Tuesday, July 14, 2009

Well They Finally Did It: Your Life Costs Too Much!

The National Cancer Institute just posted a note that Physicians treating cancer patients should (must?) tell the patient how much it will cost and then focus them on the less expensive path! Imagine just being told you have breast or ovarian cancer, or that your child has leukemia, and then being told about how much it will cost and then why you should select the cheapest treatment! This is the new health care world.

The NCI note states:

"The skyrocketing cost of medical care has been front and center in the current deliberations over how to reform the country’s health care system. A new guidance statement released last week by the American Society of Clinical Oncology (ASCO) tackles one component of the issue head on, urging oncologists to discuss the potential financial costs of care with their patients. These clinician/patient discussions about cost, the guidance statement declares, are “a key component of high-quality care.”"

It continues in classic bureaucratic fashion:

"The new guidance statement, published in the Journal of Clinical Oncology, is intended to help not just oncologists, Dr. Schnipper explained, but also other stakeholders—including patients, insurers, and industry members—better understand how cost can affect care choices and decisions."

I love the word "stakeholder". It is corporate jargon meaning something I have never figured out. It is akin to the statement "walk the talk". Try that on anyone who speaks English as a second language, they try to parse it and get no where.

The note continues:

"Oncologists should acknowledge in discussions with patients that treatments may be very expensive and “should seek to identify any specific cost-related barriers to optimal treatment,” the guidance document recommends. To aid in these discussions, oncologists should be “armed with information that will help them assess and communicate the value of specific cancer treatments,” including trying to quantify “how much benefit might be expected from a particular therapeutic option.”"

The question is what happened to quality care. Does this mean that if you are seventy that you should not be treated for prostate or colon cancer since you are due to die soon anyhow. Is this the approach that Senator Kennedy used in his decision process, doubtful. But it may very well be the decision process for a ten year old dying with ALL. Are we interested in quality care or low cost care. Apparently we rather do it on the cheap for those who cannot pay.

I fear that this is the first shot across the bow of the destruction of one of the best health care systems in the world.

The final quote is chilling:

"“We’re not saying that physicians should be experts on insurance or even have all the direct conversations [with patients],” stressed Ms. Blum, a patient representative on the ASCO task force. “But it has to be some place in the care protocol. Ideally, the physician would talk about the relative costs and benefits of treatment, but the doctor doesn’t have to be the one to help the patient sort out what a situation will allow them to choose.”"