Drug company Dendreon makes Provenge, the only drug on the market which shows some success in extending the life of prostate cancer victims.  However, the treatment costs $93,000 in order to get an average of an extra four months of life.  (To be clear

Shortly after his recess appointment by Barack Obama (while the Senate was out of session for one week), Donald “I love socialized medicine” Berwick apparently decided to hold off on allowing Medicare to cover Provenge, preferring to pass the buck for the first time ever to an advisory panel regarding whether the government should cover the drug.

Wednesday afternoon, that panel voted in support of the drug in a non-binding tally that the Center for Medicare and Medicaid Services will use in their final decision due in the first half of next year.

It’s not surprising that a Berwick-led CMS would balk at paying for Provenge.  Berwick is a man in love with the British National Health Service, an organization which provides far worse outcomes than America’s health care industry.  He’s been very clear that the role of government is to “ration care", something even his supporters don’t deny.

So to the extent that today’s vote is a slap at Berwick, I like it.

But really, it’s the only thing I like about it.

Berwick is the perfect face of Sarah Palin’s dreaded “death panels", mythical bureaucratic bodies designed to determine who gets what share of taxpayer-funded “free” health care.

And while everyone denies that there will be “death panels", at the end of the day there must be something like them because there is a limited pool of money to spend even if in recent years our politicians have forgotten that.

This may sound heartless, but it’s hard for me to say that government should spend $23,000 per month for four months to keep someone alive who’s almost certainly going to die anyway.  That’s $23,000 of other peoples’ money.  That’s potentially the cost of an operation which could keep someone alive for years, or the cost of enough insulin to take care of a dozen diabetics for a decade, and that’s if they don’t buy their insulin at Walmart (in which case it would take care of a dozen diabetics for 25 years.)

Really, how is a bureaucrat supposed to say that a nameless, faceless patient’s life is or isn’t worth $750 a day for four months?  I don’t mean that as an insult to the bureaucrat.  Who wants to be in such a position?  Who is suited to answer such a difficult question.  (My religious friends would have one possible answer, but that guy doesn’t happen to work for CMS.)  My gut instinct is that government should not spend $93,000 for four months of someone’s life…but I’m glad I don’t have to actually make that decision.

If patients or their families want to spend $93,000 themselves then they should go for it – with their own money – and get charitable help if they need to.

What this episode shows is the necessary result of creating a “right” to health care, something which would have caused our Founders to scream “absolutely not!”

Remember, anytime there is a claimed “right” to something which is not free, that’s the same as saying that others have a responsibility to pay for that thing for you.  In other words, a “right” to health care is just a slightly more palatable way to call for income/wealth redistribution.

Once you let government refuse a treatment because of cost, you’ve let them draw a line that they can and will soon move, especially as cost pressures become more intense.  For example, in England, the NHS will only cover treatment for age-related macular degeneration ("AMD") for one of a patient’s two eyes.  Price pressures have made it so that government says you must go blind in one eye if that ailment strikes you.  And that’s a relatively cheap drug, especially compared to Provenge. As the UK’s Daily Mail notes, “(AMD) is the principal cause of irreversible blindness in Britain but the sight of many sufferers can be saved at a cost of around £1,500 per patient if treated early enough.

The only way to begin to fix this problem is to increase the percentage of a treatment that a patient must cover, and then let the patient decide how much of his heirs’ inheritance he’s willing to spend on his own life.  There’s no right answer to that question and I have no more or less respect for someone who spends all his savings for an extra few months versus someone who is willing to die sooner to leave more to his children.  It’s a very personal decision, the most personal decision possible, and that’s all the more reason to take it out of the hands of government.