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Rationing by any Other Name

Posted 5/7/2014

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  Rationing by any other name is still rationing. This article from Medscape,  although it describes a controversy in the UK, surely smacks of the infamous "Death Panels" and feels just plain un-American. On the other hand, it raises a chilling reality that we, as a country, are going to have to face in the near future. Health care costs are soaring, and the national budget is in danger of being overwhelmed by these expenses. We are accustomed to having access to care (well, some of us are, but that is a whole different topic), and we delude ourselves that modern medicine can keep us all alive close to forever.

  The controversy centers around a recent remark by an oncologist in the UK who suggested that the new expensive drugs should be saved for younger patients. Bringing age into the equation is an explosive issue--although common sense may suggest that it should sometimes be a factor. Actually, as I write that, it isn't just age as a number, but age and overall health condition. There are healthy and vital 75 year olds, and there are 55 year olds who have many other medical problems, and are already been living reduced and difficult lives. How can we possibly pass judgment on the value of an individual's life? And yet, as a nation, we are going to have to address these painful questions and come up with some kind of consensus about our health care policy.

  Here is the start of this very interesting article and then a link:

Reserve Expensive Cancer Drugs for Younger Patients?
Zosia Chustecka

Now that many of the new cancer drugs are hugely expensive, should they be reserved for use in cancer patients who are still "in their prime," but not used in elderly frail patients with numerous other comorbidities?
The controversial suggestion that age should be a factor in making the decision on whether or not to use expensive cancer therapies, made by British oncologist Karol Sikora, MD, PhD, has reverberated around the national newspapers in the United Kingdom over the past few days, alongside condemnation of the suggestion as "blatant age discrimination."
But Dr. Sikora emphasizes that oncologists are having to make such decisions every day, and he argues: "As
technology improves, we simply can't do everything for everybody."
The sentiment coincides with a new proposal from the National Institute for Clinical Excellence (NICE), which evaluates new drugs for cost-effectiveness and decides whether or not they can be prescribed on the National Health Service (NHS), that these decisions should also take into account the "wider societal impact."
The new proposal, which is now undergoing a consultation period that will end on June 20, is considering "ways to take into account more systematically and explicitly the severity of a disease, as well as the effect that diseases and conditions have on our capacity to engage in society."


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