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>>As we move into an era of personalized medicine, we'll be subsidizing better healthcare and better outcomes for some ethnic groups over others. I think you m
by robbiep 13y ago
>>As we move into an era of personalized medicine, we'll be subsidizing better healthcare and better outcomes for some ethnic groups over others.
I think you miss the point of universal healthcare. It is not that one group has a higher utilisation of the healthcare system and therefore should pay more - the principle is that everyone is guaranteed the same provisions for healthcare, regardless of their risk factors.
Personalised medicine contributes nothing to the concept of universal healthcare; except for the noble aim of enabling better treatment of people through understanding individual responses. '
The idea that someone should be restricted in their level of healthcare utilisation under a universal system is absurd; As is the notion that someone should be forced to contribute extra (apart from the incremental addition of a high income earner through increased taxation) due to a perceived increase in risk.
>>The faulty assumption behind universal healthcare is that a one-size-fits-all prescription is good for everyone,
Again, I feel like you are trying to talk about personalised medicine inside of the concept of universal healthcare. Forget about personalised medicine. What the US needs first is access that won't bankrupt.
The fact is we don't know enough about personalised medicine to give people different treatments based on genetic characteristics. And we won't for years. Sure, you can look at 1 or 2 isolated instances at the moment (ACE-inhibitors and ARBs in Black people for instance) - but none of this matters when it comes to life-saving care, for which the treatment is going to be the same for everyone anyway, unless you happen to have some rare blood disorder in which case racial profiling and blood tests at the time of intervention will dictate management.
>> so in a way, it's a subsidy for rich white people.
How so? Because they live longer anyway? Because they are less likely to indulge in the risk factors that result in early mortality? Again, Universal healthcare doesnt discriminate. But since rich black/brown/yellow/white/green people pay a higher proportion of taxes anyway, shouldn't your argument here be that Universal healthcare is a tax on rich people?
Additionally, just because you are on a high dose of a Statin, in a high risk population, doesn't mean you are developing myopathy. CK levels should usually be checked after a month or 2 of Statin therapy in line with followup for new lipid levels, and in the absence of symptoms it can be fairly safely ruled that you aren't experiencing a complication of a statin drug. But you probably already know this.
- dnautics 13y ago>is that everyone is guaranteed the same provisions for healthcare You're missing my point. If those provisions are the same, that's exactly the problem. It's only worse if they aren't the same (because who chooses?) CK levels warnings are only triggered when you are having a serious complication from the statin. When you have a lesser complication, like, "going to the gym sucks instead of making you feel good", and you aren't aware of what's happening, and it's making you fatter, and your quality of life is going down, then what?
- robbiep 13y agoAgain i'll have to insist you are missing the point. Not my point, although I am advocating it; but the point of universal healthcare is to enable everyone access to the same level of healthcare for free. (Or, paid for by the taxpayers if you insist). The principle is not about ensuring that someone with a specific amino acid substitution receives a specific drug, because this is an example of the specific medical management of a specific patient. If you are going to continue to insist that your dad was treated inappropriately, and I have no reason to be able to assume one way or the other from my current position on the other side of the planet without a through examination of your father and his medical results, then what you are complaining about is not universal healthcare per se but in fact poor care by the treating physician. Which could happen under any system, anywhere.
- dnautics 13y agocan you define for me what you mean by "the same level of healthcare"? >universal healthcare ... poor care by the treating physician These issues are entangled. I should let you know, that despite being in the US, my father is effectively being treated by a "universal healthcare" system - the VA.
- robbiep 13y agoAccess to life saving treatment when required, as required, access to free hospital and cheap/free out of hospital medication. The issues are no more entangled than that 'healthcare providers' are a subset of 'healthcare' and within healthcare providers are going to be doctors administrating care that is not up to the best evidence. Universal healthcare is no defence against that, but either is any other form of healthcare. If you select your own doctor you have every chance of choosing one that may give you treatment against the best evidence. It seems you are saying that universal healthcare means that you will get poor healthcare. I vehemently disagree with this proposition, not just based on your single anecdote but because I live in a country with a universal healthcare system and I have worked within it and in a few months I will be dispensing care from within it as a doctor. Every system has failures but this criticism isn't an indictment of the entire system