3 ms·

I thought it was the UK that had things like 'Death Panels'.

tialaramex 8y ago
Because healthcare requires resources and resources are inherently finite, rationing is inevitable. This means there have to be policy decisions. If you want to, you can label the policy decisions over rationing "death panels", or you can say it's just "market forces" or "God's will" or whatever turn of phrase suits your pre-existing position. Obamacare as originally designed would have such a policy setting panel, now it does not so you're at the mercy of whatever for-profit insurance companies decide. In terms of the specifics, the UK has an public body named NICE that makes decisions about how to spend limited resources in the NHS, it uses a model called Quality Adjusted Life Years, in which it tries to spend no more than a certain amount of money to buy people healthcare that will improve the amount of "quality adjusted" life they get, where e.g. "Give blind toddler normal vision" would be a big boost of quality even though it doesn't actually increase their lifespan, whereas often cancer treatments have a headline boost to lifespan but quietly admit you spend the extra time crippled by pain or other health problems the treatment does not fix or even exacerbates, so NICE would discount those extra months accordingly. But NICE does not directly mandate patient care, they're like the legislature making a sentence guideline, not the judge passing sentence on a specific criminal. NICE provides guidance, individual doctors can override that guidance, although where it's very expensive they may need clearance from somebody controlling the purse strings. For example NICE guidance might say Drug A is recommended because although Drug B has slightly better outcomes in most respects, Drug B causes incontinence in most patients and the loss of dignity from being incontinent makes for poor quality of life. Your doctor sees you're incontinent anyway for other reasons, figures you may as well have Drug B and suggests you have Drug B. They're the one signing a prescription, not NICE.
tbihl 8y ago
The failure of Americans to recognize death panels as a feature rather than a bug are why American healthcare can't be done on a nationalized basis. As to the misunderstanding, I assume that's based either on a misstep in logic, or on moral repugnance for it.

Because healthcare requires resources and resources are inherently finite, rationing is inevitable. This means there have to be policy decisions. If you want to, you can label the policy decisions over rationing "death panels", or you can say it's just "market forces" or "God's will" or whatever turn of phrase suits your pre-existing position. Obamacare as originally designed would have such a policy setting panel, now it does not so you're at the mercy of whatever for-profit insurance companies decide. In terms of the specifics, the UK has an public body named NICE that makes decisions about how to spend limited resources in the NHS, it uses a model called Quality Adjusted Life Years, in which it tries to spend no more than a certain amount of money to buy people healthcare that will improve the amount of "quality adjusted" life they get, where e.g. "Give blind toddler normal vision" would be a big boost of quality even though it doesn't actually increase their lifespan, whereas often cancer treatments have a headline boost to lifespan but quietly admit you spend the extra time crippled by pain or other health problems the treatment does not fix or even exacerbates, so NICE would discount those extra months accordingly. But NICE does not directly mandate patient care, they're like the legislature making a sentence guideline, not the judge passing sentence on a specific criminal. NICE provides guidance, individual doctors can override that guidance, although where it's very expensive they may need clearance from somebody controlling the purse strings. For example NICE guidance might say Drug A is recommended because although Drug B has slightly better outcomes in most respects, Drug B causes incontinence in most patients and the loss of dignity from being incontinent makes for poor quality of life. Your doctor sees you're incontinent anyway for other reasons, figures you may as well have Drug B and suggests you have Drug B. They're the one signing a prescription, not NICE.

tbihl 8y ago

The failure of Americans to recognize death panels as a feature rather than a bug are why American healthcare can't be done on a nationalized basis. As to the misunderstanding, I assume that's based either on a misstep in logic, or on moral repugnance for it.