Patients who use drugs intravenously may be at high risk for relapse, but their situation is no more futile than that of persons with diabetes and coronary artery disease who smoke and frequent all-you-can-eat buffets.
In cost-effectiveness research, the cost of a medical intervention is reported as a dollar amount per quality-adjusted life year gained—the quality of health and the length of time over which the health state exists.
The future success of the Affordable Care Act depends on doctors' willingness to take the lead in identifying reforms that will lead to high-quality, cost-effective health care.