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Post by sadie1263 on Dec 27, 2010 20:15:41 GMT
Saving costs over lives by Llew-Ann Phang PETALING JAYA (Dec 19, 2010): Doctors have a responsibility to practice good judgment and prudence in deciding whether to prolong the life of a terminally ill patient or to leave their families bankrupt. The Malaysian Medical Association (MMA) says this is the moral dilemma most medical practitioners are faced with. Its president Dr David Quek was responding to theSun’s article on Dec 13 on budgetary constraints on life-saving treatment or medicines that can help prolong lives of patients. “It’s not a matter of saving costs over lives, but about being prudent and making a decision in the interest of the public good. “Patients already have to fork out a lot of money to pay for their treatment. If the government has to pay RM20,000 to RM30,000 more for an injection that may extend his or her life by two to three weeks wouldn’t the money be better spent on better causes?” he said. Citing a recent example, Quek said he had personally been involved in the case of a patient who had lung cancer which had metastasised to the brain. The patient suffered a stroke and became comatose. He said the patient, who was a father of two young children, was in the ICU for one and a half months in critical condition. “I was there because they asked me to look after his cardiomyopathy (deterioration of the heart muscle). One of the doctors recommended treating the tumour with Avastin, which is very expensive. “The family had already spent so much on treatment and used up insurance claims of between RM50,000 and RM60,000 besides the cost of treatment. “A few days later he succumbed to his condition and when the family went home they found they didn’t have enough money and couldn’t pay the bills. “These are the things we have to consider – what happens to the family? We don’t want to create bankrupt families,” Quek said, adding that someone has to pay because there is no such thing as free medicines. “We have finite resources and a finite budget so every healthcare practitioner has to practise good judgment and prudence. “They may say I’m rationalising this unfairly but we have to be realistic and it is also for this reason that the MMA has been pushing for the establishment of a catastrophic fund which has to be reinsured and again, patients to benefit from it must be wisely chosen,” he said. -- theSun www.thesundaily.com/article.cfm?id=55324
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Post by Deleted on Jan 2, 2011 15:52:33 GMT
It is a sobering reminder of how lucky we are to have a free health service.
I wonder if it was his money being spent? I mean, if other family members simply refused to use their own money to pay the bills, what would happen? Would treatment be refused?
Obviously I'm not expecting anyone to know the answer, but what would happen in the US? Would the State pick up the tab, let the guy die, or force close relations to pay?
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Post by sadie1263 on Jan 2, 2011 16:29:53 GMT
This is a story I found of someone that didn't have a life threatening illness:
Three years ago, Jenna Smith, 48, of Paris, Maine, was an avid outdoorswoman, award-winning equestrian, entrepreneur and on-the-go mother of six. Today the pain, exhaustion, sensory sensitivity and memory problems brought on by an extreme case of Lyme disease have devastated Jenna and her husband. They now live with her mother after losing their farm to foreclosure and burning through more than $100,000 in assets in the search for a cure for Jenna’s illness. Much of the Smith’s money went to fill the gap in Medicare’s prescription drug coverage called the “doughnut hole.” Under Medicare Part D, only 75 percent of the first $2,830 in prescription drug costs are covered after a $310 deductible. After you hit that dollar amount, the next $3,610 comes out of your own pocket. Once you’ve paid that amount, Medicare drug coverage kicks in again, but you still contribute 5 percent of the drug’s costs.
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So imagine.....trying to save someone that has just been in a traumatic accident.......you are telling the doctors to do ANYTHING......you don't think of the costs.......until later.....when the bills start coming in........
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Post by Deleted on Jan 2, 2011 16:50:44 GMT
Families often have an unreal expectation of their loved-ones recovery. I know I did when my father suffered a severe stroke; I kept thinking that it would only take the "right" treatment to improve his condition, but it was wishful thinking on my part.
In the Maylay case, it sounds as if the patient is out of it, and it is merely a question of keeping him alive for the sake of it. It was with this kind of case in mind that I posed all those questions!
So I think doctors do have a responsibility to say "no, I'm not going to do what you ask, it would waste your money".
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Post by sadie1263 on Jan 2, 2011 21:17:53 GMT
I always wonder about that case where the woman had been in a coma for years and years and the husband wanted to discontinue food and let her pass and her family fought him on it.......I can't remember the name anymore..........I know he won and afterwards the autopsy did show there was no way there was brain activity..........but years of even the gov't paying for care like that.........(if the family wasn't)......wouldn't it be better to use that money for cases where there was a possibility of saving someone? But then who makes that decision as to what case is worthy and what case isn't? How much money to spend? How long to try?
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Post by Deleted on Jan 3, 2011 8:06:34 GMT
Sadie, you raise a good point. At some stage the decision needs to be taken out of the hands of the (possibly squabbling) relations and made by an independent body. By the time they get to court much money has been spent on keeping someone alive, and families are bitter and divided.
But that doesn't answer the questions you raise, nor the question of who should foot the bill if the panel determines that life should continue.
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Post by sadie1263 on Jan 4, 2011 12:26:09 GMT
I know there was also a case here (in the U.S.) of the mother and father fighting over a baby that was declared brain dead......the mother wanted to disconnect life support and the father went to court fighting it. The twist there was that the father had caused the injuries that harmed the baby. He was only facing assault charges. If the baby died he was facing murder charges.
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