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Limited resources, unlimited needs: Americans should ration health care, says MSU ethicist
Date:3/10/2009

ccessfully knock back the disease for years, though many patients cannot afford them. At the same time, Fleck said, there are advanced cancer therapies costing as much as $100,000 that only prolong life for a few extra weeks. Would Americans be willing to give up access to the more advanced treatments to ensure all cancer patients have access to the lower-cost treatments? "Patients could still pursue the higher-cost options, just at their own cost," Fleck added.

Cardiac arrhythmia: More than $8 billion is spent each year on supplying 200,000 Americans at a cost of $40,000 each with an implanted cardiac defibrillator that regulates electricity in the heart. More than 80 percent of the patients never need the device during a five-year period, and about 10 percent die within a year from other causes. There is a $60 test that if given to all 200,000 Americans could predict within 98.5 percent exactly which patients really need the device. If only those at greatest risk received the device, about $3 billion would be saved. However, the 1.5 percent of patients who were not correctly predicted represent about 800 deaths.

Decisions on how to best ration health care require Americans to recognize they all are part of the same health care system, in which the savings achieved by imposing rationing on our future selves will be captured and used for what we judge are higher priority, more cost worthy and more beneficial services, Fleck said.

As health care costs exponentially rise 5.2 percent of the U.S. gross domestic product was spent on health care in 1960, compared with 16.5 percent presently Fleck adds this is an issue that needs immediate attention.

"What we have to identify are marginally beneficial, non-cost-worthy health care options that we would be willing to deny to our future selves to guarantee we have sufficient resources to provide health care to everyone," he said. "If we are unable to control health care costs, we have no cha
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Contact: Jason Cody
codyja@msu.edu
517-432-0924
Michigan State University
Source:Eurekalert

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