The Perils of an Infinite Progress Model

In an interview by Beth Baker of the Kaiser Foundation, published on December 10, 2009, Ethicist Daniel Callahan makes some interesting observations about the American health care system. Initially, he describes it in this fashion:

"Our whole health care system is based on a witch's brew of sacrosanct doctor-patient autonomy, a fear of threats to innovation, corporate and (sometimes) physician profit-making, and a belief that, because life is of infinite value, it is morally obnoxious to put a price tag on it."

He is quoted in the interview as saying:

"Cost is a symptom of a deeper problem. We have an "infinite progress" model. Nothing is ever good enough. The standard of care is raised higher and higher--but death always wins.

"The National Institutes (sic)of Health is always giving priority to the most lethal diseases--cancer, heart disease, strokes. Things that really make you miserable like mental health [problems] or arthritis don't get nearly as much money. The fight against death has been a very central part of American medicine. It's a weird system where you get saved from heart disease at 65, treated for cancer at 75, and then after that end up with Alzheimer's at 85--this is progress?"

Just this week, researchers announced the complete decoding of the genome for two forms of cancer. They are excited that this will lead to more successfuly treatments for cancer, and this is exciting. But it also means that hundreds of thousands of additional people will reach old age.

His concluding comment mirrors our concerns. "Medicare is going to run out of money shortly, and we're finding more and more expensive ways to keep people alive. So we have to find ways to set some limits." To Tax or To Ration. That's what it keeps coming down to.