Government Restricted Health Care - How Much is Your Life Really Worth?

nicurn001 · May 28, 2008

ZASHAGALKA the articles premises is set out in the first paragraph "

In theory, a year of human life is priceless. In reality, it's worth $50,000.

That's the international standard most private and government-run health insurance plans worldwide use to determine whether to cover a new medical procedure. More simply, insurance companies calculate that to make a treatment worth its cost, it must guarantee one year of "quality life" for $50,000 or less. New research, however, would argue that that figure is far too low."

The article is meant to pertain to BOTH private and government - run healthcare!

So lets rather than have another diatribe from you , about the ills of government run healthcare have a discusion of the advantages and failures of private healthcare .

For starters how can the private system be viewed as a sucess when ,it refuses to cover people who are ready ,willing and able to pay for insurance ( pre existing conditions ).

Cherry picks patients from low risk groups , leaving the agent of last resort ( the government ), to cover any one who is too likely to use the insurance and therefore not be profitable for the Insurance Co. and it's shareholders:twocents:

ZASHAGALKA, RN · May 28, 2008

For starters how can the private system be viewed as a sucess when ,it refuses to cover people who are ready ,willing and able to pay for insurance ( pre existing conditions ).

Easy. Get the gov't out of the business of protecting the markets of private insurance. The free market depends on customers. All customers. Will those with pre-existing conditions be treated as favorably as those that don't have them? Probably not. But they will get a much more fair shake than from gov't that writes them off (and allows them to be written off).

Real insurance is DESIGNED to pool risk. But everybody is not weighted equally. Get a few speeding tickets or an accident and you'll discover this about car insurance, real quick. But, from a simply 'cherry-pick' point of view, most insurance companies WILL cover people with muliple accidents (high risk), just at a higher price. They aren't priced altogether out of the market.

Health insurance IS IN THE SAME BOAT AS GOV'T currently. In that you are correct. They are in bed together. As a result, neither has to be either competitive or responsive to their customers. Or, more to the point - YOU aren't their true customers. The effect is that government conspires to make insurance too expensive for you to get any way but the gov't's desired way: through your employer. It's too expensive unless it's gov't subsidized through work. But you pay for that subsidy. The gov't and its lobbyists have loaded up every conceivable expense into health insurance. So much so that it's not technically even insurance anymore. No, it's pre-paid care.

You can't afford insurance without leaning on the gov't NOW and that's the way the gov't's lobbyists love it. Did you think this was for YOUR benefit. The gov't has been bought and sold and chances are, you weren't the highest bidder.

But a free market will expand to meet any and every customer base. UNLESS, the gov't interferes. NOW, insurance CAN'T provide for ANY service for pre-existing conditions without providing EVERY service the gov't dictates. The result: there is no way to provide such a service and stay competitive.

I'll give you an example of the difference: you want to treat a headache? The relatively free OTC market ensures a wide variety of options, at low cost: Tylenol, Motrin, Alieve, ASA, etc. etc. On the other hand, say you need an antibiotic? Ever had to pay close to a hundred bucks for one? The more regulated prescription market, with its doctor gate-keepers, means that you aren't the ultimate customer of that new-fangled antibiotic; your doctor is. As a result, there is limited choice on your part, and much less competitive pricing. This is an exact parallel to the the current health care situation. Health insurance today is so regulated, it's anti-competitive. The insurance companies like that. The government's pols like that. Their lobbying buddies like that. It benefits EVERYBODY. But you. You? You're an afterthought.

Competition brings down prices and improves quality. Government only interferes. You want solutions? I'll give the easiest way to bring down the cost of insurance and improve coverage, for all: remove the subsidy for employer provided insurance. Decouple your health care from your employer in a very specific way - get the gov't out of sponsoring it.

