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Markets in everything, death edition
Critics of the measure point to the story of Barbara Wagner, a cancer patient in neighboring Oregon, whose [state-run] insurance company denied her request for coverage of potentially life-saving drugs, and instead offered her money for lethal drugs.
Here is more. I do not expect this to be the last story of its kind.
Posted by Tyler Cowen on October 27, 2008 at 10:54 PM in Economics | Permalink
Comments
Insurance company? She was on a State Health Plan. Big distinction there.
Posted by: Doubtful WM Student at Oct 27, 2008 11:04:45 PM
And given the backlash a few cases like this have already sent through the bioethics circles, there's a pretty decent chance this WILL be the last story of its kind. Oregon is under ridiculous scrutiny for its assisted suicide program (which isn't unreasonable, of course... the scrutiny, that is).
Posted by: Pup, MD at Oct 27, 2008 11:14:10 PM
If we get national health insurance via Mr Obama this (well hidden, mostly) will be commonplace.
Posted by: at Oct 27, 2008 11:17:07 PM
This notion that a day of (my loved one's) life is worth "whatever it costs (someone else)" has got to be 'fixed'. If a high school student cannot explain the fallacy in such a ridiculous statement, they ought not graduate. If the teachers cannot explain it, they should be fired.
Posted by: at Oct 27, 2008 11:36:22 PM
This notion that a day of (my loved one's) life is worth "whatever it costs (someone else)" has got to be 'fixed'.
I'm trying to have sympathy for her, but I'm having a hard time. She is on free state-run health insurance for the poor. Considering that without the state-run insurance she wouldn't have been able to afford the radiation and chemotherapy that put her lung cancer into remission in the first place, I think she came out ahead in the deal. Otherwise she would have died months ago from lung cancer that she couldn't afford the treatments for. She's essentially complaining that her free health insurance isn't good enough. I'm not for free government health insurance that allows for unlimited expenditures per patient.
Posted by: JordanT at Oct 28, 2008 12:06:38 AM
We wouldn't be hearing this story, if she never had insurance.
A lifelong smoker, wants to try an expensive treatment which has less than 5% survival rate after 5 years. The pro-lifers should take care of her expenses.
Posted by: Jesus saves America spends at Oct 28, 2008 12:30:32 AM
Someone should tell Oregon about the Internets. A quick google finds me Tarceva at half the price in Canada. Oregon is so close they should have regular supply runs north.
People are denied health care from insurance companies all the time. What makes this a newspaper article instead of a statistic is she was offered a drug to kill her in the same letter as being denied the drug she wanted.
Posted by: Mike M at Oct 28, 2008 1:58:10 AM
Would medicare cover the drug?
I'm surprised that we don't here these stories in regards to Medicare.
Posted by: travis at Oct 28, 2008 2:32:45 AM
And the solution is so obvious, too. In any sane world. What a hideous pity...
Posted by: Eliezer Yudkowsky at Oct 28, 2008 3:11:03 AM
If the implication of the parenthetical state-run addition is that this is something that doesn't happen with private health care, that's just ridiculous.
Posted by: J at Oct 28, 2008 3:15:15 AM
We won't hear these stories with medicare until the taxpayer is tapped out. Then it will be all we hear.
Yes, the solution is obvious. Cryonics.
Otherwise, chemotherapies wouldn't really "save her life," and if they do, she should have to repay. I could come up with an ineffective treatment for half the cost! She should be allowed to sell her kidney, though organs riddled with metastatic cancer may not be in demand. Terminal patients should be paid to undergo experimental treatments. We need better personalized diagnostics that target chemotherapies that will actually work for your specific type of cancer. And, where are her friends and family?
People don't get to live forever, even if they believe there are magical miracle cures that fall from heaven but for big mean insurance companies keeping everyone from having them.
Posted by: Andrew at Oct 28, 2008 4:19:19 AM
And how is offering her an assisted suicide option any worse than offering her hospice care or no care? All are certain death in her case, but the latter two are somehow accepted despite the fact that they are much lengthier and often involve lots of pain and suffering.
Once the conclusion that she will not survive has been made (and thus experimental treatments will not be used), the driver is not expense or markets. It's pain and suffering.
Posted by: Mike Huben at Oct 28, 2008 5:18:34 AM
"money for lethal drugs."
This reminds me of the countries that require people to own guns. Government just doesn't get it.
Posted by: Andrew at Oct 28, 2008 7:10:50 AM
Once the conclusion that she will not survive has been made (and thus experimental treatments will not be used), the driver is not expense or markets. It's pain and suffering.
None of us will survive. We all have pain and suffering.
This is the human condition.
Should poor folks with major depression kill themselves? How about people who are bi-polar? Should we help them?
