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In Reply to: RE: the core issues? posted by Bruce from DC on November 05, 2008 at 09:44:12
that it is okay for the government to create entities that are "too big to fail". CMHC and the provincially run but federally mandated health care systems in Canada are two fine examples. Neither is it correct to assume that stronger regulation of the financial sector would stifle growth, or for that matter that government strategies in areas such as energy or manufacturing can't catalyze growth is specific sectors. But really galls me in the whole shrinking government mantra, because in practice it's been an outright lie.
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I confess I don't know much about the Canadian health systems. Tell me, how do they decide who gets treated and who doesn't? How do they decide how people with difficult diseases, like cancer, get treated and who don't? How do they decide what kind of treatments these patients will get? Cancer drugs are very expensive. Who gets them, and who doesn't?
It's worth noting that, in the UK, survival rates for various cancers, after diagnosis, are significantly lower than in the U.S. Why is that? Because the National Health doesn't want to spend the money on treating them.
As someone who has been told (a) that I wasn't a candidate for surgery because my cancer was too advanced and (b), after surgery, was told that I wasn't a candidate for post-operative radiation, for the same reason, I have a rather personal view of these issues. (By the way, in both instances, these recommendations are contrary to some established medical protocols; and other physicians disagreed -- strongly -- with these views.)
As you, yourself should know, the market is a mechanism for allocating scarce resources. If you remove the market mechanism, then something else has to take its place.
In the case of the Canadian system, there must be some cost control mechanism or health care would eat up the governments' budget (as it threatens to do here in the US for old people). And, if you limit practitioners' incomes (as appears to be the case in the UK), they will simply exit the business or practice somewhere else.
Generally in Ontario if a treatment is funded, it's up to the physician. Occasionally, new or very expensive treatments are funded with explicit restrictions - only a certain number of people who meet certain criteria will be treated. Generally speaking, if a treatment is approved but not funded you can get private treatment at your own expense or using coverage from your employer. I'm sure the treatments you're undergoing would be funded. How are you doing anyway? Nice redirection.
P.S. The National Health Service in the U.K. is a whole other "kettle of fish", but I'm not conversant enough to discuss it.
Thanks for your informative answer, Jim. I'm doing fine. Of course, I'm through the "easy" or "routine" part of the treatment (except for the androgen deprivation shots, which continue quarterly into the indefinite future).
The question for me, as it is for most other cancer patients after the initial treatment that appears to eradicate it, is whether it will re-appear in metastatic form. For this particular cancer (also like most), the onset of metastasis is the beginning of what is no more than a delaying action, where the patient is subjected to a series of increasingly expensive and increasingly ineffective treatments.
There is some chance that a combination of my otherwise robust good health, dietary changes, my surgeon's unusual and aggressive treatment (removing 50 lymph nodes, when 2 or 3 of them turned out to be cancerous) and good luck might actually have me cured.
But the odds are against it. I figure I have 5-6 years before things get ugly, but my oncologist says it could be as little as 2. There are some promising new drugs . . .
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