4 ms·

This is somewhat of a straw man fallacy often cited by proponents of profit centric healthcare. In reality it happens relatively rarely and is usually linked to

by altacc 5y ago

This is somewhat of a straw man fallacy often cited by proponents of profit centric healthcare. In reality it happens relatively rarely and is usually linked to the effectiveness of that treatment. In the UK, a typical example of state provided healthcare, some extremely expensive treatments which can only increase life expectancy for a few weeks or months are not approved as there is little benefit. But not every health insurance policy in the US will cover this treatment, especially without some copay. On the other hand, a treatment was recently approved for use which costs £1.795 million per patient. The cost to the patient for that treatment is zero. I find this argument not only provably less relevant than the poster thinks is is, but also it's not much different from dying as you can't afford to pay even the copay for your cancer treatment. The USA can't even sort out decent healthcare for children, who haven't yet had the opportunity to get a job to pay for their healthcare. No healthcare system is perfect but that's not a reason to not seek something better, fairer and more efficient.

refurb 5y ago
It's happens more often than you think. In single payer system, those therapies aren't even discussed with the patient since the physician knows if it's not paid for by the gov't it's effectively out of reach. Sure, the US system isn't perfect by any means, but one reason why it's so expensive is they throw everything plus the kitchen sink at patients. And this is even for Medicaid which covers the poorest Americans. Having lived in 4 different country with 4 different healthcare systems, if I got diagnosed with a serious cancer you can damn well be sure I'll get treated in the US. I have a friend who got diagnosed with breast cancer who did the same, moved back to the US and with ACA subsidies was getting the latest therapies with a monthly premium of $200. And the drugs she received weren't even paid for in her home country.
- altacc 5y ago
  That's due to ACA, which is only about 7 years old and has an uncertain future. The cancer survival rates are a few percentage points better in the US than many other countries, but this is not uniform and still depends upon your level of insurance. If you are uninsured or underinsured your survival rate is significantly less than if you are fully insured. The "everything plus the kitchen sink" approach isn't ideal in all scenarios and the US healthcare system has a high level of overtreatment, often with potentially harmful interventions. It also pushes up the cost for everyone. However there are economic models that provide for a high level of universal healthcare equal to what the US has now and also cost less than the US spends right now. The difference is that is moves from a combination of clear personal cost and obfuscated public costs, to purely public costs and many in the US seem opposed to that relatively minor shift. It also means the politicians are even more responsible for their society's healthcare and I imagine many of them don't want that responsibility.
- gambiting 5y ago
  >>In single payer system, those therapies aren't even discussed with the patient since the physician knows if it's not paid for by the gov't it's effectively out of reach. I genuienly don't think that's as common as you think it is. Anecdote time: when my dad was diagnosed with GIST in Poland(you know, not a very wealthy country), his prognosis was about 6-12 months if lucky. But the doctors at the oncology unit knew that the drug Glivec was being approved against GIST but not yet refunded by the Polish healthcare system. They basically applied and got approved to fund his therapy along with 5 other people(GIST was and remains super rare). The national healthcare system paid for his treatment with Glivec for the next 8 years(until he died), despite the huge cost of the medication. Like, maybe he was lucky. But again, I think you are misrepresenting the system by saying "doctors won't even try". Sure, maybe some won't. Some will. I've heard similar stories from US where doctors won't order certain medically necessary treatment because they know insurers won't pay for it - it doesn't mean anything in isolation.
  - refurb 5y ago
    I have no idea what the timing was but Gleevec was first approved in the US 20 years ago. It was an old drug by the early 2010’s. And that’s what I’ve observed. Yes, in universal systems you’ll get cancer care, but you’ll get the standard of care from 5-10 years ago. All the while cancer can has advanced by leaps and bounds.
    - gambiting 5y ago
      Well, maybe. In my dad's case he started treatment in 2003, so I don't think it was that long after the first approval in the US.

by altacc 5y ago

refurb 5y ago

It's happens more often than you think. In single payer system, those therapies aren't even discussed with the patient since the physician knows if it's not paid for by the gov't it's effectively out of reach. Sure, the US system isn't perfect by any means, but one reason why it's so expensive is they throw everything plus the kitchen sink at patients. And this is even for Medicaid which covers the poorest Americans. Having lived in 4 different country with 4 different healthcare systems, if I got diagnosed with a serious cancer you can damn well be sure I'll get treated in the US. I have a friend who got diagnosed with breast cancer who did the same, moved back to the US and with ACA subsidies was getting the latest therapies with a monthly premium of $200. And the drugs she received weren't even paid for in her home country.

altacc 5y ago
That's due to ACA, which is only about 7 years old and has an uncertain future. The cancer survival rates are a few percentage points better in the US than many other countries, but this is not uniform and still depends upon your level of insurance. If you are uninsured or underinsured your survival rate is significantly less than if you are fully insured. The "everything plus the kitchen sink" approach isn't ideal in all scenarios and the US healthcare system has a high level of overtreatment, often with potentially harmful interventions. It also pushes up the cost for everyone. However there are economic models that provide for a high level of universal healthcare equal to what the US has now and also cost less than the US spends right now. The difference is that is moves from a combination of clear personal cost and obfuscated public costs, to purely public costs and many in the US seem opposed to that relatively minor shift. It also means the politicians are even more responsible for their society's healthcare and I imagine many of them don't want that responsibility.
gambiting 5y ago
>>In single payer system, those therapies aren't even discussed with the patient since the physician knows if it's not paid for by the gov't it's effectively out of reach. I genuienly don't think that's as common as you think it is. Anecdote time: when my dad was diagnosed with GIST in Poland(you know, not a very wealthy country), his prognosis was about 6-12 months if lucky. But the doctors at the oncology unit knew that the drug Glivec was being approved against GIST but not yet refunded by the Polish healthcare system. They basically applied and got approved to fund his therapy along with 5 other people(GIST was and remains super rare). The national healthcare system paid for his treatment with Glivec for the next 8 years(until he died), despite the huge cost of the medication. Like, maybe he was lucky. But again, I think you are misrepresenting the system by saying "doctors won't even try". Sure, maybe some won't. Some will. I've heard similar stories from US where doctors won't order certain medically necessary treatment because they know insurers won't pay for it - it doesn't mean anything in isolation.
- refurb 5y ago
  I have no idea what the timing was but Gleevec was first approved in the US 20 years ago. It was an old drug by the early 2010’s. And that’s what I’ve observed. Yes, in universal systems you’ll get cancer care, but you’ll get the standard of care from 5-10 years ago. All the while cancer can has advanced by leaps and bounds.
  - gambiting 5y ago
    Well, maybe. In my dad's case he started treatment in 2003, so I don't think it was that long after the first approval in the US.