True, it would be a lot cheaper in a single payer system. But still extremely expensive.
mmmmmmm, that’s only in a country where the actual hospitals are run by the government. That’s not really the most common model and not really what’s being considered for the US, where "Medicare for All’ seems to be the current fad.
I’m always amazed at how well the Scandinavian countries run their bureaucracies. If American government worked that well we’d probably all be liberals too. Seriously, I’m amazed at how easily those numbers were calculated and budgeted.
The boy isn’t getting proton beam therapy, he’s getting complicated hemophilia treatments for a rare version of the disease. Proton beam therapy is just a commonly cited example of one of the most expensive American health care treatments that is currently available only to those who are rich or who have really good insurance plans, such as union workers. It’s unlikely that we could extend such treatments to all within a single payer system. It’s probably only possible if hospitals are directly run by the government, which is just not even on the table in this country anytime soon.
I suspect the first thing we’re going to try is basically unlimited single payer. The public wants access to everything, and for a short time, we’ll get it. Then the budget realities take over and we get “death panels”.
I would not be surprised if there are overruns in the construction, and a big political fight about where to locate the second centre though. The 8-10 % of patients need it probably comes from oncologists, and there are people who work with just budgeting what government setups will cost.
Well, we can give it to everyone, and we have a higher cost-of-living than you do and spend less on government healthcare. And you are the can-do nation. I think you undersell your country.
As to the cost…I have no idea how many people you need for providing the treatment. Or what kind of maintenance the equipment will need. But the first year, the cost of setting up the centre will be 250 000 $ per patient treated and after 10 years, 25 000. Eventually the cost per patient will approach running cost/1000.
I undersell our government, and not because our government is inherently more corrupt, but it’s design is not optimal for large national projects. We are a decentralized country and generally only get motivated by warfare or the threat of warfare to embark on truly national projects. Interstate highway system=way to evacuate cities in case of nuclear war. Space program=beat the Commies. Manhattan project=beat the Axis. In peacetime, we tend to be divided on means and ends and our system makes it very hard to settle those differences definitively. Often, payoffs to interest groups in order to get legislation passed make the legislation much less efficient. There are a ton of moving parts to health care, which is why we came up with Obamacare, which IMO is probably the best UHC system America can administer. We’re not built for single payer.
Insurance companies don’t price human life, so much as seek ways to avoid payment. But if the case for payment is ironclad and it’s a covered procedure, they do shell out. Which is why we get lots of MRIs, PET scans, knee and hip replacements, etc.
The way it works is price+life expectancy determines whether it’s worth paying for. Some things don’t get approved for ANYONE if they are too expensive. Herceptin, a breast cancer drug, was initially rejected by NICE solely due to cost concerns. It’s hugely expensive and extends life by an average of six months. But breast cancer advocates are pretty powerful in any country, so they eventually got their way.
Which Republican talking head was it who said that if Stephen Hawking had been British, he’d have been left to die?
And it’s certainly not true that everyone in Canada gets the same amount of care. I get zero medical care, and I’m sure that there are people in Canada like me. It’s not that I don’t have the means to get medical care; I’m just blessed with good health, and so don’t need it (at least currently, knock wood). Obviously healthy people, in any system, get less medical care than others.
Actually, it’s your own assumptions that are a combination of false and misleading. Health care can be complicated and one needs to speak with precision about what kinds of limitations can arise and where they come from.
One of the big differences between single-payer and private insurance is that single-payer doesn’t have bean-counters assessing claims; private insurance does. Basically single-payer exists to provide health care, while private insurance exists to make money, and this difference underlies their relative performance and priorities. You might not be able to imagine single-payer covering expensive treatments but it does, and there’s no one in the system to stop it from doing so as long as it’s an accepted and necessary medical procedure. It’s the bean-counting bureaucrats in private insurance who raise red flags about costs, which impact their ever-important medical loss ratios. Single-payer operates on aggregates and averages. Indeed I remember a news story a few years ago about someone who was costing the system millions annually due to some rare disease, which caught some people’s attention because the person was a newly arrived refugee.
That said, there are exceptions that occur in cases of rare diseases that require ongoing drug treatment with so-called “orphan drugs” that are rare and very expensive, many of which may not be in the provincial formularies at all. But whatever such limitations one finds, in general private insurance systems – even the best ones – tend to be far more cost-sensitive and exercise close scrutiny of each case while demanding often punitive co-pays. Single-payer does none of those things.
