Great Britain’s socialized medical system rations care by restricting patient access to providers and state-of-the-art treatment. The NHS uses a variety of tactics to accomplish this, including the refusal to pay for some highly effective cancer drugs.
Some NHS patients have responded to this egregious policy by offering to pay for the needed drugs out of their own pockets. Incredibly, the NHS won’t allow it. The London Times reports on the latest victim of this bureaucratic insanity:
A woman will be denied free National Health Service treatment for breast cancer if she seeks to improve her chances by paying privately for an additional drug.
The patient has been told that, if she pays for the drug Avastin from her own funds, she will be denied any further cancer treatment by the NHS. In other words, the NHS is coercing her to accept substandard care. And what is their justification for this outrage?
Ministers say it is unfair on patients who cannot afford such top-up drugs … “Co-payments would risk creating a two-tier health service and be in direct contravention with the principles and values of the NHS.”
That Avastin may buy this patient another year of life is less important to the bureaucrats than the “values of the NHS.” And chief among these “values” is the enforcement of one-size-fits-all mediocrity.
And if you don’t think this sort of thing could happen here in the United States, think again. CMS already bans Medicare patients from buying additional medical services with their own money.
This is government-run health care, folks. Think about it.
Comments 13
Because Britain doesn’t operate their single payer correctly is not America’s problem.
I do not believe in the concept of government-run health care. Health care is the doctor—patient relationship, and therefore, health care is “run” by that relationship. If their is failure, (in America) look to the two participants in that relationship as to the cause regardless of who the payer is, unless, of course, the payer interferes with the relationship, which happens regularly with our private insurance industry and HMOs. A properly run single payer is one part of the necessary complete overhaul of our health care system.
R. Garth Kirkwood M.D.
Posted 17 Dec 2007 at 11:37 am ¶The main reason for this ruling is that the drugs still have to be administered in controlled conditions, but she is not offering to pay for consultants, nurses, facilities etc. All countries including the US operate effectiveness assessments on expensive drugs, and Avastin is simply not effective for breast cancer.
Posted 17 Dec 2007 at 12:18 pm ¶“…which happens regularly with our private insurance industry and HMOs. ”
Medicare interferes regularly and often.
I presume, under any single payer system, that there will need to be determinations of medical necessity, allowable charges, and the like, in order to contain costs. How then can such a system NOT interfere with the doctor-patient relationship?
Posted 17 Dec 2007 at 1:01 pm ¶Response to Rich #3:
Need is determined by the patient initially. Then, follow up with the doctor and/or referral for other specialty treatment is determined within the context of the doctor—patient relationship. Cost is controlled by the single payer through a system of negotiation between the single payer and the various, individual health care businesses. Sensible profit for the business is maintained, i.e., managed capitalism, but greed, unbridled capitalism, is removed. For the doctors, reasonable fees are set by the single payer.
I develop these concepts in detail in my book, EQUAL HEALTH CARE FOR ALL.
In the system which I describe, there may have to be some rationing for procedures such as vanity plastic surgery and the like, which can be determined by common sense to be not medically necessary. Patients would have the option of paying for these themselves. However, vital, comprehensive health care and utilization of same is determined within the context of the doctor—patient relationship and not by the payer.
Of course for this to really succeed, our congress would have to mandate that the new bottom line for our health care system is penetration of the doctor—patient relationship, i.e., health care, into every community, while the financial success of the health care economic marketplace, although preserved, falls to a place of secondary importance.
R. Garth Kirkwood M.D.
Posted 17 Dec 2007 at 3:52 pm ¶RE: #4
I believe you are referring to the cure for our healthcare system that Teddy Kennedy gave us and Nixon proudly signed off on.
The wonderful
The marvelous
The HMO!
BTW take out the profit from the greedy healthcare companies and you will see a whopping rate decrease. If averages from the last ten years hold, that will be about 6% as a one time discount. The only constant to rising insurance rates is a rising cost of care.
Posted 17 Dec 2007 at 6:07 pm ¶“Sensible profit for the business is maintained”
and
“reasonable fees are set by the single payer”
There are the money quotes.
Sensible profit by whose standards? Is the phsyician with a higher debt load paid more? What about variations in rent, payroll expense, malpractice expense?
No. This is price controls, which inevitably, invariably, result in infinitely expanding demand and shrinking supply, i.e. shortages.
As for the payer setting reasobale fees: what If I don;t find them reasonable? I know, there is a new Plasma TV that I would like. Reasonablty I would like to pay $1 for it. It’s not free. i pay something, and I, the purchaser, believe that $1 is reasonable. Now you will say that it is not a fair comparison, because I am not the single payer, but what if I wee? How could the TV outlet argue with my price? They have no one else to sell to.
Posted 17 Dec 2007 at 8:25 pm ¶I ragged on your last layout, so it’s only fair that I tell you I like this one a lot better.
Posted 17 Dec 2007 at 9:37 pm ¶Thanks … I think I’ll stick with this one for a while.
Posted 17 Dec 2007 at 11:20 pm ¶Rich, we have to go grab a beer sometime.
Posted 18 Dec 2007 at 10:54 am ¶To RM Kirkwood “MD”,
“Greed” would be eliminated via single payer, eh? “Managed Capitalism” is the high falutin’ word for Socialism.
Let us read the definition of “greed,” from the Wiktionary:
“A selfish or excessive desire for or pursuit of more than is needed or deserved, especially of money, wealth, food, or other possessions.”
Who (or what) decides what is “selfish or excessive?” Who (or what) decides what is “more than is needed or deserved?”
Gee, I guess that would be the all-knowing and all-seeing “Single Payer!”
So, if “Single Payer” thought that you, RM Kirkwood, MD, only “deserved” $1 per year for your services, then anything more would be “greedy.”
God, I hope to become the all-knowing, all-seeing “Single Payer.” Then, the entire medical establishment would know pain, despair and suffering. Not a single one of you “deserve” more than $1 a year in compensation. Not a single one of you “need” to live anywhere but a homeless shelter. Not a single one of you “require” more than 900 calories a day of sustenance.
All of you are guilty of greed for owning a car, a cell phone and a coat.
I declare this to be a fact because I AM THE ALL-KNOWING, ALL-SEEING “SINGLE PAYER!”
Arbitrary? Yes. Any economic system that installs a “higher authority” to run it becomes entirely arbitrary and political. And it fails.
FYI, back in 1998, John Stoessel did a segment on “Greed.” You can buy it here:
http://www.citizenreviewonline.org/
Posted 18 Dec 2007 at 11:09 am ¶citizen_shop/john_stossel_videos.htm
Matt:
Posted 18 Dec 2007 at 4:48 pm ¶Anytime.
Bobman,
Posted 19 Dec 2007 at 6:33 am ¶after running a primary care practice for two years and actually providing care to over 1500 patients, I was homeless and lost my car, didn’t count my calories but lost about 15lbs. So you won’t have to wait for single payor to see me get what I deserve, sorry for being so greedy that I wanted to provide care to people as my oath requires.
I would hope you’d have the grace to withdraw this post now that the FDA has ruled that Avastin is not effective for breast cancer. And you have the cheek to accuse others of not doing their research!
Posted 20 Dec 2007 at 4:15 am ¶Post a Comment