Tuesday, December 16, 2014


How do you discuss a subject that is taboo but essential?  For example, the cost effectiveness of health care.  In the US, the idea that someone's life might not be worth the cost of restoring to health is anathema.  Americans consider it outrageous that they might not get care they need even though it runs into millions.  This burdens the health community, insurance companies and the rest of the public, but patients and their families do not think of that.  They are focused on getting better no matter the cost.  Ultimately, economic necessity dictates that effectiveness analysis be done, and it is a matter of the courage of physicians, hospital administrators, insurance companies and others to determine who should be treated and who made comfortable until death.  It is a difficult but mature relationship to the public, and it depends on the public's understanding as well. Avoiding the discussion helps no one iand drives up the cost of health care to a point where there is less treatment for all.  


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