Spending $93,000 to extend life four months

[Guest guest]

,

I agree that I wouldn't pay $93,000 for four months more life because I too would rather the money go to my heirs, so I couldn't in conscience ask other taxpayers to pay for it. The question I have is will Provenge be found to prolong life longer if tried earlier? Those in the test apparently were out of other options and in tough shape.

Mike

Subject: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 12:52 PM

Medicare has just approved reimbursement of $93,000 for a course of treatment with Provenge which has been shown to extend the lives of HT resistant PCa patients by an average of four months.Now if I was one of those patients, I would want the drug if it were provided free by Medicare. But as an American who pays for that treatment with taxes and insurance premiums I don't think it is worth it. This treatment wouldn't meet the criterion of Great Britain's NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone know?), so why pay for it in America?And twisting my decision another way, if I had HT resistant PCa and given my current financial resources, I wouldn't pay for it out of my own pocket, which I could. I would want my wife and kids to get that money, not waste it on an extra four months of my life. Tough call but that is how I feel now (but with PCa a distant memory).We are going to

have to make some tough choices to reign in our country's health care cost and this is one of them. The medical industry can and will develop more expensive treatments than we as a society can afford to pay for.What do you guys think?------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

[Guest guest]

It's not approved, it has simply cleared one more hurdle.

As was posted by Nowack in response to a similar question:

To clarify, technically this decision does not " approve " Provenge for Medicare funding, this is only an advisory committee's decision.  The process that now will happen is a 30 day public comment period followed by a formal decision within another 60 days. 

As to your question about  anyone not being approved to date by Medicare, we have on this board some members who have reported not getting coverage in the Arizona CME region. 

Usually, private insurers follow Medicare decisions, so most of the privates have been paying.  A formal positive determination will cause all CMEs to cover it and most likely all the privates will also cover it.

 

Medicare has just approved reimbursement of $93,000 for a course of treatment with Provenge which has been shown to extend the lives of HT resistant PCa patients by an average of four months.Now if I was one of those patients, I would want the drug if it were provided free by Medicare. But as an American who pays for that treatment with taxes and insurance premiums I don't think it is worth it. This treatment wouldn't meet the criterion of Great Britain's NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone know?), so why pay for it in America?

And twisting my decision another way, if I had HT resistant PCa and given my current financial resources, I wouldn't pay for it out of my own pocket, which I could. I would want my wife and kids to get that money, not waste it on an extra four months of my life. Tough call but that is how I feel now (but with PCa a distant memory).

We are going to have to make some tough choices to reign in our country's health care cost and this is one of them. The medical industry can and will develop more expensive treatments than we as a society can afford to pay for.

What do you guys think?

-- Emersonwww.flhw.org

Every 2.25 minutes a man is diagnosed with prostate cancer.Every 16.5 minutes a man dies from the disease.

[Guest guest]

You know I suspect that the time is skewed to less months because of the sample for the study. I also suspect the more they use this approach the better they will able to target and the more life it will give. I also suspect given this in combination the other drugs may also extend life. Yes 93,000 is a lot and also the future of medical science. How much does taxotore cost with everything for the same length of time and the side effects. If they get better at this with practice and cobine these cells with a bit of nano....

I often get impatient with the cost analysis when we just threw 500,000,000 or more in three days. I do not disagree with the action but just how are we breaking the government when we are paying for three wars. Sorry will stop now.

Tom W.

Subject: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:52 AM

Medicare has just approved reimbursement of $93,000 for a course of treatment with Provenge which has been shown to extend the lives of HT resistant PCa patients by an average of four months.Now if I was one of those patients, I would want the drug if it were provided free by Medicare. But as an American who pays for that treatment with taxes and insurance premiums I don't think it is worth it. This treatment wouldn't meet the criterion of Great Britain's NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone know?), so why pay for it in America?And twisting my decision another way, if I had HT resistant PCa and given my current financial resources, I wouldn't pay for it out of my own pocket, which I could. I would want my wife and kids to get that money, not waste it on an extra four months of my life. Tough call but that is how I feel now (but with PCa a distant memory).We are going to have to make

some tough choices to reign in our country's health care cost and this is one of them. The medical industry can and will develop more expensive treatments than we as a society can afford to pay for.What do you guys think?

[Guest guest]

We need to clarify some issues in this conversation.  The first is the common, but significant error about the survival advantage that Provenge can provide.  The 4.2 month survival is the median, not the average as was mentioned.  The difference between the median and the average can be very significant. 

