Critical Condition

Provenge Controversy Makes the Case for Medicare Vouchers

The new prostate-cancer vaccine Provenge (from manufacturer Dendreon) appears to extend life by an average of four months at the relatively high cost of $93,000 per patient. This week, Medicare bureaucrats will conduct a national coverage analysis before deciding whether Medicare will cover the vaccine. This “unusual” step has sparked charges that government bureaucrats are rationing medical care to save money.

The Washington Post published letters from two cancer survivors that neatly illustrate why the government should not be in the business of providing health insurance or purchasing medical care at all. Cancer Survivor #1 argues that Medicare should cover Provenge:

“Expensive” treatments have given me many extra years with my family. I witnessed my older daughters graduate from high school, start college and celebrate events doctors told me I would never see.… Time is precious, life is priceless and every breath is a gift.

Cancer Survivor #2 says no way:

As a 63-year-old cancer survivor, would I forgo just four more months of life if it would cost $93,000? Yes, in a heartbeat.… Let’s quit trying to live forever and put those millions of dollars into educating the next generation.

If the government stayed out of health care, or just subsidized Medicare enrollees with a voucher, then both cancer survivors would get their wish. Cancer Survivor #1 could purchase coverage for expensive cancer treatments. Cancer Survivor #2, and millions like her, could buy lower-cost insurance and donate the savings to scholarships.

Yet politicians and government bureaucrats dictate what type of insurance Medicare enrollees get, which means they also decide what enrollees will not get. And no matter where they draw the line, someone loses. Either Cancer Survivor #1 won’t get her expensive medical treatment, or Cancer Survivor #2 won’t be able to fund scholarships for kids.

The only way to satisfy both is Medicare vouchers. In addition to being the most plausible way to reduce Medicare spending, vouchers are the only way to protect Medicare enrollees from government rationing.

Michael F. Cannon — Mr. Cannon is director of health-policy studies at the Cato Institute and co-author of Healthy Competition: What’s Holding Back Health Care and How to Free It.

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