Monday, September 24, 2007

On public vs private health care -

Al over at The Old Whig wrote about H Clinton's public health proposals. I left this as a comment, but it is worth repeating here -

I am very much of two minds here. Or perhaps I should say two hearts.

I have had all of my treatment, surgery etc for little more than a few hundreds.

I was talking with the corporate health insurer last week and she (the rep) said that the insurers would be looking at in excess of $50,000, perhaps even closer to $100k if there had been complications. The conversation came up because my boss could not understand (and neither could she) why my mitral valve was excluded under the corporate policy. It should, apparently, have been covered. However, I have the piece of paper that says otherwise.

Using that as a guide, I have recouped probably most of the tax I have paid in total over the past 15 years.

On the other hand, how does Rand's theories cope with the refusal of a private provider to cover for some medical events. More to the point, my wife would be faced with having to help me decide between another 5 years or so of fairly restrictive life for me and a $100,000 mortgage as we move toward retirement. Suggestions?

There are whole rafts of other considerations that are being debated here in NZ - not the least of which also directly impinges from my own surgery.

For example, the number of patients on waiting lists, defects in the process of determining priority for treatment, and that is the consequence of having restricted resources available. No argument from me on the need for limiting public funding of resources but it does have some interesting sidelights.

Over the past twelve months or more there has been a very emotional and persistant campaign for the use of Herceptin as a standard treatment of breast cancer. After much pushing from the womens' rights groups Pharmac has agreed to fund a 16 week treatment course, costing some $16,000 per patient. The WRGs are still pressing for 12 months treatment - potentially costing over $100,000 per patient. Well what is wrong with that?

In the past few days, a new test for male prostate cancer has been announced. It is not yet available in NZ. It is apparently far more accurate than the existing hormone test - which gives a very high rate of false negatives.

This new test is too expensive!! Hence it will be made available only by private providers, probably at an even higher cost to the patient.

How much? Reportedly $500 or thereabouts per test...

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