One calculates an average by adding together all the numbers, in this case the survival times of the men in the trial and dividing it by the number of subjects.  On the other hand a median is not calculated, it is the score directly in the middle of all scores.  So, if 101 men received Provenge and 50 of them died one week after the treatment was given to them, 1 man died at week 3 and the remainder 50 men died 10 years after the treatment the median is only 3 weeks.  Using these same figures the average would be 257.9 weeks of survival.  Does saying that the survival advantage is 3 weeks (that is the median) really reflect the reality of the situation?  I don't think so. 

If you take the same example, but instead the 50 men on the right side of the curve died 20 years after the treatment the median (the measure that we are using) remains 3 weeks!Then compound the fact that the clinical trial for Provenge allowed a crossover.  This means that men who received placebo were offered Provenge when they showed signs of disease progression.  Even though these men did get Provenge (and probably also had a life extension advantage from the treatment) they were considered to be a part of the placebo group for the purpose of calculating survival numbers.

Statistics are only a way to describe a group trend, they never describe the experience of the individual.  You can not use statistics to know what your individual fate or experience will be in the future.  Then there is the issue that is raised about the cost of Provenge.  Provenge is not more expensive for the median month of additional survival than is taxotere.  Taxotere, the drug, does cost less than Provenge.  However the side effects and toxicities of Provenge vs. taxotere end up at at least balancing the monthly life extension cost differential.  Taxotere comes with many additional costs including the supportive medications that are required to deal with the blood problems, nausea and the required steroids.  Added to that taxotere usually requires some emergency room visits and hospitalizations.     The usual additional costs of Provenge might be an aspirin or Tylenol.  

None of these costs factor in the cost of human suffering and mental distress.  All the chemotherapy drugs are toxic.  If you put poison into your body your body will suffer, Provenge causes nothing more than flue like symptoms for a few days. 

 

 

Medicare has just approved reimbursement of $93,000 for a course of treatment with Provenge which has been shown to extend the lives of HT resistant PCa patients by an average of four months.

Now if I was one of those patients, I would want the drug if it were provided free by Medicare. But as an American who pays for that treatment with taxes and insurance premiums I don't think it is worth it. This treatment wouldn't meet the criterion of Great Britain's NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone know?), so why pay for it in America?

And twisting my decision another way, if I had HT resistant PCa and given my current financial resources, I wouldn't pay for it out of my own pocket, which I could. I would want my wife and kids to get that money, not waste it on an extra four months of my life. Tough call but that is how I feel now (but with PCa a distant memory).

We are going to have to make some tough choices to reign in our country's health care cost and this is one of them. The medical industry can and will develop more expensive treatments than we as a society can afford to pay for.

What do you guys think?

-- T Nowak, MA, MSWDirector for Advocacy and  Advanced Prostate Cancer Programs, Malecare Inc. Men Fighting Cancer, TogetherSurvivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancers

www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.org - information and support about prostate cancer

http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer

[Guest guest]

<snip> What do you guys think? <snip>

I think you may not understand the outcome

of the Provenge study or the meaning of median as opposed to average.

Half the men who took Provenge lived

longer than the median – that’s what a median means; some of them

are still alive years after they started the therapy. They didn’t all die

spot on the ‘average’ four months after the non-Provenge people. That’s

not how these things go.

So the question really is – is it

worth $93,000 to possibly defeat HT resistant PCa? There are many men who are

prepared to pay very large sums of money to defeat prostate cancer tumors that

are never going to be a life threat – PBT (Proton Beam Therapy) for

example can cost up to $100,000 if you don’t have the right connections –

yet everyone demands that should be paid for even for indolent tumours in old

men.

Doesn’t make sense to me to object

to one therapy over another except to say that there is a tremendous amount of

gouging that goes with medical treatments.

All the best

Prostate men need enlightening, not

frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of

Sent: Friday, 1 April 2011 3:53 AM

To: ProstateCancerSupport

Subject:

Spending $93,000 to extend life four months

Medicare has just approved reimbursement of $93,000

for a course of treatment with Provenge which has been shown to extend the

lives of HT resistant PCa patients by an average of four months.

Now if I was one of those patients, I would want the drug if it were provided

free by Medicare. But as an American who pays for that treatment with taxes and

insurance premiums I don't think it is worth it. This treatment wouldn't meet

the criterion of Great Britain's

NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone

know?), so why pay for it in America?

