Monday, December 5, 2016
1012 C Street  •  Floresville, TX 78114  •  Phone: 830-216-4519  •  Fax: 830-393-3219  • 

WCN Site Search


Preview the Paper Preview the Paper

Preview this week's Paper
A limited number of pages are displayed in this preview.
Preview this Week’s Issue ›
Subscribe Today ›

Lost & Found

Found: Red Chihuahua, male, friendly but frightened, need to find his owner, in Floresville. 830-534-6413.
*Includes FREE photo online! mywcn.com/lostandfound
Lost: Male Great Pyrenees, all white, double dew claws on back legs, sweet, shy, not aggressive, Nov. 10, C.R. 404/405, neighbors heard 2 shots, any information appreciated. 830-393-0801.
More Lost & Found ads ›

Help Wanted

>Dean & Peeler Meatworks Custom Butchery in Poth TX will be opening in early 2017 and is searching for a head butcher and qualified meat cutters. This will be a cattle only federally inspected facility focusing on full high quality fabrication for customers and private labels. Those individuals interested please contact us at (806) 789-6359 or dustin_dean@hotmail.com.
Your #1 Advertising Resource! Call 830-216-4519.
More Help Wanted ads ›

Featured Videos





Video Vault ›

Commentaries


A Framework for Patient Harm




E-Mail this Story to a Friend
Print this Story

Disclaimer:
The author of this entry is responsible for this content, which is not edited by the Wilson County News or wilsoncountynews.com.
September 6, 2015 | 2,471 views | Post a comment

By Robert Goldberg

A group of doctors has decided to rewrite the Hippocratic Oath.

The ancient pledge charges physicians with applying "all measures that are required" to help the sick. The American Society of Clinical Oncology wants to add a caveat -- "unless those measures are too expensive. Then let the patient die."

The oncologists' group has developed a "conceptual framework" that relies on cost-benefit analysis to determine the most "valuable" treatments for different patients.

Sounds innocent enough. But healthcare outcomes cannot be reduced to cost-benefit calculations. By focusing on the cost of a treatment -- rather than its potential benefit -- the oncologists are allowing dollar signs to dictate whether a patient lives or dies.

Under ASCO's framework, new treatments will be judged "based on clinical benefit, side effects and cost." Those are the exact same measures health insurers use in limiting patient access to treatments. Indeed, ASCO wants insurers to use its calculator to "evaluate the relative value of new treatments" as they develop benefit structures and adjust premiums.

Such "controls" could include shifting drugs to the highest cost-sharing tier of an insurance plan or requiring patients to try older, cheaper drugs before receiving the most cutting-edge therapies.

Never mind that the Obama Administration has warned "placing most or all drugs that treat a specific condition on the highest cost tiers discourages enrollment by individuals based on age or based on health conditions" is discriminatory.

The oncologists are effectively asking insurers to discriminate against cancer patients -- in direct contradiction of the Affordable Care Act's intent.

Further, ASCO has concluded that a treatment that can keep patients alive for weeks or months has no value.

The framework assigns zero value to any treatment that doesn't increase survival by 20 percent. Right away, the formula would deem numerous modern treatments for cancer worthless.

That 20 percent figure is arbitrary. Take a lung cancer patient who is alive today because of the accumulation of treatments that never made that arbitrary threshold. Cardiologists hailed a just approved drug that reduces the risk of death from heart failure by 20 percent as revolutionary.

Under ASCO's framework, sorry -- not good enough.

Between 1987 and 2000, various AIDS therapies increased patient life expectancy by less than 20 percent a year. Had ASCO's framework been instituted then, thousands of AIDS patients who benefited from those treatments wouldn't be alive today.

ASCO defends its guidelines by claiming that expensive new treatments have sown "unrealistic patient and family expectations that lead clinicians to offer or recommend some of these services, despite the lack of supporting evidence of utility or benefit." America's healthcare system can't afford limitless spending on cancer treatments, the group says.

True, spending on cancer drugs has risen. In 2014, it topped $100 billion. But that's just 1 percent of U.S. healthcare spending.

Moreover, these medicines are worth their price tags.

Successful drug therapies reduce overall costs by diminishing the need for future medical attention. According to a study from the Center for Value and Risk in Health, specialty drugs "tend to confer greater benefits and hence may still offer reasonable value for money."

Successful treatment also benefits the nation. Cancer survivors have contributed $4.7 trillion to the economy since 1990, simply by living and working longer.

By valuing treatments based on costs rather than the benefit they provide to patients, the ASCO framework violates both the letter and spirit of the Hippocratic Oath. It should be scrapped before it puts patients in danger.

Robert Goldberg is vice president of the Center for Medicine in the Public Interest.
 
‹ Previous Blog Entry
 

Your Opinions and Comments


Be the first to comment on this story!


You must be logged in to post a comment.




Not a subscriber?
Subscriber, but no password?
Forgot password?

Commentaries Archives


Commentaries
Commentaries page govtrack.us
Commentaries who represents me?
Heavenly Touch homeTriple R DC ExpertsAllstate & McBride RealtyVoncille Bielefeld homeFriesenhahn Custom Welding

  Copyright © 2007-2016 Wilson County News. All rights reserved. Web development by Drewa Designs.