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Politics : A US National Health Care System?

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To: John Koligman who wrote (3466)	12/24/2007 1:30:50 PM
From: Lane3	Read Replies (1) of 42652

The 'experimental' label has been a gray area in terms of approval. Yeah, it's gray. And I'm not sure it's even real but rather a proxy for something not "worth" paying for. In either case, a medical system has to have some threshold beyond which it will not pay. Some seem to think that threshold is death. If the patient is still alive, you do everything possible, no matter the cost and no matter the anticipated outcome. Perhaps if the patient was 70 it is a different case than 17 though... Perhaps. Seems to me, though, that paying several hundred thousand dollars for a 65 % chance of surviving for six more months with a questionable quality of life is pretty much the same regardless of age. A young person's quality of life might be better because he would recover better from the immediate effect of the surgery but would be just as dead in maybe a year. Right now, even when cost is no object, we have some patients choosing to pursue a cure despite the hardships and others declining to suffer further in a lost cause. Insurance companies support that choice either way unless they have an out, such as the infamous "experimental" one. Could a single-payer system remain solvent without that out? Or would it come up with that and other outs of its own? And how would we fight a decision that went against our desire to pursue a cure in that environment? I've seen calculations of the dollar value of years of life. Those are usually done in terms of earning power. They used that framework when compensating victims of 9/11 and a lot of people were outraged. But should there be no expense spared in keeping a patient alive another year? Or another month? I don't think we can afford that.

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