http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm199374.htmIt is safe, effective and in use regularly here in the US. All insurers cover it.
In the case of lapatinib, it is not pointless or untested. Unless, of course, you are the NHS and you want to save as much money as possible -then yeah "pointless and untested!"
Yes, US insurers cover it. So NICE just has to dance to their tune? Tatyana has shown how questionable the safety and efficacy are. And with the complex commercial webs tying US healthcare players together, I don't think we can be assured that US insurance companies are making an arms-length decision on this.
So a child born in the Democratic Republic of the Congo has no inalienable rights of their own? They can be used as soldiers because that's what their society has deemed OK? I think even you would agree that there are certain rights we are born with and that it's wrong for society to take away.
Why is murder wrong, Rolfe? Could it be because we are all born with the right to life? And if society legislates that children can be used as soldiers, then that's OK? Or is it violating their inborn human rights?
No, I don't agree. Your thinking is muddled. Who would confer such rights? How can you tell they're there? In what way would the observed world be different if no "inalienable rights" of that sort existed?
A child born in the Democratic Republic of Congo has exactly the rights accorded to it by the laws of that country,
and by any international organisations which might attempt to impose more humane standards from outside.
Start thinking right and wrong, moral and immoral, not "inalienable rights".
Should these children have the right to life. Our moral sense answers "yes". Thus, if their society doesn't confer that right on them, international organisations such as the UN will attempt to intervene to grant the rights they believe people
ought to have.
This works a helluva lot better than standing there bleating, "but they
have the right to life," if in fact they don't.
The question you need to ask is,
should US citizens be given the right of access to affordable healthcare? In most other countries, the answer (on behalf of their own citizens) is a resounding "yes". Why should the USA's mileage vary, the biggest, richest plutocracy on the planet?
You tell me.
No, no. You have it twisted. You guys have already decided it's a right.
"Us guys" have decided to institute a universal healthcare system, paid for from general taxation, and the right that all legal residents have is the right to access that system when they need it.
The USA could easily do something similar. Your choice.
Yet your system lets people die everyday because their treatment isn't "cost-effective."
No, it doesn't. You have provided precisely zero evidence of this preposterous statement.
And who determines cost-effectiveness? Why, your government of course! You know, the ones who hold the purse strings? In this way, your government is no different than a US insurer except for the fact that your poorer citizens have no choice to find an alternative.
What's completely insane is continuing to insist that the NHS provides for everyone's needs. The evidence is mounting that this is not so, especially for people in poorer regions. Now you are qualifying your statement with "only what is reasonable and deliverable." Interesting change from your rosy-cheeked description earlier.
You are the only person who called anything "rosy-cheeked". I said everyone was entitled to the healthcare they needed, and very very few people would ever see any ceiling in their lifetimes, either for themselves or their friends and family.
When I referred to "reasonable and deliverable", you can look back and see that I was refuting a ridiculous American notion that a universal healthcare system would require that any patient who requested it on a whim would have to be flown thousands of miles at public expense to see the surgeon of their choice. This is not so. You fund your own transport to get your healthcare, unless you're very very poor. If you're very very poor you may apply to have your transport paid for, but in that case you will not be seeing a surgeon 1,000 miles away
unless your physician believes that is the surgeon you have to see.
What is covered on the NHS is decided by senior physicians looking at the evidence. This is something of a world first. Your country might learn from this.
No one said the US system was perfect the way it is. It needs major changes to make it accessible to everyone.
Indeed it does. And there are a number of ways this might be achieved, and examples of these can be seen around the world. None, zero of these rely on an unregulated free market. None, zero of these operate without the richer members of the society contributing to the costs of the healthcare of the poorer members.
And that system works for you. But to say that the NHS should be our model for healthcare is wrong. I'd rather look at what countries like Switzerland and yes -Singapore are doing. They've found ways to
- Provide care to all citizens
- Make people personally responsible for their healthcare -thus lowering costs
- Keep medical decision making in the hands of doctors and patients
- Keep physician pay at acceptable levels.
And it doesn't involve a single government payer solution.
Those are the four things I think we need for America. Everything else is just emotional hand-wringing.
You're right to look at other systems, and I think you'll find I have been advocating this from the beginning. However, your monstering of the NHS is based on entirely false premises, and your bullet points are naive in the extreme.
- It is impossible for costs to be significantly lowered by "market forces" while continuing to pay doctors superstar incomes.
- It is impossible to provide care for all citizens without forcing the richer citizens to contribute to the care of the poorer citizens.
Again, no one is disputing the fact that the current American system mostly sucks. What I say is that NHS-style UHC would be an economic disaster here in the US based on numerous reasons which I've presented here. There has to be a better way to do it and that's what we should be fighting for.
An NHS-type system may indeed by inappropriate for the USA. I wouldn't press it as the obvious solution. It was established a long time ago, and there are a lot more examples to look at mow.
However, the fact remains that the NHS works.
- It provides care for all residents, not just affordable but free.
- It does not have a significant problem of over-utilisation, a situation achieved by education rather than financial coercion.
- Medical decision-making is in the hands of the doctors and the patients, in marked contrast to the USA where insurance companies insinuate themselves into the equation in an entirely inappropriate manner.
- Physician remuneration is excellent, when you look at the complete package including costs of their own healthcare, and insurance and other overheads.
The USA is under no obligation to adopt a similar model. However, monstering a system which works extremely well in comparison to the USA's broken train-wreck is not a constructive way forward.
If you want to keep the insurance companies administering healthcare funding, you have to confront the fact that the corporate culture in the US health insurance industry is to treat customer contributions like a cash cow, and seek to minimise the amount of money paid back to their customers at every opportunity. In that context, some problems might be encountered if the same people are left within sniffing distance of a potential gravy train.
Rolfe.
) also have to worry about getting sued for not over-treating.