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  #261  
Old 14.08.2009, 17:20
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Re: Americans put the boot into the NHS

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Pelosi has gone on record repeatedly saying the insurance companies are "evil", and the public plan as it is written is designed to drive those private health insurers out of business. Even if they are not all driven out, many will go under because their business models will no longer be profitable.

Morg

I canīt say that they are necessarily evil, but their business models need to change, so to my mind, could be a good thing.

And Morg, perhaps even you might agree that the physician should be dictating standards of care rather than the insurer. Certainly your wife has better things to do than spend time on the phone with a clerk telling her what she can and cannot prescribe.
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  #262  
Old 14.08.2009, 17:22
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Re: Americans put the boot into the NHS

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they don't make desions on cost alone the nice panel is made up of dr's for god sake!

but if they are given a case where drug x cost 15 times the price of drug y gives more or less the same results, but drug x may cure you that little bit quicker (but hasn't been available long enough to prove itself), which one do you think they'll go for.

YOU STILL GET TREATED!!
I'll take that as a "yes".

How about if drug x has a 65% of curing you, but drug y has a 15% of curing you, and drug x is 15 times more expensive?

You're still dealing with cost constraints. Which leads to health care rationing. Which most Americans oppose period.

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you seem to love focusing on 1 hearsay case, that has already been dispelled
I'm focusing on one hypothetical example to get you to clarify your position on the topic.

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You can also appeal nice / local health trust desicions.
And if they rule against the person who would have the 65% of being saved? What do you do then? Bow to the wisdom of the "death panel" and put your affairs in order?

Or better yet, how long do these appeals take? Weeks, months, years? People can die waiting that long for treatment which would ordinarily save them.

On this issue, at least, you are taking the socialist stance. Sorry to break it to you.

Morg
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  #263  
Old 14.08.2009, 17:23
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Re: Americans put the boot into the NHS

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Personally I think the state has an obligation to provide healthcare to the people that pay it taxes, or at least subsidise it in some form.
Would heartily agree. Long live the benevolent state.


Larry
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  #264  
Old 14.08.2009, 17:26
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Re: Americans put the boot into the NHS

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I canīt say that they are necessarily evil, but their business models need to change, so to my mind, could be a good thing.

And Morg, perhaps even you might agree that the physician should be dictating standards of care rather than the insurer. Certainly your wife has better things to do than spend time on the phone with a clerk telling her what she can and cannot prescribe.
See, this is just my point - Instead of the private company making a health care rationing decision, now you have the United States government making that decision. If a public health care system is implemented, then the paperwork / bureaucracy becomes ten times as bad as it already is. That one clerk becomes ten.

Morg
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Old 14.08.2009, 17:26
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Re: Americans put the boot into the NHS

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That's what I thought but then the poor fill up on McDonald's one dollar menuso or any cheap carbs, so weight s a dicey one. Smokers, heavy drinkers or people who have a risky lefstyle I have no sympathy for. Gee, I sound like such a Puritan!
A McDonalds isnt any than buying real food in a UK supermarket... you can get a good meal of vegetables and some good quality sausages for Ģ3.50.
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  #266  
Old 14.08.2009, 17:28
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Re: Americans put the boot into the NHS

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NICE are a national body that determines which drugs are going to be allowed / not allowed based on what can be afforded. I would imagine that Private companies equivalent is the amount of treatments available to you under your policy ?
Most insurance plans in the US have a formulary, or list of preferred drugs. If you have prescription coverage, then you pay a co-pay on your prescriptions ranging from $45 to $5 per prescription. If your physician chooses to prescribe something not on the formulary, then he or she must wrestle with whoever manages prescription coverage for the insurer. In the US, for example, there is a company called Medco. There have been some quality issues with generics in the past.... if a physician prefers to give a patient a non-generic, the patient has to have the physician contact the prescription management company, and negotiate, or prove that the patient needs the non-generic drug.

And yes, private companies allow X number of treatments, and then re-evaluate them as time goes on. Not too different from nice, as I see it.
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  #267  
Old 14.08.2009, 17:30
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Re: Americans put the boot into the NHS

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See, this is just my point - Instead of the private company making a health care rationing decision, now you have the United States government making that decision. If a public health care system is implemented, then the paperwork / bureaucracy becomes ten times as bad as it already is. That one clerk becomes ten.

