
A Million-Dollar Cancer Treatment: Who Will Pay? - onetimemanytime
https://www.wsj.com/articles/the-million-dollar-cancer-treatment-no-one-knows-how-to-pay-for-1524740401
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neonate
[http://archive.is/bOjVZ](http://archive.is/bOjVZ)

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RcouF1uZ4gsC
An issue with how health care is funded in the US, is there is not often a
rational consideration of cost. People are balking at the cost of a cancer
treatment that costs 1 million dollars. However, if it cures a person and the
person lives a good quality life for 20 years, then the cost per quality
adjusted life year is around $50,000.

On the other hand, the median cost for traumatic brain injury is around
$160,000
([http://n.neurology.org/content/82/10_Supplement/P5.337](http://n.neurology.org/content/82/10_Supplement/P5.337))
with many of the patients dying or having poor quality of life. If you looked
at cost per quality adjusted life years, it would probably be a lot higher.

In terms of what cost per quality adjusted life year to target, it seems that
the UK NHS targets 30,000 GBP
([http://www.bbc.com/news/health-28983924](http://www.bbc.com/news/health-28983924))
and there are calls to increase it to 70,000
GBP([https://www.bmj.com/content/338/bmj.b181](https://www.bmj.com/content/338/bmj.b181))

We need to get away from looking at the sticker price for health care, but
look in terms of cost per quality adjusted life year before we can have
meaningful discussion as to what and how to pay for health care.

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Karishma1234
When government pays for your healthcare some civil servants who look at you
as merely statistics make that call to keep you alive or to let you die. In
that sense the money spent is actually controlled.

In USA there is this weird concept that "all lives matter more than anything
else" and hence doctors spend millions.

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telchar
Well it's a concept, but it's applied very hypocritically. It seems mostly
about social status. "All lives matter more than anything else but some lives
don't matter very much at all" would be more accurate. Some people get
millions of dollars in treatment (they're wealthy or have employment with a
company with good insurance) while others die slowly for lack of a few bucks
for a prescription (they already lost their jobs due to previous illness,
mental illness or addiction, or just got unlucky with timing).

Politicians in certain states and in the federal government are doing their
best to make sure people without jobs can't get help with affording treatment
as well. Frankly to claim that we in the US care more about lives than those
in other developed nations with rational disbursement of healthcare funding is
just wrong.

Sorry if you weren't implying that, but I think you were.

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Karishma1234
The person who has lost job or does not have a good job is not likely going to
have much of a life either even if he is cured. If he has hope of having a
good life he might as well borrow some reasonable money.

This might sound evil but what is really evil here is the US government and
FDA that has put regulations which essentially say you will either get best
possible treatment or none.

It is not clear to me why the prescription system is so ridiculously
regulated. Not clear to me why people having opioids is such a big deal and
why we can't have more of health workers giving minor treatment instead of
just doctors.

In country like India there will be lot of quacks who are not real doctors and
yet serve in villages where no real doctor would work.

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prolikewhoa
Simple (yet complex) Solution: don't make health a for-profit business.

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txsoftwaredev
Then what's the incentive to spend millions to develop new treatments?

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Spooky23
To serve humanity.

Why do people teach? Become soldiers? Priests?

Money isn’t the only motivator.

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woolvalley
Those people have to live, eat, and see my family do well. Those people can
decide to go do something else, most people are not financially independent.

The money has to come from somewhere, always.

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Spooky23
All of these things are true. None of these things require a $1M dose of a
drug.

