What follows is a letter from TWS reader Alex Vuckovic on health care rationing. By way of introduction, Dr. Vuckovic happens to be the TWS reader who emailed the boss in the wake of the Senate's passage of Obamacare in December to suggest that there was a chance we could elect a Republican senator from Massachusetts and thereby stop the bill from becoming law. Well, we know that that didn't stop Obamacare in the end. But Alex's email did pique the boss's interest in the Massachusetts Senate race, and before I knew it I was on a plane to lovely South Boston in early January (and then, well, this happened the following week in D.C.). The point: if you email us with comments, dear reader, who knows what will happen?
Without further adieu, here's Dr. Vuckovic's letter:
Rarely is one afforded a glimpse into the dark heart of the contemporary "Heath Reform" project as unwittingly honest and searing as that provided by an exchange of opinions between Mark Thornton, in a Wall Street Journal op-ed regarding the FDA’s approval process for investigational cancer treatments, and a Dr. James Smith, replying in the Letters to the Editor page on May 13. Mr. Thornton's point was that the FDA delayed the approval and caused even more money to be wasted in redoing a successful trial of the drug Provenge. He has forcefully argued in the past for better access to investigational treatments by terminally ill patients, a position which is awfully hard to refute, from both a common sense and a humanitarian point of view. Rather than responding to this point directly, however, Dr. Smith takes things a step further by borrowing a chapter heading from the Ezekiel Emanuel textbook of snuff medicine and arguing that such drugs are of little value for the expense. He notes--triumphantly!--that the drug sells for $90,000 to $100,000 per patient and will only extend life an average of four months at a "cost to society" of $8 billion for the theoretical (not actual--they're dead, you see) treatment of 80,000 patients who died during the extended drug approval period. To put it in perspective, that's 26,000 patient years of life which would have been apportioned to men who would have had a chance to see sons graduating, daughters married, grandchildren born, perhaps wonder one last time at the pyramids of Egypt or the Grand Canyon. And remember--an average of four months translates to anywhere from zero to a year or more of life in that population, as well as including a few actual cures. To Dr. Smith, however, those cancer patients had a duty to die sooner so as to relieve us of the burden of the cost of their care. That a physician can make such an argument and at the same time act morally superior to the rest of us is an indelible bloody stain on my profession. President Obama’s most recent health-czar designate is an unabashed admirer of the British National Health Service, where the Dr. Smiths of the world make the life-and-death decisions. This is the future of American medicine unless we rise up and repeal the Obamacare monstrosity which will soon be gently reminding us all of the duty to die cheaply.