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On the Third Hand: Drugs

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While I was reading about this past week’s American Health Insurance Plans (AHIP) annual meeting in Seattle, I found myself thinking grumpy thoughts about people with cancer.

The Center for Medicine in the Public Interest — a group that has a history of sticking up for the pharmaceutical industry in public discourse — has started My Life Is Worth It, a grassroots organization that promotes the idea that people with cancer should have access to new therapies, even if those therapies are expensive. One of my great-grandfathers died of bladder cancer. My grandmother died of breast cancer. I know that, like anyone else out there, I could have cancer. 

One of the people who’s been tweeting for them is Bob Tufts, a former Kansas City Royal who has beat multiple myeloma. I’m from Kansas City and love the Kansas City Royals.

But Tufts was tweeting things like: “If cancer care is battle, why does AHIP unilaterally disarm by denying weapons to doctors & patients waging the fight?” and “Who do I want in charge of my cancer care? A doctor who knows me as individual or ins. co that pushes 1 size fits all?”… I started to get grouchy.

Yesterday, I just thought: “Interesting. People with cancer have organized a social media campaign.” Today, I thought: “Hmm… the pharmaceutical companies have created a fake patient advocacy group.” I rooted around on the Internet and found evidence that My Life Is Worth It has connections with the Center for Medicine in the Public Interest, which has connections with the pharmaceutical and biotech industries.

Aha! I tweeted about my find. Then I rooted around some more and found that My Life Is Worth It actually says on its website that Robert Goldberg, a co-founder of the Center for Medicine in the Public Interest, is a co-founder of My Life Is Worth It.

Goldberg called and acknowledged in an interview that his center gets money from pharmaceutical companies. “I wish we had more,” he said.

Goldberg argued that one problem, from his point of view, is that health insurers may be teaming up to design benefits in ways that keep patients with cancer from getting the drugs they want. Another problem is that insurers are looking at the wrong kinds of cost-benefit numbers.

New drugs may be expensive, but researchers have shown that if the country were still using the anti-cancer treatments available in 1993, the country would be spending about $50 billion more per year on fighting cancer, according to Goldberg. Further improvements would help patients live longer, happier lives, Goldberg said.

Of course, on the one hand: What kind of ogre could possibly disagree with what Goldberg was saying, or with the idea that we need a strong medical research community?

But, on the other hand: U.S. health care costs about two or three times what it does in Europe. One reason is that we’re letting Europe stick us with the world’s bill for medical research, including pharmaceutical research. That’s not fair.

On the third hand: Maybe insurers and public health officials should look harder at the big picture. If a drug is expensive, but it dramatically improves people’s ability to work, or it simply makes them much happier and more comfortable, maybe someone, somewhere, needs to figure out how to help patients pay for that expensive drug.

But, on the fourth hand: I think one way patient groups — and, especially, any business groups out there that are participating in the conversation — should help is by trying to be honest about costs and limits on resources.

At some level, every life is infinitely precious. On this level, in this world, money and time are not infinite.

How many of the people who say life is precious have actually maxed out their credit cards to save strangers’ lives?

If the health insurers’ math is wrong, or insurers are failing to account adequately for benefits that flow to parties than the insurers, OK, correct the math. Make sure the system as a whole recognizes the value of all of the benefits.

But efforts to pretend that health care resources are infinite, or that the insurers are the bad guys for acknowledging the limits, are counterproductive.

We need medical research — but real research paid for with money that actually exists. Pretending that resources are unlimited will lead to a path that ends in a clinic with a beautiful poster promising the Moon on the outside, and a few bandages and an expired bottle of aspirin on the inside.