What is the current Republican position on this?

[Malcolm Kirkpatrick]

So people would pay for the services they want. What if they want to live, but don't have the money for treatment? You're okay with letting people die because they don't have a few hundred thousand dollars just sitting around?

That's everyone. We are all born terminally ill and no amount of money will change that.

 

[Drachasor]

Flat false. Part of the "problem" is the uncertainty at every step in the process. That cannot be wished away. Neither can the other part: the different values which people place on human life. Does a death-row inmate with liver cancer get a lung transplant? Does a 92 year-old get a kidney transplant? Won't the value of an artificial hip or knee implant depend on the expected years of active life?

Again, if you think they have a problem, then cite EVIDENCE, because I've cited plenty and there's no sign that they do have remotely significant problems defining care. This is a problem you are making up.

Further, even if this make-believe problem was real, there's no reason why private insurance wouldn't have the same issue. However, they can define "medical care" perfectly fine as well.

We will all be denied or deny ourselves care we "need". Everybody dies. For every human for every dollar-denominated amount of medical resources __$X__, no matter how small, there will come a time such that some additional increment of longevity expectation __Y__days, is not worth __$X__.

That's not how medical care works in general. It can sometimes VAGUELY be like this with a chronic or long-term health condition. However, you can't just toss more and more money at a problem and get a better and better solution for someone's health care. That is definitely wrong.

Someone comes in to the ER who is partly crushed. If they die from that it isn't because there wasn't enough money spent on them. It's because they suffered injuries that could not be healed PERIOD.

Again, people with health care don't die because treatments are too expensive, they die because there are no treatments that prevent death.

We've been over this time and time and time again. I've repeatedly pointed out that if what you were saying was a valid way of looking at things, we'd expect wealthy people to live much longer than those without a lot of wealth. This is decidedly not the case.


I REPEAT: State-run health care is better and cheaper than private insurance. All evidence backs this up. Whatever cost concerns there might be, State-run systems handle them better and more efficiently, providing equal or better care that privatized systems. None of you arguments invalidate this FACT.

 

[Drachasor]

That's everyone. We are all born terminally ill and no amount of money will change that.

Health care can certainly change how long someone will live. In fact it has a very significant impact.

 

[rustypouch]

That's everyone. We are all born terminally ill and no amount of money will change that.

So why have health care at all? If we're just going to die anyway, why bother with all this messiness that is life?

 

[BenBurch]

That's everyone. We are all born terminally ill and no amount of money will change that.

In that case, you don't bother with food, sleep, or exercise because it would be pointless, correct?

 

[Chaos]

So why have health care at all? If we're just going to die anyway, why bother with all this messiness that is life?

And indeed, why outlaw murder? I´m sure that if we legalize murder, the resulting boom in the hitman industry will help the economy recover.

 

[Malcolm Kirkpatrick]

Again, if you think they have a problem, then cite EVIDENCE, because I've cited plenty and there's no sign that they do have remotely significant problems defining care. This is a problem you are making up.

Further, even if this make-believe problem was real, there's no reason why private insurance wouldn't have the same issue. However, they can define "medical care" perfectly fine as well.

Drachasor should take up this argument with Drachasor, who has argued that US hospitals spend needlessly on high-tech imaging devices. So Drachasor argues that some "care" is counter-indicated.

That's not how medical care works in general. It can sometimes VAGUELY be like this with a chronic or long-term health condition. However, you can't just toss more and more money at a problem and get a better and better solution for someone's health care.

Quite often, additional tests increase the confidence of a diagnosis. At some point, depending on uncertain human knowledge and personal value judgments, some additional test is not worth the additional expense.

Someone comes in to the ER who is partly crushed. If they die from that it isn't because there wasn't enough money spent on them. It's because they suffered injuries that could not be healed PERIOD.

Good example. Sometimes they enter the ER with a prognosis of __X__ years of additional life at Y level of activity. These are variables that range from "75 years of normal health" to "15 years as a doorstop" and include everything in between.

 

[Drachasor]

Drachasor should take up this argument with Drachasor, who has argued that US hospitals spend needlessly on high-tech imaging devices. So Drachasor argues that some "care" is counter-indicated.

False dichotomy. Some procedures can be more expensive than is necessary. That doesn't mean that care is problematic to define nor does it mean that you can spend unlimited wealth on care.

