Socialized Medicine, Leaving Her to Die

[Adak]

Do you REALLY want gov't running your healthcare system?

http://www.dailymail.co.uk/health/ar...HS-chiefs.html

[Spexxvet]

With all the anecdotes about private medicine/insurance screwing patients/customers, do you really want to go there?

[Adak]

Originally Posted by Spexxvet

With all the anecdotes about private medicine/insurance screwing patients/customers, do you really want to go there?

Just a counterpoint back to reality. I'm in favor of nationalized health service, but only if it's done right.

Obama care is NOT right - it's a disaster. NHS in the UK has some kinks to work out, clearly.

[Happy Monkey]

I'd rather have those decisions in the hands of someone trying to best manage the money they are budgeted than someone who gets to keep any money they don't spend.

[orthodoc]

That's pretty much what I just posted in the other health policy thread. Socialized systems try to save money in order to spread a global budget across more needs; private insurance companies try to avoid spending money in order to maximize profit. And no, they aren't sinking that profit back into improved patient care!

Perhaps none of the socialized health care models have been 'done right' yet. That doesn't mean we shouldn't keep trying.

[Lamplighter]

Agreed.

[Lamplighter]

Originally Posted by Adak

Do you REALLY want gov't running your healthcare system?

http://www.dailymail.co.uk/health/ar...HS-chiefs.html

'The Trust decided not to obtain Kalydeco on a compassionate basis
because the drug company named patient scheme for free Kalydeco is temporary
and the Trust would face withdrawing the medication when the scheme stops,
which would be unethical.

Isn't the fault here with the drug company, not the government ?

[DanaC]

'The Trust decided not to obtain Kalydeco on a compassionate basis because the drug company named patient scheme for free Kalydeco is temporary and the Trust would face withdrawing the medication when the scheme stops, which would be unethical.

'We have approached our commissioners to apply for funding and are putting together an exception application to the Primary Care Trust.

'As soon as we receive an update on our application for funding and the special exception application to the Primary Care Trust, we will share this with our patients and their families.'

A spokesman for NHS Birmingham and Solihull said: 'We are unable to discuss individual cases. However, we can confirm that to date we have not received a formal request for this drug.

'Any request we receive will be considered in line with guidance that has recently been received from Midlands and East Specialised Commissioning Group.'

But more importantly:

She could benefit from new drug Kalydeco, which normally costs £182,000 a year - money that the cash-strapped NHS are unable to afford due to swingeing cuts.

Swingeing cuts made by a conservative led government, obsessed with using austerity measures, slashing public service budgets and cutting taxes.

The National health Service would do just fine if right-wing governments would stop slashing budgets, and driving foward the privatisation of care. Look anywhere in the country and the problems in healthcare are a direct result of moving towards a Health Trust system, whereby local areas are responsible for their own health budgets (ramping up costs as an additional layer of management was added in order to manage the trusts), housed in PFI hospitals which end up costing the taxpayer three times more than a similar building built with public funds, which we would then own in perpetuity.

It pisses me off it really does. The Right in this country are constantly doing down public services, whether the NHS or schools, or transport. Anything still in public hands gets stripped back and 'streamlined' and made to function as near to a free market as possible, and then when the system no longer functions properly they say: ah well, what can you expect with socialised medicine?

The pronblems with the NHS aren't because it's a socialised system, the problems are because it is becoming so much less of a socialised system. Opening it up to profit on the one hand and slashing budgets on the other is what is breaking the system.

[DanaC]

Incidentally, from a study in 2009:

Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday

"We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage

The Harvard study, funded by a federal research grant, was published in the online edition of the American Journal of Public Health. It was released by Physicians for a National Health Program, which favors government-backed or "single-payer" health insurance.

An similar study in 1993 found those without insurance had a 25 percent greater risk of death, according to the Harvard group. The Institute of Medicine later used that data in its 2002 estimate showing about 18,000 people a year died because they lacked coverage.

Part of the increased risk now is due to the growing ranks of the uninsured, Himmelstein said. Roughly 46.3 million people in the United States lacked coverage in 2008, the U.S. Census Bureau reported last week, up from 45.7 million in 2007.

Another factor is that there are fewer places for the uninsured to get good care. Public hospitals and clinics are shuttering or scaling back across the country in cities like New Orleans, Detroit and others, he said.

http://www.reuters.com/article/2009/...58G6W520090917



Now, there are times when the NHS fails. There are times when even insured US citizens are denied care. Even taking away the millions of American citizens who have little to no access to routine healthcare or complex care in the event of chronic illness, how many of those who are insured would be covered for almost $300k per year of a drug that is still not totally proven?

