TW: Am going to address health care from a different angle by using a real life example. Ms. Blogger's sister is undergoing chemo. She is using Herceptin which provides an opportunity to compare and contrast our system with others but more importantly frame the challenges associated with universal care and medical costs overall.
Quick context:
1)Herceptin is a "monoclonal antibody," or a targeted biological therapy
2)We will assume it is efficacious
3)It costs roughly $70,000 per patient
4)It has been used widely in the U.S. for about ten years
5)Australia held off approval until 2006 based on concerns about cost/benefit
6)Asked to described the difference in approaches a doctor responded- "If we think it would do some good, we go for it. And then years down the road, we see the evidence of of how much good it does. In a system like Australia's, they have the cost-benefit discussion first."
My questions:
1) Herceptin costs $70,000 per treatment. It is only a part of a person's overall cancer treatment whose other components also have significant costs. How does a society define cost/benefit? At what point does the cost become too high to justify? $700,000? $7,000,000? More? Less?
2) Is the "if we think it would do some good, we go for it" a viable approach given limited resources? If viable for Herceptin, why not for non-health related expenditures such as climate change? education initiatives? etc.
3) Should Herceptin only be available to those with insurance coverage of the type which covers $70K per treatment expenses or should it be available to all who suffer from the relevant cancer(s)? If not available to all, why?