Quite often, additional tests increase the confidence of a diagnosis. At some point, depending on uncertain human knowledge and personal value judgments, some additional test is not worth the additional expense.

So? This is far, far, far from saying you can spend unlimited wealth on someone's health care. It isn't even stating that more tests are even USEFUL after a point.

Good example. Sometimes they enter the ER with a prognosis of __X__ years of additional life at Y level of activity. These are variables that range from "75 years of normal health" to "15 years as a doorstop" and include everything in between.

So? That doesn't support you claim that you can spend unlimited money on someone's care. I'm not saying money doesn't matter, but you act like more money can always be spent on someone's health and the vast majority of the time this isn't the case.

Further, to the very limited extent that this is true, it only supports State-run health care, since they get the same performance for less money. It's just far, far more efficient.

 

[bikerdruid]

Flat false. Part of the "problem" is the uncertainty at every step in the process. That cannot be wished away. Neither can the other part: the different values which people place on human life. Does a death-row inmate with liver cancer get a lung transplant? Does a 92 year-old get a kidney transplant? Won't the value of an artificial hip or knee implant depend on the expected years of active life? We will all be denied or deny ourselves care we "need". Everybody dies. For every human for every dollar-denominated amount of medical resources __$X__, no matter how small, there will come a time such that some additional increment of longevity expectation __Y__days, is not worth __$X__.

your continued nonsense just further demonstrates that you have no idea how socialized medicine actually works.
i can assure you that in canada and the u,k,, people are not denied service because of age or infirmity.
you really are ignorant of the real world, or perhaps you are just trolling..

 

[Malcolm Kirkpatrick]

...Some procedures can be more expensive than is necessary.

What is "necessary"?

...That doesn't mean that care is problematic to define nor does it mean that you can spend unlimited wealth on care.

"Care" is very problematic to define. At least if "care" means "resources and attention that enhance life expectancy". "What works?" is an empirical question. Any rational system will weigh some treatments against others and against alternative (non-medical) uses of the resources. This weighing will include empirical assessments and value judgments.

...So? This is far, far, far from saying you can spend unlimited wealth on someone's health care. It isn't even stating that more tests are even USEFUL after a point.

I can spend my entire bank balance on medical care for my cats if I want to. A bureaucrat can spend to the limit of his budget. One can always spend more, so long as one has more money available. The point is, we trade resources devoted to medical care against other uses for those resources and subsidization changes the calculation.

...So? That doesn't support you claim that you can spend unlimited money on someone's care. I'm not saying money doesn't matter, but you act like more money can always be spent on someone's health and the vast majority of the time this isn't the case.

You can spend up to the limit of your budget.

...Further, to the very limited extent that this is true, it only supports State-run health care, since they get the same performance for less money. It's just far, far more efficient.

Drachasor keeps insisting. They DON'T get the same level of performance, according to Thomas Sowell.

 

[Malcolm Kirkpatrick]

your continued nonsense just further demonstrates that you have no idea how socialized medicine actually works.
i can assure you that in canada and the u,k,, people are not denied service because of age or infirmity.
you really are ignorant of the real world, or perhaps you are just trolling..

Here.

The calculations are complicated, but imagine that a cancer treatment costs $100,000 and that it extends the life of the average patient by four years. That means the cost of the treatment per year gained is $25,000.

Now imagine that for part of those four years the patient will be in pain and bedridden. NICE might figure the quality of that life at 50 percent of perfect health. Under NICE's formula, that would make the drug half as cost-effective. In other words, the result would be $50,000 per quality-adjusted year gained.

NICE has set a maximum that it will spend on a treatment: about $47,000 per quality-adjusted year gained.

NICE tends to assume, without always performing calculations, that most common treatments are cost effective -- including insulin for diabetes, cholesterol-lowering drugs for heart disease, and kidney transplants.

Instead, NICE analyzes only selected therapies, such as expensive new drugs that may extend life at the end of life. It has calculated that some of the more expensive drugs meant to slow the progression of Alzheimer's Disease and some cancers fall below the cost-effectiveness threshold. In such cases, NICE says, the NHS shouldn't pay for the drugs.

NICE chairman Michael Rawlins acknowledged that his agency's decisions deprive some patients of drugs that may extend their lives by several months or more.

