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June 01, 2008

Government-run Healthcare Is a Killer

One of the problems with government-run healthcare is that faceless, bureaucratic rulemakers prescribe courses of treatment instead of doctors in consultation with patients. If the bureaucracy decides that a drug isn't cost-effective, it simply will not be provided, no matter what the doctors or patients want. It's not about saving lives or easing suffering. It's about plotting life-expectancy graphs and rationing finite taxpayer-provided resources.

Losing medical autonomy is bad enough, but government-run healthcare programs are also bound to public perceptions of fairness and equality. Which means that they usually end up doing things like forbidding a person to pay for treatment outside of the government-provided program.

That's just what the UK did last year when the Health Secretary ordered the NHS not to permit patients to pay for unfunded treatments themselves. He said that these "co-payment schemes" would create "a two-tier NHS" with preferential treatment for people who could afford their own medical care. We now know that the policy claimed its first life in March.

A grandmother died from cancer after her free NHS treatment was withdrawn because she had paid privately for a drug that could extend her life.

Linda O'Boyle, 64, had been receiving state-funded care including chemotherapy after she was diagnosed with bowel cancer.

But her local health trust made her pay for her treatment after she started a course of cetuximab, which is available on the NHS in Scotland but not in England and Wales.


Mr O'Boyle said his wife, who died on March 26, had to stop taking the drug after developing some side-effects but added he was convinced it had extended her life by three months.

Medical experts say the ban on co-payment is one of the reasons Britain has one of the worst survival rates for cancer in Europe.

Cetuximab, also known as Erbitux, cost around 3,700 a month and prolongs the life of bowel cancer patients by six months on average.

It is one of many medicines that the government's rationing body, the National Institute for Health and Clinical Excellence, has denied to some patients on the grounds of cost-effectiveness.

Let's be clear about what happened here. Mrs. O'Boyle was diagnosed with cancer and had NHS-provided operations, chemo, and other care. Then she found out about a cancer-treatment drug that could prolong her life. Since NHS wouldn't pay for it, she bought it herself. At that point, NHS started charging her for her care that had previously been provided free-of-charge.

This type of policy isn't an unintentional side-effect of government-run healthcare. In fact, the whole point of "universal" healthcare is that it is provided to everyone regardless of their ability to pay. The guiding principle is equality of treatment, which means that any treatments which are too expensive to give to everyone must be denied to everyone. For fairness' sake.

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posted by Gabriel Malor at 06:32 PM

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