Proton beam therapy is an example that keeps coming up in anti-UHC arguments. The reality is that while it’s a promising technology it has limited applicability to certain rare tumors or to very specific cases of more common ones, and even there the efficacy is usually unclear over more traditional treatments. If this were not so, cancer survival rates would be proportionately higher in the US where they may be more readily available, but they aren’t. The US does indeed tend to have more new and experimental medical technologies in many cases than most other countries, but this is more to do with the technology infrastructure than with the medical system, and clearly has little impact on outcomes compared to other advanced countries. This is not because the most advanced medical technologies aren’t necessarily efficacious, but because other technologically advanced countries are quick to adopt them when warranted, assuming they didn’t originate there in the first place.
Here’s a good article on Bernie’s visit to Canada that you should read. To be clear, Bernie is promoting an agenda and, like most staunch advocates, tends to emphasize the positives while downplaying the negatives. The Canadian system isn’t perfect by any means, and some Canadian observers are amused – or bemused – by Bernie’s enthusiasm for it. But it’s important to keep things in perspective. It is an overwhelmingly popular system that serves very well the health care needs of the vast majority of citizens, as does UHC in most other countries, too. Most of the criticisms leveled at it, particularly from the US, are flat-out wrong or seriously misleading. I would characterize it as a system that provides first-class urgent care, unparalleled quality of care for the elderly, and improving but still problematic issues of wait times for some elective procedures and some specialist consultations. I wouldn’t trade it for the US system for anything, and neither would any of the Canadian ex-pats I know who have taken up residency in the US. The costs and unbelievable dysfunction of the US health care system compared to what they were used to at home is, if not their #1 complaint, pretty near the top, and all of them are well-compensated professionals with top-tier insurance.
Not sure, but obviously that was wrong. However, if Stephen Hawking gets extraordinary care, it’s because of his importance and unofficial. The NHS does not cover everything and as Hawking ages, they are going to be willing to do less and less expensive things for him, at least if they stick to their rules and don’t make an exception for him.
And yes, he was doing a bit of salesmanship. Another aspect of Canadian care that not only we won’t accept but nobody will, and even Canada not for long, is equality of care. A human rights court ruled a few years ago that it is a violation of human rights to prevent people from buying better care if they have the means. Bernie’s enthusiasm for restricting people from buying more care is an ideological evil.
Do you bother to google first ?
Around 5000 in Britain suffer from this, and they are all covered by the NHS.
Most ALS patients only survive 3-5 years from the point of diagnosis, but this varies from person to person. Some people can live up to ten years and in a few rare cases, such as Professor Stephen Hawking, even longer.
I’m aware of that. I don’t know enough about ALS to know if there are any extraordinary treatments available to him that he can’t get in Britain. Since ALS cannot be cured and treatments are rather limited, he might not be too much of a cost burden on the NHS. If all they are doing is handling complications from his condition, then that’s pretty normal stuff.
But will the NHS be there for him if some awesome new treatment that costs $50,000 per dose and gives him a 10% improvement in his condition? Those are the kinds of decisions NICE makes and that’s part of how they restrain costs.
A quick Google comes up with a brand new drug, actually:
It costs $145K per year of treatment in the US, although one fourth that in Japan. Presumably the NHS would pay what Japan pays. The article says that no new drug has been approved to treat ALS in 22 years, which is not a good thing but does serve to keep costs down. Dying is free.
Even this drug isn’t THAT expensive given how few ALS patients there are, so NHS will probably use it if they aren’t already.
I did find this interesting from the NHS though for the older ALS drug:
Primary costs aside, I wonder about what else we miss out on by (mostly) tying healthcare to employment. E.g. I know folks who have skipped out on entrepreneurship opportunities because they couldn’t risk their health plans. Or reducing sick days. They all factor into the cost benefit analysis but are hard to add up.
And again, I do admire how transparent Britain is in how they run the NHS:
They actually have a budget for this specific drug. That’s amazing detail. I’m becoming less opposed to single payer than I used to be, but if we did implement it, I’d demand this kind of transparency.
You see, that’s one of the most important things ACA was supposed to fix. I don’t get how ACA supporters can call this program a success when it hasn’t actually solved any of the problems it was supposed to solve.
Yes, on all metrics it’s made things a little bit better. It was not sold as making everything a little bit better. It was supposed to be universal, it was supposed to make health care more affordable, it was supposed to make it easier for people to leave their jobs.
They don’t just own the nation’s capital, even the states won’t touch the issue.
California is a deep blue state. So is Vermont. Neither is willing to touch single payer because of the disruption that system will cause, the higher taxes, and the retaliation from health care providers who will see their business model lose influence.
If Vermont and California can’t pass meaningful health reform, it won’t pass on the national level anytime soon. Then again, we said that about gay marriage in 2000, and within 15 years it was national policy.
