This paper provides a response to the issues discussed in the article by Rob Stein “Review of prostate cancer drug Provenge renews medical cost-benefit debate” published in The Washington Post on November 8, 2010.
The policy decisions about what will or will not be paid for in modern American healthcare are made on the basis of the economic consideration. Economics are driving the U.S. healthcare because the federal funding for this field is decreasing annually, with a growing budget gap and suggested reforms. Healthcare delivery is a big business in which patients are perceived as consumers. At the same time, the cost of care is increasing with every year as does the number of patients (Utah Business, 2011).
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The article in Washington Post illustrates the current tension between cost and care by exposing how such economically non-measurable things as human life are measured from the position of cost and economic benefit. It is clearly shown that the patients are willing to try Provenge and are looking forward to Obamacare’s provision of the chance to try the new vaccine. At the same time, all other stakeholders, as it is noted, are most likely to consider the cost benefit first of all. Such approach violates three of the four main ethical principles to healthcare: beneficence (i.e. to help patients advance their own good), non-maleficence (i.e. to do no harm), and justice (i.e. to be fair and consider the cases alike). In practice, this situation is another example of the tension between cost and care in America’s healthcare system. Other examples are rising healthcare costs and lowering quality of healthcare (McGinnis et al, 2010); the need to base the healthcare quality improvement strategies on evidence based results and the scarcity of resources to implement this approach (Auerbach et al, 2007).
The economic challenges clearly outweigh the value of ethical consideration in the minds of the policy makers in today’s healthcare. At the same time, the overall re-structuring of healthcare (using the examples of other developed countries, such as France, Sweden, or Japan) would the best solution. Clearly, healthcare delivery should cease to be perceived as a product and patients are mere consumers.
- Auerbach, A., Landefeld, C., Shojania, K. (2007). The Tension between Needing to Improve Care and Knowing How to Do It. The New England Journal of Medicine, 357, 608-613.
- McGinnis, M. et al. (2007). Value in healthcare: Accounting for cost, quality, safety,
outcomes, and innovation: WorkshopsSummary. National Academies Press. - Stein, R. (2010). Review of prostate cancer drug Provenge renews medical cost-benefit debate. The Washington Post. Retrieved 16 June 2014 from http://www.washingtonpost.com
- Utah Business (2011). Healthcare. Utah Business, 25 (11), 95. Retrieved 16 June 2014 from
http://www.utahbusiness.com.
