The Lancet Endorses Rationing

The authors lament that the therapy costs roughly $100,000 a head. “The treatment is proven to be effective,” muses the report, “but how shall we determine its value?” The report’s royal “we” returns again and again to such questions, claiming that “we overdiagnose, overtreat and overpromise.” And the main cure the report proposes lies not necessarily in more or better medicine, but in more allegedly enlightened forms of rationing and price controls.

The authors hope that ObamaCare’s various commissions will “lead to a wider application of cost-effectiveness based criteria for determining treatment entitlements in America.” They even recommend integrating cost-effectiveness with the Food and Drug Administration’s clinical approvals, along with tighter regulation of off-label drug use, which would be a disaster for terminally ill patients.

From The Wall Street Journal. Lancet report here [gated, but with executive summary].

Comments (6)

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  1. Brian Williams. says:

    Perhaps the value should be left up to the consumer, rather than the government.

  2. Devon Herrick says:

    I believe this is the direction health policy wonks at HHS are moving. At some point overt rationing will be the offical policy rather than something nobody talks about.

  3. Dave says:

    So if I’ve been denied a procedure by my corporate health insurance provider based on a similar metric of value, except add in the additional metric of determining profitability, that’s a good thing, right?

  4. Virginia says:

    $100,000 per treatment is completely different depending on the relative health of the patient and the removal of the patient from bill for the treatment.

    At the end of the day, you either pay out of your own pocket or you have an insurance policy that covers the cost via insuring a large number of other people who don’t need costly care. We’re reaching a point where the pool of people who don’t get sick is becoming too small to cover the cost of those who do. It’s a tough question, but someone always has to figure out an answer. It’s either the consumer or the insurer (government or private). In both cases, death is not pretty.

  5. Linda Gorman says:

    A disaster for terminally ill patients now, and for those who wouldn’t necessarily be terminally ill in the future if new treatments had been explored.

  6. John R. Graham says:

    I had a quick look at the CIA World Factbook, which informed me (after interpolation) that Gross World Product in 2008 (at Purchasing Power Parity) was about $71 trillion. So, $895 billion in cancer care accounts for less than 1.3 percent of that.

    We should be celebrating that we are so prosperous that we can devote almost a billion dollars a year to cancer care, not fretting about how we need to ration it!