Flutterby™! : Health care comparisons 2009-08-18 15:42:31.986133+00

Health care comparisons

2009-08-18 15:42:31.986133+00 by Dan Lyke 16 comments

A couple of stories from the UK healthcare system from this MeFi thread.

"Former nurse is forced to sell her home after forking out £100,000 on treatment abroad because of NHS shortfalls". Well, actually, she went to Monaco to have two pacemakers fitted because she was worried about the wait at her local hospital, and then went to Germany for some experimental stem cell procedures. Nothing in the article about the background on the wait.

"A Kent man with lung cancer is paying £70 a day for tablets which are not available on the NHS." A Roche spokesman, this is a guy who's job it is to sell the pills, said "Tarceva can slow the progression of cancer, but cannot stop it. It can increase life expectancy by two months or longer." Here are some notes on erlotinib (Tarceva®).

I think both of these stories are instructive because discussions about these aspects of healthcare are exactly the sort we need to be having. Private health insurance is available in Britain. So far as I can tell (from these articles) both of these patients could have bought that insurance and they didn't. Both patients are now complaining about not having full free funding for experimental therapies.

Either we're going to end up paying 90% of our GDP to health care, or we're going to have to be willing to give the hard-ass answers to these issues.

Of course he's using this as a call for more spending on medicine, but I think it's fairly plain: We're spending an awful lot for fairly small incremental quality-of-life changes.

Hmmm... $121B works out to roughly $400 per person on soft drinks. Are we really drinking an excess of one soft drink per day, per person, at vending machine prices? The sports figure seems similarly inflated - not by much - but still inflated.

I'm beginning to think that the cheapest thing health insurance could cover would be bullets... Well, maybe target practice too.

Still, I bet if we reduce our spending on soft drinks and got personally involved in amateur sports instead of spending our time and money on professional sports we would also spend much less on health care.

Larry, yep. As long as we also get reasonable about end-of-life care, because if we're all healthier younger we'll be living longer...

Some time ago in Cincinnati the Hamilton county sales tax was raised 0.5% to help build/finance the Cincinnati Bengals new football stadium. (The Bengals, by the way, have had maybe one winning season in the past 20 years). Their new stadium is used 8 times per year for football, and a few other ancillary events which don't create much real revenue for the city.

And yes, end-of-life care is key. Not only because we're potentially living longer, but because SO MUCH money is spent keeping people alive for very little ROL (return on life).

If we are healthier younger we are more likely to continue to live that lifestyle throughout life making us healthier older. Isn't that going to reduce the need for severe care for the aged? A healthy geriatric crowd should mean we see more people just dying in their sleep in their nineties and above after a day on the golf course.

Canadian health care system imploding (according to the incoming president of the Canadian Medical Association)—true assessment or cynical statement to get more tax money?

Sean, yeah, I've known several doctors and nurses who moved to the U.S. from Canada, although that's been years and years ago. I don't particularly know how it's struggling now, and I'm also sensitive to the argument that the U.S. pays R&D costs for a lot of drugs. But I think the point is that healthcare systems are always going to be imploding, because we treat them like a necessity, but they're really paid for out of the entertainment portions of our budgets.

Jeff, yeah, sports impose a generally regressive tax on their populace, and its becoming a priority for me to start to figure out ways to avoid paying things like the stadium taxes when I rent a car or get a hotel room in a city: that stuff can add up to huge bucks, where if I can find a shuttle out of the city/airport zone and rent a car in a surrounding area I can pay a lot less (Seattle comes to mind as a town with a particularly onerous tax rate, and next time I go there I'll be taking a bus or shuttle somewhere out of town to rent).

re: soft drinks.. I know enough 6-pack-plus a day people to say: Yeah, sounds right.

Seriously, though, I watched my grandfather die a very, very slow death. There's nothing humane about it. This was someone who signed a DNR and did everything "right" according to the current rules. If he had access to a painless way to die, he would have passed much sooner. Not only would it have saved him and his loved ones suffering, it would have saved the tax payers tens of thousands of dollars since his care was covered by Medicare.

Do you think there could be any traction for getting tax credits for passing a fitness test? Maybe even giving $50 trade in allowances on new skinny pants for old pants with more than a 40" waistband?

Larry, I think that'd work only if there were a large U.S. textile industry that had been criminially mismanaged for a few decades and whose employees were unionized and politically active.

The trade in allowance on pants was my way of using humor to show precedent for things like this having been done before but I'm serious about tax credits for a healthy lifestyle. The government already has guidelines established for fitness. I'm thinking of using tax credits as an incentive for meeting the fitness standards. We do it to encourage the use of alternative fuels I think that the same justification of need can be made for this plan.

#Comment Re: Living Longer? made: 2009-08-19 17:56:21.413567+00 by: jeff [edit history]

And we're supposedly living longer. But I still question the relative effectiveness of health care and the ROL those last few years for many.

Larry, I'd go for insurance that gave me discounts based on my physical condition. I'd also go for insurance that let me selectively decline certain benefits, like psychiatry.

Jeff, from that article it seems like there's a lot of fudging in the life expectancy numbers...

Dan--right on about the selective and elective health coverage selections. And I agree about the life expectancy numbers. (RE: Living Longer?)