And twisting my decision another way, if I had HT resistant PCa and given my

current financial resources, I wouldn't pay for it out of my own pocket, which

I could. I would want my wife and kids to get that money, not waste it on an

extra four months of my life. Tough call but that is how I feel now (but with

PCa a distant memory).

We are going to have to make some tough choices to reign in our country's

health care cost and this is one of them. The medical industry can and will

develop more expensive treatments than we as a society can afford to pay for.

What do you guys think?

[Guest guest]

<snip> What do you guys think? <snip>

I think you may not understand the outcome

of the Provenge study or the meaning of median as opposed to average.

Half the men who took Provenge lived

longer than the median – that’s what a median means; some of them

are still alive years after they started the therapy. They didn’t all die

spot on the ‘average’ four months after the non-Provenge people. That’s

not how these things go.

So the question really is – is it

worth $93,000 to possibly defeat HT resistant PCa? There are many men who are

prepared to pay very large sums of money to defeat prostate cancer tumors that

are never going to be a life threat – PBT (Proton Beam Therapy) for

example can cost up to $100,000 if you don’t have the right connections –

yet everyone demands that should be paid for even for indolent tumours in old

men.

Doesn’t make sense to me to object

to one therapy over another except to say that there is a tremendous amount of

gouging that goes with medical treatments.

All the best

Prostate men need enlightening, not

frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of

Sent: Friday, 1 April 2011 3:53 AM

To: ProstateCancerSupport

Subject:

Spending $93,000 to extend life four months

Medicare has just approved reimbursement of $93,000

for a course of treatment with Provenge which has been shown to extend the

lives of HT resistant PCa patients by an average of four months.

Now if I was one of those patients, I would want the drug if it were provided

free by Medicare. But as an American who pays for that treatment with taxes and

insurance premiums I don't think it is worth it. This treatment wouldn't meet

the criterion of Great Britain's

NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone

know?), so why pay for it in America?

And twisting my decision another way, if I had HT resistant PCa and given my

current financial resources, I wouldn't pay for it out of my own pocket, which

I could. I would want my wife and kids to get that money, not waste it on an

extra four months of my life. Tough call but that is how I feel now (but with

PCa a distant memory).

We are going to have to make some tough choices to reign in our country's

health care cost and this is one of them. The medical industry can and will

develop more expensive treatments than we as a society can afford to pay for.

What do you guys think?

[Guest guest]

wrote:

> Medicare has just approved reimbursement of $93,000 for a

> course of treatment with Provenge which has been shown to

> extend the lives of HT resistant PCa patients by an average of

> four months.

>

> Now if I was one of those patients, I would want the drug if it

> were provided free by Medicare. But as an American who pays for

> that treatment with taxes and insurance premiums I don't think

> it is worth it. This treatment wouldn't meet the criterion of

> Great Britain's NHS and I suspect that it doesn't qualify in

> other Eurpean countries (anyone know?), so why pay for it in

> America?

>

> And twisting my decision another way, if I had HT resistant PCa

> and given my current financial resources, I wouldn't pay for it

> out of my own pocket, which I could. I would want my wife and

> kids to get that money, not waste it on an extra four months of

> my life. Tough call but that is how I feel now (but with PCa a

> distant memory).

>

> We are going to have to make some tough choices to reign in our

> country's health care cost and this is one of them. The medical

> industry can and will develop more expensive treatments than we

> as a society can afford to pay for.

>

> What do you guys think?

>

>

,

I think the point you raise is important. The argument you make

is a general one, not specific to Provenge. Maybe it could be

argued that $93,000 for 4 months is okay, but what if it's

$500,000 for 3 months? What if it's a million dollars for one

day? At some point we would certainly say that the benefit

doesn't justify the cost.

If there is any point at which we are willing to say that the

benefit doesn't justify the cost (clearly there is such a point)

then we have acknowledged that we need to weigh benefit against

cost and we can't make blanket statements about any treatment

being justified.

Now having said that, I'll weigh in in favor of Provenge on

several grounds. The first is what said in his analysis of

the math. Median life extension may be lower than average life

extension. I also agree with other posters' arguments that the

median might be higher if the drug is used earlier or with

different combinations of other treatments, or possibly if more

research indicates which patients will benefit most.

A second point is that I personally believe that medical

treatment is a social benefit that I would like to see extended

to everyone, just like public education, public libraries, public

police and fire protection, and so on. Not everyone agrees with

that. Some vociferously oppose it. But if we do believe in it,

we have to think about whether some treatments should only be

available to rich patients.

