En pille for alt som er ille

av: Arne Valen

Siste to uker har vi hatt en debatt  om helse og ressurser med utgangspunkt i Helsedirektør Bjørn Inge Larsens utsagn i Aftenposten. Samfunnet har ikke råd til å gi den dyreste behandlingen for alle typer sykdommer. Eldrebølgen vil tvinge oss til å prioritere og si nei til behandling som blir for kostbar, sa helsedirektør Bjørn-Inge Larsen. Han stiller spørsmål ved om det er forsvarlig å bruke millioner av kroner dersom det beste man kan oppnå, er å forlenge livet til én eldre med ett år.
Pasienter med KOLS, kreft og hjertesykdom nektes allerede i dag den mest effektive behandlingen av økonomiske grunner. Han peker også på at om lag 25 prosent av kostnadene til medisinsk behandling går med til å forlenge livet til eldre med et år. Finansdepartementet har satt en veiledende grense på kr 425000,- for forlengelse av et liv med et år. Nasjonalt råd for kvalitet og prioritering sier nei til en ny behandling av tykktarmskreft fordi den koster nærmere en halv million kroner.

Medisinsk forskning gir oss i dag muligheter til å gi avansert behandling til svært gamle mennesker. Når mor på 85 år kjøres med blålys inn i akuttmottaket på nærmeste sykehus med hjertestans, maser barna på legene om å fortsette gjenopplivingen. Troen på det evige liv her på jorden er utbredt.

Ett år lenger til kr 425.000,-? Tid er penger. Debatten fokuserer mye på levetid og mindre på livskvalitet. Adressen din kan avgjøre hvor lenge du lever. Folk på Oslo Vest lever gjennomsnittlig 12 år lenger enn folk på østkanten.  Har man undersøkt om det er forskjell på livskvaliteten mellom øst og vest?

Jeg er ikke uenig i at det må finnes en grense for hvor mye penger vi bruker på helse. Det finnes andre sektorer som også trenger ressurser. Jeg ønsker at mine barn og barnebarn skal gå få på en skole med nok ressurser.

Men fordelingen av helsekronene forfordeler somatiske lidelser på bekostning av psykiatrien. Hjerte og kreft er høystatussykdommer som har fått mest forsknings-og behandlingsressurser. Rus og psykiatri er lavstatus-sykdommer i samfunnet. Hvor mange opptrappingsplaner må vi ha for å skape ballanse i regnskapet?

Menneskers forventninger om et liv uten lidelse gir helsetjenesten en umulig oppgave. "Gi meg en pille for alt som er ille" Idealet er det unge, vakre og friske mennesket.  Sykdom trenger ikke å bety fravær av livskvalitet. Hvordan livet leves er viktigere enn hvor lenge det varer.

Sosialmedisiner Per Fugelli har selv vært døden nær på grunn av kreftsykdom siste året. I Aftenposten 8. juni sier han at jakten på mer tid kan virke forstyrrende på det å forsone seg med at døden kommer.

Lev vel!  

 

    

 

16.06.2010

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