posted on Dec, 28 2011 @ 03:43 AM
The cost of medical care is a very complex thing. I am in agreement with you for the most part. Having much experience in the medical field I can tell
you that older, cheaper medications that are just as, if not more effective get passed up routinely for the new, expensive designer drug that is the
flavor of the month. Thorazine Vs. the plethora of newer drugs for example. Thorazine could be used for psychosis, anxiety, and nausea. Had a few side
effects but not too bad for short term use. It's dirt cheap, easy to make, and works great, but is almost never used anymore because we have 20 or 30
new benzos that cost way more, and have jazzy new names, and much larger profit margins.
So while there is absolutely a lot of greed, and waste, and profiteering modern medicine is, and always will be expensive. The reason is because we
have all come to expect Cadillac medicine. We have such a capacity to do so much now that we all expect everything to be done all the time. Diseases,
and injuries that would have just killed us 25 or 30 years ago we are surviving. We can kick the dead horse so to speak nigh unto forever. However the
equipment, techniques, and services to pull off these everyday miracles are expensive.
Also as harsh, and blunt as it sounds to say we spend well over half of our healthcare dollars on futile care to make you feel better about Uncle
Joe's passing so you won't sue us. I have opened vials of $10K medication knowing full well that there wasn't a snowball's chance it was going to
work, but the family wanted "everything" done, and so we do it. Bottom line? Uncle Joe died with $10K worth of medication in his arm that the family
had no way of paying for, but you helped pay for it if you have medical insurance. If that family had to hock the family car, take out a loan, or get
a second mortgage on the family home for that 1 in a million $10K shot, I think they would have thought twice about it, but from their perspective it
was basically free, so what the heck? Why not? Uncle Joe was 87 years old with diabetes, COPD, on dialysis, and had mentioned his wish to go see his
long passed relatives, but we just couldn't let him go without trying. Yet if trying had PERSONALLY cost them tens of thousands for a long shot, the
thinking, and self justification would be far different.
On the other hand if it is a person in otherwise good health, and stands a decent chance of going on to have a good quality of life for a significant
time afterward then by all means pull out the stops. What's money compared to the value of a life? So the conundrum is that we spend so much money
saving Uncle Joe at 87 years old that the system is already over burdened, and that makes providing that high level "miracle" care hard when we
really need it because everyone wants to miracle Uncle Joe into immortality.
Making the decisions as to who should get what level of care is a powder keg. Logically it is insane to spend the amount of money we do on futile
care, but we are not logical beings we are emotional. We spend billions of dollars every year to assuage the feelings of people loosing their own
life, or a loved one. Should we just deny any care decided by a panel to be futile? Should we make care past a certain point private pay only? There
are no easy answers. It's easy to crunch numbers, and say "Look at all that waste." It is hard to look a human being in the eye, and tell him his
care is too expensive for the meager chance of success, and we aren't even going to try. Most people, and most doctors just can't do it. It is
cruel, and offensive to our sensibilities. Yet it is a huge chunk of our healthcare problem. It easily out weighs the greed, and corruption
aspects.
I am not endorsing, or proposing that healthcare should become a cruel numbers game. I do think however that ethics commitees, and multidisciplinary
teams should weigh the needs of the hopeless, against the needs of the saveable, and think more long term. They may feel bad, and be the bad guy, and
risk litigation with an angry family, and displaced anger is a big issue when dealing with the pain, and loss of a family member, but the system is
indeed broke, and not just financially. Healthcare right now is kind of like fast food. We all want big greasy burgers, and we want them NOW. We will
pay for it later, but we want it all for now. Same in healthcare. We want our family members to live, and live forever! Damn the cost! So we spread
around this huge burden of debt in the insurance risk pool for people who really didn't have a chance to begin with. So of course in that environment
corporations will charge all they can for something that is demanded, and people will basically pay anything for it. Law of supply, and demand. The
demand is astronomical, so guess where the price is set? We are irrational, emotional creatures that pay an insane price to try, and accomplish the
improbable. Were it my family, I'd be just as insane.