Evanthia Pappas, a Bay Area prosecutor is diagnosed with an uncommon, aggressive type of breast cancer. Oncologists at the University of Texas’ M.D. Anderson Cancer Center have offered her hope through a clinical trial. However, this clinical trial is unfunded and costs $235,000. This means that no drug company, the federal government, or any other source will pay for the cost of the treatment. Pappas’ health care provider, Kaiser Permanente, refuses to cover the cost of the trial saying that the procedure does not benefit patients (relying on data of 15 randomized high-dose chemotherapy studies carried out between 1988 and 2002 that found it did not benefit long-term survival rates). However, doctors disagree with Kaiser Permanente and say that the procedure may be successful depending on the patient’s responses to chemotherapy. Since Kaiser Permanente will not cover the cost, M.D. Anderson considers Pappas uninsured. In most cases, clinical trials in which the patient puts himself/herself at risk are sponsored by the federal government or private industry. Dr. John Park, a medical oncologist at UCSF, states “It is extremely unusual for a hospital to require a patient to pay large sums of money to participate in a trial. Usually if patients have to bear some costs, they are relatively small.” He says that insurers usually pay for the routine costs of care related to the trial. Pappas and her doctors believe that this trial may be her best chance for survival and finding a cure. So far, she has already accumulated more than $100,000. San Francisco District Attorney Kamala Harris states, “This is also a statement about what we need to do about health care in this country. She already has to suffer the physical and emotional toll in terms of her illness, and has to suffer the anxiety about whether she can pay for the treatment she needs." Most industrialized countries, like Britain, France, and Canada provide universal healthcare to all citizens, whether they can afford the fees or not. Do you think the American health care industry is doing its job by denying patients that need help? Should Pappas have to pay for the whole bill herself when it is not 100% sure that the trial will cure her and since in most cases, it is rare for the patient to pay a large amount of money to participate in the trial? Or, should Pappas pay for the bill herself since she agreed to the trial?
6 comments:
Personally I'm for universal health care, since insurance is so expensive. Having universal health care and helping those in in need is a great idea and maybe even the moral thing to do, but I'm pretty sure that there has to be pros and cons.
Obviously everybody gets coverage; but that might result in higher taxes or spending cuts in other areas, and increased wait times to see the doctor. I think the US is also the only wealthy nation that doesn't have some form of universal health care.
I don't think the government has any responsibility in paying for the clinical trial in this case. The biggest knock on the universal health care programs of countries such as Canada is that the quality of the health care is much worse than it is here. I remember an injured basketball player for the Toronto Raptors had to come to the states to get an MRI since there were only three working MRI machines in the entire city of Toronto. This leads me to believe that even countries with universal healthcare would be reluctant to put up $235,000 of the taxpayer's money on a risky treatment with little past success.
I think that although universal health care is such a great idea and important asset, Jeff has a really good point. Our quality of health care would greatly diminish. However, in circumstances like these, I think that another thing we must consider is, if she is given money by the government to undergo this trial, the trial may be extremely successful and a huge turning point in treating breast cancer. So, putting the issue of health care aside, it may be in the governments best interest to fund this trial and see if it does have an effect on breast cancer treatment.
This trial can look either really good or really bad for the government. By funding this trial they make themselves the one to point the finger at if it is unsuccessful. But on the other side of that they might look really good if it is a successful trial.
I agree with Matt on the universal health care issue but I do see where Jeff is coming from. The health care system may get worse if it turns universal, however we may be going extreme in thinking of how bad it would be instead of seeing the positives.
I agree with Emma on this issue. This new procedure can be a big step towards finding the cure for breast cancer and since nobody will fund it, it is just sitting on the shelf untested. Therefore, I think the government should help Pappas fund her treatment, but not entirely. Since it is her choice to undergo the chemotherapy, Pappas should be willing to pay for some of the treatment and she is. A clinical trial is necessary for a drug to be FDA approved and without any help in funding, Pappas won't be able to take part in this clinical trial and therefore halt a new step towards the cure for breast cancer.
To Gen: although it may be Pappas' choice to go through with treatment, and although I'm not the expert on medical/cancer related stuff, isn't she making that choice because she wants to live? I mean when it comes down to it, these cases are not only about health care or about research, but about an individual's life. Yes, I know that I sound dreamy and naive, but shouldn't people give a crap about her life? Although caring about everyone's lives would involve lots and lots of money...
Addressing Matt, Jeff, and universal health care:
While I acknowledge the fact that universal health care could lower the quality of health care, I do believe that the Americans that are dying because they cannot pay for health care should be insured. Yes, I know it could lower the quality, but honestly all the Americans that need help but can't get it should die? I don't think so. I think that the right to health should be a standard in American society.
But how do we do that? Maybe it's some kind of program (some other countries have this) where there is basic universal health care and then on top of that some pay for extra "quality" or care etc. Could that work? Once again I understand the difficulty in making something happen, but I don't believe that things should stay the way that they are. We can't be content with this.
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