Friday, September 30, 2011

Whats it worth?

A recent study (of course there was another study - nothing can happen these days without a study) says that cancer costs are spiraling up and turning into a 'cancer cost crisis'. I can see this, medications, treatments, tests, and fun medical adventures (a/k/a procedures) are expensive and getting more so. More people are being diagnosed each year due to better technology and an aging population among other reasons.

As I have discussed before, lots of pharmaceutical companies are getting rich with their huge prices for new prescriptions (because they are recouping their research costs but that is another or several other blog posts). Sometimes doctors also prescribe expensive tests to reassure a patient or to prevent a potential malpractice suit. New medical devices can also be expensive - another MRI machine, that will cost you some big bucks - insert lots of zeros please.

There is a call to reduce testing and help reduce costs. What about a closer look at very expensive chemo treatments which might lengthen a life by only a couple of weeks? Be stricter in requirements for who can receive which tests and when surgery is really needed.

I can see both sides. As a patient which a couple of tiny little cancer diagnoses behind me, I am the first one to jump to the 'holy cr*p is that it again?' state of mind and want/need reassurance that it is nothing. On the other hand, I have had plenty of medical (mis)adventures in my life that I am happy to avoid as many as possible. But how do you draw the line as to what is needed and what isn't?

There are some problems here. It is very difficult to put a standard requirement for the need for a certain test. What I am trying to say is it is not medically correct for an insurance company to dictate when a test is needed or not. That is a medical decision which varies from patient to patient. The one thing I have learned from my medical (mis)adventures is that every patient is different and every cancer is different. So what is right for me, is probably wrong for the next person. What was standard protocol for treatment last year, may not be standard any more.

If it is a financial decision, who is right to make the decision of is it worth it? If my doctor says 'this surgery will save your life', I'm all for it. If the doctor says 'this chemo might make you live (in pain, nauseous, and blotto on morphine) for two more weeks, I would probably opt to skip it.

The only ones who can decide what the worth of a treatment is regardless of its financial cost are the doctor and the patient. However if a drug costs $100,000 and will prolong life for only a couple of weeks, where do we draw the line? Is the insurance company right to refuse to pay it? Or is the pharmaceutical company wrong for overcharging? Are they putting a value on someone's life by charging so much? I don't know what the answers are to all of this and I'm not sure anyone else does either.

1 comment:

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