[derekp7]

That actually makes a lot of sense, in that if there is a limited amount of funding then that 50K should go to a treatment that will give someone another 10 years. Under the US system, private insurance is just as quick (if not quicker) to deny that treatment.

Of course, under either system, if you come up with the 50K, then the treatment is all yours.

[ed_elliott_asc]

I’ve lived through a cancer and dragging it out for another 6 months doesn’t help anyone.

[refurb]

As someone who has worked in the US system, private insurers often pay for treatment quite quickly after approval. Unless the evidence is quite shaky, it’s usually paid for.

Now whether that’s a good thing is a separate question.

[rayiner]

> Under the US system, private insurance is just as quick (if not quicker) to deny that treatment.

It’s hard to find data on this, but I haven’t seen any basis for concluding that private insurers are “just as quick” to deny treatment. In the past, private insurers tended to have lifetime limits. They’d let you blow through the lifetime limit, and then deny care. In the NHS, the cost benefit of care was more carefully scrutinized from the outset. There is a lot of coverage of the NHS denying hip replacements and cataracts surgery, which is almost universally covered in the US: http://www.telegraph.co.uk/science/2016/04/27/hip-replacemen.... The US also does quite a bit better in cancer survival rates, suggesting that insurers aren’t just denying treatment to cancer patients: https://qz.com/397419/the-british-seem-less-likely-to-get-ca....

The ACA eliminated lifetime limits, but also limited insurer profits to 20% of expenditures. So now, insurers really have no reason to deny care.

[HarryHirsch]

Cancer survival rate is tricky but probably explained by better screening in the US: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706735/

The hip replacement issue is known as the "little old lady problem" in NHS circles. Hip replacement is not urgent, you'd like to concentrate the limited funds where lives are at risk. Unfortunately, little old ladies are fodder to enemies of public healthcare and always rolled out in this context.

[DanBC]

Cancer survival rate uses "5 year survival rate".

Take every man over the age of 50 and then give them prostate screening, and then don't do anything else at all. Don't test any of the prostate cancer that you find.

Your 5 year cancer survival rates go up, because most prostate cancer is slow growing.

But this situation isn't what happens. The US screens a bunch of men, and then treats the cancer they find. Does this reduce all cause mortality?

No.

https://www.harding-center.mpg.de/en/fact-boxes/early-detect...

This is what people in the American system pay for: testing and treatment that causes harm and which doesn't prevent death.

[JamesBarney]

It's my understanding is the U.S. is especially aggressive with screenings, which might have some impact on % of cancer deaths, but has an even larger impact on cancer survival rates.

Ex. If a cancer will kill you in 5 years and there is no treatment. Catching it year 2 vs 3 will prolong your lifespan 50%.