Profits before patients: another important side of the coin

[LeftishBrit]

It is clear and regrettable that financial considerations often come before the real needs of patients, and can adversely affect people's health care. This is a serious and dangerous problem.

People have frequently, and rightly, brought this up on the board. But the assumption sometimes is that it only operates in one direction: that of Big Pharma wishing to palm off ineffective or dangerous treatments onto patients, because that increases its profits.

In fact, the other side of the coin is at least as important. People are often denied life-saving or life-extending treatments, because these are seen as too expensive.

This can be a problem when a conservative or conservative-in-all-but-name government is in charge of a country with state-provided health care. It has been a significant problem in the UK, especially recently:

www.news.scotsman.com/health/Patients-denied-access-to-kidney.4365522.jp

www.manchestereveningnews.co.uk/news/health/s/233/233832

www.news.bbc.co.uk/2/hi/health/618294.stm

(Note for any lurking Freepers: This is *not* an inevitable result of 'socialized medicine' but a particular problem in post-Thatcher Britain. We have one of the worst records on access to drugs in Europe; and also some of the worst life-expectancy and cancer survival statistics. We still do better than the USA on most measures!)

I realize that most of you are not living in Britain under our current government - but in America under an even worse one. But exactly the same problem arises with American insurance companies:

www.query.nytimes.com/gst/fullpage.html?res=950CE3D61F3BF936A15752C0A9649C8B63

www.opa.ca.gov/report_card/hmochoose.aspx

www.newsinferno.com/archives/3136

www.crn.cancer.gov/publications/capacity_collaboration_investigation.pdf

www.articles.latimes.com/2000/jun/13/news/mn-40445 - 38k


www.wordsoup.com/blog/2008/08/my_hmo_recommends_euthanasia.html


Thus, because of cost-cutting profit-seeking insurance companies, AND because of Pharma companies over-pricing many medicines, many people, especially those who are not well-off, are deprived of access to the best treatments!


The problem is of course far worse with regard to the developing world, but I am confining this post to the problems in America and Britain.

Thus, there seem to be two opposing financial motives: that of Pharma companies to sell medicines in order to increase profits, and that of insurance companies and governments to restrict access to medicines in order to cut costs. It might be nice to think that these competing motives eventually lead to a 'meeting in the middle' that offers optimal benefit to patients - but it is pretty obvious that quite the reverse is generally the case. And it seems to me that, while there are cases *both* of useless or dangerous medicines being pushed on patients; *and* of patients being deprived of access to the medicines they need; that the *second* is the commoner and more pervasive problem.

So how can this be reversed or changed? How can the profit motive/ cost-cutting motive be made less influential in patients' treatments? Can we learn anything from those countries that seem to do rather better than the UK, and a lot better than the USA? It seems to me that these generally have in common that (a) people are more willing to pay taxes to support health-care; and (b) not so much money is being spent on unnecessary wars. But do people have any more detailed ideas about how things can be improved?

[GreenPartyVoter]

1. Thank you. This is _exactly_ why we in the USA need to be cautious of

what "flavor" of universal healthcare is offered to us.

[Warpy]

2. The main problem with the UK system is that it has more than

one standard and more than one level of insurance, probably due to the dying gasp of the class system.

The last thing the wealthy and/or titled ever wanted was equality, so they made damned sure there was room for private insurance and different accommodations for themselves while allowing a bare bones system for those who lacked either a fortune or a managerial job.

The bare bones insurance for the proles has been systematically underfunded ever since Thatcher tacitly agreed with Reagan that the best thing the poor and working classes could do for the country was crawl off and die quietly.

This is why any insurance we get over here must be universal, with no "out" for the wealthy and powerful unless they have the leisure to go offshore to seek treatment.

Anything they are likely to need in an emergency is far likelier to be fully funded, meaning we won't be cheated when we need the system.

Still, given a choice between the deeply flawed UK system and the US system, I'd take the UK system in a heartbeat. I have been uninsured for the past 20 years and have no hope of ever getting private insurance in the US.

[beam me up scottie]

3. K&R

While it may be empowering to vilify the drug and insurance companies, it's much too simplistic.
When profit is the motive, we often don't know who to trust.

[mhatrw]

4. Capitalism and medicine mix very uneasily.

Their goals are generally in competition with each other which is why we need a government with the will to put patients before profits.