What worries many people, not just pro-lifers, is who will make the decision. And the emerging death culture....
Posted by: at Oct 28, 2008 7:12:29 AM
Article that was forwarded to me recently on this topic:
"Cost-effective Medical Treatment: Putting an Updated Dollar Value on Human Life"
http://knowledge.wharton.upenn.edu/article.cfm?articleid=1949
Posted by: NGoldschlag at Oct 28, 2008 8:03:48 AM
Maybe free marketeers should focus more outrage on why a life-saving drug costs $4,000/month but one which will kill you costs $50.
Curious how many of you can afford $4k/month which is what you'll face when your utopian free market insurance company drops you like a bad habit.
Posted by: meter at Oct 28, 2008 10:20:46 AM
meter, what are you talking about? Do you know how to read? It isn't a for profit insurance company that is denying this woman care, it is the state. Get it? The state. The same entity that will be supplying insurance under any non-free market health care plan.
Interesting that ABC News is flat out dishonest in its coverage, referring to an "insurance company" rather than "the government."
Posted by: y81 at Oct 28, 2008 11:19:14 AM
@meter:
I'm no physician, but I'm guessing it takes something special to fight off bad diseases to prolong life, hence the $4000K per month figure.
As for the flip side, drugs that can kill you have been around forever. What did that Socrates guy take? Forget the drugs, we can do it a heckuva lot cheaper than $50. They sure did it a heckuva lot cheaper back in the day (think the wild, wild West era).
And I'm just looking at the cost side - my guess is there is much more demand to prolong life than there is to end it.
Posted by: AZ at Oct 28, 2008 11:20:46 AM
Maybe free marketeers should focus more outrage on why a life-saving drug costs $4,000/month but one which will kill you costs $50.
Am I supposed to be outraged because it took an army of doctors and researchers and several hundred million dollars worth of drug trials to prove it's saftey and efficacy? Or because those same people expect some compensation for it?
Posted by: apostate at Oct 28, 2008 11:22:20 AM
Meter: our health insurance system is "free market"? News to me...
Posted by: Henry V at Oct 28, 2008 11:39:42 AM
In poor countries, doctors will sometimes recommend that a patient save their money because their condition is terminal. It is up to the family whether to deplete life-savings to save a life, or accept fate and save their resources. In our system, the insurance company or state makes the decision, and it creates an antagonistic relationship. The family bears no cost, so they almost always choose to save the life, versus the cost bearer who wants to save money. I don't know why anyone wants to further remove this decision from the family and leave it up to the state, with sovereign immunity, to decide. I'd rather we return control of the money to individuals and let this heartwrenching decision be made at the family level.
Posted by: 8 at Oct 28, 2008 11:52:44 AM
y81: go back and actually read what I wrote; feel free apologize whenever convenient.
Apostate: a free market/privatized health insurance system wouldn't have made this situation any better. Again, do you have $4k/month disposable income?
AZ: ya don't say.
Posted by: meter at Oct 28, 2008 11:52:48 AM
I thought my post was clear, but let me be clearer:
No, we don't have a free market health insurance system. My comment is that were we to, this situation would have had the same result: the woman would have been dropped by her provider and would have had to either come up with $4k/month out of pocket or suffer the ravages of her illness.
We *do* have a free market in drug prices. So even with privatized health *insurance* that $4k/month figure doesn't change.
Posted by: meter at Oct 28, 2008 11:57:55 AM
meter, you claim that I will face $4000 per month in costs when my "utopian free market insurance company" drops me. That is what this woman faces NOW from the state. So I frankly have no idea what you are talking about.
You know, it reminds me of when I worked at Legal Aid. For every one person who came in with a complaint about a private party, say a landlord, there were 50 coming in to complain about the state (the Housing Authority, the police, Social Services, Housing Preservation and Development, etc.). Why people think that having the state run things will be an improvement is beyond me, except that it makes more work for Legal Aid lawyers.
Posted by: y81 at Oct 28, 2008 12:06:31 PM
This story is very striking, but with a deep irony. This approach to healthcare is very reasonable. A 5%, 5 year rule is a perfectly reasonable standard. You could argue for a different standard, but the idea that there should be some kind of similar standard is pretty much indisputable. Once you recognize that, it also makes sense for the insurance company to offer a legally assisted suicide option. This is all independent of who is providing the insurance. Now, maybe it was a poor decision for the insurance provider to advertise the suicide option to the patient, but you are bickering over details at that point. I should add that I'm a liberal, not a libertarian and that I think universal healthcare would be a good way to go. This is an example of things working more or less the way that they should. The fact that it is regarding as newsworthy is what is striking. People need to come to accept that these are the kinds of cost saving measures that make the most sense in a healthcare plan.
Posted by: mpowell at Oct 28, 2008 12:45:07 PM
