The government Medicare system reimburses hospitals to cover the actual cost of services the Hospital provides. However, according to the Medicare Payment Advisory Commission, hospitals receive anywhere from 93.1-94.1 cents for every dollar spent treating Medicare patients. This is because the government’s actual cost of providing services doesn’t include costs for investing in advanced medical technologies. Hospitals use profits from the private sector to fill this gap. If a public option exists and hospitals continue to invest in cutting-edge medicine and technology, its reasonable to conclude that another gap will develop in the hospitals budgets.
Which technology worked and which didn’t would be the government’s decision. Either way, the government would effectively refuse to invest in new technologies that haven’t proven to be more effective. But what if those seemingly worthless investments funded one that actually worked?
Here’s the big question: If you were dying of cancer, and there was a drug or procedure available but the government said there was a high likelihood that it would not work, therefore refusing to pay for its actual cost, would you want it anyway?
Additionally, in the public option, would you support a provision that permitted risky investment in technology meant to cure life-threatening illnesses? The provision would effectively be asking the government to continue subsidizing innovation in medicine, procedures, and technology that could save lives. In this way, innovation would be focused on curing life-threatening illnesses.
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1. I would not want to take a drug that has had little to no success in clinical trials. If it has been tried and tested and truly does little to preserve or cure the cancer, there is no reason to take it. However, if there was nothing out there proven to cure me, I would be very open to participating in an experimental trial for a new drug.
ReplyDelete2. Of course innovation in medicine must continue- but is the public option the place to do it? Well first, who innovates now? I believe there are government funded agencies as well as private companies researching new medical technologies. One may assume that it should be left to private companies because capitalism will reward new and brilliant cures, treatments, etc. However, we've gotten to a point where drug companies slightly alter one small aspect of medicines like Ibuprofen or Zoloft, get a new patent, and make loads of money. Is that the type of "innovation" we want? Similarly, cancer is a huge money maker for companies who have developed drugs that may ease pain for cancer patients rather than cure them. If there is a miracle cancer curing drug created, most companies would lose a ton of money on all of their treatments designed for terminal or chronic cancer patients.
It is imperative for any successful care provider such as the large HMOs and the VA to restrict use of their limited resources to interventions that are evidence based. This equates to rationing of care based on what is known to work. I believe that it is even more important now to continue in this mode in order to support care expansion and coverage for all in our country. Any individual is of course still free to pursue non proven treatments for any ailment at their own expense.
ReplyDeleteThe government already catalyzes research in many ways via corporate income tax credits and support for medical resident training and grant programs like the NIH.
So it sounds like the government is already investing in medical innovation, but is it enough? I've heard many conservatives argue that America's private sector health care system harvests the best drugs in the world. Jiggles noted the patent issues drug companies have been taking advantage of, but besides that, do American drug companies really make the best drugs in the world?
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