Once you have to pay directly for it, it simply cannot be loaded up with so much garbage that 47 million people can't afford it. The market can only charge what the market will bear. What you will get is a return to insurance and not pre-paid health care. That will bring sanity to pricing. I don't get my car insurance from my work; I don't WANT to get my health insurance from work. Right now, though, I don't have a choice. And that's the point. It's too expensive on purpose: to deny you a choice.

You have to wonder why gov't, with its array of lobbyists, always conspires to build solutions that deny YOU choice. To whom is the gov't giving your choices? I wonder?

~faith,

Timothy.

ZASHAGALKA, RN · May 28, 2008

Cost effectiveness analysis is in effect, how to ration care. I want to give an example because I want to comment on it. I want to discuss a study. First, I'll explain the study in this post and then, in the next post, I'll discuss it. It's time consuming, but it's on point and it's more than just some talking point.

http://content.nejm.org/cgi/content/full/334/18/1174

"A basic assumption of cost-effectiveness analysis is that one should always prefer a health care intervention that provides a population with more benefit per dollar than another intervention. However, sometimes budget constraints make it impossible to offer the most cost-effective intervention to everyone in the population, raising issues of equity. For example, suppose one has a fixed budget of $200,000 with which to screen a specific population for colon cancer. Test 1 costs $200,000 to offer to everyone in the population and prevents 1000 deaths from colon cancer. Test 2 costs $400,000 to offer to everyone and prevents 2200 deaths from colon cancer. Because of the budget, it is impossible to offer test 2 to everyone. However, it is possible to offer it to half the population, thereby exhausting the $200,000 budget and preventing 1100 deaths from colon cancer. Test 2 is more cost effective than test 1, because for the same number of dollars, it brings more benefit."

This study then compared what ordinary people, hospital ethicists, and expert decisions makers would do. The authors were surprised in that a majority would favor equity over efficiency: test everybody even it it meant 100 less lives were saved than would be by only testing half of the population with the more expensive test.

So. Decisions makers must not only measure effectiveness but also, equity. This it the case even if it could be determined that the half that would get the more comprehensive screening were completely randomized. Random or not, saving more lives or not, it was still considered unacceptably un-equitable for the majority of respondents not to offer a test, an inferior test, to everybody.

Next, I'll discuss my take.

~faith,

Timothy.

ZASHAGALKA, RN · May 28, 2008

The study presents its respondents with a best case situation on how to spend a limited budget on colon screening: $200,000 to cover everybody and save 1,000 lives or preform a better test that cost twice as much and perform that test on half the population, and save 1,100 lives - 100 more lives.

1. Ethics or not, doesn't it smack of arrogance to presume to have the sanctioned ability to play life and death games with the population as a whole? Who gives ANYBODY the right to think they should have the power to coerce such submissiveness to authority? THIS is what is meant by the term, elitist.

2. Since when did ethics become a barrier to saving human lives? In the name of 'equality', it's 'ethical' to let 100 more lives die than would otherwise be necessary? THIS is how you want your health care decided - for you?

3. A key third option wasn't even discussed: spending 400k to test everybody and saving 1,200 more lives. But we are talking about a fixed budget. I know. THAT is the chief flaw of gov't restricted health care. In this scenario, the patient is never consulted about THEIR best options and allowed to make PERSONAL decisions about their health. MAYBE some would opt to pay extra for the more comprehensive test.

I can assure you, offering the patient a personal choice and stake in his own care won't happen under gov't restricted healthcare. Why not? For the same reason the study found objections to saving 100 more lives: it wouldn't be 'equitable'.

But, this is telling. "Universal Health Care" isn't about universality; it's about some notion of fairness. If that means letting 100 (1,200 if everybody were screened better) more people die, so be it.

That's all nice and good-intentioned until YOU are one of those 1,200 needless deaths. Or, your child is.

Rationed care isn't compassionate care. Even if you want it to be. "Access to a waiting list is NOT access to health care."

~faith,

Timothy.

HM2VikingRN, RN · May 28, 2008

Actually what this points to is one of the great virtues of single payer.

