How many other countries in the world consider medical bankruptcy a thing to be accepted and tolerated?
That’s what makes me nervous about socialized medicine in the US. I’m absolutely in favor of universal coverage—a healthcare system that maximizes the health of the average productive person. But I worry that Americans lack the cold realism of Brits, and won’t be able to effectively control costs by denying cost-ineffective treatments.
With the big pool comes big leverage. The NHS effectively said "We're not paying that much", and the pharmaceutical companies decided they'd rather be paid something. Because if someone is not getting treatment, then they're not getting those drugs.
Medicare in the US does this. "This is what we are paying for this drug".
The issue isn't so much this. It's that drug industry lobbies in the US will have far more sway over the politics of this than they would in the UK (or Canada, or Australia, or...).
I definitely don't claim to be an expert on these things. But I have lived in the UK with the NHS, in Australia with its medical system, and now in the US. In addition to that, I've worked as a healthcare provider, and for a Health Benefits Management software company, so I'd at least like to think I have something of a varied perspective.
https://www.nytimes.com/2019/02/27/obituaries/carrie-ann-luc...
> Her family said an antibiotic Lucas needed to treat her symptoms cost about $2,000 and her insurance company denied coverage of the medicine, leading her to take a less-effective drug. Lucas, who was allergic to multiple drugs and antibiotics, had a reaction to that medication, Lee Lucas said.
https://www.denverpost.com/2019/02/28/carrie-ann-lucas-obitu...
That is definitely not true. Part of the prescription drug coverage that was added during the Bush administration was that Medicare could not negotiate drug prices.
https://www.politifact.com/wisconsin/statements/2017/jan/17/...
And I don’t think that’s necessarily a bad thing — if a drug costs $500,000 and keeps my cancer at bay for 6 more months, it provides a high personal benefit from my selfish point of view; but at a high cost to society without much societal benefit. I think you’re right that Americans do lack the realism, but it may become easier if those treatments aren’t developed in the first place.
People are employed and knowledge is gained. That may be $500,000 treatment for 6 months now, but that treatment may be improved and democratized until it evolves into something that is $50,000 for 6 years.
As it is, if someone finds a new life-saving use for an 80 year old drug, there are suddenly shortages of the old drug while a new, patented analog is sent through clinical trials. See also ketamine and depression.
this, in my opinion, points out a significant flaw in the rush to privatize just about everything:
there are many many “markets” that are either under-served or not served at all because the rate of profit would be (a) too low to “justify” or (b)none at all.
jmo but, there has to be a balance between for-profit and basic research that won’t necessarily be able to be monetized to the extent many in industry would want...
No, we're much better off denying basic ass treatments because there isn't enough money in it.
And it makes sense. If a treatment is super-expensive and unlikely to be effective anyway, and that money could be put to better use to help more other people ... It's like how someone who smokes isn't going to get a lung transplant; there's too many others that need transplants and not enough lungs to go around, so give the lungs to the people who will benefit the most from them (generally, people who are young and otherwise healthy). There aren't infinite resources in this world, so in the cases where scarcity comes into play, they should be doled out in the way that creates the greatest good.
Although, the distinction wasn't very meaningful because you could be denied for pre-existing conditions, so if you had hit a lifetime limit on one policy, good luck being able to get another one anywhere else.
Obviously, most people in the US don't have access to such a generous plan, or the amount of medical expenses they can tolerate without going into bankruptcy is below the legal out of pocket maximum (6k/yr individual, 12k/yr family). Hence the GoFundMe pages to raise money for medical treatment.
So rich people can still get the latest $500K insta-cure prostate cancer treatment (and they are paying out of pocket for most of it), and the rest of us make do with surgery/radiation.