The Editor,Demand for a treatment procedure to remove blood vessel restrictions for multiple sclerosis known as liberation therapy (LT) challenges accepted practices for medicare in Canada and Saskatchewan. If LT were a new pharmaceutical, patents, phase 1 to 4, clinical and post market trials between lab bench and Rx availability and use of regulatory and economic critical control points would restrict timely generic, off-label, economical access for 2 to 4 decades. This is how public and private insurance works with the health industry to ration services in modern developed countries. For LT, MS medical tourists willing to take personal risk with their health and money can almost immediately go to clinics abroad to get LT without having to endure traditional rationing methods.The Canadian medical establishment now suggests clinical trials before medicare considers offering this procedure. During this maybe period, the criteria for acceptance of trial subjects are created. If not just anyone is allowed in, should the trial prove the treatment is effective, only those who fit the trial criteria have a case for coverage by insurance. Those who plan insurance budgets work the numbers and are capable of suggesting criteria that ration the cost to the system to just enough people to fit a predicted future budget insurers will find acceptable. Today, I suggest advocates for broad, immediate access to this liberation therapy for multiple sclerosis speak up with a message. Do not allow future restriction for access by allowing the health industry to stack the deck and prejudice future access. To repeat, only patients with the same parameters as those who are part of the trials will be funded for coverage by medicare after the trial is complete that is the whole idea behind careful selection of trial participants. Yes we do not know how useful this therapy will be, but we know its cheap and requires only that doctors take some training to adapt something they already understand how to do. The risk for government and medicare in Saskatchewan is whether to take a side and put conditions on funding clinical trials. I suggest to make trials large in size, without restrictive criteria, require that they begin in 90 days (not a year or so) and be not be afraid if the results are modest ? be proud that those who are living under the stress of wishing for a miracle at least get an answer post-haste. For diseases without proven cures even a placebo effect can spread a message that brings a huge wave of ill people and their friends and families to demand this same service somewhere near them and also to ask for the service to be free or subsidized by insurance.Bean-counters do get scared that a huge amount of resources may be used for this therapy. If it is only a fad, be assured this mob of Multiple Sclerosis patients will soon disappear. If it has effects that range from minor to dramatic for large numbers ? yes, the economic moral hazard (the punishment we get for doing good deeds) for government is one of high demand by many MS sufferers which will keep those patients coming. The moral hazard for Canadian medicare is the fear of setting a precedent that other diseases might use to demand services. MS sufferers and their advocates should demand pay-back from their hard earned tax dollars, in my opinion, and not let moral hazard in the health industry take from them health span that cannot be bought back.Morris Johnson,Beaubier, Sask.
