The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Richard L. Kravitz, MD, MSPH and Jodi Halpern, MD, PhD
Patients have a responsibility to discerningly present the drug information they receive from direct-to-consumer advertising and to be active partners with their physician in making health care decisions.
Physicians are cautioned that the two obstacles to reforming post-marketing clinical trials are the FDA's reluctance to revisit past approvals and its inability to enforce pharmaceutical companies' commitment to conduct Phase IV trials.
The conventional quality-adjusted life years approach to resource allocation has greater societal value if it is distributed among many rather than concentrated on a few, assuming that severity of illness is the same.
A bioethicist argues that two journal articles about quality of life-adjusted years research oversimplifies the issue and do not take into consideration people's abilities to adapt to disability and disease.
A health economics professor believes more research is needed on quality of life-adjusted years to explore the way we describe health states, the elicitation of patient values, and how to develop methods for obtaining informed general population preferences.