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the Russian healthcare system lets tens of thousands of people die every year because they can't get stents? Isn't that true of any nation's healthcare system?

the Russian healthcare system lets tens of thousands of people die every year because they can't get stents? Isn't that true of any nation's healthcare system? They do have finite budgets, and have to make decisions to draw a line somewhere. This is the point that was blown out of proportion during the Obamacare debates, where the GOP claimed the legislation would involve "death panels". This caricature was hyperbolic enough to backfire, but the fact remains that there's always going to be a decision about where to invest scarce resources.

snowwrestler 10y ago
> Isn't that true of any nation's healthcare system? Not for coronary stents in the U.S. If needed to treat a heart attack, a coronary stent is administered regardless of the patient's ability to pay. Generally speaking, emergency treatment is available to all humans in the U.S. regardless of ability to pay. You might get a bill afterward, but first they will save your life. As for prophylactic coronary stents, the little bit I've read about them suggests that they don't actually keep people from dying, compared to other cheaper and less invasive treatments.
- CWuestefeld 10y ago
  That's not the point I was trying to make. In America, the coverage provided by Medicaid, Medicare, and private plans under ACA rules, will determine whether to approve or deny a treatment plan based on a number of criteria, which are largely based on a balance between the cost of the treatment versus its likelihood of resulting in additional QALYs (Quality-Adjusted Life Years) for the patient. An expensive treatment that's unlikely to help, or even a less-expensive treatment for somebody who's already 90 years old, is likely to be approved. Thus, there are potential treatments that the government will deny. You're right that in America, emergency acute care is going to be provided in any case. This was true before ACA, and in this context may be seen as one way that the American system, as defective as it might be, is still better in many ways than is commonly admitted. (Source: my wife's job used to be Medicare reimbursement, and now centers on "DSH" payments to hospitals, which is essentially reimbursing hospitals for bad debts from indigent care and stuff like we're discussing in this sub-thread)

snowwrestler 10y ago

> Isn't that true of any nation's healthcare system? Not for coronary stents in the U.S. If needed to treat a heart attack, a coronary stent is administered regardless of the patient's ability to pay. Generally speaking, emergency treatment is available to all humans in the U.S. regardless of ability to pay. You might get a bill afterward, but first they will save your life. As for prophylactic coronary stents, the little bit I've read about them suggests that they don't actually keep people from dying, compared to other cheaper and less invasive treatments.

CWuestefeld 10y ago
That's not the point I was trying to make. In America, the coverage provided by Medicaid, Medicare, and private plans under ACA rules, will determine whether to approve or deny a treatment plan based on a number of criteria, which are largely based on a balance between the cost of the treatment versus its likelihood of resulting in additional QALYs (Quality-Adjusted Life Years) for the patient. An expensive treatment that's unlikely to help, or even a less-expensive treatment for somebody who's already 90 years old, is likely to be approved. Thus, there are potential treatments that the government will deny. You're right that in America, emergency acute care is going to be provided in any case. This was true before ACA, and in this context may be seen as one way that the American system, as defective as it might be, is still better in many ways than is commonly admitted. (Source: my wife's job used to be Medicare reimbursement, and now centers on "DSH" payments to hospitals, which is essentially reimbursing hospitals for bad debts from indigent care and stuff like we're discussing in this sub-thread)