"We do recognize that the end of life is a very special time," Rawlins said. "[It] allows people to attend weddings, see a grandchild born, seek forgivenesses."

But he argued that if Britain spends a lot of money at the end of life, "we're going to have to deprive other people of cost-effective care." Rawlins said that might mean spending less money at the beginning of life -- and might result in a higher infant mortality rate.

Your continued nonsense just further demonstrates that you have no idea how socialized medicine actually works. You really are ignorant of the real world, or perhaps you are just trolling.

 

[bikerdruid]

Here. Your continued nonsense just further demonstrates that you have no idea how socialized medicine actually works. You really are ignorant of the real world, or perhaps you are just trolling.

dude...
i live with socialized medicine and have for almost 60 years.
my 94 year old mother gets excellent care from three doctors that se sees regularly.
according to you, she would have been ignored by now.
i live 6 hours drive from the nearest large city, but if an emergency arose, i would be airlifted to edmonton where a surgical crew would be waiting for me.
i see a specialist once a month, a g.p. whenever i need.

you really have no idea what you are talking about. zero. zip. zilch.

 

[Malcolm Kirkpatrick]

you really have no idea what you are talking about. zero. zip. zilch.

And neither does this guy, right?

NICE chairman Michael Rawlins acknowledged that his agency's decisions deprive some patients of drugs that may extend their lives by several months or more.

 

[bikerdruid]

And neither does this guy, right?

canada's system does not include pharmaceuticals.
so that is irrelevant.
most companies offer benefits that include those and dental care.

 

[Malcolm Kirkpatrick]

...We will all be denied or deny ourselves care we "need". Everybody dies. For every human for every dollar-denominated amount of medical resources __$X__, no matter how small, there will come a time such that some additional increment of longevity expectation __Y__days, is not worth __$X__.

..in canada and the u,k,, people are not denied service because of age or infirmity.

Here.

...NICE tends to assume, without always performing calculations, that most common treatments are cost effective -- including insulin for diabetes, cholesterol-lowering drugs for heart disease, and kidney transplants.

Instead, NICE analyzes only selected therapies, such as expensive new drugs that may extend life at the end of life. It has calculated that some of the more expensive drugs meant to slow the progression of Alzheimer's Disease and some cancers fall below the cost-effectiveness threshold. In such cases, NICE says, the NHS shouldn't pay for the drugs...
But he argued that if Britain spends a lot of money at the end of life, "we're going to have to deprive other people of cost-effective care." Rawlins said that might mean spending less money at the beginning of life -- and might result in a higher infant mortality rate.

...you really have no idea what you are talking about. zero. zip. zilch.

And neither does this guy, right?

NICE chairman Michael Rawlins acknowledged that his agency's decisions deprive some patients of drugs that may extend their lives by several months or more.

canada's system does not include pharmaceuticals.
so that is irrelevant.
most companies offer benefits that include those and dental care.

The linked article discussed "therapies", not just "drugs", and "money at the end of life". Contrary to Druid's assertion: "people are not denied service because of age or infirmity", both "age" and "infirmity" enter into the calculations that determine who gets what treatment.

And what will Drachasor say in response to "canada's system does not include pharmaceuticals"?

 

[bikerdruid]

The linked article discussed "therapies", not just "drugs", and "money at the end of life". Contrary to Druid's assertion: "people are not denied service because of age or infirmity", both "age" and "infirmity" enter into the calculations that determine who gets what treatment.

certainly not in canada.
you need to do more homework.

 

[Malcolm Kirkpatrick]

(Malcolm): "The linked article discussed 'therapies', not just 'drugs', and 'money at the end of life'. Contrary to Druid's assertion: "people are not denied service because of age or infirmity", both 'age' and 'infirmity' enter into the calculations that determine who gets what treatment."

certainly not in canada.
you need to do more homework.

Druid wrote: "..in canada and the u,k,, people are not denied service because of age or infirmity." We have established that in the UK, the State sets a limit to the budget for a patient's treatment, based in part on considerations of age and/or quality of life (i.e., "infirmity"). By Druid's admission, we have "canada's system does not include pharmaceuticals", so there's a whole class of treatments the Canadian system "denies" to everyone.

