The cost of saving a life

-
Today I researched on the internet the cost of the maintenance drug that I take to help extend the length of my remission. Although I could not find 2017 prices or the price at which the pharmaceutical company had sold the drug to the government in prior years, I did find lots of prices for the drug sold to individuals or non-federal healthcare providers in prior years. A reasonable estimate is that my monthly maintenance dose costs approximately $15,000.
When that cost is combined with other treatment and healthcare that I have received because of having cancer, in the eight months since being diagnosed with cancer my care has cost more than $200,000. Ongoing care in years while I remain in remission plus additional costs related to forcing the cancer into remission a second and perhaps third time could easily drive the total cost of treating my cancer to well over one million dollars.
Few Americans can afford to pay one million dollars to treat a catastrophic illness.
On the other hand, few Americans would opt to refuse treatment to a person who suffers from the type of cancer that I have who cannot pay for treatment when the person can reasonably expect to enjoy several or more years of healthy, productive life.
The best way forward in dealing with the cost of catastrophic illness is for the US to implement single payer, universal healthcare. The single payer would be the federal government. Universal access means that everyone would have access.
Half of all persons employed in the healthcare industry, which is 20% of the US Gross Domestic Product, are not healthcare providers but administrative, etc. A quarter of healthcare costs is attributable to billing and associated costs. Eliminating private payers would shutter the immensely profitable private health insurance corporations, but would concurrently generate tremendous savings in healthcare related costs for the entire nation.
Two examples of a single payer system – with the federal government as that single payer – already exist in the US, though both systems limit access. The first is Medicare, available to everyone over 65 and the lowest cost provider of healthcare. The second is the military healthcare system, available to active duty and retired military personnel and their families.

Congress should replace the Affordable Care Act (Obamacare) with a single payer system that provides universal access.

Comments

Student22314 said…
Do you expect that a single payer/universal access health care system would increase keep same, or decrease the total share of GDP allocated to health care services? Would overall administrate costs increase, stay the same, or decrease? How much, if any, of the administrative costs now included would be eliminated, rather than merely shifted from the private sector to the public sector? What is the government administrative cost per beneficiary for Medicare and Medicaid? Is this more or less than the administrative cost per beneficiary of the private health insurance system? If the administrative cost per beneficiary for Medicare/Medicaid is greater, does this imply that s single government payer system would experience a net increase in the administrative cost component, eliminating the anticipated resource saving? If not, how much would be the efficiency gain of shifting resources from administration to direct services provision? The U.S. devotes a larger share of GDP to health care than many other economically advanced countries, but what is the reason for this and how, if at all would the adoption of a single-payer, universal care system affect the causes of the U.S. outcome? How much of the cause of higher GDP proportion allocated to health care is the result of administrative inefficiency; how much is the result of poorer health condition of the U.S. population because of behavioral choices; how much is the result of a greater desire to consume health care services, especially near the end of life? How would a single-payer universal access system constrain utilization to control and ration total resources available for health care? or would it or should it constrain individual choices to consume health care services? There are both ethical and economic issues here that need to be addressed carefully and honestly.
February 19, 2018 at 9:34 AM
George Clifford said…
You ask a plethora of good questions. Medicare/Medicaid currently provides the lowest cost option for healthcare in the US, so costs should decrease. Administrative costs for all healthcare averages 25% of spending on healthcare, so both administrative costs and total healthcare spending should decrease. Most importantly, a single payer system would provide universal access. Presumably, behavioral choices in the US are not dramatically different than in developed European countries (there are differences, but I'm guessing that the differences as a whole do not represent a huge difference in health outcomes); substantial differences in outcomes are attributable to how the US funds healthcare and the disproportionately large expenses on people near the end of life on treatments that neither improve their quality or length of life in a way commensurate with the cost. We now ration healthcare based on ability to pay, a very unethical approach that values the well-being of the affluent over all others.
February 19, 2018 at 4:07 PM
Post a Comment

Popular posts from this blog

TMT

-
The question of whether to support or oppose building the Thirty Meter Telescope (TMT) atop Mauna Kea, a dormant volcano on the island of Hawai’i, has recently attracted the national media’s attention and preoccupied a significant portion of The Episcopal Church in Hawai’i (TECH). The controversy came to a head in July when TMT opponents physically prevented construction crews and their equipment from using the only access road to the site. Over three thousand protesters have spent time in the encampment that blocks access. In spite of final court approval and issuance of all relevant permits, construction of TMT atop Mauna Kea now appears unlikely.
As an ethicist, a mediator and a Christian priest, I offer three observations.
First, the discipline of ethics offers little help in resolving ethical dilemmas such as this one that have valid, rational arguments on each side. The two sides rely upon different, incompatible frameworks to justify their conflicting positions.
Proponents advance…
Read more

Healing healthcare

-
In the gospel reading for next Sunday (Luke 13:10-17), Jesus heals a woman who has been crippled for eighteen years. In biblical numerology, the number eighteen symbolizes bondage. The number eighteen also connotes a long time.
Pursuing the list of the world’s largest corporations by global revenue, I was surprised to discover that four of the ten largest U.S. corporations are healthcare focused: UnitedHealth Group, McKesson, CVS Health and AmerisourceBergen. Altogether, seven of the world’s one hundred largest corporations are in the U.S. healthcare industry (pharmaceuticals, medical equipment, health insurance, etc.). No healthcare focused corporation based in another nation made the list of the one hundred largest corporations.[1]
The list puts the size and economic power of the U.S. healthcare industry into perspective. No wonder the U.S. has the world’s most expensive healthcare and only mediocre results as measured by patient outcomes.
Persons who live in the U.S. are crippled,…
Read more

The Crash is Coming

-
A friend sent me this email which links to the Crusty Old Dean bewailing the continuing numerical decline of The Episcopal Church (TEC):


The Crusty Old Dean is at it again: http://crustyoldean.blogspot.com/2019/09/the-collapse-is-here.html


Most of what he writes, makes sense to me. But until at least 20% of the TEC power structure agrees with his ideas, nothing will happen. I say 20% because it’s the minimum for voices dissenting from the status quo to compel attention to their views. Of course, there is a gap in time between 20% and 50.1% but we have to start somewhere.


In response, I wrote that I’m becoming increasingly pessimistic about Christianity in general and the Episcopal Church in particular:
·The quality of leadership continues to decline, a decline compounded by some dioceses creating local alternatives to seminary (my anecdotal assessment);
·There appears to be no increase in the number of congregations that are actually growing;
·Too much money and other resources are wasted o…
Read more