Another Nudge Toward Health Care Rationing: Questioning "Costly Valve for the Frail"

The next big thing in heart surgery are replacement valves, which can be implanted without open-heart surgery, a benefit to elderly patients who may not be able to survive more invasive measures.

But instead of evaluating this as a straightforward boon to humanity, the Times' Barry Meier maintained the paper's year-long green-eyeshade obsession with rising health care costs, emphasizing in a text box that this newest leap in quality of life is a "costly valve for the frail."

Previously the Times has come out against "wasteful" medicines and "expensive" new medical procedures that are only worth "a few months" - or even five years - of extra life. The Times, which supports universal health care coverage, seems to be trying to soften people up into accepting future limits on care in the name of reducing national health care costs. "Rationing," to coin a phrase.

From Meier's report on the front of Thursday's Business Day section, "A Race in Cardiology":

A race is on to develop the potentially next big thing in heart surgery: a replacement valve that can be implanted through thin tubes known as catheters rather than by traditional open-heart surgery.

The contest pits two major companies, Edwards Lifesciences and Medtronic. Analysts estimate a market for the product that could exceed $1.5 billion within six years. But if the valves catch on, their benefits for the nation's aging population could be substantial - even if the impact on the nation's health care bill may be hard to calculate.


In the United States, the devices are currently being tested in older, critically ill patients in clinical trials. Many medical experts and financial analysts predict that if the devices live up to their makers' claims, they could revolutionize valve replacement, a common heart operation, and extend the lives of thousands of frail patients who are not now considered candidates for surgery.

The development of the new valves makes it clear that even as Congress debates ways to control the nation's skyrocketing health costs, medical technology continues to advance in ways that may drive up health care spending even further with costly new procedures that can enable more people to live longer. Most heart valve replacements involve people of Medicare age.

After discussing the bureaucratic hurdles the technology faces in the United States, Meier again emphasized:

But the new technology would not be inexpensive.

The current cost of heart valve replacement surgery is about $50,000, a sum that includes surgical fees, hospital costs and the price of a replacement valve, which sells for about $5,000. By contrast, the new valves currently sell for up to $30,000. Both Edwards and Medtronic, though, say that the higher prices for the valves would be offset by lower costs from anticipated shorter hospital stays.