Expectations vs. Entitlement, Part II
Let's apply the expectation/entitlement principles to a few of the issues of the day.
Are all Americans entitled to access to the finest healthcare? I would say that in a modern affluent society, we should have the expectation that as a national community we should all contribute to assure this but alas...it is not an entitlement.
Consider this:
I am not entitled to that drug for free or even at a reasonable cost. I can expect it- but is only my expectation. We are not entitled to have reasonably priced medications. No matter how greedy the pharmaceuticals appear to be we still are not entitled to determine their price.
How would you feel if you were one of the participants in the clinical trials for these treatments? Knowing what you know today, were they entitled to your participation? Should you expect their motives to be as pure as yours when you chose to participate?
What is Roche entitled to? They can expect whatever reaction the medical community doles out at them for this brazen behavior and disdain for that failure to view themselves as a partner in the public trust of medicine. They should not be surprised if doctors around the country stopped using all Roche products across the board.
They are not entitled to get my business. In fact, if Congress enacted severe price controls on the pharmaceutical industry it would not be fair or unfair - it would just be the expected response to irresponsible corporate behavior. One thing I know for sure- Congress in entitled to make any law they want. I don't expect this would happen. I am at least entitled to expect it to happen - A guy can dream, can't he?
The major difference between expectations and true entitlement in medicine has to do with the consequences of actions - where they originate and to whom they are targeted.
Your recourse stems from you. Your behavior dictates the punishment. If you are entitled to, for example, full thought and consideration of your medical problems in your best interest, your recourse is not only from your behavior but you have real recourse in the governing and licensing bodies that helped create that entitlement in society.
If you truly did not get what you were entitled to by law, you may have recourse in the court system. You may have the ability to report a healthcare facility or physician to the Office of Professional Conduct. You may even report the party who did not afford you a real entitlement, like safe transfer from an emergency facility to a treating hospital (a legal entitlement under a statute called the EMTALA Act) to authorities for civil and possibly criminal penalties. True entitlements come with substantive rights to allow you to try to regain these entitlements.
Unfortunately, most things in healthcare that people think they are entitled to are really their own expectations- some reasonable and proper, others selfish and self-serving. The more we increase the public discussion of these expectations and entitlements the more we will begin to flush out true core values in healthcare.
Next installment: The best stories of the most entitled patients, doctors, and corporations I have seen...
Dr. K.
Related Topics: Medicare Benefits, Clinical Trials
Technorati Tags: avastin, herceptin, roche, cancertreatments, entitlement, expectation
Are all Americans entitled to access to the finest healthcare? I would say that in a modern affluent society, we should have the expectation that as a national community we should all contribute to assure this but alas...it is not an entitlement.
Consider this:
"As we look at Avastin and Herceptin pricing, right now the health economics hold up, and therefore I don't see any reason to be touching them," said William M. Burns, the chief executive of Roche's pharmaceutical division and a member of Genentech's board. "The pressure on society to use strong and good products is there."Burns, in cold blood, stated this economic fact which effectively assures a death sentence to many he does not know.
I am not entitled to that drug for free or even at a reasonable cost. I can expect it- but is only my expectation. We are not entitled to have reasonably priced medications. No matter how greedy the pharmaceuticals appear to be we still are not entitled to determine their price.
How would you feel if you were one of the participants in the clinical trials for these treatments? Knowing what you know today, were they entitled to your participation? Should you expect their motives to be as pure as yours when you chose to participate?
What is Roche entitled to? They can expect whatever reaction the medical community doles out at them for this brazen behavior and disdain for that failure to view themselves as a partner in the public trust of medicine. They should not be surprised if doctors around the country stopped using all Roche products across the board.
They are not entitled to get my business. In fact, if Congress enacted severe price controls on the pharmaceutical industry it would not be fair or unfair - it would just be the expected response to irresponsible corporate behavior. One thing I know for sure- Congress in entitled to make any law they want. I don't expect this would happen. I am at least entitled to expect it to happen - A guy can dream, can't he?
The major difference between expectations and true entitlement in medicine has to do with the consequences of actions - where they originate and to whom they are targeted.
Your recourse stems from you. Your behavior dictates the punishment. If you are entitled to, for example, full thought and consideration of your medical problems in your best interest, your recourse is not only from your behavior but you have real recourse in the governing and licensing bodies that helped create that entitlement in society.
If you truly did not get what you were entitled to by law, you may have recourse in the court system. You may have the ability to report a healthcare facility or physician to the Office of Professional Conduct. You may even report the party who did not afford you a real entitlement, like safe transfer from an emergency facility to a treating hospital (a legal entitlement under a statute called the EMTALA Act) to authorities for civil and possibly criminal penalties. True entitlements come with substantive rights to allow you to try to regain these entitlements.
Unfortunately, most things in healthcare that people think they are entitled to are really their own expectations- some reasonable and proper, others selfish and self-serving. The more we increase the public discussion of these expectations and entitlements the more we will begin to flush out true core values in healthcare.
Next installment: The best stories of the most entitled patients, doctors, and corporations I have seen...
Dr. K.
Related Topics: Medicare Benefits, Clinical Trials
Technorati Tags: avastin, herceptin, roche, cancertreatments, entitlement, expectation
2 Comments:
Herceptin is available here in the Uk, but it depends what zip code you live and it may not be availble if you life in the wrong post code;-)
Quite a lot of breast cancer patients have taken their hospitals to court about it amd most of them have won.
IMHO if you have that kind of breast cancer you should be entitled to it. But hey live in the wrong post code and die! Yeah that makes a whole hell of common sense doen't it?
If I won the lotter I'd set asdie a whole lot of money so those women who want it and can't get it because of where they live, would be able to have the treatment without worrying for about the costs
Actually, Congress ISN'T entitled to pass any law they want- they are prohibated by the Constitution in certain instances.
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