Gorilla's Blog

As the New York Times points out, the late Senator Ted Kennedy’s medical treatments in the last year of his life cost anywhere from $100-500,000.

The brain cancer for which he was treated has no known cure, and in the past 40 years life expectancy has gone from 4-6 months to 15-18 months.

Of course Senator Kennedy had insurance and sufficient private resources to pursue any kind of treatment anywhere in the world.

But the issue illustrated here is the vast amount of resources (estimated at 70% of all medical spending) that are spent on the last year of life, with no great change in the outcome. These costs are born by everyone in the form of higher insurance premiums, and in the case of the poor no insurance at all (both the rich and poor help to make our costs the highest by far in the world).

It’s exactly this sort of discussion that is missing from the health care debate. That’s what rationing is all about. We have to decide what treatments are worth covering and at what cost, because we as a society cannot afford unlimited care for every disease.

Currently, the insurance companies and the size of one’s wallet do the rationing, in future it is hoped that a more competitive system will bring the administrative costs of private insurance down and provide a basic standard of care for all. Those with the resources will of course be able to pursue more expensive treatments.

I think Ted Kennedy was prepared to make these hard choices in order to achieve the cause of his lifetime. But many of us don’t seem ready to have a serious debate leading to pragmatic decisions on providing coverage and accepting the inevitability of death. Until we do, health care reform is little more than a slogan.

Gorilla says: “We won’t be able to plug in lower costs until we unplug our fear and electrify our rationality!”