With health care reform front and center, opposing sides are easily reduced to citing stats and figures which purportedly prove their respective arguments correct.
Often not discussed (at least not in the way it should be) in the exchange is the level of care afforded those patients who face serious illness in the various systems being debated.
After all, it is one thing to be “covered.” It is another thing for the government (in a universal healthcare system) to pull out all stops in an attempt to save your life.
One such person who puts a human face on the grievous downsides of government-controlled health care is Virginia Postrel.
Virginia Postrel, a breast cancer patient, was saved by a drug called Herceptin. She recently detailed her battle against breast cancer and her ongoing fight to ensure that other cancer patients are not denied life-saving drugs because government bureaucracies deem said drugs not “cost-effective.”
Her story is emotionally potent and should be required reading for those US policymakers hellbent on taking this country down the road to government-run healthcare.
Here are a few excerpts from Postrel’s piece worth repeating.
On the U.S. health care system as a driver for biomedical innovation and medical progress:
The American health-care system may be a crazy mess, but it is the prime mover in the global ecology of medical treatment, creating the world’s biggest market for new drugs and devices. Even as we argue about whether or how our health-care system should change, most Americans take for granted our access to the best available cancer treatments—including the one that arguably saved my life.
On Herceptin:
Starting in the late 1990s, oncologists had used Herceptin to extend the lives of patients whose HER2-positive cancers were advanced and metastatic, buying them months, and in some cases years, of life. Then, in May 2005, reports of clinical trials on patients with early-stage HER2-positive breast cancer electrified the American Society of Clinical Oncology’s annual meeting. Herceptin halved the chances of cancer recurrence: from one in six to one in 12 after two years. No one knew what would happen after five or 10 years, but the preliminary results were, to quote a New England Journal of Medicine editorial, “stunning.”
For breast cancer that hasn’t spread elsewhere in the body, Herceptin offers the possibility of a cure. It enhances chemotherapy, encourages the immune system to attack cancer cells, and hinders those cells from reproducing. A year of the drug, with one dose every three weeks (or, for some patients, along with weekly chemotherapy), is now the international standard of care for patients with cancers like mine. So, along with chemotherapy, another round of surgery, and seven and a half weeks of daily radiation, that’s what I got. The Herceptin treatments cost my insurer about $60,000. A year later, I have no evidence of disease and, though it’s still early, I have hope of staying that way indefinitely.
On New Zealand’s “cost-effective” approach to treating patients compared to the United States:
Not everyone in similarly rich countries is so lucky—something to remember the next time you hear a call to “tame runaway medical spending.” Consider New Zealand. There, a government agency called Pharmac evaluates the efficacy of new drugs, decides which drugs are cost-effective, and negotiates the prices to be paid by the national health-care system. These functions are separate in most countries, but thanks to this integrated approach, Pharmac has indeed tamed the national drug budget. New Zealand spent $303 per capita on drugs in 2006, compared with $843 in the United States. Unfortunately for patients, Pharmac gets those impressive results by saying no to new treatments. New Zealand “is a good tourist destination, but options for cancer treatment are not so attractive there right now,” Richard Isaacs, an oncologist in Palmerston North, on New Zealand’s North Island, told me in October.
A more centralized U.S. health-care system might reap some one-time administrative savings, but over the long term, cutting costs requires the kinds of controls that make Americans hate managed care. You have to deny patients some of the things they want, including cancer drugs that are promising but expensive. Policy wonks dream of objective technocrats (perhaps at the “independent institute to guide reviews and research on comparative effectiveness” proposed by Barack Obama) who will rationally “scrutinize new treatments for effectiveness,” as The New Republic’s Jonathan Cohn puts it. But neither science nor liberal democracy works quite so neatly.
To read this piece in its entirety, click here.
