Saturday, May 06, 2017

Riddle Me This, Socialized Medicine Advocates

My grandfather died from ALS.  I have skin in this game:
The Food and Drug Administration said Friday it had approved the first new drug in 20 years to treat the paralyzing disease ALS.

The drug is not a cure but can slow down the inexorable worsening of the disease, which gradually paralyzes patients completely. It's always fatal and there is no cure...

It's in fact the first new drug approved for ALs since 1995, when riluzole, sold under the brand name Rilutek, was approved.

Radicava is given in the form of an intravenous infusion, with two weeks of daily treatments followed by a two week break...

It comes at a price. Mitsubishi Tanabe Pharma America says the drug will cost more than $1,000 per infusion.

"If taken annually for 12 months or 13 cycles, according to the dosing and administration in the label, the cost before government discounts, will be $145,524," the company said.
So you want single-payer health care.  You want insurance companies to go out of business, and you trust the government (currently run by Donald Trump and the Republicans in Congress) to pay for your health care.  How much should government spend?  When is an amount too much?  Uncle Sugar has big pockets, are you OK with the cost above--for all 20,000-30,000 people in the US with ALS?

You can't just go on emotion, you have to think as well.  Can we afford this?  What are the costs--not just dollar costs, but costs to freedom and privacy--in having the government this involved in your private life?


Joshua Sasmor said...

Assuming the middle number (25000) in your range for the number of people with ALS, that is a gross cost of $3.64 billion; assuming the top number (30000) this is a gross cost of 4.36 billion. This is approximately 35%-42% of the cost of a Ford-class aircraft carrier (estimated $10.44 billion). The last budget (FY17) was $4.15 trillion, which makes this 0.09% of the federal budget for that year. I hate the idea of single-payer, but the cost comparison is actually a net positive in this case.

Now as we aggregate the costs for _all_ of the different drug treatments and the gross costs for _all_ of the medical care we are dealing with, then the numbers get HUGE. At that point the bureaucracy of the federal government makes it impossible to manage. The transition to single-payer health care in the US would be a disaster.

Anonymous said...

You are asking what a person's life is worth. That is one slippery slope. Who do we let die? How about a type one diabetic child? Your grandfather two extra years of quality life? My wife's 94 year old WW II vet father?

Those decisions are way above my pay grade. I hereby put you in charge. Sleep well.

By the way, that $145,524 cost here is $35.000 in Japan.


Pseudotsuga said...

Richard --
Those decisions are already made by the government in places like Canada and the UK, where the government decides that the hip replacement is too expensive for the 60 year old woman, and the cancer drug that will save the life of the child is too expensive for National Health to purchase, so they won't offer it.
You also might find it helpful to explain why that one drug is only (35 dollar? 35,000 dollars?) in Japan.

Auntie Ann said...

According to the US DHS, we spend $10,345 per person on healthcare in the US. We have a population of about 330 million, but only 153 million are employed. Which means health care costs amount to about $22,300 per worker--that's all workers, including the working poor, including families taking care of kids and elderly, trying to pay a mortgage, and their kids' orthodontist, and save up for college...and paying off their own college debt.

So, the fundamental question is: How do we pay for $22,300 per worker?

Anonymous said...

HI Pseudotsuga--I'm a Pinus strobus man myself.

Anyway, yes it is $35,000 in Japan. Probably the reason is that our health insurance CEO's make twenty million a year and up. The highest Medicare salary that I have seen is $165,000. Quite a difference. that's why I had always advocated that anyone should be able to buy into Medicare. With reasonable restrictions of course.

I know many folks from Ontario. They like their health care plan and think we are nuts. Two thirds of the hip replacements in Canada are for people over 65.



PhillipMarlowe said...

Neulasta, which is given to chemo patients to up their white blood cell count, costs about $10,000 a dose.
My wife has cost $70,000 in just neulasta so far.
I guess, Darren, like those who voted for Trump, belieieving he was going to give them even better health care, and jobs and clean air, and freedom to won a gun , and freedom to practice their religion, I'm willing to accept what the government can do to keep my wife alive.
Almost like taking a job teaching in government schools instead of private school.

Darren said...

You suggest that as a conservative I shouldn't work for the government. Do you *really* think that's a good argument, one that paints me as a hypocrite? Or are you just throwing crap up on the wall and hoping someone sticks? Perhaps I'm a hypocrite for working for the government as a soldier, too? Come now, you can do better.

I get that you're willing to accept what the government can do to keep your wife alive--and that's *exactly* why policy should be created by disinterested (not *un*interested) people who can look at things rationally. I'd do anything to keep my son alive, but I don't know that all the things I can come up with should be legal just because of my emotions.

And see? That's where you and I seem to disagree. I want logic, and principle, and *economics* to have a say in policy, not just "I want".

PhillipMarlowe said...

Do you, as a conservative, take the very generous health benefits negotiated by the teachers' union for your government job?
Benefits that are better than what is offered/promised by the socialized medicine of the Affordable Care Act/ObamaCare?
(I'm presuming that the teachers' unions in California are able to negotiate great health benefits like their comrades do out here on the East Coast. I make that presumption based upon the complaints by conservatives about the ever powerful teachers' unions in California. And if I remember correctly, I believe that was a complaint from the Friedrich plaintiffs that the health insurance offered niceties like abortion coverage and contraceptive coverage that offended their religious beliefs.)

But I don't see how your logic, and principle, and "economics" are going to have the say in policy.
For example, I know a fellow who worked for himself on the renaissance faire circuit. A few years back, his wife got cancer, received treatment, but died. He was left with a $60,000 bill from the health care practitioners in Texas. He was able to negotiate them down to $20,000. So what's the deal here?
Connections? Luck of the draw? Knowing the right people?

Darren said...

Just like car insurance and homeowner's insurance and food, health insurance *shouldn't* be provided by jobs--and neither should it be provided by government. Government, especially the federal government, exists to secure rights, not to provide goodies. At least, that was the idea....