In the UK, six months is worth about $22,750.
The NY Times profiles the UK’s comparative effectiveness agency, NICE, and the repercussions of their draconian decisions.
In many ways, what they are doing is admirable, because the British public is aware that there is a limited supply of health care dollars, and you have to have the ability to say “no.”
It’s no accident they spend almost $4,000 less per citizen in health care.
Folks, rationing is coming to America. There is no way around it. Starting the dialogue, by publicizing what other countries are doing, is an important step in educating Americans who are blissfully unaware of how much health care costs.
Related posts:
- Vaccines: Rising costs are putting children at risk
- We get too little for our health care dollar: Is this a myth?
- ACP: Putting effectiveness into the health care equation: Rational or rationing?
- The strong Canadian dollar
- Government-run health care?
- The inevitability of saying no
- Health Care Reform: Putting Patients First, medical bloggers at Washington, DC
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{ 13 comments }
I’m sure you didn’t mean it this way… but I always object when people who say “rationing is coming” to the US are asserting that health care in the US isn’t already rationed.
The choice of words is important. In order to have constructive public dialogue, everyone needs to understand that the US already has an irrational rationing system that provides some people with access to anything (often too much) while others aren’t assured of anything beyond stabilization in an ER.
The question isn’t whether we have rationing or not. All finite goods and services (all of them) are rationed.
The question is how it gets done—-by the market or by some soulless apparatchik in a government bureaucracy.
I’ll take the market.
I think it is reasonable and even necessary for the public to decide how much it is willing to pay for a persons life. If, however, they attempt to limit my expenditure of my own earnings for healthcare according to my own autonomous valuation, then that is a violation of my most fundamental liberty rights.
That of course mean inequality–always a necessary accompaniment of liberty.
To follow up on what Andrew Holtz and Catron said, “rationing” is already here. Example – Flu vaccines.
Ignoring the “goods” perspective for a moment and look at insurance. In some regards they are making the decision to “ration” who gets what service as well.
Just wanted to throw that out there…
V
http://vansantos.com
Yes Catron, the “market” has just done such a great job recently that it was just bailed out by that big bad soulless government bureaucracy. When a scumbag like Richard Fuld receives 1/2 BILLION dollars for running a company into the ground (Lehman brothers; a company that survived the US Civil War, Great Depression, and WWII, but not unchecked Greed) there is something seriously wrong with “the market”.
@Anonymous
I don’t believe Catron referring to the stock “market”.
Even with the failures of major financial companies, free enterprise still continues – people still pay what they feel is the correct value for the good/service.
So, that “market” didn’t fail… but I will let Catron talk for themselves.
Just an alternative view.
V
http://vansantos.com
Van:
I was not referring to just the “stock market” either. Markets are intertwined. If an insurance Co suffers major paper losses, they will make it up somewhere else (your premium). I am not for british style NHS. I am also not for Catron’s laissez-faire system without any accountability. That is unless you think United’s William McGuire was really worth 125 million in 2005 and you really think it makes sense that private HMO’s admin costs are 25-30% while the VA’s are 4-5%? I don’t.
The “market” has just done such a great job recently that it was just bailed out by that big bad soulless government bureaucracy.
Wake up, Anon. It was Congress that created the current economic mess by meddling in the market. As to all of the salaries you note, they are red herrings that have been waved under your nose to distract you from the real problem.
I am also not for Catron’s laissez-faire system without any accountability.
I recommend a couple of semesters of basic economics. There is plenty of accountability in a market-based economy. The producers are accountable to the customers. This only becomes distorted when those morons in D.C. insert themselves between the two.
No dear Catron YOU are part of the problem if you don’t acknowledge that HMO overhead costs are orders of magnitude higher than the VA (no snide comments since I trained at a VA I know better than you what is wrong with it). The simple fact is HMO’s have too many middleman getting a cut (people like yourself). The simple fact is CEO compensation is NOT a red herring when all the CEO’s make multiple orders of magnitude more than their european counterparts and hundreds of times ordinary workers. Why is this the case? Because there is little/no oversight. If you are such an economics expert, then you know damn well the controlling interest in CEO compensation is typically the board made up of crony’s and CEO’s of other companies. Your statement that “There is plenty of accountability in a market-based economy” is laughable. Have you not paid any attention the last four months. This is what happens when checks on complete greed such as the Glass-Steagall act have been removed (thanks, Phil Gramm). What most people here don’t realize is this whole debacle is intertwined eventually. Believe it or not Catron, I too believe in the free market, with checks to control greed that leads to unethical behavior. This behavior has been rampant and unchecked the last decade whether it be Richard Fuld, William McGuire, or your local mortgage broker who OK’d an ARM loan to someone who didn’t have the credit worthiness based on an increased commission. Well, the chickens have come home to roost. Open your eyes pal.
@Anonymous
Agreed, the markets are intertwined . I also agree that there needs to be accountability.
While a company may make up the losses by raising prices, we as consumers, have the ability to find a different provider.
That is the whole point of the free market. You have the ability to find who works best for you. If you have a problem with 30%, find someone else. Sure, there may be pains in doing so, but it is still an option.
Also, not all HMOs admin costs are at 30%. NIO run HMOs are historically around 5%
Best,
V
http://vansantos.com
Anonoymous said;
‘The simple fact is CEO compensation is NOT a red herring when all the CEO’s make multiple orders of magnitude more than their european counterparts and hundreds of times ordinary workers.’
Quite so. The two key factors keeping US healthcare costs so high are doctor/administrator remuneration and the huge associated costs of admin, drugs and procedures that are applied to episodes of care. When many other items are cheaper in the US than Europe, healthcare stands out as an exception.
Actually freemarket BS one can argue about MD pay. English and Canadian PCP’s do better than their American counterparts. Additionally, though one can argue about pay of some specialties (radiology, dermatology, etc) the fact is there has not been a significant increase in any MD pay per visit/procedure in over a decade thanks to the 1997 SGR formula. Think about the increase in costs of running a practice since 1997. MD’s take less than 20% of all medicare dollars. You could cut them down to zero and it it would not solve the medicare budget issues. Also, don’t forget you typcial American medical school grad comes out of scholl with close to 150 K in debt. Many come out with over 200 K in debt. European med school grads usually have 0 in debt. Look at the big picture here.
Anonymous said:
‘…one can argue about MD pay. English and Canadian PCP’s do better than their American counterparts’
Fair enough. That’s one reason primary care is so poor in the US. But the overall cost of healthcare is higher, and salaries of executives and medical staff do contribute. Another reason is that there is or has been a large section of Americans who earn more than Europeans and can be tapped for higher prices.
‘…don’t forget you typcial American medical school grad comes out of scholl with close to 150 K in debt. Many come out with over 200 K in debt. European med school grads usually have 0 in debt.’
Yes but that makes the point for higher remuneration. A lot of European students do have considerable debt – tuition in the UK is no longer paid by the state for example and a loan system is in place – but agreed it’s not at US levels.
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