steveq

No, I think there is a lot in what he's saying. Look at cancer spend per patient, look at outcomes, they throw money at cases with really no hope.

Sally Redux

That's because the system here is based on profit, and you make a profit by treating even hopeless cases.

British people still have extremely high expectations for longevity and complain very loudly about any waits.

scrubbedexpat099

So how do you explain the mis application of resources in the UK?

steveq

....when we should be demanding better service. Doesn't happen. Even after mid-Staffs.

scrubbedexpat099

The Woolworth syndrome, private companies eventually go bust, a lot sooner than Countries do..

Steve_

Deficit and national debt are not the same thing, you can have a smaller deficit and still have an increasing debt, also you can spend more on healthcare with the idea that you will realize savings in other areas.

The point I'm making is that spending goes up in one area so to keep the overall size of the budget the same, spending goes down elsewhere. Obama is already doing that with the military.

I think it's more to do with history than anything else, the VA came about largely because of the Bonus Army demonstration after WW1 which scared Congress so badly they actually did something. That led to the VA in 1930, back when there was no Medicare or Social Security.

There is a need for a few specialized hospitals to deal with injuries that you get in war you wouldn't get in civilian life, but to have a separate hospital system purely for veterans is simply a hangover from the 1930s. Doesn't make sense anymore. It's one of these things that just carries on because people are too scared to do something about it.

Steve_

I take it you didn't click on the link then.

And there most certainly is a comparison between Canada and the US, they're on the same continent after all.

Pulaski

You make money by treating easy cases, phantom illnesses, and hypochondriacs who aren't ill at all. Hopeless cancer cases are money pits that lead to insurers cutting off the funding for treatment and/or lifetime limits of coverage being reached.

notshipman

Very true but they have little idea of how much healthcare actually costs hence e.g they lose hearing aid costing 2k then expect the state to give them another. Why?!! Families use hospitals as free nursing homes when they dont want to pay for care for elderly rels.

Also I find generic prescribing to be much better in the US. If you say to a punter you can have med x for $ hundreds or med y which does exactly the same thing for $3 its an easy choice.

There needs to be some form of copay in the UK to bring some reality to the madness going on and bring some responsibility back to use the system not abuse it.

Steve_

Yeah, the approx. retail price of everything should be made known to the person who gets it, I wouldn't have thought that was hard to do. Here in Alberta they do it.

The problem is the govt. negotiates bulk pricing so it's not a "real" retail price, but still, more realistic than nothing at all.

Here with ABC prescription coverage (the most common) you pay $25 for each prescription - but they point out on the receipt what the real price is and the difference between what you paid and would have had to pay. Although the "real" price is artificially lower.

Pulaski

Personally I don't think insurance should cover more than the cost of the generic if one is available. Or at least insurers should offer "generic whenever possible" policies at a discount.

scrubbedexpat091

Same in BC as you mentioned. The receipts have:

Drug cost
Government coverage
Private coverage
filling fee
Patient pays

Giantaxe

28% of Medicare's spending is for end of life care. There's plenty of money to be made there.

Insurers are no longer allowed to impose lifetime limits.

Pulaski

Considering that Medicare's sole reason for being is to provide health care for people approaching the end of their life, I'm surprised that it's only 28%.

To your other point about limits, a colleague of mine who was undergoing terminal cancer treatment within the past 12 months had his insurer refuse to pay for treatment towards the end of his life. I am not sure why he was refused, but a friend and neighbor reported that the patient's MIL had been footing the bill for at least some of his treatment during his final weeks.

Giantaxe

US life expectancy at the Medicare eligibility age of 65 is 20 years. So 28% is quite a chunk given an average of two decades of coverage.

I think the prohibition on lifetime limits only started this year. There may also be "grandfathered" plans that can still impose a limit.