kausfiles.com
Medicare Just Says No (August 15, 2010 11:30 PM)
This could be bigger than the mosque flap--remember, MSM nightly news broadcasts cater to seniors (their remaining audience) and love cancer cure stories:
For the first time, an FDA approved anti-cancer therapy may not be covered by Medicare.
Do you think people on Medicare will stand for that sort of thing? I don't--which is why Peter Orszag's (and Ezra Klein's!) predictions of trillions saved thanks to the health care bill's anti-democratic cost controls have always seemed bogus.** ...
Update: The relevant federal panel (the CMS) appears to have opened a "national coverage analysis" to decide by next June whether to pay for the drug (Provenge). If they think this will get it out of the news they are kidding themselves, I suspect. ... Here is a protest letter from the American Society of Clinical Oncology arguing that Medicare's required to cover the therapy if it is FDA-approved. ... In this case, the therapy appears to work but is expensive--costing about $750 for each extra day of life. ...
**--Naive or cynical? You make the call! .... [via Althouse via Instapundit] 11:40 P.M.
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Comments
August 18, 2010 3:00 PM
From: Eric (ejohnson@phjlaw.com)
Subject: re: Medicare Just Says No
Mickey, I don't really get your point. You're the one who ran for Senate on the platform that oppressive government is just fine as long as the unions are kept in check. So it turns out that oppressive government is oppressive without regard to unions. No kidding.
August 18, 2010 12:00 PM
From: Kaus Fan (johann@4intrepid.com)
Subject: re: Medicare Just Says No
Please get a real website again. Maybe a wordpress blog, a blogger site. anything. This sitebuilder thing is so very sad, man.
August 18, 2010 11:00 AM
From: Clark
Subject: re: Medicare Just Says No
RE: kieth nissen: "Someone has to draw the line don't they?"
No! Let people choose the health care coverage they want and can afford. Get gov't out of the business of writing health care policies, and let insurance companies offer varied policies. If you want every drug, no matter the cost, buy the more expensive plan.
If you are worried about the poor, you can provide vouchers for people to buy coverage in an open market.
August 18, 2010 10:00 AM
From: Mark Buehner
Subject: re: Medicare Just Says No
"so Mickey what is the alternative to the "death panel"; everybody gets to live another six months and the country borrows money from the Chinese to make it happen."
Who knows? What we do know is this bill of goods Obama sold us PROMISED up and down this type of decision wouldn't have to be made- and called anyone who told the truth liars and fiends.
Of course all of us in the real world new the refuge of the scoundrels was going to be 'well of course we had to have death panels, you have to in the system (we designed)'... even after fighting to the death to renounce them. Its not about what you say or said yesterday, its about whats expedient for your agenda. The problem the left has run headlong into is the startling realization that that agenda is not foremost with most Americans. And they hate that.
August 17, 2010 8:00 PM
From: Kevin (kpmonroe@gmail.com)
Subject: re: Medicare Just Says No
srp: I like your thought process on this, but beyond the administrative complexities might this approach limit innovation? Will drug development firms now need to include a ratio of those patients who may benefit from such a treatment opt out to receive their share of the savings? Wouldn't this model then require even higher reimbursements to account for those who do opt out?
Somebody: I don't think that there is much question that we will have to make tough choices to decrease healthcare spending. But I wonder, why is the decision maker assumed to be the government and not the patient?
So right now we spend something like 17% of GDP on healthcare and the consensus is that this is too much to spend. So my question is what is the appropriate amount of money that should be spent on healthcare? How will the dollars that are to be saved be spent?
August 17, 2010 7:00 PM
From: srp (spostrel@gmail.com)
Subject: re: Medicare Just Says No
There is a way to attack this sort of cost-benefit problem without relying 100% on philosopher-technocrats to make one-size-fits-all decisions for everyone. Consider grossly inefficient treatments where the patient would not spend his own money on it even if he the cash. The answer is to give the patient the option of forgoing the expensive treatment but cutting him in on the savings from NOT using it. Lots of administrative complexities, but you can get fiscal savings without rationing and without taking anything away from the patient.
August 17, 2010 3:00 PM
From: kieth nissen (kietharch@comcast.net)
Subject: re: Medicare Just Says No
Someone has to draw the line don't they? what if the treatment is $8,000 per day? it seems to me that someone who is spending his own money (and his heirs money) would hesitate to make that buy. I hope I would turn it down (if it were my own money or Medicare's money) because having the taxpayer keep everyone alive will bankrupt us. Isn't that right? so Mickey what is the alternative to the "death panel"; everybody gets to live another six months and the country borrows money from the Chinese to make it happen.
