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$89,000 for 18 hours of emergency care: The Wild West of Medicine

2014-01-29

Here’s another shock value story: a man was treated for snakebite with four vials of rattlesnake antivenom.  He spent 18 hours in the Emergency Department.  The bill was $89,000, including $20,000 a vial for the antivenom.  Of course, Medicare pays about $2,000 a vial.  The man was insured by Blue Cross, and they paid about $5,000 a vial.  The man paid $5,4000 including deductible and copays.

All this is recorded at this news site: http://www.charlotteobserver.com/2014/01/27/4643457/mooresville-patient-stunned-by.html#.UulSOhBdXNl for the Charlotte (NC) Observer.  In the 1980’s, rattlesnake antivenom cost $50 a bottle; a severe case of envenomation might require a dozen or more vials to reverse the shock and vascular collapse.  You can see where this might add up; however, rattlesnake bites are extremely rare and the bottles may sit on the shelf for five or ten years.  Manufacturing the antivenom is a tedious job, and insurance problems also weigh heavily.

However, it seems obvious that the law governing food and drug manufacturing should provide for “orphan” drugs with regulations that smooth the production of rarely used or small quantity items.  The problem of coccidiodin manufacture, which I mentioned before in the context of Valley Fever, is a good example of the need for regulations.  Vaccines, even widely used ones, are another example of items that need special treatment to ensure adequate manufactures for the maximum public good.  This is a place where special federal regulations are sorely needed to provide for the common good.  There is no better example of how government can be good and why government is really needed.

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