I suspect that the majority of prostate cancer patients either

could not afford Provenge at all, or could only afford it at the

cost of significant deprivation to their families. Other

patients have so much money that $93,000 is peanuts to them.

Because of my first argument, I recognize that there must be a

point at which we say no and only offer certain treatments to

millionaires. But I would like that point to be skewed as far as

practicable towards benefiting the common man.

Finally, I'd like to address the issue of who pays and how much

they pay.

The cost of Provenge is not $93,000 because the treatment costs

that much. It's that high because Dendreon has patent protection

on the process and so can charge whatever the market will bear.

Actual cost might very well be less than half of $93,000.

There are great social benefits to patent protection for drugs.

Venture capital is invested in medical research and the

technology entrepreneurs try like hell to make the treatments

work. There are also great social costs. If the treatment does

work the entrepreneurs get rich on our payments and insurance

premiums. We all pay through the nose and our (United States)

medical treatment costs much more than treatment in other

countries. I don't know where the needle should point between

the extremes of long and short patent protection, though I

suspect we could do better than we're doing, especially in light

of the huge U.S. government payments for NIH sponsored research

that winds up in private hands.

As for who pays, in my personal view, I'd like to see more

general government tax funds invested in health care and I'd like

to see a much higher marginal tax rate in the U.S. in order to

help pay for Provenge and many other social benefits. But the

argument for that is getting off topic and, although I'd love to

continue, I'll refrain from going into that issue.

Alan

[Guest guest]

wrote:

> Medicare has just approved reimbursement of $93,000 for a

> course of treatment with Provenge which has been shown to

> extend the lives of HT resistant PCa patients by an average of

> four months.

>

> Now if I was one of those patients, I would want the drug if it

> were provided free by Medicare. But as an American who pays for

> that treatment with taxes and insurance premiums I don't think

> it is worth it. This treatment wouldn't meet the criterion of

> Great Britain's NHS and I suspect that it doesn't qualify in

> other Eurpean countries (anyone know?), so why pay for it in

> America?

>

> And twisting my decision another way, if I had HT resistant PCa

> and given my current financial resources, I wouldn't pay for it

> out of my own pocket, which I could. I would want my wife and

> kids to get that money, not waste it on an extra four months of

> my life. Tough call but that is how I feel now (but with PCa a

> distant memory).

>

> We are going to have to make some tough choices to reign in our

> country's health care cost and this is one of them. The medical

> industry can and will develop more expensive treatments than we

> as a society can afford to pay for.

>

> What do you guys think?

>

>

,

I think the point you raise is important. The argument you make

is a general one, not specific to Provenge. Maybe it could be

argued that $93,000 for 4 months is okay, but what if it's

$500,000 for 3 months? What if it's a million dollars for one

day? At some point we would certainly say that the benefit

doesn't justify the cost.

If there is any point at which we are willing to say that the

benefit doesn't justify the cost (clearly there is such a point)

then we have acknowledged that we need to weigh benefit against

cost and we can't make blanket statements about any treatment

being justified.

Now having said that, I'll weigh in in favor of Provenge on

several grounds. The first is what said in his analysis of

the math. Median life extension may be lower than average life

extension. I also agree with other posters' arguments that the

median might be higher if the drug is used earlier or with

different combinations of other treatments, or possibly if more

research indicates which patients will benefit most.

A second point is that I personally believe that medical

treatment is a social benefit that I would like to see extended

to everyone, just like public education, public libraries, public

police and fire protection, and so on. Not everyone agrees with

that. Some vociferously oppose it. But if we do believe in it,

we have to think about whether some treatments should only be

available to rich patients.

I suspect that the majority of prostate cancer patients either

could not afford Provenge at all, or could only afford it at the

cost of significant deprivation to their families. Other

patients have so much money that $93,000 is peanuts to them.

Because of my first argument, I recognize that there must be a

point at which we say no and only offer certain treatments to

millionaires. But I would like that point to be skewed as far as

practicable towards benefiting the common man.

Finally, I'd like to address the issue of who pays and how much

they pay.

The cost of Provenge is not $93,000 because the treatment costs

that much. It's that high because Dendreon has patent protection

on the process and so can charge whatever the market will bear.

Actual cost might very well be less than half of $93,000.

There are great social benefits to patent protection for drugs.

