Posted on 12/20/2005 3:44:01 PM PST by Aussie Dasher
Rationing health spending by denying repeat open-heart surgery to smokers who refuse to quit would be fairer than picking on women in their forties having IVF, an expert says.
Michael Chapman, chairman of the IVF Directors' Group, was commenting on research which showed that producing a child through in vitro fertilisation cost around three times more, on average, for women aged 40 or older than for IVF patients as a whole.
An article published on-line in the Medical Journal of Australia (MJA) found the average cost of a live birth through non-donor assisted reproduction was $32,903 compared with $97,884 for women aged 40 or older.
But this skyrocketed to $182,794 for women aged 42 or over.
Nevertheless, the researchers said assisted reproduction services in Australia accounted for less than one per cent of the $8.6 billion Medicare benefits paid in 2004.
"It will be difficult for the government to make significant savings by limiting funding in this area," they said.
"Furthermore ... as the overall success of assisted reproductive technology improves, so should its cost-effectiveness.
"Indicative of this is the increase in live births per embryo transfer cycle from 13 per cent in 1993 to 21 per cent in 2001."
Professor Chapman said $180,000, spread over an IVF child's expected lifetime of 75 to 80 years, was "relatively cheap" compared to a lot of medical interventions.
He said if federal Health Minister Tony Abbott wanted to introduce rationing of health services, IVF was not the place to start.
"If he's going to go down that track, he should make it a much more open debate," Prof Chapman said in an interview.
"For instance ... open heart surgery for second or third timers who continue to smoke, why should we be spending $50,000 in that arena when the patient isn't complying?
"And it's clear in a range of medical operations, the more obese you are, the less successful operations are. That's where the focus of the rationing debate should be.
"There are countries around the world that do that. They say that if you're over 90 kilos, then you can't have a particular operation because the success rate is lower.
"I think that's more rational than picking on women in their forties ... and saying we're not going to fund your fertility treatment."
Based on 2002 figures, the MJA research found women aged 40 to 44 had a six per cent chance of achieving a live birth using their own eggs, compared with 18 per cent for those aged 35 to 39 and 25 per cent for women aged under 35.
Prof Chapman said Australia's IVF Directors were working on guidelines to maximise success rates based on scientific evidence.
"We're developing a greater understanding of the interpretation of some of the blood tests that we do to be much more precise in picking those patients who are likely to conceive, or not conceive," he said.
"As that science becomes more robust, I think we will be able to focus IVF treatment on patients who are most likely to get pregnant."
A government-appointed committee is reviewing the cost-effectiveness of IVF and is due to report to Mr Abbott in February.
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I'm pro-smoker's rights, but gimme a break.
About as fair as providing "assisted reproduction" for those who are too bloody old for it!
...and deny access for rock climbers to any treatment for broken limbs.
On the other hand, women over 42 having babies...?
A ringing endorsement for an anti Socialized Medicine position.
How is it fair to collect someone's taxes to support socialized medicine and then refuse them services?
If you wanna have a baby at that age, pay for it yourself.
IVF is a vanity procedure that is never necessary to save lives. It should be banned.
Welcome to the decision making that comes with National single payor style health care. Gov. types meeting in committee deciding who gets care, and then when the money gets tight, who lives and who dies.
And the next time the debate comes up, all the socialists have to do is say, "Look at who's using the socialized medical services--everyone."
What about men over 42 having er...nevermind.
I'm all for smokers, but they usually argue that it's their life and their choice. I agree. But a second open heart operation because you couldn't kick something that screwed up your heart in the first place? Smokers suddenly turn into Gimme Gals (and Guys)--the rest of us have to pay for their excesses.
What are you talking about? The notion that you or anyone should impose arbitrary behavioral standards for others is precisely a consequence of socialization. In the diametric opposite system, no one would care one or another if the smoker continues smoking because he will only have open-heart surgery if he pays for it, whenever he pays for it.
I am not saying that the opposite extreme is right, but that the notion that it's somehow 'fair' to deny the smokers repeated surgery because of their continued smoking is absolutely a socialist mindset.
If you want to stop men over 42 having nevermind, there's gonna be as much (or more) opposition from those women over 42 as from the men. :D
It's a different story if they're paying for it. Only when dealing with socialized medicine must value judgments like this be made. The free market takes care of this through price rationing if people are actually individually accountable for their decisions.
And here's my real opinion: If socialized medicine is denied to any class of individuals because of their behavior, then they should be exempt from the confiscation of the taxes which support the health care that's denied to them.
Let's see how many people then choose smoking over socialism!
Heh... I accidentally read that as "women having over 42 babies."
Uh...what?
Strrrrrrrrrrettttttttttchhhhhhhhhh.
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