[Adak]

Excellent discussion, DanaC!

Your argument against the added expense of a private hospital building being used, (along with an added layer of management for the districts), is exactly what we want to remove from any plan we decide to use.

Reminds me of San Diego, when they had a severe money crisis, they brought in a new financial manager, and elected a new Mayor. Naturally, they both wanted a full accounting of all the city's assets, including real estate.

They were quite shocked to find out that there WAS no list of the city's real estate, and there hadn't been one for at least a decade or three.

Ho hum, just another bureaucratic boondoggle, that has cost the city millions. More likely hundreds of millions.

My problem in this case, is that the drug company was offering the drug FREE ----> FREE! Only for awhile, but still ----> FREE!

There is always the possibility of negotiating a deal later on, and this drug is working quite successfully for this type of cystic fibrosis, and they know it.

Also, there are others in the UK with this same type of CF, and if the NHS decides to ban it, then these patients also, will die - it's not an IF, it's sometime before they're 32 years old.

Clearly, the drug company wants to make some money off this, and clearly the patients want to take advantage of this wonderful drug. Seems like there's common ground for a deal to be reached, that would benefit both the patients and the company.

But if the NHS bans the drug with no negotiating, then these type of CF sufferers, are as good as dead.

Which is just wrong. It's a Health service, not a Death service.

[DanaC]

Depends exactly what the success rates are with it really. As I understand it there are still negotiations going on for the drug on a permanent basis, but the drug company will have to drop its price. $300k per year, per patient is all well and good but the success rates may not be good enough to warrant that. For eveyr new drug there has to be that discussion and that measuring: what benefits does/can it bring -v- cost of treatment.

In every health system, socialised or private such decisions are made. The difference is that in the socialised system, the decision is made based on that cost to benefit assessment, in order to maximise what can be done with limited resources. There is no profit consideration (or shouldn't be) and there is not a predisposition towards minimising access to treatment in order to maximise profits.

In both systems the wealthy can opt for treatment not covered by the health service or insurance company. In the socialised system the poorest is guaranteed medical care, though may not be guaranteed specific treatments if they have not yet met the NICE requirements and been incorporated into NHS provision. IN the private system the poorest are guaranteed only emergency care in the event of accident.

I have a couple of chronic illnesses for which I have received the necessary care and treatment my entire life without ever having to worry about anything more than the cost of prescription charges (fixed at £7.50 per item). My father would have been bankrupted by his cOPD, and my cousin's family probably would have spent ten years repaying the costs of patching him back up after his road accident.

It ain't perfect. Mistakes are made, poor decisions are made, hospitals are mismanaged. But no more so than in any other system. To point to the refusal of a specific treatment for a specific condition, which is still new, not wholly proven, and with the high cost of a new medicine as evidence of something fundamentally wrong with socialised medicine is disingenuous to my mind. Because you are not comparing like with like. You are comparing the experience of British socialised medicine with that available for insured Americans, which is only part of the picture. How many uninsured people will die at a significantly younger age because they have had inadequate health care? Sure, if they break their leg the hospital will set it for them. But if they have chronic lung disease, will the same emergency hospitals provide long term medication and therapy?

You're also comparing an unusual situation with the norm. Most medications that are proven and cost effective become available on the NHS within a year or so of going onto the market. You need an expensive liver transplant, or brain surgery, or lifelong medical treatment running into the hundreds of thousands of pounds, most of the time that will be covered, whether you are rich or poor, and whether you have a pre-existing condition or not.

And the drugs company will not drop prices without pressure.

The NHS is one of the most powerful drugs purchasers in the world. It has successfully driven down prices on all sorts of medicines. This process happens intermittently. New drug comes out, gets hailed as a wonderdrug, and ppeople who are desparately in need of something that works try to get it on the NHS. They get refused, either because the results are just not good enough, or because the drug company has set the price far too high for the benefits offered. This then gets into the popular pres as 'leaving people to die' and lots of people get upset.

The next stage is either that the drug turns out not to have been half as good as it was being touted as (like a recent cancer drug which for a cost of many thousands of pounds might have extended life for bowel cancer sufferers by 6 mths to a year), or the price drops. Drug companies desperately want their products to be put on the NHS approved list.

[Clodfobble]

Originally Posted by DanaC

how many of those who are insured would be covered for almost $300k per year of a drug that is still not totally proven?

Just to make sure the obvious is confirmed here, the answer is approximately zero. Just ask Classicman about his bills from medical treatment that is totally proven.