Medicare must consider cost of treatment


As medical costs soar, fewer people have access to treatment as the funds are not available. Difficult decisions on what is affordable have to be made.

Would you spend $93,000 for a cancer drug that, at best, would extend your life about four months?

That's a gut-wrenching question for reasons ranging from emotional to practical. Spending that sum of money could put a family deep in debt and even threaten the family's long-term financial security.

While it's difficult to consider cost when lives are on the line -- money is the least of a people's concerns when in an emotionally fragile state -- the financial reality has to be considered.

Medical care is extremely expensive, and not just for families or individuals. Medical care and health insurance is a huge cost to taxpayers who support federal, state and local governments.

Ironically, most people consider -- as painful as it is -- the cost of medical care before they make the decision to proceed, but government officials aren't necessarily as thoughtful or pragmatic.

Last week officials who oversee the Medicare-Medicaid programs said program will cover the $93,000 price tag for prostate cancer drug Provenge. The drug is considered an innovative therapy and typically gives men suffering from an incurable stage of cancer an extra four months to live.

The decision from the Centers for Medicare and Medicaid essentially reiterates an earlier proposed ruling that the biotech drug, made by Dendreon Corp., is a "reasonable and necessary" medicine, The Associated Press reported.

The decision ensures that tens of thousands of men will be able to take the drug through the taxpayer-backed health care plan that covers older Americans. This decision is expected to sales of the drug over $1 billion a year because most prostate cancer patients are 65 or older.

This is hardly a surprise since Medicare is legally prohibited from considering price when determining whether to pay for a new drug or treatment.

Perhaps the law needs to be changed as soaring medical costs threaten important and needed programs such as Medicare.

We would hope the government officials wouldn't become hard hearted or mean spirited in figuring cost into the equation, but we would expect them to use the same kind of cost-benefit analysis ordinary citizens use in such situations.

Yes, this is going to make some people very angry as they have come to expect that government to pay regardless of cost.

The harsh reality we all must face is that there is 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. Today's $93,000 cancer treatment could easily be $1 million or more.

Given that access to health care has been diminishing as costs soar and government reduces the number of people eligible for subsidized insurance plans, price in government-funded insurance programs must be considered.


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