cause the FDRQ are politically protected
Posted on 10/01/2011 12:50:16 PM PDT by wagglebee
“Get out of the lifeboat you expensive terminal cancer patients! Sure, your lives could be extended months, maybe even years,–but it isn’t worth the money! You’re going to die sooner or later, so it might as well be sooner. We need the money for more important and productive patients.”
That, in a harshly stated nutshell, is the recommendation of a committee of doctors in Lancet Oncology who recommend money by rationing therapies that don’t save the lives of cancer patients, but can extend their lives. From the Daily Mail story:
Patients with terminal cancer should not be given life-extending drugs, doctors said yesterday. The treatments give false hope and are too costly for the public purse, they warned. The group of 37 cancer experts, including British specialist Karol Sikora, claimed a ‘culture of excess’ had led doctors to ‘overtreat, overdiagnose and overpromise’…’We clearly would want to spare the patient the toxicity and false hope associated with such treatment, as well as the expense,’ the experts told the European multidisciplinary cancer congress in Stockholm.The doctors point out that many patients do not want to spend their final days undergoing exhausting chemotherapy in hospital and would rather be at home surrounded by loved ones.
Oh, quit pretending that it’s for the patient. It’s about money.
Indeed, we are now seeing a drive to extend the cancer of Futile Care Theory beyond ICU-style life-sustaining treatment, to other forms of care in which the patient may not even be hospitalized. When I was researching Culture of Death, I interviewed an advocate of medical futility and noted that refusing ICU treatment wouldn’t save a lot of money. I asked, what will futilitarians try to cut next? He responded, “marginally beneficial care.” And here we are.
Don’t get me wrong. I support people deciding not to go for the last shot of chemo, with the terrible side effects that can bring. But the decision should not be up to the doctors to withhold what is, after all, efficacious treatment that extends life. Doctors should give clear and honest pros and cons of the treatment–including onerous physical effects–but it should be up to the patient to decide whether the time has come to enter a hospice situation.
Patient advocates are pushing back:
But a spokesman for the Rarer Cancers Foundation said: ‘Describing all treatments near the end of life as futile is tantamount to writing patients off. ‘Just because they cannot be “cured” does not mean that we cannot give them valuable treatment, care and support.’ Ian Beaumont of Bowel Cancer UK said money was not the sole issue. ‘While cancer care can be expensive, it is unjust to put a cost on the lives of patients, especially when modern treatments can often give them precious time with their loved ones and increase their length and quality of life,’ he added. Only last week a pill for prostate cancer, Abiraterone, was made available in the UK for the first time at a cost of £35,000 a patient. Although on average it only extends lives by a few weeks, some patients survive for five years.
We all have our stories. When my dad was dying of colon cancer–for which he generally received awful care (I now know) from the Veterans’ Administration–doctors very reluctantly offered him a last ditch chemo that might give him a few months, with terrible side effects. He took it, and the cancer actually went into remission for a year. Not only that, the side effects were few. Indeed, it was a time of relative health for my dad, in which he and mom traveled and he thoroughly enjoyed every minute.
Bottom line: By accepting the philosophical premises of Futile Care Theory, bioethicists have opened the door to now imposing greater restrictions in the name of “fairness.” We should not let utilitarian central planners to take away hope and create a putative “duty to die.”
Chode do you notice this is not said about those members of society who willing contracted AIDS in a dirty toilet and AIDS is ten times more expensive than cancer ever was?
Do you wonder why?
Not that I do.
Just pointing it out.
cause the FDRQ are politically protected
It won't come to pass in that way, wagglebee.
Current Medicaid systems reimburse doctors, hospitals and clinics at rates which are so low that patients are effectively rationed out of the market. That's what will be coming to Medicare in the very near future. Watch and see if either party proposes to maintain or increase Medicare reimbursements, I'm quite confident they will not.
Costs can be drastically reduced without the government ever having to explicitly deny a single service. For example, hospitals are already reducing the number of defibrillator implants placed in Medicare patients because the US DOJ has started a criminal investigation of cases where implants do not meet Medicare's rationing guidelines. No bureaucrat has to say no to a patient....they just put the fear of prison into hospital administrators and let them do it.
Much of this sort of thing will happen without respect to whether the government is conservative or liberal...the demographics of Medicare in particular are inexorable.
The answers to your questions are yes,yes,no,no.
And the key question is number 3. Since I do not pay all my medical expenses out of my own pocket, I accept without question that those who do pay the residue are entitled to a say in what services they will cover.
Suppose there is a treatment that will extend the lives of cancer patients by five years. This treatment costs $100,000 per year of treatment (that's high, but within the realm of current possibility).
Further, suppose that of the approx. 47 million Medicaid patients in America, 1 million have cancer and could benefit by this treatment. Do you:
1 - raise taxes on the rest of America by $100 billion to pay for this treatment?
2 - set the Medicaid payment rate for this treatment so low that no one will offer it?
3 - Empower someone or some group to decide who of the 1 million can receive the treatment, based on limited funds as available?
4 - Publicly say "Sorry. The taxpayers can't afford this. Medicare won't be covering it".
Note that there is no option 5 "cut foreign aid to pay for it" or 6 "find a pot of gold at the end of a magic rainbow".
My choice as you can imagine is #4. What's yours?
4 - Publicly say "Sorry. The taxpayers can't afford this. Medicaid won't be covering it".
Here are the FACTS:
1. The treatment you base everything on DOES NOT EXIST.
2. It is highly improbable that there are one million Medicaid patients with cancer (feel free to offer proof of this if you want to go down this road).
I am curious though, why did you choose Medicaid? This program is mainly run by the individual states and that is where much of the funding comes from.
Your illustration simply doesn't work; however, it does demonstrate the liberal/libertarian mindset of supporting death panels based on a problem that doesn't actually exist.
If a new and expensive treatment comes along, which was not contemplated in the program's budget, the choices are still (1) don't cover it, (2) cover it selectively, or (3) raise taxes to pay for it.
If you believe that the nation's taxpayers have a duty to accept (3), that's a valid argument. But you should say so.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.