Decision making processes about the cost of care and coverage levels for health care is transparent and subject to public review through the political process. Try getting United health to justify its 30% profit/cost ratios. 30% of health care dollars are flushed down the drain for CEO salaries and administration.

The data from the world stage shows that patients from almost every one of our OECD peer countries (NZ, Germany, AUS, UK) has better and quicker access to care. We have only marginally better access than Canada and arguably the differences in access are insignificant. (The Commonwealth Fund has the best available data for these issues.)

See:

nicurn001 · May 28, 2008

ZASHAGALKA let us accept your premise that private insurance will ,if it controls the whole populations access to healthcare , creat insurance products to cover all risks , the premiums would be related to the risks the individual presents when they apply for insurance .

When the client with a pre-existing , chronic condition receives multiple quotes ,none of which they can afford , what then?. Do we as in the case of car insurance , then accept that we are going to have a large number of uninsured , or do we the paying clients of the insurance companies ,then have to pay out for the uninsured to be covered ( which is what we are doing at present , through our tax dollars, subsidizing the private industry ). In answering this question remember that you are advocating private healthcare for all , so do not throw these clients under the wheel of the bus , rather enlightene us as to how an unfettered private system would cover all .

As to government lobbyist , I thought lobbyist were those who represent the insurance industry .

nicurn001 · May 28, 2008

As to government lobbyist , I thought lobbyist were those who represent the insurance industry , to insure their profitabilityand stop their insurance pool from being polluted ,by high risk / low profit margin clients.

sorry ran into edit time limit

allnurses Guide · May 28, 2008

If it costs more than 50k, then you don't need it. The government says so. THIS is 'universal healthcare'. England goes ONE step further. If the government says no, and you do it anyway, then the gov't revokes your health care because it's 'unfair' for you to go beyond what the average person gets. And now comes new considerations for no longer covering smokers and the obese.
How much is a year of healthy living worth to you? Priceless? Well, that's your opinion.
~faith,
Timothy.

Timothy I am struggling to understand what you mean by this, are you suggesting that the UK government withdraws healthcare from those who use their own means to get the healthcare that they feel have been refused?

nicurn001 · May 28, 2008

Adding to Sharrie's comment ,if you do a google search " private healthcare UK ", you will find links to private provision of healthcare in the UK .

Unless things have changed a great deal since I left the UK ,people accessed private healthcare for elective procedures , using the NHS for emergency and chronic conditions .

If you were to prohibit future use of the NHS services , because of use of private care , I think you could wave good bye to a viable private healthcare system in the UK and for that matter in the USA . If government funded healthcare did not provide care for the uninsured , how would private healthcare be able to cover everybody ?

Silverdragon102, BSN · May 28, 2008

Well when I lived in the UK I opted to pay privately for RNY but all my aftercare was done by the NHS and when I had some blood test issues by surgeon accepted me as a NHS patient not private. There are times when people in the UK opt to go private but they are not penalized by the government.

ZASHAGALKA, RN · May 28, 2008

Well when I lived in the UK I opted to pay privately for RNY but all my aftercare was done by the NHS and when I had some blood test issues by surgeon accepted me as a NHS patient not private. There are times when people in the UK opt to go private but they are not penalized by the government.

http://www.timesonline.co.uk/tol/life_and_style/health/article3056691.ece

NHS threat to halt care for cancer patient

"A WOMAN will be denied free National Health Service treatment for breast cancer if she seeks to improve her chances by paying privately for an additional drug.

Colette Mills, a former nurse, has been told that if she attempts to top up her treatment privately, she will have to foot the entire £10,000 bill for her drugs and care. The bizarre threat stems from the refusal by the government to let patients pay for additional drugs that are not prescribed on the NHS.

Ministers say it is unfair on patients who cannot afford such top-up drugs and that it will create a two-tier NHS. It is thought thousands of patients suffer as a result of the policy."

~faith,

Timothy.