Captain's Quarters -

You're health care WILL be rationed. Either by availability (long lists and inflexible calendars) or by price. I'd rather have the chance to come up with the money somehow.

I thinjk that the reason that Congress wants to mandate a European style system for the US is that members of Parliament in Europe automatically go to the head of the line. Congress expects to be given all the latest treatments immediately rather than having to wait like everyone else.

Note the "Related Articles" appended to the Telegraph story. One reports that Erbitux was denied to the British National Health Service because it was "not cost- effective". Such a judgment is truly scary but entirely consistent with socialist thinking, i.e. all metastatic colon cancer patients are alike, and will respond identically (rate of disease response and duration of response). Fact is that only a minority of these patients respond to Erbitux-the cancers are biologically heterogeneous!- but the responders often benefit greatly in life extension. This is a truism that applies throughout the oncologic realm-nothing is a slam dunk- which egalitarianism cannot face. If you don't try it, it can't work on your cancer, and you'll never know if it would've. And trying it costs money, which could be "better" used elsewhere, like immunizing kids, as if we had to choose. In nationalized health schemes, the beaurocrats do the choosing, and the colon cancer patients slide on out, untreated.
I am an oncologist.

What are the survival rates for US patients? The Telegraph article doesn't say.

Cap'n Ed wrote:

It's funny how the supposedly equalized treatment of people under Western socialized-medicine models holds people back from new therapies and new medicines, while the American model of market-based medicine (with significant regulation) outperforms in this regard by a factor of 10. That response allows patients to start treating their cancers earlier, but what this report misses is that the American model also allows for earlier detection, thanks to the long waits for procedures like CAT scans and the like in Britain and other socialized systems.

You're looking at this all wrong. You seem to have some crazy idea that the health care system is supposed to be about curing or at least ameliorating disease.

You're wrong. WRONG, I say.

The health care system is about fairness, i.e. making sure that some people don't get better health care than others. I'll bet all those Americans who got the news drugs and therefore survived longer after diagnosis were all rich. And it's not FAIR that rich people should get the goodies.

Therefore, what needs to be done is exactly what Britain appears to be doing: deny treatment to EVERYBODY. That way, everybody suffers and dies to an equal extent. Because, again, it's not FAIR for some people to survive when other people don't, ESPECIALLY if it's only because they're rich.

/sarcasm

I don't believe the motivation of leftists is to save the maximum number of lives. Do you?

These people believe humans are a threat to the planet. Many of them are atheist-materialists who admit no inherent value in human life. They want population control. You want to give these people access to your ventilator?? Ask the folks in Amsterdam how that worked out for their retarded children.

The leftist agenda is not to promote life, but to establish an infrastructure for the scientist-kings who will manage things not for the sake of the individual but for the collective of the planet.

We identify leftists as a culture of death for a very good reason.

Slightly off topic (not too much though) is the unmentioned socialist healthcare phenomenon of "queue jumping". Reserved for the members of the establishment mostly (remember: all the animals are equal, but some are more equal than others). Queue jumping became a must in countries like Canada, where waiting list for the simplest MRI is 6 – 8 months. Yes it is MONTHS, like ~200 days! But as I said, the more equal animals get it right away so there is no problem and nobody is asking why.

The article says that the US has 10 times the use rate of Avastin as Europe does. This is an absolutely trivial point, and to extrapolate it into an evaluation of a nations entire heath care system is ridiculous. The referenced study did not even include the US in it, and the “10 times higher uptake” comment is not to be found within the study. I am not sure where that quote originated from, but it is certainly not from the study. To point to this as proof of the effectiveness of the US system is silly, and in reality it shows the exact opposite.
Avastin is a monoclonal antibody with anti-angiogenic properties that is used in conjunction with standard chemo to treat colorectal cancer. The yearly cost of Avastin is $55,000, certainly out of reach for those in the US without insurance, and even for those that do have it, the copayment is still pretty high. This drug extends a patient’s lifespan by an average of 5 months. The science of the drug is very impressive, but does it really contribute more to public health, or to Genentech’s profits? Health care, like anything else, must be looked at in cost to benefit terms. If every person in the US got a presidential physical every year, it would save lives. But this is impossible to do because of how much it would cost, so it is ridiculous to consider. Cost to benefit ratios are usually looked at in terms of dollars per life-year gained. Let’s say the average colon cancer patient receives treatment for 5 years (The survival rate is at least that long). Let's be very conservative and say that the patient receives Avastin for only 2 years. The cost will still be $110,000, and life span will be increased by 5 months, on average. This works out to $264,000 for every life year gained. This is insanely high. To compare, screening the population for colorectal cancer using a fecal occult blood test every 5 years costs $55,600 for every life year saved. Even better results were reported a couple weeks ago in the journal “Cancer”. Optical colonoscopy screening costs $9,180 per life-year saved, while virtual colonoscopy costs $4,361 per life year saved.
So even though the Captain claims that access to Avastin saves lives, the opposite is true. Spending health care dollars on Avastin costs lives. Using that same money on simple screening tests for citizens can save over 60 times as many lives per dollar spent. This would be a much more effective use of the health care dollar. Countries like the UK know this, which is why they end up spending much less money than the US does, while offering better health care systems at the same time. Screening citizens is certainly not as sexy as the science behind Avastin, but it is much more effective at saving lives. Avastin and drugs like it, however, are certainly much more effective at making money for pharmaceutical companies. Genentech had 1.7 billion dollars in Avastin sales last year. This may have saved 6,400 life-years, which is great. Using the same money for screening, however, could have saved 390,000 life-years. Actually, colorectal cancer organizations are saying that screening is the answer to eliminating the disease, and not just treating it. Finding and removing a polyp can add decades to a person’s life. The problem with this solution is that screening is relatively inexpensive, and has no benefit for big pharma. Allowing a person to get cancer and then treating them with Avastin will lengthen their life by 5 months vs not treating them, and the benefit is hundreds of thousands of dollars profit for big pharma. That’s what the US health care system is about.
This is a perfect example, then, why the US health care system can be rated 37th in the world by the WHO, behind virtually every other industrialized country and equal to poor nations like Cuba who spend 4.5 % as much as the US does on health care. This example shows how the US system is actually poor, and at the same time seems so great to many US citizens that are duped by pharmaceutical propaganda. The advanced science of Avastin sounds like good evidence of the quality of the US system, but in reality it is the opposite. In reality, the most critical requirement for a good health care system is making basic health care available to all, along with good preventative medicine (such as screening) ,and the promotion of a healthy lifestyle. The US system is lacking in all these critical areas, which is evident in the fact that over 40 million of Americans uninsured, leading to 18,000 deaths per year. The US system ignores these areas because it is concerned with profits, and not public health.
There’s another Avastin related example of how the US health care system works. Genentech has a drug called on Lucentis on the market, which is used to treat vision loss caused by macular degeneration. Avastin was shown in clinical trials to be just as effective as Lucentis for treating the same disorder. For macular degeneration, however, Lucentis costs 40 times as much as Avastin would. If Genetech were to bring Avastin to the market, patients could end up paying 40 times less for the same treatment. In Europe, this is the approach that would be taken. So what happens in the US? Genentech is refusing to market Avastin for macular degeneration, so they can continue to sell the far more expensive Lucentis instead. US health care is about money, not health.

