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The Perils Of "Free" Healthcare

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The Perils Of "Free" Healthcare
First of all, take economics 101: If we have socialized medicine, it's not going to be free health care, it's going to be very expensive health care, because we're all going to be paying for it; we're just going to be taxed and taxed for it.

And when some politician says, "Sorry, kids, we have to pay for it somehow," and raises your taxes, and raises them again and again, what do you do? Tell them the country should buy cheaper Bandaids?

There's a story in today's IHT, by Sarah Lyall, of what happens when British patients go in for private care; in this case, Avastin, a drug I know about because it help keep Cathy Seipp with us a little longer. The problem is, as Lyall puts it, "how to handle patients with complex illnesses who want to pay for parts of their treatment while receiving the rest free from the health service":

One such case was Debbie Hirst's. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist's support, she decided last year to try to pay the roughly £60,000, or $116,000, cost herself, while continuing with the rest of her publicly financed treatment.

By December, she had raised £10,000 and was preparing to sell her house to raise more. But then the government, which had tacitly allowed such arrangements before, put its foot down. Hirst heard the news from her doctor.

"He looked at me and said, 'I'm so sorry, Debbie. I've had my wrists slapped from the people upstairs, and I can no longer offer you that service,' " Hirst said.

"I said, 'Where does that leave me?' He said, 'If you pay for Avastin, you'll have to pay for everything' " - in other words, for all her cancer treatment, far more than she could afford.

Officials said that allowing Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.

Patients "cannot, in one episode of treatment, be treated on the NHS and then allowed, as part of the same episode and the same treatment, to pay money for more drugs," Health Secretary Alan Johnson told Parliament. "That way lies the end of the founding principles of the NHS."

But Hirst, who is 57 and was first diagnosed with cancer in 1999, went to the news media, and so did other patients in similar situations. And it became clear that theirs were not isolated cases.

In fact, it is widely acknowledged by patients, doctors and officials across the health care system that patients suffering from every imaginable complaint regularly pay for some parts of their treatment while receiving the rest free.

..."People swap from public to private sector all the time, and they're topping up for virtually everything," he said.

For instance, he said, a patient put on a five-month waiting list to see an orthopedic surgeon might pay £120 for a private consultation, and then switch back to the health service for the actual surgery from the same doctor.

"Or they'll buy an MRI scan because the wait is so long, and then take the results back to the NHS," Charlson said.

In his paper, he also wrote about a 46-year-old woman with breast cancer who paid £250 for a second opinion when the health service refused to provide her with one; an elderly man who spent thousands of pounds on a new hearing aid instead of enduring a year-long wait on the health service; and a 29-year-old woman who - with her doctor's blessing - bought a three-month supply of Tarceva, a drug to treat pancreatic cancer, for more than £3,150 on the Internet because she could not get it through the NHS.

...But in a final irony, Hirst was told early this month that her cancer had spread and her condition had deteriorated so much that she could have the Avastin after all - paid for by the health service. In other words, a system that forbade her to buy the medicine earlier was now saying that she was so sick she could have it at public expense.

Hirst is pleased, but only to a point. Avastin is not a cure, but a way to extend her life, perhaps only by several months, and she has missed valuable time. "It may be too bloody late," she said.

On a side note about Cathy, she's often in my thoughts -- randomly, when there's something in the media that she would've written about (in her sharp, biting, Seipp-ian way), or when I think of something she chastised people for.

Just last night, on the way to dinner, I mentioned to my friends Richard and Vincent that Cathy said something along the lines of "Gum chewing is vulgar!"...and any time I thought of popping a piece in my mouth, her words came echoing back to me. I enjoy this -- it's like a little visit from Cathy, although it doesn't do much for the economics of the Trident company.