We've moved!
DakotaFreePress.com!

Social Icons

twitterfacebooklinkedinrss feed
Showing posts with label rationing. Show all posts
Showing posts with label rationing. Show all posts

Wednesday, October 21, 2009

Good News: Madison Arts Surge, Stricherz Supports Troops, SF Rations Flu Meds

Who says I never look at the bright side?

Arts Center to Open in Madison: The Madison Area Arts Council announces that it will open a Community Arts Center on November 1. They'll be at 106 Southeast 2nd Street, south of the Leader building. First they'll seet up an office for the organization and some public meeting space, then by spring get going with some classes and exhibits. Remake the city branding line: "Discover the Arts," indeed!

Stricherz Working Hard with Operation Homefront: Can't keep a good woman down—former legislative candidate Patricia Stricherz from the southern Moody County metroplex is busy running a new chapter of Operation Homefront, a national organization that provides support for families of deployed and wounded soldiers. They do things like help with auto repairs and utility payments, provide backpacks for school for soldiers' kids, and provide holiday meals and gifts. Stricherz says the South Dakota branch is finally moving out of her living room and into real office space—if you have any office equipment or furniture you could donate to help Operation Homefront set up shop, or if you'd like to help out in other ways, give Stricherz a call: 888-293-3775.

Of course, one could argue that the best help we could give Operation Homefront would be to eliminate the need for their services by bringing the troops home....

Free Market Shows Rationale for Rationing Medicine: In a demonstration of why free market principles don't work in health care, Sioux Falls docs say they aren't testing for swine flu. They aren't even handing out Tamiflu to everyone who wants it—also known as rationing. What? Did we turn into Canada?

No: the doctors are just practicing good, efficient medicine, with a dose of socialism:

"We're seeing huge numbers of patients presenting all across the region and it just doesn't make sense to try to test because we know it's there, it's widespread," Sanford Infectious Disease Dr. Wendell Hoffman said.

He says that means if you feel like you have the flu, it's a safe bet it's H1N1, which many can recover from without seeing their physician.

"Unless they're part of those designated groups that are at high risk for the complications of influenza, they also don't need to be treated," Hoffman said.

...Hoffman says there's one more thing the public should know. TamiFlu isn't widely available. And because health officials aren't really sure where this virus is headed and because we're early on in the flu season, giving the medication to only those who need it is crucial [Kelli Grant, "Why... Doctors Aren't Testing for H1N1," KELOLand.com, 2009.10.20].

The free market would lead to overutilization: underinformed citizens flooding clinics and inflating demand for goods and services they don't need. That demand would prevent some people who most need care from getting it, and that would mean more dead people. The free market also apparently can't produce enough of the irrationally desired product, Tamiflu (Gilead Sciences holds an exclusive patent on the drug until 2016). Thus, doctors have to step in and ensure that the drug is distributed on the basis of need rather than ability to pay... a nice little affirmation of socialist principle over free-market fundamentalism.

-------------------
Update 09:40 CDT: And some bad news/good news: The bad news is, no South Dakota Online broadcast today. The good news: the delay is because Ben Hanten got new gear! They're putting together new equipment and a new set and are aiming to broadcast tomorrow, Thursday, at 2:30 p.m. (New set? Rumor has it Ben's pals raided KELO's secret warehouse south of Rowena and liberated KELO's 1968 newscast set, complete with Terrace Park signs and the original 50 pieces of Dave Dedrick's ugly necktie collection.)

Tuesday, August 18, 2009

German Health Care Beats U.S.: Less Rationing, Better Coverage... and with Older Population!

My comment section brings Linda McIntyre's concern about rationing. It also brings a useful link from Tony Amert. Even though Tony wrote first, his link responds well to Linda's concern:

From an American perspective, Germany’s health care system represents a nettlesome challenge. Americans now spend 14 percent of their gross domestic product (GDP) on health care, while Germany spends less than 10 percent. Yet, for all that heavier spending, the U.S. health care system has never managed to provide all Americans with secure, portable health insurance. Evidently, for many low-income Americans without health insurance, the system now rations health care by income and ability to pay.