Morg
But that's not MY point. I don't think a for profit company is effective in making such a decision. You do. End of discussion.
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  #268  
Old 14.08.2009, 17:32
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Re: Americans put the boot into the NHS

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Have you stopped beating your wife yet Morg ? Yes or No.....

As in, its not a yes or no question
Sure it is. Your "comparison" notwithstanding.

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NICE are a national body that determines which drugs are going to be allowed / not allowed based on what can be afforded. I would imagine that Private companies equivalent is the amount of treatments available to you under your policy ?

So for sure, if your treatment is not available because NICE say we can't afford it then Financial constraints have stopped you, but that is an entirely different thing to claiming they put a counter on you and when the spreadsheet says you have reached x thousand pounds your treatment stops period, which would cause outrage in the UK.
A financial constraint is a financial constraint is a financial constraint. Doesn't matter if it's measured in total care dollars spent or limiting access to expensive treatments.

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Death Panel ? Perhaps it's your view, but perhaps look at our 'Death Panel' as your Terms and Conditions of your Insurance Contract - there will be experiemental treatments on there I am sure you are not allowed.
I'm sure there are limitations - but I can always go out to the private marketplace and find a company that will cover those treatments. Pelosi and Co. want to destroy the private health insurance companies, and thus limit our choices, which I'm having none of.

If I were rich enough I could pay for the treatments myself, but there are rumors circulating that you won't even be able to do that under the more extreme versions of the plan.
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  #269  
Old 14.08.2009, 17:33
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Re: Americans put the boot into the NHS

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I'll take that as a "yes".

How about if drug x has a 65% of curing you, but drug y has a 15% of curing you, and drug x is 15 times more expensive?

You're still dealing with cost constraints. Which leads to health care rationing. Which most Americans oppose period.



I'm focusing on one hypothetical example to get you to clarify your position on the topic.



And if they rule against the person who would have the 65% of being saved? What do you do then? Bow to the wisdom of the "death panel" and put your affairs in order?

Or better yet, how long do these appeals take? Weeks, months, years? People can die waiting that long for treatment which would ordinarily save them.

On this issue, at least, you are taking the socialist stance. Sorry to break it to you.

Morg

There are None so deaf as those who will not hear.

For the last time, now listen carefully, your not refused treatment, the nhs will treat you with what they consider to be the best treatment, that gives the best results, we DO NOT have a system like the us where drug companies advertise there wears on tv etc.

Its not a case of well you cant have wonder drug xxx so you'll get nothing! you'll get some of the best care in the world, that according to the WHO is better the the US's

now I'm owt, its tedious making the same point again and again just for some argumentative ill informed person to keep twisting them, you live in your little utopia of lovely health insurance and watch all those inconvenient poor people suffer and die, America F**k Yeah!
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  #270  
Old 14.08.2009, 17:34
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Re: Americans put the boot into the NHS

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But that's not MY point. I don't think a for profit company is effective in making such a decision. You do. End of discussion.
Then you must think a government agency is effective in making such a decision, right? We simply put our faith in different institutions then - you in the public, and me in the private.

Nothing wrong with that. I just don't agree with your viewpoint.

morg
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  #271  
Old 14.08.2009, 17:41
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Re: Americans put the boot into the NHS

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There are None so deaf as those who will not hear.
Physician, heal thyself.

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For the last time, now listen carefully, your not refused treatment, the nhs will treat you with what they consider to be the best treatment, that gives the best results, we DO NOT have a system like the us where drug companies advertise there wears on tv etc.
That should be up to the doctor and the patient. Not a panel of so-called "experts".

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Its not a case of well you cant have wonder drug xxx so you'll get nothing! you'll get some of the best care in the world, that according to the WHO is better the the US's
No, you won't get wonder drug X that has a 65% chance of saving you, you'll get wonder drug Y that has a 25% change of saving you. Hope Lady Luck is watching over you.

I'm not saying the UK has bad health care. I'm just saying it's not for me, or for my country.

