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BATTLING LINKS

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This is the place for interactivity and debate among members! Many controversial topics are worth debating - so please feel free to submit your ideas. One so-called "all-spark" that may pique your interest:

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As opposed to transplantation, mechanical assist devices are virtually an unlimited therapeutic resource—sparing the cost—and with a peek at the near future, one might see the evolution of a life saving option for many more patients than transplant has ever provided. However, in an era of limited resources, for countries' fiscal balances, and for public and private healthcare systems, unrestricted MCS implantation may have serious ethical and economic consequences; for example, an increase in the number of patients implanted would presumably improve survival of severe heart failure patients conceivably driving more centers willing to pursue implantation for fiscal reasons (profit), therefore compounding a health care spending problem. The balance between patients' rights to receive modern and effective healthcare, physicians' therapeutic freedom, and budgetary constraints from healthcare authorities, is like an exercise with a teeter-totter on a tight rope while holding a glass of battery acid on your forehead. On one hand it is seemingly unethical not to offer an effective therapeutic strategy to all the patients who may benefit from it. On the other hand, unbridled use of expensive resources may inappropriately divert funds from much less expensive therapies involving large numbers of subjects.

Should healthcare authorities strictly regulate MCS implant by limiting the number of centers allowed to implant? Is the policy of favoring the use of bridge to transplant indication over destination therapy still current? Are transplant centers entitled to represent the hub of a referral network to which non-transplant cardiac surgical centers connect and refer to share common policies for patients' selection and indications? How do we avoid over-implantation (i.e. implant in patients not enough sick), and implantation in patients without a clear expected implant benefit over time? Will we reach a peak to balance discriminatory undertreatment with potentially non-beneficial overtreatment?


conAnyone willing to participate in this debate bordering on becoming a bit pugilistic about it or any other controversial topic, please SEND IN your ideas, comments, rebuttals, opinions, etc. to us!

Some of these topics could generate an "all-spark" transformation of ideas (reminds me of the movie, Transformers), in areas as hot as the Red Hot Chili Peppers; if so, then This is the Place. Or we can simply debate over the usage of pique, peek and peak.