A Medicare Cap That Ends Up Costing System More Money
14th September 2009
The scenario: Medicare’s three-year limit on payment for anti-organ-rejection drugs led to a woman needing a second kidney transplant, because she couldn’t afford to the medicine that would have allowed her to keep her first transplanted kidney in healthy, working condition.
The cost of anti-rejection drugs for the patient? $1,000 to $3,000 a month. Cost of the second transplant? $125,000. The average Medicare expenditure per kidney transplant patient care is $17,000 yearly, while it’s $71,000 a year for dialysis patients and $106,000 for a transplant, according to the Times.
That’s the problem with having the government pay for this stuff: If the law allows for discretion on the part of providers, it opens itself up to fraud and abuse; if it doesn’t, it leads to ridiculous (and expensive) outcomes. The only solution is to keep government completely out of the process.