Tuesday, August 04, 2009

U.K. Patients Forced to Live in Agony

UK TELEGRAPH -- The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known. Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy.

Specialists fear tens of thousands of people, mainly the elderly and frail, will be left to suffer excruciating levels of pain or pay as much as £500 ($835) each for private treatment. The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 ($55) million.

HT: NCPA

MP: Another example of the significant rationing that always results from government health care.

9 Comments:

At 8/04/2009 1:28 PM, Blogger happyjuggler0 said...

It's also yet another example of the inadequacy of comparing life expectancy and using it to contrast the effectiveness of health care spending.

 
At 8/04/2009 3:22 PM, Anonymous Anonymous said...

So there is no rationing by private insurers? How ever do they make profits?

Do you have any data that shows relative rationing among for-profit private insurance, not-for-profit private insurance, Medicare, and public options in other countries?

Here's one for you - X is 15, which doesn't seem good, so Y must be lower. Meaningless point, right?

 
At 8/04/2009 4:51 PM, Blogger QT said...

Happyjuggler,

Well put

 
At 8/04/2009 7:24 PM, Anonymous Dr. T said...

The British government is doing worse than rationing care. It is substituting quackery for medicine. This is both immoral and unconscionable.

We've already taken two baby steps in that direction: Congress sanctioned the formation of a government body to study the efficacy of quack remedies (giving them a patina of legitimacy) and the FDA promoted the lie that phenylephrine (PE) works just as well as pseudoephedrine for treating congested sinuses. The FDA's own studies indicate that phenylephrine is worthless, but it wanted to help the DEA remove pseudoephedrine from over-the-counter allergy and cold medicines. (Because pseudoephedrine is easily converted to amphetamine.)

If ObamaCare comes to pass, it will soon resemble a hybrid of Britain's system and the worst pieces of our own system. I can easily imagine the FDA telling people that cheap drug A works just as well as expensive drug Z when, in reality, drug Z is much more effective. The same will occur for cheap medical therapy vs. expensive surgery: ObamaCare board, "The medical therapy is just as good!"

 
At 8/04/2009 8:59 PM, Blogger QT said...

Another method of rationing commonly used in Canada and the U.S. is salary caps.

In Ontario, salary caps have meant that many surgeons and specialists hit the cap by April or May and therefore, do not work in Canada beyond the spring. Who would work for free? Many of these physicians work for 6 months in Canada and 6 months in the U.S.

The result for patients is that access to care is compromised. Wait times for referrals to specialties and therapy have increased substantially in recent years.

NICE illustrates many of the problems with trying to run a low cost, universal health care system. Many newer drugs and procedures will not be available, patients will be triaged with older patients being denied access to care, unacceptable wait times compromising patient safety, inadequate funding for diagnostic equipment, skeleton staffing and employee burnout, etc.

In Canada, 50% of the time one gets good/adequate care. The problems are encountered when you have a complex problem or a problem that has a time sensitive window of treatment (ie. cancer)where the care is almost impossible to access. It is almost impossible to find information or other treatment options.

In a single-payer system, you have no options aside from the public system.

 
At 8/05/2009 3:49 AM, Blogger 1 said...

"So there is no rationing by private insurers? How ever do they make profits?"....

anon @ 3:22 PM, you're missing the OBVIOUS point, the U.K. doesn't offer much in the way of alternative choices to those patients...

 
At 8/05/2009 9:37 AM, Blogger Kat said...

Do you have any data that shows relative rationing among for-profit private insurance, not-for-profit private insurance, Medicare, and public options in other countries?

Rationing only happens in the presence of supply constraint. An insurance company or medicaid's unwillingness to pay for a certain treatment or pharmaceutical is not rationing.

Insurance companies pay for treatment from premiums. To provide unlimited care, they must have no limit on how much they can raise premiums. Government programs must have no constraints on how much taxes can be raised to fund unlimited health care.

If people can dig into their own pockets to pay the amount government or insurance or government won't pay, then there is no rationing - so, we don't have rationing here. That option is unavailable in Canada and won't be in the United States either if this legislation comes to pass. There will be true rationing.

The fundamental problem with this debate is that people believe they have a right to an infinite amount of healthcare which they want someone else to pay for. If people don't want to provide for themselves, supply will be rationed. However, the promise of Obama and socialized care in general is that you'll get all the care you want and need but you'll be able to enslave the top 2% to pay for it.

Well, that herd is thinning.

 
At 8/05/2009 2:01 PM, Blogger OBloodyHell said...

.

Neo-neocon also has written about this topic, from a personal PoV:

Chronic pain, health insurance, and me

.

 
At 8/08/2009 7:10 PM, Anonymous Anonymous said...

Might be worth reading the guidelines. Not quite as threatening as the headline implies.
http://www.nice.org.uk/nicemedia/pdf/CG88NiceGuideline.pdf

 

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