Monday, October 18, 2010

In Holland life is worth $ 110.000

It is a figure that is astonishing and probably is valid for many more countries: one out of three persons from the Netherlands will get cancer.
That is a pretty high risk.
If flying had the same figures, every plane out of three having an accident, not many people will feel comfortable to book a trip.

But life is not a plane ticket and we are traveling on a forced upon journey.
Not to be the one out of the three getting cancer remains a lottery although it may help not to smoke and to eat healthy and to do exercises and to be happy and relaxed.

The issue that is coming up in the Netherlands these days is the costs of treating patients with cancer.
It is becoming a moral and ethical matter.
For example, there are people with cancer who are terminal.
They will die of the cancer no matter what and often the doctors can say how much time more they can live.
There was this man who had cancer of the bladder that had spread to the lymph nodes.
He was soon going to die.
A matter of weeks.
But in the hospital they had a strong medicine that would guarantee he would have two months more of painless and comfortable living.
After he also would die.
The man was excited to be able to live happily for another two months.
But the issue was that the medicine was costing € 4.000 ( $ 5.600 )
Should the health insurance of this unfortunate man pay for this medicine?

The answer is, they don’t know.
Not yet.
There are no unlimited amounts of money for health care.
Choices need to be made.
Is it responsible to pay to have somebody live two months longer?
For the moment the Government of the Netherlands have a guideline:
the financial limit of costs for medical treatment should not surpass the amount of € 80.000 ($ 110.000 ) annually.

This means that the chemotherapy a cancer patient is getting may be halted once it is costing over € 80.000 within 12 months.
Or the chemotherapy will not even be started if the doctors know it will exceed the financial limit.

A disturbing aspect to this dilemma is that in the case of oncology a lot of the treatment is not more than slowing the tumors therefore only extending the time of life.
Sometimes with weeks, sometimes with months.
Therefore the question lives how much money the community should make available for this purpose.
For the people who can’t pay for it themselves.

In Africa it has been witnessed that the old man of a Kraal who could not assist anymore in feeding the family by working on the land took a jar and walked away into the mountains.
To die and not be a burden to his family.
But this sense of responsibility for the community has been terminated once societies adapted capitalism and liberalism.

In the end, these days, money decides how long a person will live.
You can go far, in case you have a good health insurance.
But more far if you are rich: you can buy your own time.



Dawn Pier said...

Dear Michel,
Please check your statistics. I do not believe it is possible that 1/3 people will get cancer in the Netherlands. This would suggest an epidemic of extreme proportions.

Here are some statistics I found related to the incidence of cancer in the netherlands in 1999:

The crude cancer incidence
rates were 451 per 100,000 males and 416 per 100,000 females...

That is less than one chance in 200. You can breath a little easier now.

Michel Szulc Krzyzanowski said...

On they claim the chances of getting cancer is 40 %.
Two out of five.