Can we really afford any more medical advances?

Nurses General Nursing

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Medicine has come up with more wonder drugs, procedures, technologies than ever before. All of it very expensive, too. It all comes at a big price. It's becoming more and more difficult to deliver it to everyone.

Have we gone as far as we really can practically manage, without going broke? More and more can be done, but will it end up bankrupting us? Obama is talking a lot on controlling Medicare costs before it goes bankrupt.

There's a lot of talk of how socialized medicine, universal coverage, is our salvation. But, is it really? I seriously doubt it.

How much does one MRI machine cost? Astronomical. Think of all the other expensive machinery in the hospital. And, at what cost is the regulatory burden? Then add in all the other costs. After that, figure in a bunch of heroic new surgeries and treatments. How about surgery on babies in the womb? Genetic manipulation, cloning body parts, new expensive treatments for AIDS patients with drug regimes totaling in the tens of thousands a year. Then add on all the new dialysis patients expected in the wake of our obesity/diabetes epidemic.

I don't think we can afford much more of this.

Specializes in LTC, Med/Surg, Peds, ICU, Tele.
How about my pt recently - a father of 3 in his early 40s - who is not going to receive the transplant he needs to live because he doesn't have the money to pay for his immunosuppressants? Care is rationed in the US as well, it's just based on finances rather than percentage of survival.

Good point.

Specializes in Medical.
How about my pt recently - a father of 3 in his early 40s - who is not going to receive the transplant he needs to live because he doesn't have the money to pay for his immunosuppressants?
I'm sorry to hear about your father, MB37 - that must be really hard.

In Australia he'd go on the transplant list regardless of his financial status, and (though only available with an authority application) have subsidised medication. For example, a 50ml bottle of cyclosporin suspension (100mg/ml) costs $32.90 ($5.30 for people with a concession card, which includes everyone on a pension), and after the safety net threshold is reached that drops to the concession price for most people and zero for concession card holders.

Care is rationed in the US as well, it's just based on finances rather than percentage of survival.

Yep, once again, the model of health care you support depends on what philosophy you (or your country) have. I believe that it's the obligation of an advanced society to care for the most vulnerable as well as those able to care for themselves, and am happy I live in a country whose policies reflect the same ideology. As I posted earlier, it's not perfect (way short of perfect, sadly), and there's been a disturbing trend over the last decade toward a more US-like model, but with a new leader I'm hoping that trend will be reversed.

Specializes in NICU, PICU, PCVICU and peds oncology.
How about my pt recently - a father of 3 in his early 40s - who is not going to receive the transplant he needs to live because he doesn't have the money to pay for his immunosuppressants? Care is rationed in the US as well, it's just based on finances rather than percentage of survival.

So instead the family will end up on food stamps and Medicaid at the very least, because they've lost their breadwinner. The long-term costs of that will probably exceed the cost of supporting him in paying for his meds by a fair amount. False economy?

Twenty years ago tomorrow, my son received a liver transplant. We were a single income family with three young children and never had to worry for a moment about paying for his surgery, his hospital care (five months in hospital with seven weeks in PICU) or his drugs. He is alive today because we live in Canada. Every province has a form of life-saving drug program and no Canadian will be denied a transplant on the basis of income. The only means test for us is compliance.

Specializes in Mostly: Occup Health; ER; Informatics.
... Care is rationed in the US as well, it's just based on finances rather than percentage of survival.

Healthcare rationing in the U.S. certainly exists. As one deep-thinker puts it: "While we have inherent spending limitations that unavoidably require healthcare rationing, we find that there can be no limits and therefore, no rationing. Indeed there can be no discussion of rationing, except to bitterly condemn the very idea.

...So these two basic imperatives shaping our healthcare system - the economic need to ration and the culture of no limits - are in their essence completely incompatible with one another.

Given our need to simultaneously hold onto both of these incompatible but necessary imperatives, our only option has been to conduct the unavoidable rationing in a way that maintains the fiction that no rationing is necessary, in a way that allows us to ration while declaring that there are no limits, and to deny that any rationing is occurring at all.

We can ration secretly. We can ration deceptively. We can ration covertly. "

from http://covertrationingblog.com/introduction-to-the-covert-rationing-blog/

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