Venture capital is invested in medical research and the

technology entrepreneurs try like hell to make the treatments

work. There are also great social costs. If the treatment does

work the entrepreneurs get rich on our payments and insurance

premiums. We all pay through the nose and our (United States)

medical treatment costs much more than treatment in other

countries. I don't know where the needle should point between

the extremes of long and short patent protection, though I

suspect we could do better than we're doing, especially in light

of the huge U.S. government payments for NIH sponsored research

that winds up in private hands.

As for who pays, in my personal view, I'd like to see more

general government tax funds invested in health care and I'd like

to see a much higher marginal tax rate in the U.S. in order to

help pay for Provenge and many other social benefits. But the

argument for that is getting off topic and, although I'd love to

continue, I'll refrain from going into that issue.

Alan

[Guest guest]

Alan:

Thank you for your well reasoned reply. Your reply was on target. Many others

have missed the point, bellyaching about means vs medians, recommendations vs

approvals, or whether the Provenge study was designed properly. All of that was

irrelevant to the point I was trying to make.

What I was trying to say is " Should we ration healthcare, like other countries

do? " . Interestingly of those who weighed in on this question, all said that the

public (in the form of taxes or insurance premiums) should not pay $93,000 to

extend a life by four months. I suspect that a wide poll of Americans would come

to that same conclusion.

So whatever you want to call it: healthcare rationing, grandma's death panel,

etc; some of us (at least those that answered the question) believe in

rationing. It is the only way to stop the health care industry from bankrupting

our country.

I believe that we as a society need to come to grips with this reality and stop

the demagoguery and do something about it. I have as healthy a disrespect for

government commitees as the most staunch conservatist.

But who can act as the " death panel " , fairly and compassionately. We need it. We

are spending more for healthcare for less and the problem isn't going away.

[Guest guest]

Sorry . You set up a case that is too easy, and too misleading to argue for rationing. Where do you set the bar? Who sets the value of those four months (or year, or two years?), and on what basis. Does Britain's significantly higher rate of prostate cancer death have any connection to the fact that its national health system won't pay for certain tests or treatments? I don't know the answer, I'm just asking.

I don't want the government making those life and death decisions. If a private insurance company makes a decision not to pay for something, I can appeal to the courts and the government. If the government makes that decision, if there is any appeal it is only to another government panel, and that's not likely to help. When the FDA makes a decision not to approve a new drug, to whom do the drug companies appeal and how successful are they?

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society need to come to

grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change

the title if the content requires it

[Guest guest]

Sorry . You set up a case that is too easy, and too misleading to argue for rationing. Where do you set the bar? Who sets the value of those four months (or year, or two years?), and on what basis. Does Britain's significantly higher rate of prostate cancer death have any connection to the fact that its national health system won't pay for certain tests or treatments? I don't know the answer, I'm just asking.

I don't want the government making those life and death decisions. If a private insurance company makes a decision not to pay for something, I can appeal to the courts and the government. If the government makes that decision, if there is any appeal it is only to another government panel, and that's not likely to help. When the FDA makes a decision not to approve a new drug, to whom do the drug companies appeal and how successful are they?

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society need to come to

grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change

the title if the content requires it

[Guest guest]

What is the URL for the page where we can post our comments to CMS?

Sent from my iPad

[Guest guest]

What is the URL for the page where we can post our comments to CMS?

Sent from my iPad

[Guest guest]

It is my opinion that extension of life is only a small part of the equasion. How about quality of life? also the chance for a cure? That is what I would be concerned about the cost is very high and for me this would be prohibative for the welfare of my family.

In short, I would not want to be a significant burden to my loved ones to gain a few months of living and breathing with no chance for a cure.

Medicare has just approved reimbursement of $93,000 for a course of treatment with Provenge which has been shown to extend the lives of HT resistant PCa patients by an average of four months.Now if I was one of those patients, I would want the drug if it were provided free by Medicare. But as an American who pays for that treatment with taxes and insurance premiums I don't think it is worth it. This treatment wouldn't meet the criterion of Great Britain's NHS and I suspect that it doesn't qualify in other Eurpean countries (anyone know?), so why pay for it in America?And twisting my decision another way, if I had HT resistant PCa and given my current financial resources, I wouldn't pay for it out of my own pocket, which I could. I would want my wife and kids to get that money, not waste it on an extra four months of my life. Tough call but that is how I feel now (but with PCa a distant memory).We are going to have to make

some tough choices to reign in our country's health care cost and this is one of them. The medical industry can and will develop more expensive treatments than we as a society can afford to pay for.What do you guys think?

