Medicare, the government-run health insurance program open to those 65 and over, is legally prohibited from considering price when determining whether to pay for a new drug or treatment.
So it's hardly a surprise Medicare officials last week gave the green light to pay for an innovative drug therapy to treat prostate cancer that costs $93,000.
Still, many of those who read about Medicare agreeing to pay for this drug were stunned. They might wonder whether spending $93,000 to prolong life for about four months is really a wise use of public money.
But the truth is that far more than $93,000 of public - and private - money is spent on the last few months of life.
Where do you draw the line?
That's such a difficult question that we, as a nation, have opted not to ask. This is why Medicare can't consider cost when determining coverage for a treatment or drug.
The Associated Press reported Medicare officials made the call to pay for the drug, Provenge, because it is "reasonable and necessary." The drug treats aggressive prostate cancer by interacting with the patient's immune system. It is very expensive because the drug has to be tailored specifically to the patient through an elaborate process.
"It's impossible to put a dollar figure on a human life, especially when you're talking about a drug that has such mild side effects," said Jim Kiefert, a prostate cancer patient who was part of the Provenge study.
Yet, there is a dollar figure on every drug or medical treatment from the most basic to the most complex. And we are all paying for it whether it's through our taxes, our medical insurance premiums or out of our pockets.
Given that access to health care has been diminishing as costs soar and government reduces the number of people eligibile for subsidized insurance plans, is it time to consider price in government-funded insurance programs?
All of us do it when we are responsible for paying the bill.
So, would you spend $93,000 for this cancer drug to extend your life about four months?
The answer depends on a variety of factors, starting with whether you have the $93,000 to spend.
It would also depend on whether spending the $93,000 would create a burden for your family when you are gone. And, of course, another consideration would be the quality of life you would have in the last four months.
Even then, people who answer those questions exactly the same wouldn't necessarily make the same choice.
Some wouldn't spend the extra money if there was only a slight decline in their health while others would want to spend the money even if they would be in a coma for the entire four months.
Coming to a consensus will be extremely emotional and difficult. Yet, it's the direction we will have to go. As medical science continues to advance, a $93,000 cancer drug could become common.