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Finneran: Money Well Spent

Friday, May 18, 2018


The pain never left.

It was always there, as excruciating at 2:00 in the morning as it was at 2:00 in the afternoon.

Sleep was hard to find. And, because of the pain, it took real willpower to go upstairs to empty the hamper and then downstairs to the laundry room in the basement. She was only 53 years old but the pain was now etched into her face. I suspect that it affected every decision she made---work activities, family events, vacations, sleep habits, medications, even something as simple as where to park the car. And, at 53, she faced another thirty or more years of nagging ceaseless pain.

She had watched her mother and father limp through a similar challenge. The issue was not so much family DNA and genetics. Rather, it was the simple fact that, over time, the human body wears out.

Her parents’ generation used the all-encompassing word “arthritis” to describe their condition. Truth be told, the last twenty years of their lives were miserable, suffused in pain and frustrated at their limitations. Our 53-year-old friend had better options.

Thank you, American healthcare. Thank you, medical device manufacturers. Thank you, pharma and biotech innovators. You have given our friend thirty additional years of a great quality of life.

A Boston Globe story by Robert Weismann tells the backstory. It’s not about our 53-year-old friend. It’s about all of us, Americans from coast to coast, whose active lifestyles have accelerated the normal aging process for knee and hip joints and whose determination to stay active—running, hiking, skiing, biking---brings them to a decision regarding joint replacement surgery. You dear reader undoubtedly know someone who has had a knee or hip replaced. The numbers tell the story. And, as is often the case, there is a story within the story.

There were 160,000 hip replacements in the year 2000. That number jumped to 370,000 in the year 2014. The increase in knee replacement surgery was even higher, going from 274,000 in 2000 to 680,000 in 2014. That’s over one million joint replacement surgeries in one year. Let’s not forget that joint replacement surgery was just a fantasy, no more than a pioneer’s pipe-dream, two generations ago. Your grandparents, crippled with pain from life’s wear and tear, did not have the option of having a knee or hip replaced. Their remedy was aspirin. Or Jack Daniels. Let’s just say that the aspirin-Jack Daniels’ model left a lot to be desired.

We hear constant complaints about the cost of healthcare. We hear little appreciation for the daily miracles we enjoy. Our 53-year-old friend now walks a lot every day. She does so without the withering pain of the past. She has a young granddaughter and she’ll soon have a grandson. Her days with them will be days of joy. She’ll play with them as they crawl and walk and run. They will know her as an active and fun grandmother rather than as an old woman whose face is pinched with pain, lightened only by the nip of whiskey in her purse.

The Globe story tells us that these procedures cost about forty to fifty thousand dollars a pop. There is no argument that that’s a lot of money. And we could save that money and our healthcare costs by outlawing such procedures. In fact, we could save a lot of money by outlawing all sorts of things, including care for the sick and dying. After all, a dead person costs nothing to insure.

Happily, our moral compass is not so askew. Happily, human life is still valued. Happily, the quality of life remains important. Happily, the roughly 10,000 days of pain-free mobility our friend has gained stacks up pretty nicely against the fifty thousand dollar cost. Let’s call it five bucks a day. You pay a lot more to your local cable company for mind-numbing garbage. Or for your daily coffee and bagel, neither of which will increase your mobility or improve your health.

Consider this fact: Never in human history has anyone enjoyed the quality of healthcare we enjoy today. Miraculous medicines, with more on the horizon. Pain-free mobility into our seventh, eighth, and even ninth decade of life. These are amazing leaps forward in the human condition.

Yes, it’s expensive. And yes, it’s money well spent.

Tom Finneran is the former Speaker of the Massachusetts House of Representatives, served as the head the Massachusetts Biotechnology Council, and was a longstanding radio voice in Boston radio  


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