August 17, 2010 10:00 AM
From: OSweet
Subject: re: Medicare Just Says No
The solution of course is to undermine the pharmaceutical companies' profitability, and eventually put them out of business, so they can't keep inventing cures society can't afford.
August 17, 2010 10:00 AM
From: Casey (casonkathleen@yahoo.com)
Subject: re: Medicare Just Says No
So we're to pay for illegals, viagra, sex change operations, but if you've got breast cancer you just need to die or go away and die. If you take hope of life away from people they're sure to fight back or make you're life miserable.
August 17, 2010 10:00 AM
From: Ricardo (rrollo@pacbell.net)
Subject: re: Medicare Just Says No
RE Clark. But, if the FDA rescinds the approval, then the whole FDA approval process loses its scientific credibility. Anyway, there will be a new senior's organization that will emerge to replace the AARP. It will look a lot like the late 1960's, and it will do as much damage. Orszag's departure
from Washington looked like two hours ahead of the Sheriff.
August 17, 2010 10:00 AM
From: Somebody (whydoesmyemail@havetobevisible.edu)
Subject: re: Medicare Just Says No
Obama was always up front about needing to make tough choices to decrease spending on health care. Gleefully announcing that people won't stand for anything other than what they stand for right now is not a counter argument. If you think that structurally we will eventually have to make tough choices, and that everyone should make tough choices together, then it seems to me that HCR puts us on the best track to do that. But you're just another guy who wants free unlimited health care for everybody. Did you hand out cash to your voters too?
August 17, 2010 8:00 AM
From: jeanne (jeannebab@comcast.net)
Subject: re: Medicare Just Says No
All these years I've supported the heavy investments we've made in cancer research.
They never told us, though, that breakthroughs wouldn't be available to us if they're expensive.
Typical government.
August 17, 2010 7:00 AM
From: SongDog (RCT@Alumni.Rice.edu)
Subject: re: Medicare Just Says No
The real danger will arise when they fail to approve drugs because of cost, and then in response the drug companies limit their research and development to drugs that can be offered at low cost. What will be lost when that happens?
August 17, 2010 7:00 AM
From: Tim G
Subject: re: Medicare Just Says No
Of course, the cost of the drug wouldn't be so expensive in the first place if FDA's clinical trial burdens weren't so astronomical. The time and expense involved in doing human oncology trials ain't cheap...especially when you are talking about a drug with potentially limited applications.
August 17, 2010 7:00 AM
From: jaed (bittersanity@jaedworks.com)
Subject: re: Medicare Just Says No
So it won't just be Medicare patients who can't get the drug covered; it will be anyone who's on insurance that uses the FDA approval as an imprimatur. As a bonus, the "drug scholarship" programs offering financial assistance to patients using this drug will also disappear.
All this to save Medicare some bucks while making it look like it's not a cost-saving measure. (As futile as a cat covering up on a tile floor.)
August 17, 2010 7:00 AM
From: Hal (hal@mailinator.com)
Subject: re: Medicare Just Says No
The funny thing about this $750/day cost is that it is all based on the manufacturer's chosen price. The marginal cost to the drug company is pretty negligible--they're trying to recover their development costs and get a hefty premium for the risk they took (quite reasonably). So isn't it conceivable that Medicare declining to cover the drug would just be step 1 in a price-setting game in which the drug company would eventually agree to a far lower price--and that if we don't let the game play out (ie if politics vetoes the panel) that way we will be completely screwed in terms of negotiating a decent price (on this and every other future drug)?
(Personally, I am all for successful drug developers making a lot of money, but it burns me that US customers seem to pay a far bigger fraction of pharma returns than other countries--which negotiate harder and buy in bulk. This is part of how we manage to spend more on health care and not get more.)
August 16, 2010 1:00 PM
From: Clark (clark667@comcast.net)
Subject: re: Medicare Just Says No
Of course it will be hard for Medicare to reject an FDA-approved drug. That's why the FDA is reviewing the case with the idea of rescinding the approval.
If FDA removes the approval, it takes the political pressure off of Medicare. As per WaPo:
"Federal regulators are considering taking the highly unusual step of rescinding approval of a drug that patients with advanced breast cancer turn to as a last-ditch hope."
And this is how healthcare will be rationed.
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