Mallory

Interesting article,

http://www.thenewamerican.com/world-...m-lack-of-care

Giantaxe

"What is needed instead is to jettison the NHS and let the free market provide healthcare just as it provides so many other necessities (and luxuries) in abundance and at low cost."

Because that's worked out so well for healthcare in the US presumably.

HarryTheSpider

Is this article arguing against itself?

Opening paragraph, and I quote...
Surely the corporate self-interest / cost control is part of the issue - no cost control in the US, of course, because the system is rigged in favour of the healthcare providers by the AMA and others... So you can either have cost control (UK) with the challenges that brings, or no cost controls, and yet have...

• 100,000 to 225,000 deaths per year due to going to the hospital or doctor in the USA - http://www.health-care-reform.net/causedeath.htm
• 45,000 deaths per year due to not having insurance - http://www.reuters.com/article/2009/...58G6W520090917

And of course, the free market system simply won't develop the drugs / procedures needed by a group with a particular ailment/condition if that group is unable to pay and make it worth the while of the pharmas & others to develop it in the first place, whereas a system like the NHS has more spending power & strategic direction to make at least some of that happen some of the time...

I have to say the argument put forward in the New American is a big FAIL - again...

Pulaski

If we assume that even one third of the US population has good, albeit expensive, medical insurance that will pay for more or less whatever their doctor prescribes (whether or not it is effective, but that's a whole other discussion), then that gives a population of 100 million to sell to. All the pharmaceutical companies need to do is get the FDA to approve a drug then advertise their new wonder drug on TV and turn their salesmen loose to push it on the medical profession. I don't see any basis for suggesting that the healthcare system in the US, deeply flawed though it is, isn't capable of generating new drugs to treat all manner of diseases, illnesses, and conditions.

yellowroom

Mega pharma companies, having shareholders, are obligated to maximise their profits, and so will target the conditions on which they think they will be be to make the most money. Hence all the drugs for blood pressure, cholesterol, diabetes and erectile dysfunction in the US.

There is a looming healthcare crisis coming - within a generation, antibiotic resistant strains of bacteria will be so prevalent that major surgery will no longer be feasible (eg hip replacement, heart surgery, transplants). People will once again be dying of infections like tonsillitis. Only a few pharma companies are researching the area. Because you only take antibiotics for a few days. The current business model wants to sell you drugs you take for the rest of your life.

It is left to the smaller, more niche companies and universities to pick up the scraps and try make a living from the drugs that are medically needed but not blockbusters. It is in this area that government funded healthcare systems can bring pressure to bear - with incentives and tax breaks etc.

HarryTheSpider

... Other than the 10+ years of clinical trials and other research, and several $Bn in development costs before being able to go to market...

... Would you stump up several $Bn on a bet, the outcome of which won't be known for a decade? Sure, you hedge your bets. But you can only do that so much...

Your argument works for the general case. Not necessarily (IMHO) for the specific case for a given medical condition that affects a small number (1million? 100,000?) of people, most of whom like the general population, are not loaded with cash... And perhaps a health insurance industry that ultimately doesn't want to pay for it...

Pulaski

Your argument appears to assume multiple points of failure, not all of which may be true, and I suggest none of which may be true.

The big pharma companies of today have for many years been swallowing small drug development companies with late-stage development drugs, which they can then get approved and take to market. This is a reasonably effective method of getting drugs developed; maybe a "benevolent dictator" model of centrally planned healthcare expenditure would work better, but generally government involvement in anything tends to lead to bureaucracy, inefficiency, poor oversight, and lack of accountability. For example: a development drug is not testing well, a for profit drug company will drop it and move on, or scale back to see if can still be developed successfully, but if the research team is publically funded they may be able to hold on for another year to keep their jobs.

HarryTheSpider

Yup - fair points. Except that multiple studies / data points demonstrate over many years that the efficiency of government Medicare/Medicaid administration is literally world-beating - not just gov to gov, but in comparison to any private sector equivalent - by a factor of approx 2.5x

My argument is that for a certain group of people with a certain medical condition, pharmas (medication) and hospitals (medical procedures) will not see a big enough, quick enough (i.e low enough risk) return on the presumably sizeable investment needed to develop an effective treatment - or at least one that people/providers will buy (not every pharma or treatment is effective - these companies are very competent at spinning their clinical research... Just look at how many times pharmas et al publish data that also includes significant data on failure/insufficient efficacy).

My view is that a combination of private investment, government investment & encouragement can give the best outcome for society as a whole.

Pulaski

Agreed, without reservation.

RoadWarriorFromLP

Well, I was going to get cancer, but then I decided against it when I found out how expensive it was. Supply and demand, and all that.

Lion in Winter

Yeah, those people who got ill made really poor investment choices.

AmerLisa

Or were living in the wrong postcode....

http://www.bbc.co.uk/news/uk-england-london-20272912
http://www.telegraph.co.uk/health/he...tery-case.html
http://www.dailymail.co.uk/news/arti...ttle-life.html

HarryTheSpider

Or did they choose the wrong parents?

RoadWarriorFromLP

The free market for disease just ain't what it used to be.

My goal is to get several diseases at once, so that I can negotiate a volume discount. (Buy one pacemaker, get a free liver transplant and a set of steak knives.)

scrubbedexpat099

The biggest factor - genes.