The basic problem is that government should not be making these sorts of medical coverage decisions at all. Neither the FDA, the USPSTF, the IPAB, nor any other alphabet-soup government agency should decide what treatments and procedures you may (or may not) receive when your life is at stake. Instead, patients should be allowed to purchase the treatments they wish (in consultation with their physicians) in a free market based on their own individual priorities and preferences.
This is especially important for drugs like Avastin that can still help many individuals, even if it is difficult to conclusively demonstrate a major benefit for large numbers of patients. Patients (and their doctors) should be left free to decide whether Avastin would benefit them as individuals — not as part of a statistical cohort.
Likewise, the issue of cost for drugs like Avastin would also be best addressed by a free market for health insurance. Some people might prefer to pay higher premiums for a “gold plated” insurance plan that will cover expensive drugs in the event they developed a terminal illness — even if it might only extend their life by a few months. In contrast, others might not wish to spend extra for that small marginal benefit. They might prefer more modest insurance which didn’t cover such treatments — and instead use the money they saved for more important personal priorities such as buying a new home, starting a business, or saving for their children’s college fund.
A free market for health insurance would allow insurers to offer both types of plans (or anything in-between) — and would allow customers to freely join insurance risk pools with others sharing their same preferences and priorities. Those who wished future access to expensive drugs that might lengthen their lives by a few weeks or months would be free to pay for that option. Conversely, those who didn’t would not be compelled to pay for those who did.
Only a free market avoids the twin dangers of rationing and of politicized health benefits inherent in government-run health care. Only a free market allows patients to purchase the level of insurance they wish according to their best rational judgment. And only a free market protects the right of the individual patient — not the government — to decide whether the possible extra months of life offered by drugs like Avastin would be worth to her the expense and possible side effects.
If you had terminal cancer, who should decide what treatments you may receive during your last few irreplaceable months of life? You, in consultation with your doctor? Or politicians and bureaucrats in Washington, D.C.?
Unless we repeal ObamaCare, get ready for the latter choice.