularly, should he take the position that if one doesn't, that person shouldn't receive cardiopulmonary care?

Where does it end?

We'd better be careful what prohibitions we expect others to abide by, your ox could be gored too, and in fact probably will be.


JINGOIST said...
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JINGOIST said...
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JINGOIST said...
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JINGOIST said...

Z asked: said "where market forces and pressures ONLY dictated the prices of medicines" COULD this work?--

Of course, and in this particular case it's the only MORAL way to determine if you get the $90,000 treatment. To add 4 months to your life? Most of us are going to say NO WAY! I would certainly expect/want my family to hold onto the cash given those circumstances. So, in the private payment case the family decides that this is exorbitant most of the time unless they have cash to burn.

BUT in the socialized Medicare system where the patient is removed from paying this nutty cost for an extra 4 mos. of possibly painful existence, the patient and family get a free hand to abuse their fellow taxpayer. This may sound harsh, but some stranger's mere existance doesn't constitute a lien on my life and the hard-earned wealth of my household. This is awful no matter how you cut it. And it all comes to us thanks to SOCIALISM!!!

As for the competitive market based price of a given medicine, it's ALWAYS the lowest possible price--as long as the situation is competively arrived at. This is better handled in the private sector, where it should be. Private charities are far more efficient also.

I'm getting a MONSTROUS chip on my shoulder about Social Security Z. I'm 47 and I've been paying into this Ponzi Scheme for 31 years to the tune of tens of thousands of dollars. It's been STOLEN! I'll never see a f@#$%&* penny of it, and I have BIG government SOCIALISM to thank for that. I wouldn't blame young people for working totally off the books because the smarter ones understand perfectly well that they don't stand a fart's chance in a windstorm of collecting on the Ponzi Scheme.

Socialism is an abomination.

JINGOIST said...

I had a little problem with Blogger Z. Sorry.

Z said...

No problem, Jingo, about happens.
Thanks for your comment, it really makes me think.

ALL (well, most) of your comments are excellent and I appreciate the information in them and your viewpoints.

By the way, the UN? Please read about my poor friend's grandson; he went with Africa with such an open heart and liberal pipe dreams of saving a community and ended up hating the UN for ineffectiveness, bureaucracy and unkindness. Poor liberal kid's head's spinning while he works in Haiti trying to help "The UN's standing in the way, the Haitians are standing in the way....I thought this liberal open hearted thing WORKED!" sad.

Leticia said...

No way can anyone put a price tag on someone's life. All life is precious.

If you could have four more months with a loved one, it would be worth it.

I just don't like the fact that it will be congress making that decision.

Anonymous said...

AIDS in Africa. Can everyone here spell cheap government inoculation program?

FrogBurger said...

Trivia question: Why do drug companies have higher prices for their medications in the US?

Answer: Because in most of the countries of the world, the prices are controlled, especially Europe. Therefore we American consumers subsidize socialized healthcare systems.

Anonymous said...

FB … An American citizen can walk across the border with Mexico and purchase prescription drugs at 20% of the cost on this side of the border. This is part of a socialist scheme engineered through the WTO, agreed to by Bill Clinton around the 1993 timeframe. It screws Americans and Europeans in order that people living in Africa and the Middle East can have access to medications they could not otherwise afford. It is purely and simply a redistribution of wealth, and when you talk to pharmacy professionals about it, they shrug their shoulders and say, “Well, Americans can afford to pay the higher price in order that poor people can get medications.”

Elderly Americans and Europeans can afford to pay higher prices on fixed incomes? This is the globalist point of view. This is how statists think. So our question is, do we REALLY want these name bean-counters making life and death decisions for us under Obama Care?

I know, it was only a rhetorical question.

Debbie said...

The government puts a price on health all the time, so do health care companies. They say, we will pay "this" much, the rest of up to you. Families either for up the money, or communities have fundraisers to get the money, or some benefactor provides the money, or the patient does without and dies.

It will be even worse with Obamacare, because I don't think families will be allowed to make the decisions, or pay for things themselves, it will be determined by government.

I take only 4 prescriptions daily, it costs over $200.00. My husband takes even more at a cost I don't even know. Insurance pays nothing. Luckily we can afford the medications. My heart goes out to those who cannot afford even the basic meds like bloodpressure, heart, and diabetes.

Right Truth

~Leslie said...

I understand that drug companies finance their research and therefore the cost of new drugs can be expensive due to the research funds that must be invested in them, yet if the government would take its hand out of the money pot we could see a significant drop in those pharmaceutical prices.

With that said, the act of anyone in Congress being able to decide who gets life extending drugs and who does not is one of the most insane ideas that was so brilliantly infused in the ideology of those running Germany at one time... hmmm

Jess said...

Oh boy, I am not sure what to think. $93,000 for four months? I don't know how you can put a price on life but at the same time, that's pretty expensive to put off the inevitable. I really am not sure what to think about it yet. I'm wondering why any drug cost that much. I can't imagine ANY insurance company covering it, could I blame them? And should insurance companies cover all or part?

Incognito said...

Interesting question, Z. (waves hello after so long- still dealing with health stuff)..

for someone who has a DNR mandate in her living will, and hates western medicine, you probably can surmise what my answer would be.

And I'll get flak for this..but with rising health costs, I would think that there should be some age limit.

slinks away.

Z said...

Incognito, GREAT to have you here...I hope you're doing better xxx
You know, you might think you need to slink away (cute!) but that's a side of this issue that deserves some thought...
At least an age where we must stop 'epecting' others to 'do' for us in the way of insurance, the government, etc.

As I slink away, too!!!