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Thursday, June 4. 2015
Megan McArdle: Cutting the Cost of Cancer
Rule of thumb: the more cancer treatments cost, the more hopeless they are.
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Until you have sat across from your oncologist and told that YOU hve cancer you do not know that fear. I have had friends, relatives and loved ones get cancer and die from cancer and it saddens you. But until the doctor tells you that it is YOU facing this horrible disease(s) you simply do not know how this diagnoses affects you. In my humble opinion what this article is really saying is that those who handle the purse strings in health care would like to stop paying for cancer treatment for older Americans. This is really what state health care is everywhere it is implimented. Europe, England, Canada, etc. ration health care especially for their older citizens. That is what Obama care and other efforts to nationalize our health care will do for us as well. Regardless of your age, sooner or later you will be told that because of your age and the cost of your care the spending cannot be justified. As you begin to understand that something has gone wrong in your own country you will read in the paper that your state legislature has decided to give free health care to illegal aliens. Welcome to the new USA. This should not be a suprise and to some extent YOU are to blame. You did not speak up and did not vote in a way that would change the outcome. So you got the government you deserved.
It is easy to forget that almost all medical treatments were marginal or ineffective over the last 2000 years of medicine. BUT only by trying things that didn't work and carefully observing and thinking by lots of practitioners did better treatments develop.
Drugs cost a lot if they are used by very few people since the firms try to recover costs + compensate for other drugs that never got that far. Be careful in meddling to much as you will keep the next clever guy from seeing the key to really effective stuff.
Amen to that observation.
Behaviorally modern humans have been around for ca 70K years, while medicine that makes an actual difference in the treatment of disease (excluding trauma medicine for this comment) for around 30 to 65 years. These technological advances have been costly. I can remember when there were a couple of vaccines, 2 modestly effective antibiotics, as well as topical antibiotics, a primitive insulin, digitalis and nitro, aspirin, opiates, and baking soda, oh, and alcohol. There was no holocaust, especially after sanitation was introduced to birthing.
That said, when a person got sick with a chronic, terminal, or debilitating condition, there was not all that much that could be done; in reality, it was basically hospice. It really didn’t make any difference how much money the patient had, there weren’t that many treatments that prolonged life or improved quality of life in a significant measureable way.
It is only right and fair to factor in, and consider, that health care costs are really rising and outstripping the capacity of what, we used to think of as the middle class, to pay for it. It is not always about dead beats or free riders. If the middle class was thriving, healthcare wouldn’t be that great an issue. We won’t get anywhere if we don’t acknowledge that many people have good reason to be afraid of being wiped out by a medical catastrophe.
That's just what I was thinking--the wildly expensive stuff is probably experimental. It's not so much hopeless as a very long shot that might turn out to be a cheaper and more traditional form of treatment in 20 years. Are there any standard treatments today that weren't cutting-edge and expensive at one time?
That's not to say I'm entitled to insurance coverage for an experimental treatment. It strikes me more as research than treatment. Research is admirable and a blessing, but I don't see that I have a right to expect an insurance company to fund it.
It's not just cancer.
I rarely encounter anyone who will discuss healthcare costs with candor and honesty. It’s way past time to come to terms with the reality that demand for medicine... creates...more demand for medicine, It's a paradox, I know. If this isn't part of the conversation, it is beyond me how anyone can find solutions.
The Rising Cost of Healthcare, just scratching the surface here.
1 An explosion of new and effective drugs and treatments that didn't……… exist 60 years ago.
Many of these drugs/ treatments aren't one offs but are prescribed for decades or for
2. Demographics: The population has almost doubled over the last 60 years with a disproportionate increase in the percentage of 50+ year olds. Increasing longevity means the diseases of old age are more prevalent and more older people need treatment, NOT for just a FEW golden years but for golden DECADES. In the past, many people did not live long enough to get the diseases associated with age: like cancer, Alzheimer's, Parkinson's, glaucoma, osteoarthritis (knee replacement)............In the past people didn't recover long term from strokes and heart attacks. And if they did, long term care was hospice like.
3. Survivors: In some ways, medical costs are a victim of medical success stories. Newborns, who would have died 30 years ago, survive severe problems and extreme prematurity. The trade off is that many are left with lifelong complications and side effects requiring a life time of expensive care and treatment. A similar paradigm occurs with many cancer patents or HIV patients. Don't leave out accident victims; think of wheel chairs and prosthetics and the costs of surviving a severe brain injury and I haven't brought up transplants and medivac. There are many people, with conditions that would have been terminal or debilitating in the past, who live happy, productive lives thanks to treatments and drugs that keep their symptoms at bay: kidney disease, Krohn's, MS............ Weigh that against the cost to society of nonproductive people.
4. I have read reports that American healthcare relies a great deal more on disposability of medical products than other countries, in the battle against the spread of infection. This has cost trade offs too.
I'm not saying that there aren't other drivers, like paper shuffling and reporting, waste, fraud, tort and patent law, government interference, and no doubt they add a percentage to the costs.......but to ignore the real cost drivers mentioned above gives an incomplete picture.
GWTW- perhaps your last few sentences should have been more generic. I, and many others, spoke up loudly and often to go back to the values of the America as it was founded.
Short of using Force of Arms I did everything I could, and I am not to blame for our political morass. Fact is, we lost and now America has the government that it deserves, based on the vote. To me it is questionable if we can recover from the past 7 years. Don't forget that Americas external enemies will also have a say in our future.
My point there is really very simple and ties into your opinion that we may not be able to recover after our last 7 years. I believe that if we had a real patriot/statesman elected president and a super majority of congressmen who were also patriot/statesmen we could easily fix all the things that are wrong with the country and restore a constitutional republic that put America and Americans first. I'm not even sure any of that is arguable or controversial. BUT most of us continue to vote for politicians and not statesmen because the politicians have learned that if they promise us "free stuff" we will vote for them and even reelect them when they fail to keep those promises. So while I know there is some voter fraud and some political dishonesty that puts terrible politicians into office for the most part it is all OUR fault. So while some voters may not vote for free stuff and some voters may actually research the candidates most simply vote for government largess. We are now bankrupt, we are cutting our defence while at the same time the world is becoming far more dangerous and our dependent class will soon out number our working class. We are toast.