-- T Nowak, MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Men Fighting Cancer, TogetherSurvivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancerswww.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.org - information and support about prostate cancerhttp://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer

[Guest guest]

Hello Mike:

Well, that was exactly my question. Assuming that we want some form of

rationing, who makes those decisions: the insurance companies, a government

committee, the courts?

I actually rather admire the British system, one of the most draconian. The

British committee NICE regulates reimbursement for treatments and generally sets

a limit of $49,000 per year of life extension. Several common drugs used here in

the US are not approved as a result: Avastin for one. NICE seems to do its work

free of commercial and political interference and I suspect also free of court

challenges.

By comparison the Medicare committee's recomendation is 5 times as generous.

That is one reason why our health care bill is almost double GB's.

Maybe we should just look to NICE for our Medicare reimbursement rules.

[Guest guest]

Hello Mike:

Well, that was exactly my question. Assuming that we want some form of

rationing, who makes those decisions: the insurance companies, a government

committee, the courts?

I actually rather admire the British system, one of the most draconian. The

British committee NICE regulates reimbursement for treatments and generally sets

a limit of $49,000 per year of life extension. Several common drugs used here in

the US are not approved as a result: Avastin for one. NICE seems to do its work

free of commercial and political interference and I suspect also free of court

challenges.

By comparison the Medicare committee's recomendation is 5 times as generous.

That is one reason why our health care bill is almost double GB's.

Maybe we should just look to NICE for our Medicare reimbursement rules.

[Guest guest]

Sorry, but the insurance companies have managed to gut laws to protect consumers from the rapacious insurance industry, and you are forgetting how effective most Congressional casework units can be. With a Government plan, chances of getting a problem resolved is much greater.The fact is that the private insurance industry has been making life and decision with impunity for far too long! If Medicare Part D were allowed to negotiate for drug prices, as in everywhere else, the costs would come down dramatically!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 9:34:09 AMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry . You set up a case that is too easy, and too misleading to argue for rationing. Where do you set the bar? Who sets the value of those four months (or year, or two years?), and on what basis. Does Britain's significantly higher rate of prostate cancer death have any connection to the fact that its national health system won't pay for certain tests or treatments? I don't know the answer, I'm just asking.

I don't want the government making those life and death decisions. If a private insurance company makes a decision not to pay for something, I can appeal to the courts and the government. If the government makes that decision, if there is any appeal it is only to another government panel, and that's not likely to help. When the FDA makes a decision not to approve a new drug, to whom do the drug companies appeal and how successful are they?

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society need to come to

grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change

the title if the content requires it

[Guest guest]

Sorry, but the insurance companies have managed to gut laws to protect consumers from the rapacious insurance industry, and you are forgetting how effective most Congressional casework units can be. With a Government plan, chances of getting a problem resolved is much greater.The fact is that the private insurance industry has been making life and decision with impunity for far too long! If Medicare Part D were allowed to negotiate for drug prices, as in everywhere else, the costs would come down dramatically!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 9:34:09 AMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry . You set up a case that is too easy, and too misleading to argue for rationing. Where do you set the bar? Who sets the value of those four months (or year, or two years?), and on what basis. Does Britain's significantly higher rate of prostate cancer death have any connection to the fact that its national health system won't pay for certain tests or treatments? I don't know the answer, I'm just asking.

I don't want the government making those life and death decisions. If a private insurance company makes a decision not to pay for something, I can appeal to the courts and the government. If the government makes that decision, if there is any appeal it is only to another government panel, and that's not likely to help. When the FDA makes a decision not to approve a new drug, to whom do the drug companies appeal and how successful are they?

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society need to come to

grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change

the title if the content requires it

[Guest guest]

Sorry, but the insurance companies have managed to gut laws to protect consumers from the rapacious insurance industry, and you are forgetting how effective most Congressional casework units can be. With a Government plan, chances of getting a problem resolved is much greater.The fact is that the private insurance industry has been making life and decision with impunity for far too long! If Medicare Part D were allowed to negotiate for drug prices, as in everywhere else, the costs would come down dramatically!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 9:34:09 AMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry . You set up a case that is too easy, and too misleading to argue for rationing. Where do you set the bar? Who sets the value of those four months (or year, or two years?), and on what basis. Does Britain's significantly higher rate of prostate cancer death have any connection to the fact that its national health system won't pay for certain tests or treatments? I don't know the answer, I'm just asking.

