Access to health care has become a big political issue in the U.S. And it's a legitimate issue. The American system is a bizarre mish-mash of public and private, with government incentives encouraging third party payment and employer provision of medical insurance. The result isn't pretty. But nationalized systems are far worse. Access remains an issue, since the government becomes the sole gatekeeper. And the results, well, aren't pretty. If you're in Great Britain, forget getting the best and most effective (and, thus, the most expensive) medicines. Reports the Guardian:
Drug rationing is essential in the NHS, and ministers should back the National Institute for Health and Clinical Excellence (Nice) which plays the key role in deciding which ones are worthwhile, MPs will say today in a hard-hitting report. The health select committee will call for more appraisal, not less, by Nice, which has been castigated by patient groups and drug companies whenever it has banned a new drug from the NHS. In a report following an inquiry into the workings of Nice and the fierce opposition it provokes, MPs recommend that all drugs should be given a rapid appraisal by Nice at the time of launch. Those that clearly work well enough and are cheap enough - probably no more than £20,000 a patient a year, which is lower than the current threshold - would be provided by the NHS straight away. More expensive medicines would have to go through a full appraisal which could take more than a year. Kevin Barron, the committee's chairman, said that might have the beneficial effect of encouraging some drug companies to pitch their drugs at lower prices. The drug industry was not pleased. "British patients already have worse access to new medicines than others in Europe," said Richard Barker, the director general of the Association of the British Pharmaceutical Industry. The select committee had some criticisms of current practices. It has "serious concern" about the affordability of Nice guidance and the threshold, which is up to £30,000 for a year of healthy life, that it uses to decide whether a treatment is cost-effective. Some argue it is too low, while some primary care trusts struggle to afford drugs at that cost.Oh well. What if a few people die unnecessarily? We can't expect the taxpayers to save everyone, now can we?