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Response to WilliamPitt (Original post)

Thu Mar 20, 2014, 10:22 AM

61. Now you've found at least temporary help, I'll point out that "single-payer" isn't a panacea.

For instance, under the UK NHS, stories about having problems accessing certain drugs and treatments similar to your family's aren't unheard of, though there the gatekeepers aren't insurance companies, but local health authorities. We've been discussing this in the UK forum here: http://www.democraticunderground.com/10885614

In answer to a question from steve2470 about NHS medication coverage, muriel_volestrangler replied:

For most medications, there's a standard per prescription charge of 7.85

Various groups get free prescriptions, such as children, over 60s, pregnant women, and people on benefits. If you're getting a lot of prescriptions, you can pay for a period for all of them.

http://www.nhs.uk/nhsengland/Healthcosts/pages/Prescriptioncosts.aspx

The controversy comes in because some medications are not covered by the NHS. NICE,the National Institute for Health and Clinical Excellence, evaluates treatments such as drugs, and decides if they are effective enough for a type of treatment - an evaluation which considers the price to the NHS as well as the clinical effectiveness (and can also mean a drug is approved for some circumstances, but not others - it might be accepted as effective for one type of cancer, but still thought unproven for another, and so restricted to the first).

http://www.nice.org.uk/page.aspx?o=AboutGuidance


I replied:

Related to NICE's role that m_v's mentioned, there's also the pop phrase "postcode lottery."

See Google for its prevalence.

Basically, even if NICE approves a drug or treatment, if it's new and/or expensive, there's no guarantee a patient in a particular administrative area will be able to receive it, depending on the policies and priorities of their regional health authority.

You'll maybe notice if you visit that link that the term's especially popular with the UK's RW press as a means to pick away at the foundations of the NHS, but it's a real phenomenon, and here's a brief explanation from The Guardian (over ten years old, but not too inaccurate in principle):

What is the postcode lottery?
The postcode lottery is shorthand for seemingly random countrywide variations in the provision and quality of public services - the huge gap between the best and the rest. Where you live defines the standard of services you can expect. So if you live in the "wrong" area, and, in extreme cases, on the "wrong" side of a road, you may get a poorer service than your neighbour or you may not get the service at all and have to pay for it privately. The postcode lottery is a big issue in the NHS, where the gap between the rhetoric of a comprehensive and universal "national" service and the reality is increasingly stretched.

Some problems are universal, even with single payer healthcare systems (especially when they're subject to creeping and not so subtle privatization).

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