 

[Malcolm Kirkpatrick]

Oh, and here:

Rationing : “Everything is Free but Nothing is Readily Available” (Frogue et al, 2001) Like other nations experiencing limitless demand, an ageing population and the costly advance of medical technology, Canada has faced pressure to control health expenditure. It has done so through explicit rationing.

Set up in 1989, the Canadian Co-ordinating Office for Health Technology Assessment is the Canadian predecessor to our NICE, charged with exactly the same brief and, it seems, carrying out its function in the same way. For example, in the case of new cancer treatment, the latest pharmaceuticals (such as visudyne for macular degeneration), and high-tech diagnostic tests, Canadian governments simply reduce their expenses by limiting the service. Such a method of rationing is only possible in a single-payer monopoly. Medicare also shares other defining characteristics of monopolies: limited information, little transparency and poor accountability.

Canada has faced increased pressure to reform hospital structures to accommodate the changing pattern of care from an institutional to a community-based model. Reforms have attempted to limit growth and manage the system more effectively. Provinces have proven their ability to manage cost control by the use of their monopsonistic power associated with the single payer structure (WHO, 1996). Hospitals are paid through the imposition of annual global budgets by provincial governments. The downside of this cost controlling efficiency is evident by the problem of waiting lists and dilapidated technology and equipment.

Further (Drachasor, take note)

So why does Canada perform relatively well? Studies have shown that a number of non-health system related factors affect health outcomes. Perhaps the high level of expenditure is important. Canada also benefits from lower levels of income inequality than the US and UK. Tobacco consumption is low in comparison to OECD member countries.

 

[Drachasor]

Malcolm, I am going to ask you one more time to stop composing your posts so that they are hard to respond to. Try quoting one of them to see what I mean. Making your posts require tedium to craft a response is quite annoying.

"Care" is very problematic to define. At least if "care" means "resources and attention that enhance life expectancy". "What works?" is an empirical question. Any rational system will weigh some treatments against others and against alternative (non-medical) uses of the resources. This weighing will include empirical assessments and value judgments.

Empirical assessments more than anything. Value judgments are left to the patient. There are extreme examples where this is the case, but generally costs are small enough to not be an issue.

Again, this is nothing unique to state-run medicine.

I can spend my entire bank balance on medical care for my cats if I want to.

Maybe your balance is really small. In general you couldn't spend say, 100,000 dollars on care for one cat, for example.

A bureaucrat can spend to the limit of his budget. One can always spend more, so long as one has more money available.

No, you can't. Let's say you get cancer. You can pay for some chemotreatments. You might be able to pay for a few surgeries. Possibly another procedure or two. Then that's it. There is a limit to the procedures and money that can be spent on one problem.

They DON'T get the same level of performance, according to Thomas Sowell.

Appeal to authority. I actually posted a compilation of STUDIES showing things to be pretty much equal. Why can't you respond to that?

And what will Drachasor say in response to "canada's system does not include pharmaceuticals"?

Frankly, Canada's system is far from the best. Your article indicates this, referring to how Canada ranks poorly compared to a number of other countries. Attacking the problems in Canada's system is easy, because it does need some reform.

That said, the cost of drugs in Canada is significantly cheaper than the cost of drugs in the USA. So they ARE better than the USA here.

Further (Drachasor, take note)

Respond to the study I posted that show that life span is shorter in the USA because they don't treat diseases as well as other first world countries rather than just Canada. Respond to the compilation of studies that show other first world countries in general perform as well as the USA or better, rather than just Canada. Or is your plan to ignore evidence that disagrees with your position?

 

[bikerdruid]

(Malcolm): "The linked article discussed 'therapies', not just 'drugs', and 'money at the end of life'. Contrary to Druid's assertion: "people are not denied service because of age or infirmity", both 'age' and 'infirmity' enter into the calculations that determine who gets what treatment."
Druid wrote: "..in canada and the u,k,, people are not denied service because of age or infirmity." We have established that in the UK, the State sets a limit to the budget for a patient's treatment, based in part on considerations of age and/or quality of life (i.e., "infirmity"). By Druid's admission, we have "canada's system does not include pharmaceuticals", so there's a whole class of treatments the Canadian system "denies" to everyone.

there is no limit to pharmaceuticals used in hospital, while in treatment.
however, regular doctor's prescriptions are not covered.
for about 75 dollars a month, however, blue cross will cover any pharmaceutical costs.