Steven and others
Thanks for your response.
I see your reasoning and agree a more efficient Medicare is desirable .
But putting a limit to expenditure overall and/or classes of patients isn't the answer.

As a rule I bang on about two issues...context and objectivity.

The differences in systems are such that comparisons are tenuous at best. Big Pharma and Commercial interests have far more influence.
Commercial media is hardly an absolute or objective quotable analytical source (Aus too)as they tend to focus on the sensational therefore by definition the exceptions rather than the rule.

Secondly . My point is here that if one examines the major expenditure types in the Medicare budgets the line items like you identify are small beer by comparison to other expenditures "inefficiencies and commercial manipulations".
i.e. 83 yo-ish neighbours are gold card recipients. Free private hospital/specialists They take take over 15 different medications daily. Many GCers *tend* to be obese, lifetime smokers and heavy drinkers etc. Collectively they cost FAR more than the those who are on the expensive drug you mention and for much longer periods of time. Then there's their own govt. dept. Soylent green ?

Discussions like this tend to forget that health care is funded under the principal of aggregation... simply put, by charging eveyONE a little no ONE need die or suffer unnecessarily for the want of money.
Socialised medicine? Hardly it's simply the same principal of banks and insurance without the profit rake off motive.

My initial concern is that how do you define WHO is worth spending money on without placing a $ value on a life...(variant form of eugenics).

This of course does not exclude striving for efficiencies (elimination of waste and search for better and/or cheaper solutions). More basic research makes sense. Likewise forcing Big Pharma prices to reflect govt. financed uni research.

Finally I find discussions that avoid the the systemic problems and focusing on the symptoms disturbing especially when it comes from intelligent people (as opposed to the general self interested, "instant answer" bulk of population(talk back radio mentality).

Dear Richie 10,

I wish you well with your medical problems.
May they all be solved successfully and well.
'The uncertainty that darkness brings
can humble even the hardest soul.'

Take care, and our thoughts and prayers go with you.

Examinator: “Liver, kidney cancer often has little or nothing to do with excesses or the extent of ones abstemious lifestyle.”

My father in law was hard working, physically fit and slim his whole life... died of cancer in the liver and pancreas on Friday. No special new drug offered. Father of children died two years ago at 40 years old of bladder cancer, he was slim too. Based on my personal experience I’m starting to think about eating more and doing less.

“Finally I find discussions that avoid the systemic problems and focusing on the symptoms disturbing especially when it comes from intelligent people (as opposed to the general self interested, "instant answer" bulk of population(talk back radio mentality).”

It is hard to stay up to date with all the systemic problems. How do you all do it? Does medical insurance come in to this as well?

As a healthcare worker for many years, I can say that no two cases of life-threatening illnesses of any kind are the same. There are many other variables to consider when deciding on the merits or otherwise of treatments for prolonging life.

Age, comorbidities (other illnesses), gender, race, social situations, economic situations,geographical location, and last, but not least, the quality of life likely after treatment as opposed to before treatment. Often these treatments involve decreasing the pain or discomfort of the disease process, even if only for a few months.

I believe we will be travelling a very slippery moral and ethical slope if the Health Department ever decides to make blanket statements about any drug cost as opposed to prolonging a productive,
much wanted life for a little longer.

Suzeonline

On Q&A last one of the panellists, Dr. Charlie Teo, a neurosurgeon, made the following comment. (I am quoting from memory)

"We should tell the public that Medicare just can't do what they expect it to do."

See:
http://www.abc.net.au/tv/qanda/txt/s2622519.htm

I think Dr. Teo should be commended for pointing out a REALITY that anyone with half a brain understands. NO public system can provide the level of healthcare that a wealthy man can purchase for himself. That means that there will be cases where a wealthy man can access life-extending treatment that is not available to less well-off people.

To put it bluntly, there will ALWAYS be life-extending treatments that will be denied people who rely solely on Medicare. Sometimes wealthy people will be able to buy themselves an extra year or so of life. No reforms, no economy measures, no FEASIBLE level of healthcare funding CAN alter that fact.

I think it time the politicians came clean with the public. We need a debate. What can Medicare do and what can't it do? Where are the limits? And yes there are going to be cases where terminally ill patients are going to be denied life-extending treatment because it is just too expensive. That issue CANNOT be wished away.

An interesting discussion.

There are some general issues:

>>To put it bluntly, there will ALWAYS be life-extending treatments that will be denied people who rely solely on Medicare.<<

And some specific points:

>>I think it time the politicians came clean with the public. We need a debate. What can Medicare do and what can't it do? Where are the limits?<<

I would suggest, stevenlmeyer, that the very nature of the responses on this thread clearly show that there is no point debating the value of a human life.

The individual in question, the parents, the next-door neighbour, relatives, friends, acquaintances, people in other towns and countries who have never met the person, will all have a different view of how much that person is "worth".

But "defining the limits" is certainly valid.

The most appropriate approach would be for the government to pretend to be an insurance company, and state an upper limit to claims on the "virtual policy" that is funded by the taxpayer.

But you should not expect them to justify it in any way. It would be a cold, calculated amount, that takes into account supply (the allocation of taxpayers' funds, the proportion of which should be clear government policy) and demand, which is the cost of treatment available.

There's also no point in castigating "Big Pharma" on this. The fastest way to limit R&D in this area is to try to manage their pricing policies. As it is, the most lucrative area in the business is generics, where companies take advantage of lapsing patents to churn out lower-cost clones. Their contribution to new treatments and drugs? nil.

But the "value" of human life?

Purely personal.

It ranges from zero, as with the oldie Yabby tells us about, to infinity: what mother wouldn't sell everything she had for another day with her child?

Theoretically, insurance should be the answer. Unfortunately, the act of using "other people's money" encourages all sorts of appalling behaviour, both on the supply and demand sides. The US experience of this is salutary.

It wouldn't be a bad place to start, though.