Rationing is in. First, we learned that we all need to cut back on our carbon output, then it was discretionary spending that had to be restricted. Now, some health care analysts are pointing out the painful truth that the only affordable, equitable way to provide health care may be to ration it.
Daniel Callahan of the Hastings Center has recently stirred controversy on the issue, with a New York Times blog post describing his rationing plan. Basically, he suggests that Medicare coverage for very expensive therapies (like open-heart surgery) be cut off once patients hit age 80. By the way, it seems important to note that Dr. Callahan himself is 78. "Our society can not, and should not, promise open-ended, progress-driven medical care that is indifferent to costs," he concluded.
Sound outlandish? Not to the Brits, who are already doing something along these lines. Another NYT article discusses NICE, the British government institute that decides whether a therapy is cost-effective enough to be covered. Their cut-point right now for life-extending cancer drugs is about $22,000 for per 6 months of life gained. The policy raises a whole heap of protest from pharma companies (who the article pretty well puts through the ringer) and patient advocates. Even so, numerous other countries are looking at the British example to deal with their ballooning health care costs, the NYT says.
"What price is life?" asks a woman in the article whose husband was denied an expensive drug. It's a tough question, but one which bureaucrats, health experts and politicians might soon have to answer. Is rationing the only solution?