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Comparative Effectiveness: Is Obama Really Calling for Rationing?

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Nice post, thanks for writing!

seolace of AL 4:48PM May 06, 2010

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+1

soundtracks of AL 7:18AM July 17, 2009

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Tdyoncus of MA 4:18AM July 14, 2009

Rod Porter of WV wrote: "If you are one of the 45 million people who is under 65, has a pre-existing condition, works for a small company or is an independent contractor, you don't fit into one of the protected classses, i.e. rationed groups, and you will not have open access to affordable health insurance."
So, you believe that it's my and other tax payer's responsibility to fund your health care needs?! Why don't you just walk uninvited into my house and pilfer my medicine cabinet for your cold medicine because you have the sniffles? Here's an idea, since I and other tax payer's fund your health care needs then we will dictate whether you can smoke or drink, we will dictate whether or not you can get your Big Mac, we may decide that you can only go outside when the temperature is between 65 deg and 85 deg. But it can't be raining and snowing in case you slip and hurt yourself. Oh, by the way, if it's sunny, we will require you to be covered from head to toe because skin cancer treatments can be expensive. But we pay the bill so it shouldn't matter to you what we dictate just so long as you have health insurance! Sounds absurd doesn't it?! So does the expectation that the government reach unrestrained into everyones wallet to pay for your health care! Be responsible! Get a job, save your money, live a healthy lifestyle, DO what you have to DO to get your health care, just like the countless millions of other Americans have done.

david of ID 1:59PM July 07, 2009

If you have to do it, you might as well do it right.

soma drug class of AR 5:36AM July 04, 2009

Get insurance comanies out of health care! The reason costs are spiraling out of control is due at least in part to the existence of HMOs, PPOs and other so-called cost-containment insurers. There are only 2 ways these companies can make a profit. They must either raise premiums and co-pays or limit coverage. They already have done both, and they must and they will continue to do so. Health insurance premiums provide these company's CEO's with huge bonuses, and minions of various admistrators, clerical workers, referral gaurus, gatekeepers and the like are empowered to determine what doctors, hospitals, tests and other medical treatments are necessary. Are these people qualified to make these decisions? I believe such matters are best left in the hands of qualifed physicians.Traditional Traditional Medicare coverage together with a Medigap policy has provided seniors with excellent medical coverage. Medicare Part D saw the implementation of health privatization. Over the past two years these providers have riased premiums, increased co-pays nad deleted some drugs from their formulary. Now, Medicare Advantage Plans are the latest HMO/PPO Medicare takevoer. Undoubtedly these companies will continue to insure their own profitability!

Ruth of NY 7:42PM May 28, 2009

There needs to be an awareness of cost or value in healthcare treatments but there also needs to be an awareness of all costs. Not just costs for treatment, but the cost of chronic physical and mental health issues and the quality of life cost.
To illustrate. We have two, 53 year old men diagnosed with prostate cancer. One man chooses surgery, could be either a traditional radical prostatectomy or robotic (“Da Vinci”) laparoscopic surgery. The other individual chooses proton therapy. The cost for surgery is approximately $12,000 to $23,000 dollars. Cost for proton therapy is approximately $65,000 to $77,000. This is not the complete story, however. We need to examine the long term or chronic side effects from these procedures that not only affect the overall cost model but also the quality of life issue.
Surgery is more likely to cause incontinency, 32% chance after surgery versus 1% chance after proton therapy and impotency, 75% chance after surgery versus 32% after proton therapy 3. Post surgical rankings of incontinency range from mild to severe.
If we use the mild diagnosis as our example, we would be adding to the “cost” of prostate surgery the cost to perform sling surgery for stress urinary incontinence, $2,720 and cost for incontinency pads, $1.50 per pad. How long would someone be required to use an incontinency pad? Could be a few months to the rest of their life.
For impotency, the costs could cover the surgery for a penile implant, approximately $7,000 and the ongoing use of erectile dysfunction pharmaceuticals. Again, how long would the patient need to take the drugs; could be a few months to the rest of their life. What is the cost of the most commonly prescribed erectile dysfunction drugs; Viagra and Cialis? Viagra runs about $4.86 per pill and Cialis is about $21.32 per pill. The mail order drug company we contacted limits coverage to 6 pills per month.
One in five men who undergoes prostate surgery to treat cancer later regrets the decision, a new study shows. And surprisingly, regret is highest among men who opt for robotic prostatectomy, a minimally invasive surgery that is growing in popularity as a treatment.
A prostate cancer diagnosis can be devastating for the patient and his spouse or companion. The often-resulting erectile dysfunction and/or incontinence due to surgery can bring additional grief, confusion and trauma to couples during an already stressful time. I believe we need to focus on how we can best bring cutting edge technology to more patients at a lower cost to minimize or eliminate this cost debate. The focus should be on driving the adoption and proliferation of this technology in order to achieve a value cost more in line with traditional therapies with the added benefit of minimizing the short term and long term side effects to the patient’s physical and mental health.

Jeff of IL 5:46PM March 24, 2009

Anyone who thinks the UK model is a template for US healthcare reform needs to review what is going on in the UK. For example.
The current target of 62 days from urgent referral by a doctor to starting cancer treatment has still not been met in Scotland, despite that originally being the target figure for 2005.
Treating advanced prostate cancer with radiation and hormone-blocking drugs cut the death rate in half in a study of Scandinavian men, researchers report. In the United States, the combination has been standard care since the 1990s. But in Europe, many doctors have avoided the combo treatment and used hormone drugs alone.
Long term underfunding of prostate cancer research has resulted in many unanswered questions about testing, treatments and care. Men with prostate cancer report the worst NHS experience of all common cancers, often missing out on access to reliable support and information.
Curing diseases in the UK appears to be second to containing costs. This is taken from the NHS Prostate Cancer: Diagnosis and Treatment Costing Template Feb 2008.
• Potential savings through more restrictive use of biopsies
• Potential savings through a reduction in prostatectomies
• Potential savings through a reduction in prescribing of hormonal therapy

Jeffrey S of IL 5:35PM March 24, 2009

Let's hope "Stan" and "Steve" and their loved ones don't lose their job-related health care, develop a chronic or terminal condition, or take a job where all the network physicians are too far from home to provide decent primary care. Should either of them fall prey to this kind of misfortune, which many Americans already endure, we will immediately hear about the radical left-wing agenda to deprive them of their right to the best medical treatment available.
Britain's NHS is NOT failing. It may not be the system of choice for those well- heeled individuals who have a choice, but it does provide the basics of care for the entire population. That means valuing every life, regardless of the person's financial status, and it means paying less in emergency care for untreated conditions. Our country found it unconscionable for rural dwellers to be deprived of mail service, and now our mail and packages are delivered by an efficient, affordable public-private hybrid system. Is health care less important than the latest Victoria's Secret catalogue?
Rationing, cost, and quality of care are all valid concerns, but the country can only make an informed decision when its citizens educate themselves on the issues and alternatives. Sweeping, unsupported accusations and an inability to propose working alternatives get us nowhere.

Lisa Kent of CA 4:10PM March 24, 2009