By contrast, Germans of all ages have long enjoyed fully portable health insurance that provides what is effectively first-dollar coverage for a very comprehensive package of benefits. Furthermore, unlike U.S. patients, who increasingly find their choice of doctor and hospital limited through the technique of managed competition, German patients still enjoy completely free choice of provider at the time illness strikes. In cross-national opinion surveys conducted by the Louis Harris organization in conjunction with the Harvard School of Public Health, both German patients and physicians express relatively greater satisfaction with their health care system than their American counterparts express with their system.

The relatively low level of health spending in Germany is all the more remarkable, because Germany’s population is so much older than America’s: 15.5 percent of the German population is age sixty--five or older, compared with 12.2 percent of Americans. In fact, the United States will attain Germany’s current age structure only in the year 2020 [Uwe E. Reinhardt, "Germany's Health Care System: It's Not the American Way," Health Affairs, 13(4) Fall 1994].

Catch that date: 1994. Little has changed in national differences since then. When Linda and fellow conservatives trot out the word rationing as a reason to oppose health coverage reform, they might as well be arguing that health coverage reform will make morphine addictive and cough medicine taste bad. The United States already rations care. It's been happening since well before Reinhardt's 1994 article. Americans seem to accept rationing completely... as long as it happens to lower-income people, who obviously don't deserve health care if they're poor, since lacking money evidently indicates some punishment-worthy character flaw.

By the way, Reinhardt points out in a 2003 paper that the United States' ration-by-income scheme appears to restrict care even more severely than any of the supposedly socialist dystopias across the pond. According to that paper, Europeans go to the doctor more and get more treatments than Americans do. Compared to the OECD median, the United States has fewer acute care beds available per 1000 population, fewer hospitalizations per 1000 population, shorter hospital stays, and fewer acute care days per capita. In other words, we get less health care than over half of the industrialized world. (Yet we keep spending more.)

This data shows that America already restricts care more than most industrialized countries with public health coverage do. If you're really worried about rationing, you should be clamoring for a European-style health coverage system. After all, spending less and getting more is perfectly... rational.

Tuesday, August 11, 2009

Health Care Rationing in UK: Rational, Humane, Better Than US

I just came upon an interesting Tech Nation podcast from July 21 about health care in Great Britain. Host Moira Gunn interviews Sir Michael Rawlins, chair of the UK's National Institute of Health and Clinical Excellence, the body charged with deciding what treatments the National Health Service can afford.

I know, your "Rationing!" alarms are going off already. It is true that in Great Britain, the government's single-payer system doesn't cover every drug and treatment. But the decision makers are not bureaucrats. They certainly aren't profiteers (as they are in the U.S., where an inusrance agent always stands between you and your doctor). As Rawlins explains it, the decision makers are health care professionals, folks who take a day off work once a month to come to London to serve on advisory committees. The government reimburses their train fare, but these decision makers get paid no salary for the hard decisions they must make.

And how do they make those decisions? Here's my rough translation of Rawlin's explanation (do listen to the whole interview, make sure I got it right):

Rawlins explains that each year, Parliament sets a budget for the National Health Service, and the NHS must then stay within those fiscal limits. NHS thus works to make that money work as hard as it can. Every possible treatment has an opportunity cost: spending a lot of money on one costly treatment deprives many others of cost-effective health care.

Thus, the advisory committees look at the improvement a new treatment provides compared to existing forms of treatment. They calculate an "incremental cost-effectiveness ratio." If that ratio is too high, NHS doesn't cover it.

Now that may sound cold and mathematical. But Rawlins emphasizes that there are no strict numerical limits. In each case, the advisory committees look at the particular circumstances. They give special weight to end-of-life treatments, as they recognize the special value of our final months as a time when we can make forgiveness and see births and birthdays. They pay attention to the impact of their decisions on disadvantaged populations, trying to help those who need help the most.

Rawlins cites recent examples of two drugs, one for Lou Gehrig's disease, one for flu. Both drugs had estimated cost-effectiveness ratios of £38K per year, above the general standard of £30K per year. If the process were purely mathematical, the advisroy committees would've denied coverage for both drugs. But the flu drug reduced symptoms from six days to five. The Lou Gehrig's disease drug allowed patients to avoid tracheostomies. The committees heard from patients that having a tracheostomy was simply awful, in a way that another day of the flu just isn't. The advisors thus recommended coverage for the expensive Lou Gehrig's disease drug but not the expensive flu drug.

This is rationing. But this is not fascism or the Anti-Christ at work. This is a sensible, compassionate use of limited resources. That beats America's rationing-by-wealth any day.