Health care: Our non system

This week’s at ASCO there were numberous examples of studies involving high priced drugs for treating cancer costing in the range of $60,000-$100,000 and more for the drug alone, most with very limited benefit. When one adds up other care required the yearly costs of following these patients approaches $150,000 or more. Consider that one year’s dialysis, all costs included, is in the range of $75,000. Where is the value in these new oncologic advances? True it’s wonderful that there is progress, but at what cost? Affordability? Reality?

Average individuals (median income in U.S. approximately $50,000) will can not pay more than their annual salaries for such limited benefits. Health insurance is a buffer but it doesn’t work if insurers won’t control costs. However, insurers have problems denying patients. The proposals to objectively (non-drug company sponsored evaluations) evaluate cost effectiveness would help with this. If a drug proved no better than standard and/or less expensive options there would be grounds for both the insurance company and physicians to use the more economic alternative. Patients, if they wished, could always opt to pay themselves for the more expensive choice.

Ryan, and his republican colleagues, find regulation to be abhorrent and one can predict that their “plan” will have few protections for those with serious illness and simply allow insurers to discriminate in their provision of coverage (charge unaffordable rates or not offer policies) rather than discriminate against expensive ineffective treatment alternatives.

Our population appears to have reservations about mandating that we all have insurance, high and low risk people. The mindset appears to be that ” I’m not sick, why buy insurance” and that “you can’t make me do anything.” But these same people have no aversion to appearing at ER’s and demanding free care (the most expensive, least efficient available); manipulating the system to get their parents into medicaid covered nursing homes; and demanding affordable health insurance at the moment they become ill.

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