Tuesday, July 07, 2009

Top 10 Ways UK Rations Healthcare to Save Money

WALL STREET JOURNAL -- Speaking to the American Medical Association last month, President Obama waxed enthusiastic about countries that "spend less" than the U.S. on health care. He's right that many countries do, but what he doesn't want to explain is how they ration care to do it.

Take the United Kingdom, which is often praised for spending as little as half as much per capita on health care as the U.S. Credit for this cost containment goes in large part to the National Institute for Health and Clinical Excellence (NICE). Americans should understand how NICE works because under ObamaCare it will eventually be coming to a hospital near you. NICE has established the principle that the only way to control health-care costs is for this panel of medical high priests to dictate limits on certain kinds of care to certain classes of patients.


For example:

1. In March, NICE ruled against the use of two drugs, Lapatinib and Sutent, that prolong the life of those with certain forms of breast and stomach cancer.

2. This followed on a 2008 ruling against drugs -- including Sutent, which costs about $50,000 -- that would help terminally ill kidney-cancer patients.

3. In 2007, NICE restricted access to two drugs for macular degeneration, a cause of blindness. The drug Macugen was blocked outright. The other, Lucentis, was limited to a particular category of individuals with the disease, restricting it to about one in five sufferers. Even then, the drug was only approved for use in one eye, meaning those lucky enough to get it would still go blind in the other.

4. NICE has limited the use of Alzheimer's drugs, including Aricept, for patients in the early stages of the disease.

5. NICE rejected the use of Kineret, a drug for rheumatoid arthritis.

6. NICE rejected Avonex, which reduces the relapse rate in patients with multiple sclerosis;

7. NICE rejected Lenalidomide, which fights multiple myeloma.

NOTE: Private U.S. insurers often cover all, or at least portions, of the cost of many of these NICE-denied drugs.

NICE has also produced guidance that restrains certain surgical operations and treatments.

8. NICE has restrictions on fertility treatments.

9. NICE has restriction on procedures for back pain, including surgeries and steroid injections.

10. Several young U.K. women developed cervical cancer after being denied pap smears by a related health authority, the Cervical Screening Programme, which in order to reduce government health-care spending has refused the screens to women under age 25.

Bottom Line: Rationing = Lower cost = lower quality healthcare

HT: Bob Wright

21 Comments:

At 7/07/2009 6:20 PM, Anonymous Anonymous said...

The comments regarding U.K. drug restrictions would be far more valuable if attention was directed to the "why" the restrictions rather than the "what". Both are important and leaving the "why" out makes the "whats" almost meaningless.

Ken

 
At 7/07/2009 6:20 PM, Blogger Daniel said...

Don't we already have this same situation in the US, except the rationing is being done by the HMOs etc? They all have their own lists of what drugs and treatments are not covered. It's probably not be the same as the NICE one, but the lists exist nonetheless.

 
At 7/07/2009 7:09 PM, Blogger fboness said...

Th "why" ken, is to avoid spending money.

 
At 7/07/2009 7:26 PM, Blogger mongander said...

Re:3...use of Lucentis

I have a friend in the UK that had macular degeneration. She told me that Lucentis is rebranded Avastin, at a much higher price. Her eyes were injected with Avastin and cured.
http://www.allaboutvision.com/conditions/lucentis-vs-avastin.htm

 
At 7/07/2009 7:28 PM, Blogger bob wright said...

The only way the U.S. government is going to save money in health care is to ration care.

For democrats to claim that they will pay for the cost of universal health care by computerizing medical records is a deception - if not an out right lie.

 
At 7/07/2009 7:32 PM, Blogger QT said...

Ken,

Good point but didn't you just leave out the "why"?

Looks like NICE isn't very nice.

You have overlooked my favorite, bibliotherapy, prescribing a book for a patient suffering from clinical depression rather than providing counselling or anti-depressant medication (ie. treatment).

 
At 7/07/2009 7:34 PM, Blogger QT said...

Bob,

Spot on and leading by a furlong.

 
At 7/07/2009 8:01 PM, Anonymous geoih said...

Quote from fboness: "Th "why" ken, is to avoid spending money."

I thought health care in the UK was free.

 
At 7/07/2009 8:02 PM, Blogger bob wright said...

Ken,

I don't believe that stating the "what" without stating the why is meaningless.

I believe this is so because no politician proposing universal health care is honestly telling people what the eventual outcome will be - that "what".

No politician is telling people:

1. "Medicare and Medicaid save money by paying less than the actual cost of health care - not because they are more efficient. We pay hospitals, doctors and pharmaceutical companies what we decide to pay them - not what the product or service actually costs. The government dictates the payment. The government will ration care. Medicare and Medicaid are not market systems to be competed with."