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now I'm owt, its tedious making the same point again and again just for some argumentative ill informed person to keep twisting them, you live in your little utopia of lovely health insurance and watch all those inconvenient poor people suffer and die, America F**k Yeah!
Argumentative, yes. Ill informed, no. I'm not twisting your arguments, I'm forcing you to realize the socialist premise that they're based on, and you don't want to acknowledged that.

And you live in your utopia of socialist healthcare. We agree to live in our respective utopias. I won't try to change yours, you don't try to change mine. Deal?

Morg
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  #272  
Old 14.08.2009, 17:55
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Re: Americans put the boot into the NHS

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Then you must think a government agency is effective in making such a decision, right? We simply put our faith in different institutions then - you in the public, and me in the private.
I am glad we have put this down to a matter of faith. As long as you are aware that there is always a person who does not have your best interest in mind between you and your doctor, whether it is the paper-pushing bureaucrat with thick glasses or the money-grabbing accountant at the insurance company, who you trust more is a matter of personal conviction. It is unfortunate health care is not run by Jesus.
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  #273  
Old 14.08.2009, 17:55
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Re: Americans put the boot into the NHS

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Sure it is. Your "comparison" notwithstanding.
Ok then, Morg, answering Yes or No ONLY. Have you stopped beating your wife yet ?

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A financial constraint is a financial constraint is a financial constraint. Doesn't matter if it's measured in total care dollars spent or limiting access to expensive treatments.
Agreed. But this is different from saying we will only spend 10000 pounds on each patient each year. Categorically different. you cannot tell me that is the same as an overall budget limitation.

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I'm sure there are limitations - but I can always go out to the private marketplace and find a company that will cover those treatments. Pelosi and Co. want to destroy the private health insurance companies, and thus limit our choices, which I'm having none of.

If I were rich enough I could pay for the treatments myself, but there are rumors circulating that you won't even be able to do that under the more extreme versions of the plan.
Final point, but I made this ages ago but its very very very relecant. NICE is not working towards profit. It is a public body with people's medical interests at heart. Private Health companies however, want to make money. This will affect any decision making.
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  #274  
Old 14.08.2009, 18:08
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Re: Americans put the boot into the NHS

Union refutes US 'lies' about NHS
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  #275  
Old 14.08.2009, 18:16
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Re: Americans put the boot into the NHS

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My God, 12.8% of salary just to pay for health care? And that's on top of taxes?!?!?!
Yeah and it's gross, you pay it without deductions.
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  #276  
Old 14.08.2009, 18:16
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Perhaps they just chose to, or it's a misunderstanding, or they were just having one of those days, but the National Health Service in the UK does not allow or disallow candidates to have treatments based on how much they have cost them so far. On a medical basis, yes, but on a pure cost amount, no.

The statements about Nice declaring which drugs are financially feasible, the stuff about waiting lists people are going on about - all true. But there is no cost figure that treatment stops when you pass.

Hopefully we can leave it there. Otherwise I will keep on replying indefinitely because it is this sort of misinformation that is so harmful as people use internet search software and this sort of stuff comes up.
Ok another post for you to answer. It is my word against yours. I have just seen this very statement about a price cap on Sky News being denied by someone in the UK. Interesting. So who knows? I don't and wouldn't know how to verify it.

Maybe Panorama can clarify it in a future episode.

One sure thing is that cost issues of treatment influence Doctor's decisions. FACT.

Doctor's aren't always the only people involved in all medical decisions, as you know local authority's are responsible as well and look how that works, but I don't want to go there.

Don't worry about the search you have to log on to view this thread so the audience is limited. Then word of mouth comes into play and then what are the facts.

I don't know, do you?
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  #277  
Old 14.08.2009, 18:25
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Re: Americans put the boot into the NHS

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Ok then, Morg, answering Yes or No ONLY. Have you stopped beating your wife yet ?
I never said there was no such thing as a non-yes or no question. I said that my question was a yes or no question. Yes, it is financial constraint to withold drug A from one patient in order to give 100 other patients drug B, or no it is not a financial constraint.

Patient A has his health care options restrained due to the financial decisions of NICE. Hence, financial constraint.

