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J.D. Kleinke
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Medical Economist and Author
Chairman, Health Strategies Network |
I sit down to write a few words about the value of medical innovation, about the good economic and public health news associated with the progress we have made over the past decade against cancer, HIV, heart disease, mental illness, and dozens of other diseases. But I am distracted by a fax on my desk. It is the five-page lab report of a close friend, aged 39, whose body has suddenly turned against her: a blood clot chokes her leg from hip to ankle; the joints of her fingers have swollen to the point where she cannot close her hands; she is wracked with fever, fatigue, and crushing pain in every joint. She faxed me the report because she thought I might be able to explain it with more candor than her doctors. They have suggested much but said little with any certainty, added two new medications to the three she is already taking, and ordered more tests. But in concert with her symptoms, those numbers, benchmarks, and acronyms on the report spell one thing: lupus.
There is no cure for lupus, a cruel autoimmune disease that attacks and retreats with the capriciousness of rheumatoid arthritis, multiple sclerosis, and sickle cell anemia. After her initial "flare" has done its damage, this mother of two young children will awaken every day bracing for the next debilitating onslaught. She will have access to several medicines to mediate lupus' symptoms and minimize its destruction, and each will be worth ten times its cost by precluding her need for more intensive medical care. But for the disease itself, we do not have a cure. Yet. This is where we will leave the conversation a few days from now, after my friend's doctors have told her what I already know. We do not have a cure, I will tell her, not yet. But many of the same people behind those benchmarks in her lab report are working hard on finding one - directly, indirectly, and often inadvertently - in hundreds of government, academic, hospital, and industry labs. The sheer hopefulness that their efforts inspire will lift us from the grim realities of the report, will rouse her doctors from their chastened silence when they break the news, will enshroud my friend like the wings of an angel through the agonies of her next attack.
This is who we are in America when something as unfair and vicious as lupus strikes. We strike back - with science, hard work, money, and an innate belief that we can and will right the terrible wrongs that nature too often inflicts on our bodies and minds. Yes, our progress is expensive, especially when viewed in an economic vacuum. It places those tasked with running our public and private health plans in the horrendous position of trying to arbitrate cost, appropriateness, and value. And in the short run, it puts great economic pressure on all of us. But our unwillingness to give up the fight against something like lupus is a big part of what defines us as a nation. We produce the bulk of the world's medical miracles because we do not quit; because we make room for the greatest minds and wildest ideas; because we have always dreamed of a better life for ourselves and our children; because we are willing to finance hope.
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