Why Doesn't Anyone Emphasize the Advantages of Cost-Effectiveness Analysis in Health Care?
Seems to me that--even ignoring all the other issues--whenever the subject of cost-effectiveness analysis comes up, people think of themselves as the person who wants to receive the cost-ineffective treatment as their one shot at life or somesuch.
And that's a poignant kind of thought, obviously.
But the other side of the story is the two or ten or hundred people who don't get cost-effective treatment because we spent the money on a very low-likelihood-of-success treatment for one person. So how'd you like to be the one thirty-year-old who can't get your brain tumor removed because hundreds of thousands of dollars were spent on one ninety-year-old, trying plutonium nasal spray in an effort to eak out another month of life? Personally, not only do I not want to be that thirty-year-old, but I don't want to be that ninety-year-old, either. I certainly don't want to be the person who eats up resources that could be better spent elsewhere in a futile effort to live just a little while longer. But, incidentally, I 'll tell you right now that that's what I'm likely to ask for if the decision is left up to me. I'll be as big a chicken-shit as the next guy when push comes to shove. So I certainly hope the decision won't be left up to me when push does come to shove.
Seems to me that--even ignoring all the other issues--whenever the subject of cost-effectiveness analysis comes up, people think of themselves as the person who wants to receive the cost-ineffective treatment as their one shot at life or somesuch.
And that's a poignant kind of thought, obviously.
But the other side of the story is the two or ten or hundred people who don't get cost-effective treatment because we spent the money on a very low-likelihood-of-success treatment for one person. So how'd you like to be the one thirty-year-old who can't get your brain tumor removed because hundreds of thousands of dollars were spent on one ninety-year-old, trying plutonium nasal spray in an effort to eak out another month of life? Personally, not only do I not want to be that thirty-year-old, but I don't want to be that ninety-year-old, either. I certainly don't want to be the person who eats up resources that could be better spent elsewhere in a futile effort to live just a little while longer. But, incidentally, I 'll tell you right now that that's what I'm likely to ask for if the decision is left up to me. I'll be as big a chicken-shit as the next guy when push comes to shove. So I certainly hope the decision won't be left up to me when push does come to shove.
1 Comments:
Winston,
I think Uwe Reinhart accurately captures the insane attitude in this country about health care and its financing, a large part of which is the cost-effectiveness issue you're talking about:
http://economix.blogs.nytimes.com/2009/07/31/a-common-sense-american-health-reform-plan/
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