By now you should know that governments are not actually accountable. The problems with the NHS are well known, and no one ever gets punished for it because no one is ever responsible for it.
You should be thankful for villainous insurance companies. It gives you someone to blame. Once the government takes over, you won’t know where the villains are. Or, as many do, you could just decide everything is peachy because it just has to be.
In answer to 1), I’ve never been in a country that had a single-payer system which forbade private systems. Are there any?
I’ve been Medicaid, and it’s not that great. There are a few things it covers and a lot of things it doesn’t. Medicare is better. But I think if we consolidated them and expanded eligibility,* eventually* we could have a good system.
I’m waiting any day now for the revolution that replaces elected govt with corporate rule. That will be so much better.
Canada.
And yet we are worse on survival rates after liver and kidney transplant. But cherry picking data is not the best way of comparing outcomes, is it?
Technically Canada does not prohibit private health care, at least not under the Canada health act. Some provinces do, however, prohibit private health insurance from covering things covered by the provincial plan, or having private insurance pay more for a given procedure than the provincial plan does, or to have physicians work with both the public and private system simultaneously.
Stuff that makes it difficult to operate 90% within the public system but make extra money by doing some things privately, but nothing that would prohibit an American-style private system from springing up if the public system was failing hard.
I don’t know how common it is, but in my country, adds for drugs are banned except in medical journals. So, the public never finds out about any drug.
Anecdotically, two consequences of this :
-If a drug is advertized on TV, you can tell it’s quack medecine (typically homeopathy), not a real drug.
-If there are suddenly adds about a medical condition that aren’t government-sponsored, you can tell there’s a new drug, significantly better than existing ones for this condition (that’s what happened for instance with Viagra and more recently for some eye issue). The pharmaceutical company wants you to tell your doctor about your condition.
You mean that in your country I wouldn’t find out about the perils of toenail fungus and restless knee syndrome? :eek:
Insurance companies operate for the benefit of their owners, not their customers. If they can exclude someone who will lose them money, they will. If you object to that, you must be some kind of a socialist.
Here are three sites which beg to differ, and so does my economics professor.
Price is absolutely rationing. And it is the best way to ration scarce goods and services. (Which is every good and service, by the way.) Unfortunately, price signals have been eliminated from health care since long before any of us were alive. It’s either for-profit insurance companies turning down every person and procedure they can, or the government trying with at least some sort of oversight to make sure poor people don’t die in the streets or go bankrupt from medical bills.
Now, the government can (and has and probably will) fuck this up, but it is still better than the alternative. I was originally a UHC skeptic, but now I see it falls squarely into the same category as courts, police, and other services that only work well when everyone is covered. I’m not a fan of government, but if you want to provide services to everybody, currently I don’t think there are a whole lot of other options.
You will please note that all your cites use the clunky term “price rationing”
While I agree pricing is, logically a form of rationing, one has to be fair here and note that in economics, the word “rationing” is a term of art that specifically means an artificial restriction of demand below the market-clearing price. So what adaher said is technically true, in the strict sense of that particular definition of the term.
You’re citing an article from 6 years ago.
That aside, the context here is, one the one hand, the NHS’s refusal to play the pharma game and to require value for money. NICE also requires more evidence than is commonplace in the USA.
On the other, the pharma company has a desire to recoup as much of its research costs as it can as quickly as it can e.g. from the early payers.
Fwiw, what we now know about the drug you cited from 2006:
Which, of course, means the drug companies sell even more of their products - and the game continues:
That’s a little misleading- yes, early care is normally at home until behaviour becomes difficult, but there’s a fairly wide range of benefits and respite care available, and subsidised admission to a care home is based on medical need. Charges for residential care are dependent on individual ability to pay, and the guidelines should prevent a surviving partner from being left with a bill that would leave them in financial difficulty- if a partner is still living in the house it’s disregarded as an asset, for example, and only half of a couple’s savings can even be considered.
Personally, I’ve never heard of anyone who wanted to get someone into residential care for age-related conditions, but couldn’t manage it for financial reasons. I’ve heard complaints about the standard of elder care in some places, but not the availability.
Let me give a personal example of health-care rationing under the NHS.
About 15 years ago - so before Labour’s reforms - I was in discomfort and found that all 4 of my wisdom teeth were impacting. So I was referred to a surgeon. I was told that I would have to wait 6 months. I was not in agony; I did not require immediate care. There were others with more urgent needs. Fortunately I was able to pay to have it done privately, so didn’t have to wait. OTOH a colleague who needed immediate attention got it that day.
Sorry, 15 years ago … you saw a private dentist?
Let’s turn this in to a Fox commentary:
“For 15 years, Great Britain’s National Health Service has done nothing about Quartz’s severely impacted teeth. Instead they chose to treat others (cue pictures of non-white people) who had not purchased health insurance of their own.”
Yep. And if you were poor, you would have had the choice between 6 months (potentially less time if your situation worsened) or never.
Your appeal to authority fails to refute common sense. If pricing is rationing, then the word ‘rationing’ has no meaning. Everything is already rationed. Rationing, as the term is generally used, means centralized control of supply and limits on how much any one person can buy, even if they have the money to buy more.
Wikipedia defines it as “the controlled distribution of resources”. Prices are not controlled, varying prices are what happens when a market is allowed to function normally.
Yes, but here’s the thing: that “common sense” is just splitting hairs. Yes, I suppose health care isn’t really “rationed” in that sense in the USA’s system. It doesn’t mean that everyone has access to it or can buy it. That’s because, when you stop splitting hairs, everything is rationed.
But you are correct in assuming that that makes no sense in the context of the OP’s argument on rationing. That said, there’s not true rationing there either, as the market is still able to supply private health care in essentially every circumstance – all the public health care does is offer a basis for those in need.