Lovely how it can be so cut and dried.. cost/benefit analysis.. benefit for whom, exactly?
Benefit for the patient, of course. The insurance company isn't benefiting. We all make these judgments every day.
The premise the legislation was based on was to limit the suffering of those on their death beds, now it's ridiculous vague language rationalizes those in power to move the slide rule down to deny treatment that will prolong life, or alter the course of a cancer or other illnessness's.
The fact that she has the freedom choose to end her life voluntarily in Oregon, and that it would be paid for by the plan, is not actually related
to the reasons why she was denied the expensive wonder drug. Probably a lot of low-income health plans would have said the same No on the Tarceva, and still covered palliative care.
But the letter she got was particularly badly worded, and the effect was cruel, which is a real shame.
Should those facing AIDS, under that kind of health plan be denied the meds that only offer a slight chance of prolonging their lives? Should a fireman, or police officer decide that placing their lives on the line, to save that of another, has no benefit to them, so they can impose a sliding scale to determine who and what would be worth it?
Where are we going to draw that line? We don't have the resources to let everyone have every possible medical treatment every time. We just don't
. Decisions do have to be made. Do you think I love that and think it's great? Of course I don't. Do you think I don't value another month for Barbara Wagner to see her children and grandchildren? I'm a mother. I'm a human. Of course
I feel for her.
Firemen and cops have to make those decisions every day. They can't always save everyone, and some situations are indeed too dangerous. Nobody thinks it's smart to lose six firemen to save one kitten, do they? There you go - cost/benefit analysis right there. The cost of six firemen is too high to save one kitten.
How about global warming, environmental issues? Some studies claim that the emphasis on carbon emissions provides a window of only six years.. perhaps we should judge the tremendous cost of that, with not really much benefit in the long run, wasteful?
That's exactly what we should do. If we rush into doing the wrong thing for emotional reasons, we often make the wrong choices.
In my husband's home country of the Netherlands, he tells me, they found that air quality was getting really badly fouled and decided to do something about it. They put strict limits on car emissions. The retooling of cars over several years and the money for inspections and so on cost enormous amounts of money. And in the end, it didn't make a damn bit of difference to the specific problem they were trying to address. The problem turned out to be livestock, not cars. I suppose there's a benefit to reducing car emissions anyway, but they totally missed what they were trying to do.
I don't want us to repeat that on a global scale.
I googled to examine exactly how much more complicated the case was. Barbara Wagner's oncologist recomended the treatment, he didn't say that it would be fruitless for her to take the med. Fortunately the pharmaceutical company decided to offer her the medication free of charge.
It was the Oregon Health Plan that refused the request, stating, "Treatment of advanced cancer that is meant to prolong life, or change the course of this disease, is not a covered benefit of the Oregon Health Plan,"
Changing the course, reducing the growth and spread of her cancer. The medication could prolong her life for several years, perhaps even longer. My late mother in law, a breast cancer survivor, who had a double mastectomy, outlived her doctor's predictions, for more than 20 years.
I Googled it too, and the ABC story had the most detail
. Let's be fair, here. The state plan covered her chemo, radiation, and other care, straight up. I'm sure there were expensive PET scans or MRIs, chemo drugs, etc. in there and they were all covered
Her prognosis from her doctor when the lung cancer came back after remission was that she was terminal, she had 4-6 months, and the wonder drug Tarceva would make it more likely to be 6 months or even a year.
this woman got the new wonder drug, and the letter she got was terrible, even cruel. But if a low-income health plan has limited funds, and they can't give everything to everybody, how do you suggest they make these decisions?
We do know that denying care or treatment means only death, my husband's lymphoma went undiagnosed, because he was denied access to the specialist he desperately needed as a person waiting for a transplant, who had been the healthiest person at his transplant clinic, and an ideal candidate.
What caused the imposed death sentence on him, and on people like Barbra Wagner was ability to pay. It's the devaluation of those not affluent enough to pay for what is truly is a class based system of health care. My husband had been approved for medicare, because he had proceeded into an advanced state of organ failure, but because of the government's ignoring the problem (and democrats are as responsible in that they've not only ignored the problem, but helped exacerbate it), most public hospitals (they receive most of their funding from the federal and state government) will deny medicare patients access unless they have a supplemental policy. What this means is that in the US, we have less access, and much less humane, lesser quality health care than we did in the 1970s.
I'm really sorry about your husband. And yes, I agree, we are in a health care crisis. My mom predicted it - I wanted to be a doctor when I was 12 or so, and my mom said "You'd probably be a great doctor. But the time is coming when it's going to be really difficult to be a doctor in the United States. I think you should think of something else." I think she was right - doctors face a lot of hard choices.
Debbie Hirst from Cornwall in the UK was prescribed a med that wasn't approved by the NHS, so she attempted to purchase it on her own. The government told her that if she did, she'd have to pay for the rest of her cancer care. It was an attempt to punish this woman by depriving her of what was covered under her NHS coverage, something she supports through her tax dollars. The government knew she couldn't afford to pay for all that, so it sought to punish her, and intimidate others for daring to get the best coverage they could.
I remember reading about that. Well, I guess we could say, at least Oregon didn't threaten to withdraw its other benefits from Barbara Wagner if she managed to find a way to get the Tarceva, I guess.
It's the same problem with the demand that taxpayers in Michigan fund stem cell research in the state, yet one knows that those of them too poor to pay for what will be extremely expensive treatments that result, will be denied the benefits.
Not if the system gets fixed from the bottom up. I believe it can be done. I think it should start with our whole system of medical education, personally. The profit structure of drug companies needs to change, but I think globalization is already challenging that. Although, Obama wants to address the fact that Americans are charged more for new drugs, so maybe we'll see some relief soon. We can hope, right? I hope it becomes easier to get new drugs to market, especially the newer molecular cancer drugs. Gleevec is keeping my father-in-law alive, he has chronic myelogenous leukemia.
Why is it that the powers that be in Oregon insist that their taxpayer provided health plan not be the one they impose on their constituency? But one that wouldn't subject them to the strictures they themselves rationalize imposing on the people of Oregon?
I don't follow you here.
The articles I read about The Book of Bunny Suicides didn't mention the school or schools that are distributing the book.
The one I read was about a high school library - a boy took the book out from the school library, and his mom was shocked and refused to return it.