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Agreed. But this is different from saying we will only spend 10000 pounds on each patient each year. Categorically different. you cannot tell me that is the same as an overall budget limitation.
A financial constraint is a financial constraint is ... etc. etc. I'm not saying it's the same thing as an overall budgetary limitation. I'm saying it's a stoppage in your health care (constraint) that's based on monetary (financial) considerations, made by a government panel.

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Final point, but I made this ages ago but its very very very relecant. NICE is not working towards profit. It is a public body with people's medical interests at heart. Private Health companies however, want to make money. This will affect any decision making.
You ever stop to think that maybe my insurance company will give me drug X at 15 times the cost of drug Y because it is so profitable to them? In fact, they will encourage more people to take the better drug - if they can afford it - to make more money. Basic statistics here - if more people take drug A with a 65% chance of cure and the same amount take drug B with a 25% chance of cure, the cure rate overall goes up. Health system improvement in action.

Whereas if drug A is withheld, the chance of cure stays static.

Profit fuels innovation in all industries, including heatlh care.

Morg
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  #278  
Old 14.08.2009, 18:28
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Re: Americans put the boot into the NHS

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right here are the ni rates in the uk

http://www.hmrc.gov.uk/rates/nic.htm

so you pay 12% when you earn over 5k per year, and the cap is when you earn 43k so the most you pay is Ģ5160 regardless of how much you earn ove 43k

Not bad if your a family of 5, not so good if your a single man

(all figures are rough as I can't be arsed with the .8's etc)
Not true you have forgotten the upper earnings limit.

Once you reach this (40k GBP a year) you continue to pay 1% gross on everything above 40k. Your employer however continues to pay 12.8% too on your earnings.

This was changed by Gordy and is now a nice little earner, especially as it coincides with the kick-in of 40% tax on your income above this 40k limit too.
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Old 14.08.2009, 18:43
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Re: Americans put the boot into the NHS

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I never said there was no such thing as a non-yes or no question. I said that my question was a yes or no question. Yes, it is financial constraint to withold drug A from one patient in order to give 100 other patients drug B, or no it is not a financial constraint.

Patient A has his health care options restrained due to the financial decisions of NICE. Hence, financial constraint.



A financial constraint is a financial constraint is ... etc. etc. I'm not saying it's the same thing as an overall budgetary limitation. I'm saying it's a stoppage in your health care (constraint) that's based on monetary (financial) considerations, made by a government panel.



You ever stop to think that maybe my insurance company will give me drug X at 15 times the cost of drug Y because it is so profitable to them? In fact, they will encourage more people to take the better drug - if they can afford it - to make more money. Basic statistics here - if more people take drug A with a 65% chance of cure and the same amount take drug B with a 25% chance of cure, the cure rate overall goes up. Health system improvement in action.

Whereas if drug A is withheld, the chance of cure stays static.

Profit fuels innovation in all industries, including heatlh care.

Morg
Same in America. Insurance companies refuse to pay for treatments/drugs all the time. Out of pocket payment if you want it.

In the UK, you can also have private health insurance if you don't feel the NHS is suiting your needs/will suit your needs.
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Old 14.08.2009, 18:46
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Re: Americans put the boot into the NHS

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I heard yesterday that the British health system is now in some way capped. Once you have had x amount spent on you a year you don't get any more.

I know someone who is sufferring from cancer and she has been refused the latest treatment, which can stop it getting worse because it is too expensive and she has already had a lot spent on her.

I'm not sure if that would happen here.
There is no capping that I am aware of. Having worked in the field of Oncology I'm fairly sceptical about the "latest treatment". These are usually highly experimental, unproven medicines that at best extend life by weeks, often with unpleasant side effects, and can cost thousands of dollars a month.

Of course, nobody in England is denied the right to pay for treatment if they are unhappy with the NHS. In fact the quality of private health care cost in the UK is extremely reasonable, particularly if you take out insurance, and is widely available. You might say that is paying for something twice, but I see it more like choosing an upgrade. You get private rooms and nicer food etc. In practice I don't think private healthcare in the UK provides any better outcome than NHS healthcare and I'm not aware of any evidence of that either.
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