Rationing Health Care Economically — HIV AIDs drugs

We’ve had health care rationing all along. It’s gotten worse in recent years with costs increasing at near double digits each year (130% over 10 years) and health insurance becoming unaffordable for many. With our aversion to paying taxes to cover health care (also wars, roads, social security, etc) we’re now to the point where those who cannot afford it, don’t get it. Rationing no?

From the Washington Post:

Cash-strapped states are scaling back efforts to provide life-saving medicines to HIV patients.

The result: more than 8,300 people — a record number — are on waiting lists in 13 states to get antiretrovirals and other drugs used to treat HIV and AIDS or the side effects, mental health conditions or opportunistic infections. And that number probably understates the need, say advocates, who note that many states have simply eliminated waiting lists or reduced eligibility.

Illinois, Georgia, Florida, Utah, Alabama lead the charge.

Medicynical Note: The annual cost of drugs for HIV is over $11,000/year in government sponsored programs. It’s much more if an individual goes to his/her pharmacy and buys the drugs.

This, in a country with a median household income of about $50,000, which means half of our citizens make less.

HIV drugs are of course the tip of this health care rationing iceberg. It’s not unusual in our community to encounter patients delaying evaluation of breast lumps until the tumor has spread. It’s not unusual to meet patients unable to afford the recommended medications and not having treatment. “Free” ER care is simply inadequate for managing ongoing problems in addition to being the most expensive, inefficient care available.

Our national health care problem is two fold. First we don’t seem to be able to find a structure to assure health care access to all our citizens (reform may help with this). Second, our providers and technology suppliers (PHarma, and other patent holders) have priced their product beyond the reach of mere mortals. Consider drugs with limited efficacy costing over $100,000/year.

Our non-system’s mantra is cost plus not cost efficacy. Health insurers, providers, suppliers, et. al. seem more intent on assuring profit margin and incomes than assuring affordable quality health care.

It’s a perfect mess. Make no mistake, with less funding, limited access and fewer people covered by insurance. People will die.

American Exceptionalism?


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