Economic Scene - Plan to Cut Medicare Without Stifling Innovation - NYTimes.com

[Guest guest]

The treatment of prostate cancer offers a good example of the trouble with

the current system. I devoted a column to prostate cancer last year, and the

Health Affairs article - by Pearson of Massachusetts General Hospital

and B. Bach of Memorial Sloan-Kettering Cancer Center - uses it as a

case study, too.

The brief version is that the options for treating prostate cancer include

three forms of radiation. One of them, three-dimensional radiation, costs

Medicare about $10,000. Another treatment, a targeted form of radiation

known as I.M.R.T., came along a decade ago and initially cost about $42,000.

Lately, Medicare has also started covering a third, proton radiation

therapy, for which it pays $50,000.

No solid research has shown I.M.R.T. to be more effective at keeping people

alive, with minimum side effects, than three-dimensional radiation. The

backing for proton therapy is weaker yet. As Dr. Pearson says, " There is

even less evidence on whether proton therapy is as good as other

alternatives than there was for I.M.R.T. when it was the new kid on the

block. "

But Medicare today doesn't pay for good outcomes. It pays for any treatment

that it deems reasonable and effective.

http://www.nytimes.com/2010/10/20/business/economy/20leonhardt.html?_r=1 & ref

=health