Did you watch the TV programme last night on the women who have fought to make Herceptin made available to them via their local NHS? Raw Carrot has a great post on it here, the conclusions of which which I fully endorsee. The punchline is that the NHS does not (and, as we have seen with this Herceptin case, cannot) allocate resources efficiently or equitably. That's why it needs to change, dramatically. People will need to understand that above a basic minimum of universal healthcare, they will have to PAY.
As Raw Carrot points out, "people would appreciate that healthcare does cost money, and that, sad though it may be, this means there is a price on human life. In turn this would ensure people acted responsibly, and would improve the efficiency and (in my view) the equity of healthcare provision in the UK. Of course, the “basic minimum” would need defining, but suffice to say it would only cover things which had public health implications (i.e. externalities).
He's right and he has the courage to face up to the reality that politicians run away from - namely that the infinite demand for healthcare cannot be funded or indeed even managed in an economically sensible manner that ensures equitable delivery until we remove this fantasy that it is all for FREE!
DV, As a pharmacist, I deal with this every day. Yesterday I filled a prescription for 3 months of an arthritis drug that cost the US gov. (ME) $4000 for a 3 month supply that cost the patient $60. This is under the new Medicare Rx program.
Whenever a 3rd party picks up the tab, there is no economic incentive for the patient to weight the pros and cons of a drug vis a vis the price. Sure, I'll give it a shot the patient says, it only costs $60! This is for private insurance as well.
The seniors citizens are such a strong voting block, the gov. extends all sorts of benefits to them, but we do have the working poor who have no insurance and must pay out of pocket..
With the original story, I can understand cancer patients grasping at straws, but as long as the patient in insulated from the costs of drugs, the drug companies will charge what they want, and let sick people do their marketing for them by demanding their products, WHATEVER THE COST.
Meanwhile in the 3rd world, children die from worms. I'm starting to sound like Colm!
Posted by: ch in texas | February 07, 2006 at 04:10 PM
Chas,
Fully agree with what you say.
Posted by: David Vance | February 07, 2006 at 04:28 PM
The simplest solution is to ration healthcare by price and ability to pay. This will be a return to the pre-NHS days where the rich had healthcare and the poor did not.
That way CH wouldn't be bothered with elderly patients demanding arthritis drugs - they'd be at home in pain where they deserve to be. And taxes would be a whole lot less, in Texas and everywhere else.
Posted by: Peter | February 07, 2006 at 05:23 PM
But Peter,
That is precisely NOT the case pre NHS. Permit me to post on the topic so I can widen the story.
Posted by: David Vance | February 07, 2006 at 05:30 PM
Peter, Either your argument is specious, or you misunderstood. Of course I don't want my patients in pain! Two points. When a 3rd party is paying the bill, there is no incentive for the patient or the drug compaany to hold down costs. Second, taking care of people's basic needs are fine. Where does it say however, that the government can take my $4000 and give it to someone for medicine? Even from a liberal prospective, couldn't that $4000 go to the 3rd world to save the lives of 10,000 children who are dying for the diarrhea associated with worms?
NHS in the UK, or the system we have in the US flies in the face of economic reality. Let the hidden hand of the market take care of a lot of it.
Posted by: ch in texas | February 07, 2006 at 05:58 PM
You're right. People will have to pay. But they are unwilling to. They would rather have lower taxes.
Posted by: willowfield | February 07, 2006 at 10:57 PM
The ideal system is compulsary health insurance with truely competitive supply. This is the only way to have universal coverage and efficiency at the same time.
Posted by: Alec | February 13, 2006 at 12:07 AM
How does Private medicine and Insurance ensure a competitive supply ?
30 Mobic tablets - USA $200 odd
30 Mobic tablets - UK $46 odd.
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