Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, March 1, 1992                   TAG: 9203020225
SECTION: EDITORIAL                    PAGE: E-2   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

CHOICES POSED

The upcoming generation of biotechnological pharmaceuticals includes amazing advances in treatment for heart disease, cancer, neurological ailments and an assortment of other illnesses.

The bad news is that these new treatments will cost money, gobs of it.

An example is Centoxin, an experimental drug for potentially fatal sepsis infection - of which the United States has 400,000 cases yearly. It has been used to dramatic effect.

But it costs $3,000 to $4,000 a dose, and in two-thirds of cases it doesn't work. (Doctors don't know until they try it.)

Should hospitals have to lay in a supply of this costly medicine just to be sure? If they do, chalk up yet another boost in the overall costs.

Such technological advances are welcome: They can save and lengthen lives; they can bring relief from pain and disability. Countless sufferers can benefit.

But like the wonders that preceded them - organ transplants, heart bypasses, transplants, restored limbs - these developments are expensive. And they are becoming available at a time when the nation's health-care system already is staggering from skyrocketing costs and the effort to meet mounting demands.

The desire for good health care seems endless. But neither the resources nor the money to pay for care is unlimited. Every treatment cannot be available to everyone. If the health-care crisis is to be resolved, choices must be made.

Those choices will, in some cases, involve life or death. They also will involve decisions on how resources can best be used. Should $200,000 be spent on preventive care for (say) 1,000 mothers and infants, or on a bone-marrow cancer treatment to try saving one person's life?

When an insurer pays for costly treatments, this drives up the cost for others the company insures. If the cost mounts too high, some individuals and employers can no longer afford the insurance.

Some benefit. Some lose out - on basic kinds of care that can keep them working or head off more serious disorders.

Basic and preventive care should not be denied to any American. However it is financed, it could not include the costliest of treatments; that would, again, price it out of many people's reach.

But once basic care were assured, it would be comparatively cheaper to insure against illnesses that can cause financial catastrophe.