I don't want the government making those life and death decisions. If a private insurance company makes a decision not to pay for something, I can appeal to the courts and the government. If the government makes that decision, if there is any appeal it is only to another government panel, and that's not likely to help. When the FDA makes a decision not to approve a new drug, to whom do the drug companies appeal and how successful are they?

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society need to come to

grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change

the title if the content requires it

[Guest guest]

Dave,

I'm not sure it's free of political interference. It's the politicians who set the budget for National Health spending that basically decides the limits within which NICE (an Orwellian name for a group that controls life and death decisions) must operate. I suspect that's what determined the $49,000 limit the for value put on a year of life extension.

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Friday, April 1, 2011, 10:38 AM

Hello Mike:Well, that was exactly my question. Assuming that we want some form of rationing, who makes those decisions: the insurance companies, a government committee, the courts?I actually rather admire the British system, one of the most draconian. The British committee NICE regulates reimbursement for treatments and generally sets a limit of $49,000 per year of life extension. Several common drugs used here in the US are not approved as a result: Avastin for one. NICE seems to do its work free of commercial and political interference and I suspect also free of court challenges.By comparison the Medicare committee's recomendation is 5 times as generous. That is one reason why our health care bill is almost double GB's.Maybe we should just look to NICE for our Medicare reimbursement rules.------------------------------------There are just two rules for this group

1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

[Guest guest]

Sorry, Louis, I just don't agree. Show me a government program that works well. Social Security? Meducare? Medicaid? They're all hugely in debt. The Energy Department which was set up to end our dependence on foreign oil in the Adminstration? I'm much more afraid on the government that I am of any private company.

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society

need to come to grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking

replyTry to change the title if the content requires it

[Guest guest]

Except for the fraud committed agains Medicare because the Republicans refused to allow resources needed to deter fraud, Medicare's payout ratio is some 95%, compared to less than 70% for the private insurance industry. Social Security is fully solvent for some time and there is time now to plan for the minor adjustments needed later on. The reason that Medicare total costs are rising is the FAILURE to provide universal health care for the early retirees. Most of the chronic conditions that are responsible for the huge costs to Medicare later on start to give rise in the early 50's, when simple medications and mangement by public health clinics which are far less costly to prevent the huge costs later on such as amputations, kidney dialysis, and stroke rehabilitation. It like do we fix the minor leaks

in the roof now or have to replace the building later. Remember the visitors center fiasco at the Union Station in Washington, DC, in which fancy and costly artwork was being done while the roof was leaking? Early intervention and preventive care can clearly prevent unnecessary deaths and illness later on. Maybe, if Cantor comes down with hepatitis B from some "Typhoid " in the back kitchen of his favorite eating and drinking establishment, he will not be so eager to shut down county public health clinics!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 12:00:44 PMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry, Louis, I just don't agree. Show me a government program that works well. Social Security? Meducare? Medicaid? They're all hugely in debt. The Energy Department which was set up to end our dependence on foreign oil in the Adminstration? I'm much more afraid on the government that I am of any private company.

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society

need to come to grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking

replyTry to change the title if the content requires it

[Guest guest]

Except for the fraud committed agains Medicare because the Republicans refused to allow resources needed to deter fraud, Medicare's payout ratio is some 95%, compared to less than 70% for the private insurance industry. Social Security is fully solvent for some time and there is time now to plan for the minor adjustments needed later on. The reason that Medicare total costs are rising is the FAILURE to provide universal health care for the early retirees. Most of the chronic conditions that are responsible for the huge costs to Medicare later on start to give rise in the early 50's, when simple medications and mangement by public health clinics which are far less costly to prevent the huge costs later on such as amputations, kidney dialysis, and stroke rehabilitation. It like do we fix the minor leaks

in the roof now or have to replace the building later. Remember the visitors center fiasco at the Union Station in Washington, DC, in which fancy and costly artwork was being done while the roof was leaking? Early intervention and preventive care can clearly prevent unnecessary deaths and illness later on. Maybe, if Cantor comes down with hepatitis B from some "Typhoid " in the back kitchen of his favorite eating and drinking establishment, he will not be so eager to shut down county public health clinics!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 12:00:44 PMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry, Louis, I just don't agree. Show me a government program that works well. Social Security? Meducare? Medicaid? They're all hugely in debt. The Energy Department which was set up to end our dependence on foreign oil in the Adminstration? I'm much more afraid on the government that I am of any private company.

