The Public Policy About Parkinsons Term Paper

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Health Issues for the Aging

One of the diseases that creates a burden on our health care system, especially among the aged, is Parkinson's disease. At present, there is no known cure for Parkinson's, merely treatments that can help to reduce the symptoms. This makes it difficult to develop a public health solution to Parkinson's. On the prevention side, one of the challenges is that while there have been some risk factors potentially identified, the reality is that there is no known cause either. For example, a meta-analysis suggest that living in a rural area, drinking well water, farming and exposure to pesticides all might be risk factors (Priyardashi et al, 2001). The current state of research at present is such that the different forms that Parkinson's takes are being studied (Peto, et al, 1995). Moreover, the different ways that Parkinson's presents can also bring about a number of different complications, from which the need for treatment arises. One example is that PD patients suffer from gastrointestinal issues at a higher rate than the general population – the link is known but the mechanisms by which this link occurs are not (Natale et al, 2008).

There have actually been a number of studies that show promise in getting to a cure for Parkinson's. One study showed that alpha-synuclein synaptic pathology might help in providing direction for a cure (Bellucci et al, 2012). Disruption of the brain-blood barrier may be a causal factor, and thus a pathway to a cure (Lee & Pienaar, 2014). A substantial body of research shows that cannabinoids are effective in treatment of Parkinson's symptoms, owing to the neuroprotective properties of cannabinoids (Carroll, Zeissler, Hanemann & Zajicek, 2012). Several studies of self-reporting Parkinson's patients support this, showing that many take cannabis to medicate, and that nearly half find this to be effective (Venderova et al, 2004).

Because so little is known about Parkinson's, most of the public policy response has been aimed at ensuring funding is available to researchers.

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The primary body for disbursing this funding is the National Institute of Neurological Disorders and Stroke (NINDS), which in 2016 disbursed $107 million to various agencies that conduct Parkinson's research (NINDS, 2017). In total, NIH spent $161 million on Parkinson's research in 2016. Decreasing the burden of this disease is actually one of the mandates that NINDS has, so there is a clear understanding of the need to invest in Parkinson's research, because of the burden in presents on society and on the government.

The biggest issue where government policy is concerned is in managing the cost of Parkinson's treatment. There are a variety of treatments, ranging substantially in price. The most current treatment, Gocovri, has recently been approved, at a cost of $28,000 per year (Investors.com, 2017). In 2007, the direct medical cost of PD was $6.22 billion and overall economic impact was $10.78 billion. Of this, medications are $1.47 billion of direct costs (Valldeoriola, 2010). Other costs include nursing homes ($2.6 billion), caregivers ($2.36 billion), lost productivity ($1 billion). At that time, direct cost per patient was $12, 491 (Valldeoriola, 2010), much less than would be the case today with a patient on Gocovri.

Much of the direct costs come from Medicare, but some of the indirect costs will as well, and more will come from Veteran's Affairs. So there is significant financial incentive for the US to explore all options with respect to managing these costs. Yet, cannabis is still illegal at the federal level. There are several states where it is legal for medical purposes, yet the stated policy of the White House is to increase marijuana law enforcement (Liptak, 2017), which could reduce access to cannabinoids for PD sufferers, increase their costs or risks, and could curtail their rights to care even in states with medical marijuana laws.

The federal government's lack of willingness to explore all options for treating PD sufferers is baffling – the same government is.....

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