2. "When I and the 534 other politicians in the U.S. congress take over the U.S. health care system, we will decide what medical care the other 299,999,465 people in the U.S. will receive - because we know what you need better than you and your doctor know what you need."

It is important that people understand that there will be "whats" to be contended with.

Once people understand that there will be "whats" they can further look into the "whys".

If rationing care is no big deal, why do no politicians honestly and plainly inform their constituents of this?

 
At 7/07/2009 11:51 PM, Blogger mongander said...

This comment has been removed by the author.

 
At 7/07/2009 11:55 PM, Blogger mongander said...

During WW2, only restaurants, bakeries,
and moonshiners had ample sugar.

 
At 7/08/2009 4:37 AM, Blogger 1 said...

You may want to look at this four year old opinion piece:

There's No Place Like Home
What I learned from my wife's month in the British medical system


by DAVID ASMAN
Wednesday, June 8, 2005 12:00 A.M. EDT

 
At 7/08/2009 5:10 AM, Anonymous Anonymous said...

They DO ALL THAT and they still live longer than we do in the US. Go figure.

 
At 7/08/2009 5:29 AM, Blogger 1 said...

"They DO ALL THAT and they still live longer than we do in the US. Go figure"...

Interesting comment anon @ 7/08/2009 5:10 AM...

It made me wonder where the US fell in the list of countries...

According to the CIA World FactBook the US ranks 50th out of 224...

In this country we have some problems of course...

An outfit called Bio-Medicine has the following: Life and death in the USA: New study concludes there are 'Eight Americas'

Here's one point that stood out: 'For example, in 2001, the life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was nearly 21 years'...

You may find the following John Stossel blog posting of interest: Healthcare from Dr. Krugman

Paul Krugman misleads, as he often does, in today’s New York Times:

“Universal health insurance should be eminently affordable. After all, every other advanced country offers universal coverage, while spending much less on health care than we do. For example, the French health care system covers everyone, offers excellent care and costs barely more than half as much per person as our system.”

But the French freeload off American innovation! Can you name any new drugs or medical devices that are invented in France? Nearly all the world’s innovation comes from the relatively profit-driven American system. If we relied on government healthcare, the world would still be getting 1950’s quality care.

Also, it is by no means clear that the French get “excellent” care. When you account for "Fatal Injury" rates (mostly car accidents and murder), US life expectancy is higher than in nearly every other industrialized nation, including France. And this doesn't even account for the fact that Americans are four times as likely to be obese. (there's more)

 
At 7/08/2009 6:54 AM, Anonymous Eben said...

Don't we already have this same situation in the US, except the rationing is being done by the HMOs etc? They all have their own lists of what drugs and treatments are not covered. It's probably not be the same as the NICE one, but the lists exist nonetheless.

Big difference is that in England if NICE bans the use of a drug that's the end of it, you don't have access to it. In the U.S. if your HMO wont offer coverage you can either switch coverage or pay for it on your own.

 
At 7/08/2009 1:44 PM, Blogger rufus said...

Millions of Americans would LOVE to have U.K. health care, for the simple reason that they don't have ANY Health Care.

And, NO Dammit, going to an ER, and going home with the same problem is NOT "Health Care."

 
At 7/08/2009 2:31 PM, Anonymous Γερώνυμος Αμάτι Nώνυμος said...

"
9. NICE has restriction on procedures for back pain, including surgeries and steroid injections.
"

Everyone of your should read about these steroid injections. Would you guess that it is the biggest danger that our athletes now face. It is worse than getting clipped. Worse than your helmet falling off.

Beware steroids especially injected.

Grazia,

Γ

 
At 7/08/2009 3:28 PM, Blogger Robert Miller said...

This comment has been removed by the author.

 
At 7/08/2009 4:28 PM, Blogger QT said...

Robert,

Thanks for the information regarding survival rates. You might be interested in this study regarding coronary bypass graft surgery survival rates in Ontario vs. 32 different U.S. states.

Rufus,

You might be interested in the following information regarding Canada. The ER health care that you describe is exactly what Canadians have when they travel to another province within Canada.

A friend of the family recently discovered this after suffering a major stroke while visiting Quebec. To obtain any level of care beyond ER, she has to come back to Ontario.

 
At 7/08/2009 6:51 PM, Blogger 1 said...

"Millions of Americans would LOVE to have U.K. health care, for the simple reason that they don't have ANY Health Care"...

Well his your chance to put YOUR money where YOUR mouth is rufus, buy those alledged millions of Americans air fare to go to the UK...

 
At 7/09/2009 3:33 PM, Blogger ExtremeHobo said...

I know its already been said but i find it hilarious that the trolls on here like the first Anon forget to read the title of the article. Then he might see the "why".

"to save money"

 

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