The article says that the US has 10 times the use rate of Avastin as Europe does. This is an absolutely trivial point, and to extrapolate it into an evaluation of a nations entire heath care system is ridiculous. The referenced study did not even include the US in it, and the “10 times higher uptake” comment is not to be found within the study. I am not sure where that quote originated from, but it is certainly not from the study. To point to this as proof of the effectiveness of the US system is silly, and in reality it shows the exact opposite.
Avastin is a monoclonal antibody with anti-angiogenic properties that is used in conjunction with standard chemo to treat colorectal cancer. The yearly cost of Avastin is $55,000, certainly out of reach for those in the US without insurance, and even for those that do have it, the copayment is still pretty high. This drug extends a patient’s lifespan by an average of 5 months. The science of the drug is very impressive, but does it really contribute more to public health, or to Genentech’s profits? Health care, like anything else, must be looked at in cost to benefit terms. If every person in the US got a presidential physical every year, it would save lives. But this is impossible to do because of how much it would cost, so it is ridiculous to consider. Cost to benefit ratios are usually looked at in terms of dollars per life-year gained. Let’s say the average colon cancer patient receives treatment for 5 years (The survival rate is at least that long). Let's be very conservative and say that the patient receives Avastin for only 2 years. The cost will still be $110,000, and life span will be increased by 5 months, on average. This works out to $264,000 for every life year gained. This is insanely high. To compare, screening the population for colorectal cancer using a fecal occult blood test every 5 years costs $55,600 for every life year saved. Even better results were reported a couple weeks ago in the journal “Cancer”. Optical colonoscopy screening costs $9,180 per life-year saved, while virtual colonoscopy costs $4,361 per life year saved.
So even though the Captain claims that access to Avastin saves lives, the opposite is true. Spending health care dollars on Avastin costs lives. Using that same money on simple screening tests for citizens can save over 60 times as many lives per dollar spent. This would be a much more effective use of the health care dollar. Countries like the UK know this, which is why they end up spending much less money than the US does, while offering better health care systems at the same time. Screening citizens is certainly not as sexy as the science behind Avastin, but it is much more effective at saving lives. Avastin and drugs like it, however, are certainly much more effective at making money for pharmaceutical companies. Genentech had 1.7 billion dollars in Avastin sales last year. This may have saved 6,400 life-years, which is great. Using the same money for screening, however, could have saved 390,000 life-years. Actually, colorectal cancer organizations are saying that screening is the answer to eliminating the disease, and not just treating it. Finding and removing a polyp can add decades to a person’s life. The problem with this solution is that screening is relatively inexpensive, and has no benefit for big pharma. Allowing a person to get cancer and then treating them with Avastin will lengthen their life by 5 months vs not treating them, and the benefit is hundreds of thousands of dollars profit for big pharma. That’s what the US health care system is about.
This is a perfect example, then, why the US health care system can be rated 37th in the world by the WHO, behind virtually every other industrialized country and equal to poor nations like Cuba who spend 4.5 % as much as the US does on health care. This example shows how the US system is actually poor, and at the same time seems so great to many US citizens that are duped by pharmaceutical propaganda. The advanced science of Avastin sounds like good evidence of the quality of the US system, but in reality it is the opposite. In reality, the most critical requirement for a good health care system is making basic health care available to all, along with good preventative medicine (such as screening) ,and the promotion of a healthy lifestyle. The US system is lacking in all these critical areas, which is evident in the fact that over 40 million of Americans uninsured, leading to 18,000 deaths per year. The US system ignores these areas because it is concerned with profits, and not public health.
There’s another Avastin related example of how the US health care system works. Genentech has a drug called on Lucentis on the market, which is used to treat vision loss caused by macular degeneration. Avastin was shown in clinical trials to be just as effective as Lucentis for treating the same disorder. For macular degeneration, however, Lucentis costs 40 times as much as Avastin would. If Genetech were to bring Avastin to the market, patients could end up paying 40 times less for the same treatment. In Europe, this is the approach that would be taken. So what happens in the US? Genentech is refusing to market Avastin for macular degeneration, so they can continue to sell the far more expensive Lucentis instead. US health care is about money, not health.

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