And vice-versa, although that argument is actually made, with a straight face, all the time.</p>
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Interesting hypothetical, but it glosses over some important questions. Such as - why does the chemo drug cost $100,000 per year? </p>
<p>I will say this: I have no problem with society providing effective medical treatment for anyone young enough to be a custodial parent - now or in the future - even if it costs a lot. There are a lot of sound policy reasons for doing so that don’t rely on appeals to emotion or religion. If you want to draw a line, I’d start somewhere north of child-raising age.</p>
<p>What if the 41 year old has no children? What about a 70 year old raising grandkids? Do you really want the government drawing any sort of lines on who gets care and who doesn’t?</p>
<p>Medical professionals can draw those lines, and do all the time. And, in the case of Medicaid (at least in my state) they do it very well indeed.</p>
<p>kluge – it’s not a hypothetical. It’s me. Gleevec costs $100k/yr. on the dosage I was taking. It was the first successful molecularly-targeted chemo drug, which was originally intended for chronic myeloid leukemia but is now used for some other cancers as well. It goes straight at the translocation on the chromosomes that induce CML without the massive side effects of other chemo treatments. There are a whole lot of researchers and drug companies out there spending big $$$ trying to develop the “next Gleevec” that will target other diseases. Most will fail, but those who succeed are helping to pay for the next generation of drugs. (Novartis has also profited handsomely in the process.)</p>
<p>I wrestle with the issue because I have family members who can’t afford treatment for health issues (make too much for Medicaid, can’t afford copays and/or premiums for decent coverage), while I get great coverage.</p>
<p>Well, it would all be much easier if we just had a crystal ball and could know in advance who was going to die notwithstanding the treatment, and who was going to live and for how long. Unfortunately, medical science isn’t there yet.</p>
<p>My father, who was strong as an ox and not sick a day in his life until he contracted cancer, was told by his doctors that he was fortunate to have one of the most treatable forms of cancer. They said his prognosis was excellent; they were confident they’d beat back the cancer and he would have many long, healthy years ahead of him. He had a rare bad reaction to the chemo and died within 6 months—killed by the treatment, not by the disease. No doubt well over 90% of his lifetime medical costs were incurred in the last six months of his life. But who knew? Certainly not his doctors, who were stunned to lose him.</p>
<p>My grandfather was poisoned by mustard gas in the trenches of Belgium in the First World War. The Army doctors told him he wasn’t going to live. An Army chaplain helped him write a last letter to his parents, and another to his fiancee. He rallied, and lived another 65 years, marrying his fiancee and goinf on to become one of the most successful and most respected farmers in the county. Who knew? Not his doctors, who pretty much gave up on him, deciding to cut their losses and move on to more promising cases. </p>
<p>No doub some cases are more clear-cut than these. But a lot of people die after costly medical interventions that the medical professionals believe in good faith have a reasonable or even a very good prospect of success. If the patient dies, he’s lumped into the statistics of “costly and pointless” medical interventions.</p>
<p>Then there are meds that DON’T help CURE the disease or even stop the progression (by much, if any) but help relieve symptoms. Should these meds be given @ $100+/Rx/month (sometimes MUCH higher), especially if the patient is on 3 or more for the rest of his/her life? This happens for respiratory, cardiac, cholesterol, anti-rejection meds after surgery and other meds.</p>
<p>Doctors can predict with some accuracy how long someone will live, but the numbers are based on averages. And people with terminal disease tend to have an initial high rate of mortality, then a right skew as a small percentage of people hang on much longer than is typical. There are many outliers and exceptions. If anything, doctors in general are guilty of overestimating the time a patient has left.</p>
<p>CountingDown - my most sincere best wishes to you. I hope that you continue to use your good health benefits for 30-40 more years, at least. Good luck to you.</p>
<p>Hayden – thanks. I am almost ten years out (leukies are not gone, but are relatively under control) and am humbled every day thinking of those who did not get the kind of time I have been blessed to have.</p>
<p>It’s true that sometimes the families don’t want to let go…grandpa terminally ill and on a ventilator and in great pain…“isn’t there something else you can do?”</p>
<p>But sometimes it seems the surgeons want the business, offering to do hip replacements or heart bypasses on wheelchair-bound dementia patients. True.</p>
<p>Mommusic, you are exactly right. Yes, many times families are reluctant to let go but I have seen providers, surgeons, pushing surgeries that shouldn’t have been considered. Most recently I took care of a 99 year old that had their leg amputated…despite the fact they were in severe heart failure with only weeks to live. This person died 5 days after the procedure.</p>
<p>Then you have the ones who “languish” because their family members are either in denial, feel guilty or don’t care, and let their father/mother lay in bed with a feeding tube keeping them allve. They can’t speak, eat or drink, or walk. And so they lay for years in bed. I can’t imagine spending my last years of life like that. Very sad. I would never put my loved one through that and I pray ky children would never leave me in that state. Give me some good drugs and let me sleep away! We have to accept that death is part of being alive.</p>
<p>Eleven years ago, I was diagnosed with a very serious, chronic condition & told to prepare for major transplant surgery, which had pretty grim survival statistics. Now, the docs unanimously say that I’m WAY to healthy to consider transplanting and I could easily live another 40-60 years, like my relatives & die from other causes, like “old age.”</p>
<p>My friend was told she had a 50% or less chance of living 1 year with her stage 4 breast cancer. She’s still going strong and working full time, heading toward 5 years post chemo, surgery & radiation. You never know.</p>
<p>My SIL is in her 70s & was told she had stage 4 cancer that had spread pretty widely. She had chemo & radiation with just weeks to months to live. Four years later, she is still in pretty good health and plans to come to D’s graduation this May!</p>