Cost by Day 3 your analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate your response with at least two outside resources. Cost and Care in the US
Kovner and Knickman (2011, p.280) suggested that health economist in the US used various methods to the measured value created by healthcare, the standard measure is the quality adjusted life years (QALY). The two factors whose product results in the QALY are 1) measure of the patient’s quality of life on a scale where 0.0 is essentially death, and the 1.0 is perfect health, and 2) the number of years the treatment will extend the person’s life. Applying QALY in the Provenge is by multiplying the value that is $93,000 with the number of extended months that are four. The product is $372,000 per quality adjusted life year. Provenge is just one of the expensive drugs that is utilized in the US and paid by government and other insurance. Herper (2010) reported that the most expensive drugs cost more than $200,000 a year. These are those that treat rare diseases, mostly genetic, which inflict to less than 10,000 patients. Example is the drug, Solaris, which cost $409,500 a year. This is a monoclonocal antibody drug that treats the paroxysmal nocturnal hemoglobinuria. Another drug is Elaprase that cost $375,000 a year.
This medicine treats an ultra-rare metabolic disorder called Hunter’s syndrome. The article also mentioned that the high cost of medicine is necessary to support the few patients who will ever need. I believe that for this reason, the cost for this drug is justifiable, but not in the case of the Provenge. American Cancer Society (2013) suggested that prostate cancer occurs mainly in older men; six cases in ten are diagnosed from ages 65 and older and rarely before age 40. While National Cancer Institute stated that the estimated new cases of prostate cancer in the United States in 2014 are 233,000 and estimated deaths are 29,480. These data defines that prostate cancer medications shouldn’t belong to the most expensive medication. At present, there is a $7,535 per capita spending in the US per year (Milstead, 20, p. 194). Emergence of expensive medications that will be approved by the government will increase this number. The government needs to develop programs that will cut this cost without sacrificing the necessary treatments needed by patients. One program can be giving incentives to companies that do researches and come up with an alternative and affordable drug for prostate cancer such as Prostvac-TRICOM, Ad/prostate-specific antigen vaccine Ad5-prostate-specific antigen and the DNA/prostatic acid phosphatase vaccines (Lubaroff, 2012).
Ethically, everyone should be treated equally in healthcare. The four principles that are relevant for health care are respect for persons, beneficence, nonmaleficence and justice (McAdams, n.d.). The government uses the principles of respect for a person, beneficence and justice in approving expensive treatments and medications. The US government gives their respect by performing their duty as the healthcare provider and having a goal of 21st health care excellence. It provides beneficence by being kind and providing healthcare programs to below the poverty population; on individual with a particular disability; on veterans and their family; and, on the ageing population. It practices justice by creating a law that healthcare facility/agency cannot deny a treatment in emergency setting; and by sharing the cost of healthcare. Summary
Cost versus care will always be a debate in the politics area. If we base all our actions through the principles of ethics, all necessary treatments should be delivered in the health system of the government. All patients should receive interventions for the treatment of disease and to prolong life as they wish to be. That is the reason we have the POLST, the Advance Directives and the Informed Consent. The government’s role is to source funding from everywhere to meet the needs of the patients. Funds may come from the shares of cost, from the co-pay, from the deductible, from the out of pocket, from the stocks and bonds, from “sin “ taxes and other forms of taxes, and from other sources of investment for health funds. The government, at the same time, should regulate the companies or individuals that take advantage of the private, company and government insurance that demand a higher price of service or products.
Cancer Society. (2013). What are the key statistics about prostate cancer? Retrieved from the http://www.cancer American.org/cancer/prostatecancer/detailedguide/prostate-cancer-key-statisti