My job offers one insurer - I can't really change it unless I change my job, choice in our private system is really illusory (and incredibly costly) That's not really what I'm going for, I'm talking about an example of some country that switched to a comprehensive national health system and ended up paying more and getting less than it did before. Right now we are the market leaders in paying the most and getting the least, I just find it hard to fathom that we could make it worse.
Here's the problem. A country like Australia, a Westernized advanced country, has a prescription drug plan with price ceilings and a formula for setting drug prices. Sounds great for the consumer. You pay a set price for your prescriptions regardless of the R&D and production costs the company paid to make it. So what happens? Australia has no drug companies that invest in drug research and produce little, if any new cutting edge drugs. Most of the world's prescription drugs are produced in the US where there is a financial incentive to invent a new drug.
No one is denied any kind of necessary medical help in Canada. There is no rationing in the Canadian system. Apparently that’s the spin that the right is trying to apply to wait lists. There have been times when people have had to wait for a certain operation or procedure because of a shortage of specialists, for example, but nothing is rationed. The use of the term is purely political spin.
Correct. But why should we foot the bill for the entire world to have new drugs. They made those deals with australia based on the USA giving additional $$$. You make a plan that decreases prices over the next 10 years and japan, germany and the others have to make new deals or lose out.
I think the fundamental disagreement is I think my current provider and the current system offers me better care. You guys must think a socialized system would have better care. Talk to someone in the UK and see how the care is. It is really really bad.
The middle class cannot just easily move to private. They will be forced to move to the NHS, which when it includes an extra 40 million with no extra facilities, will be slower and worse.
Well long wait times is the flip side of rationing. You either give out ration coupons for gas, or you have long lines. Either one works.
First, it's very questionable to presume that Australia's lack of pharma industry is attributable to domestic price caps and not other factors. It relies on a dubioius assumption that any aussie pharma co. would be heavily reliant on a small domestic poulace. Second, presuming you're correct in your explanation for Australia, how do you explain the large number of European based Pharmas? There are many, many large Euro pharmas - Roche, Sanofi, Novartis, Sandoz, AstraZeneca, Akzo all come to mind. Third - there's many other ways to subsidize research & development other than the extraction of monopoly rents, and I'll just leave it at that. Your presumption that R&D would vanish off the face of the earth in a scenario with lower profits just isn't very well supported. It does have better care - by many measures, the US' system overall is outperformed by its peers. At lower cost. Really this is a simple equation. YOu think you are getting more, but you're not.
But there's another side to that as well. How many new drugs do we really need? Do I need one for that ailment I didn't know I had until the the TV commercial with pretty people running through a field told me I needed to ask my doctor for that drug? I guess it'll be great for me to be able to get an erection when I'm 80, but this is something that every previous generation in the history of mankind has done without and is not really needed. Fact is, a lot of the drug research goes on here because we have (until recently) had huge amounts of disposable income and little sense, thus allowing a market to be created for personal lifestyle enhancement drugs and permitting the drug companies to create broader markets... for example, how many school kids in India take Ritalin? What percentage of the drug research goes to drugs that would treat ailments primarily found in Africa or Asia?
Ok lets compare. In the UK my friends have to go see their Dr. then convince them to go see a specialist. The waiting list is about 6-8 weeks I can look up a specialist on my list and get an appointment within a week with my POS plan The NHS (UK) seems like a crappy HMO. With a smaller choice of Dr.'s Do you have a PPO or an HMO Sam?
This is very nice anectdotal evidence about waitign lists - but benchmark after benchmark indicates that the overall quality of care received by the US as compared to its peers is not substantially better, at twice the cost, which is increasing. I don't see how this is a tenable or acceptable situation.
OK what are the benchmarks? Because waiting lists are pretty high on my priority list. Most NHS systems are like a huge HMO. Do you have an HMO right now?
Rationing implies that people will not be given all of what they need. A wait list simply means that they will have to wait for those services, but they will get all of what they need. Note also that long wait lists are acknowledged as a bad thing and a problem to be corrected. They are not an inherent part of the system. To reduce them you just have to spend a little more to hire more specialists and perhaps buy more specialized equipment. Note also that wait lists are now limited by federal law. If a province allows its wait list to become longer than the established maximums the federal government can withhold its share of the funding.
Not exactly. Long lines are the other method to give out limited supplies to people. Rationing gives everyone a share and long lines give it to those who are willing to wait for it. They could be willing to wait for it because that is their personality or because they need it worse. The theory is they wait because they need it more.
We’re talking about medical procedures here. If you need them then you need them. You’re not going to step out of line just because you may have to wait an extra month to have your operation.
Not exactly. There is not only one option in medicine. There are many. And if you are told one option is a 6-8 week wait but the other option can be started now, it will factor into the choice.
You act as if you can get into a specialist the same day that you call them here. Hell, I couldn't get into the dentist for 2 months the last time I called to make an appointment. Waiting to get into specialists isn't limited to nationalized healthcare programs, it happens right here. The fact of the matter is, these countries allow anyone that is sick to get medical care. I don't care who it is and where they are on the social ladder, EVERYONE should have access to medical care. People shouldn't suffer and die because they can't afford insurance. You b**** about other countries programs yet they are leaps and bounds better than what we have in the US. At least they are trying. Our society won't even make an effort because too many people are ignorant or greedy or both.
What dentist was that? I got an appointment at Dr. Thomas O' Brien (huge rocket and Texans fan, posters on the walls) in 3 days. I really dunno wtf you are talking about with specialists either. You just call and get an appointment when they have an opening. Under NHS you have to go to a Dr. first
Under my current insurance plan I have to go to a doctor first. Then I get the referral to go to a specialist. Once I'm in on the specialist I can just make appointments directly, but there has to be an initial referral.
yeah thats an HMO. That is how a NHS would work except your list of Dr.'s you can first go to would be less and the wait time for specialist would be longer. Right now I can choose to pay extra for a PPO where I can go directly but under NHS guidlines this would most likely be reserved for private care.