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society

need to come to grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking

replyTry to change the title if the content requires it

[Guest guest]

Except for the fraud committed agains Medicare because the Republicans refused to allow resources needed to deter fraud, Medicare's payout ratio is some 95%, compared to less than 70% for the private insurance industry. Social Security is fully solvent for some time and there is time now to plan for the minor adjustments needed later on. The reason that Medicare total costs are rising is the FAILURE to provide universal health care for the early retirees. Most of the chronic conditions that are responsible for the huge costs to Medicare later on start to give rise in the early 50's, when simple medications and mangement by public health clinics which are far less costly to prevent the huge costs later on such as amputations, kidney dialysis, and stroke rehabilitation. It like do we fix the minor leaks

in the roof now or have to replace the building later. Remember the visitors center fiasco at the Union Station in Washington, DC, in which fancy and costly artwork was being done while the roof was leaking? Early intervention and preventive care can clearly prevent unnecessary deaths and illness later on. Maybe, if Cantor comes down with hepatitis B from some "Typhoid " in the back kitchen of his favorite eating and drinking establishment, he will not be so eager to shut down county public health clinics!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 12:00:44 PMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry, Louis, I just don't agree. Show me a government program that works well. Social Security? Meducare? Medicaid? They're all hugely in debt. The Energy Department which was set up to end our dependence on foreign oil in the Adminstration? I'm much more afraid on the government that I am of any private company.

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society

need to come to grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking

replyTry to change the title if the content requires it

[Guest guest]

Louis, we disagree about a lot, and we could go on forever without reaching agreement. This is not the appropriate forum for this debate.

MikeFri, 4/1/11, Louis Carliner wrote:

Subject: Re: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Friday, April 1, 2011, 1:50 PM

Except for the fraud committed agains Medicare because the Republicans refused to allow resources needed to deter fraud, Medicare's payout ratio is some 95%, compared to less than 70% for the private insurance industry. Social Security is fully solvent for some time and there is time now to plan for the minor adjustments needed later on. The reason that Medicare total costs are rising is the FAILURE to provide universal health care for the early retirees. Most of the chronic conditions that are responsible for the huge costs to Medicare later on start to give rise in the early 50's, when simple medications and mangement by public health clinics which are far less costly to prevent the huge costs later on such as amputations, kidney dialysis, and stroke rehabilitation. It like do we fix the minor leaks in the roof now or have to replace the building later. Remember the visitors center fiasco at the Union Station in Washington, DC, in which fancy and

costly artwork was being done while the roof was leaking? Early intervention and preventive care can clearly prevent unnecessary deaths and illness later on. Maybe, if Cantor comes down with hepatitis B from some "Typhoid " in the back kitchen of his favorite eating and drinking establishment, he will not be so eager to shut down county public health clinics!

Louis. . .

To: ProstateCancerSupport Sent: Fri, April 1, 2011 12:00:44 PMSubject: Re: Re: Spending $93,000 to extend life four months

Sorry, Louis, I just don't agree. Show me a government program that works well. Social Security? Meducare? Medicaid? They're all hugely in debt. The Energy Department which was set up to end our dependence on foreign oil in the Adminstration? I'm much more afraid on the government that I am of any private company.

Mike

Subject: Re: Spending $93,000 to extend life four monthsTo: ProstateCancerSupport Date: Thursday, March 31, 2011, 11:27 PM

Alan:Thank you for your well reasoned reply. Your reply was on target. Many others have missed the point, bellyaching about means vs medians, recommendations vs approvals, or whether the Provenge study was designed properly. All of that was irrelevant to the point I was trying to make.What I was trying to say is "Should we ration healthcare, like other countries do?". Interestingly of those who weighed in on this question, all said that the public (in the form of taxes or insurance premiums) should not pay $93,000 to extend a life by four months. I suspect that a wide poll of Americans would come to that same conclusion.So whatever you want to call it: healthcare rationing, grandma's death panel, etc; some of us (at least those that answered the question) believe in rationing. It is the only way to stop the health care industry from bankrupting our country.I believe that we as a society

need to come to grips with this reality and stop the demagoguery and do something about it. I have as healthy a disrespect for government commitees as the most staunch conservatist.But who can act as the "death panel", fairly and compassionately. We need it. We are spending more for healthcare for less and the problem isn't going away.------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking

replyTry to change the title if the content requires it