Anonymous wrote:
Anonymous wrote:
Anonymous wrote:People die in America every day because they cannot afford drugs for chronic conditions, or surgeries or other treatments that are out of their reach financially.
And people die every day in Britain and Canada because the government decides what medical treatments will be made available or they have to wait six months to get an appointment.
Let's see, we're all going to pay less for health care but have better access and higher quality care? How exactly is that going to work? I guess it will work the way it works in Canada and Britain - that is, the government will ration treatments. If you only need to see a doctor once every five years or need a follow-up for your viagra prescription, it's a great system. But if you need a specialist or are diagnosed with cancer, I guess you will be SOL.
You assume that money = quality. We do a lot of stupid things in our health care system that cost money and do not improve, even sometimes diminish, the quality of care. For instance, since we compensate doctors poorly for visits but generously for procedures, we heavily incent doctors to rely on an excess of lab and radiology tests. So you can have a neurologist diagnose a patient by watching him walk, check reflexes, etc. But these days, they end up doing an MRI because MRI's bill for a lot of money and no one gets sued for doing an extra MRI.
And we could save a bundle by negotiating the same prices for drugs that European nations get today. Our PBM's are not incented to get the best prices because they get a cut from the drug companies for the prescriptions. It should be illegal, but it's not.
As for access, when I was in Britain, I had a serious and rapidly moving infection. I was directed to the nearest hospital. They asked me for nothing more than my name, address, and my next of kin. 30 minutes later, I was seen by the doctor. He diagnosed me, handed me two sets of antibiotics, and gave me follow-up instructions for my doctor after I flew home. When I asked where to go to pay, he said "don't worry about it. You don't pay here".
I got home and got in to see my doctor after two days. My doctor immediately switched my antibiotics to a new, expensive one because that is the recommended approach of doctors here. (I later found out that study data says the two cheap drugs together are equally effective for what I had, and I believe the reason has to do with avoiding malpractice if I had a multi-resistant strain). Mind you, we could already see the infection retreating after taking the original drugs. I had to pay my doctor out of pocket for the visit because he's not on my plan and I'm sick of changing doctors with every job. I had to pay a co-pay. And the health care system racked up the cost of a new and very expensive antibiotic that I had to take.
So I don't mean to discount your concern about access or quality of care entirely. What I'm getting at is that there is a lot of absurdity in the way we run health care, specifically in the U.S. It is far, far, from an efficient free market industry like we expect in other sectors of the U.S. economy.