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               donstacy.com

The Ethics of Rationing Cancer Care

2/17/2013

 
A December 15, 2012 article in The ASCO Post magazine by Jo Cavallo titled "The Ethics of Rationing Cancer Care" is one article (sadly there are many) illustrating the astounding ignorance of a health-care journalist regarding health-care economics and ethics.

Example #1: After the introduction the author lists two examples of expensive anti-cancer drug combinations that provide relatively small progression-free or overall survival benefits for relevant patients.  Does the author then explain that the primary reason the drugs cost so much is the patent/intellectual monopoly system?  Of course not; the unjust patent/intellectual monopoly racket is never mentioned.

Example #2: The author then notes the U.S. 2010 health-care expenditures data and refers to the trend of "reduced reimbursement ... by insurance companies, shifting more of those costs to consumers."  Does the author then explain that government health-care spending can only be accomplished via taxation or inflation, which also must be paid by consumers?  Of course not; the fact that health-care spending by insurance companies (above the costs of insurance paid by consumers) is the ONLY health-care spending not borne by consumers is never discussed.

Example #3: The author then interviews David Howard, PhD, Associate Professor in the Department of Health Policy and Management at Emory University, who rhetorically asks "how much can we afford?" while discussing the concept of cost vs. benefit for anti-cancer agents.  Does the author then clarify the word "we" by explaining the difference between private and public spending on cancer care?  Of course not; voluntary spending (private) and coerced spending (public) are not differentiated.

Example #4: The author then starts a discussion of health-care rationing by asserting that many "industrialized countries already consider a treatment's cost when deciding whether to pay for it."  Does the author explain that she (?) is referring to government healthcare spending, not private healthcare spending?  Of course not; voluntary spending (private) and coerced spending (public) are again not differentiated.

Example #5: Later the author claims that "shared decision-making does not solve the ethical dilemma of how to equitably allocate limited health-care resources so everyone benefits, not just those with the ability to pay for costly therapy."  Does the author notify readers that libertarians question the idea that this is an ethical dilemma?  Of course not; the idea that a free market always apportions scarce resources justly is not discussed.

Example #6: In a section called "Making Tradeoffs" the author again asks "how should health-care resources be equitably distributed?"  Does the author, as before, suggest a free market as the answer?  Of course not; the idea that a free market always apportions scarce resources justly is again not discussed.

Example #7:  In the final section of the article, titled "Reining in Costs", the author lists a variety of cost-cutting measures associated with the Patient Protection and Affordable Care Act which, if successful, "may avert the need for severe mandatory restrictions on health care in the future."  Does the author question the ethics of mandatory government restrictions on public and private health-care spending?  Of course not; the author is not troubled by the concept of a criminal organization limiting access to health-care.

The article is littered with other examples of journalistic ignorance.  I pity Jo Cavallo.  So should you. 

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    LIBERTARIAN BIOETHICS BLOG

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    Don Stacy is a 47 yo libertarian writer and physician.  His articles have been published by multiple libertarian-themed websites.  He practices medicine as a radiation oncologist in Hazard, KY.     

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