Question

The iron lung was invented as a short-term aid to breathing, not as a long-term device to live. "It was meant to bring people back to health, not keep hopelessly damaged bodies alive." (p. 62, Oshinsky). What are the economic considerations of long term therapy such as the iron lung? Discuss who pays for the treatment and who gets to decide who gets such treatment. Give an example of similar cost/benefit situation in today’s healthcare environment (prefered one page and half answer if possible).

Answer 1

Iron lung was indeed invented during the epidemic of Polio when people needed short term respiratory support. The mechanism of iron lung was more of traumatic but the modern age mechanical ventilator have replaced iron lung which are efficient, least traumatic, patient can be supported for long duration and the duration of mechanical support solely decided by the caregiver despite bad prognosis of the patient. With great inventions in medicine render more choices to individual about healthcare.

Chronic ventilator patients are a great burden to individual, hospital as well as to insurance companies and overall to the country.there have been various studies conducted to determine if care to terminally ill is a boom or a curse. Economic consideration includes the charges applied for per machine ventilator, the trained personnel to take care of patient on ventilator, the medication administered to keep improving the patient status and the physical supports like air mattress, foot blocks, DVT compressor, cardiac monitors for continuing monitoring, changing the euipments according to protocols for preventing infections etc .

Payment of such long term therapy is aided by insurance agencies but not very willingly. Medicare, medicaid do give reimbursement according to the level of long term care which compromise on such patient. Due to this issues, various units are soley created to care for patients with long term therapy to grant Prosspective Payment System (PPS) waiver but in many states, such facilities are unavailable leading to great financial burden on the caregiver and family. Descison making in such units are done based on mental capacity, role of caregivers and self advocacy. In case of pediatric long term therapy, the descison is wholly taken by the parents. Mainly such descison are taken jointly by caregiver- physician interaction about the patient prognosis and outcome but the financial burden is definitely to the caregiver in form of selfaid or insurance.

In various countries, healthcare has reached it's best inventions and many more options to sustain life but whether this options is worth it's cost is the true dilemma. Another example of cost/ benefit situation in today's healthcare environment is treatment for Cancer. The enormous advances in treatment modalities for cancer have developed but the medical prognosis highly uncertain. The cost of chemotherapy, the quality of life after cancer treatment and the uncertainity of its effect on cancer cells or even remission after complete healing is a great upcoming challenge in today's healthcare environment