Talk:Lives at Risk

National Health Care systems

From your edit Kborer, the book seems to say that with National Health Care systems "too much money is spent on the healthy, while the most critically sick are denied access to specialized care and technology". That is a quite an extraordinary claim. The only expenditure on the healthy that makes sense to me and that I actually see in national systems I am familiar with are things like health education, vaccines, periodic check-ups on things like blood pressure, cholesterol, weight, and perhaps even the targeted subsidization of sports facilities for those whose health would benefit from their use. All of these are an investment in the prevention or early detection of ill-health and therefore quite a positive thing. Similarly, the claim that the sick are denied access to specialized care and technology is equally an extraordinary claim. It seems to say "we have the technology and care programs but because you are sick, we are not going to give them to you. Quite unbelievable! What evidence is it based on?--Tom (talk) 10:19, 11 December 2007 (UTC)

Isn't the way to make claims about the failings of national health care systems to compare and contrast with nations without national health care systems, which are certainly in the dozens if not over a hundred out of the two hundred plus nations? Why isn't Afghanistan used as a model for no national health care system? Somalia? Congo? You either pay out of your pocket or rely on charity. According to critics of the US system, it has eliminated all the charity provided by doctors and hospitals, except most charity hospitals were funded by taxpayers, or Catholics by way of its institutional power to require tithing, a church tax, enforced by government in some nations even today. These are obviously my "original work" and I'm not aware of published work that points out the logical fallacies in this book and many others of the same theme. Can anyone find such sources, or is the argument made in this book so nonsensical no one bothers to refute it? Mulp (talk) 19:23, 9 September 2012 (UTC)

Rights

"According to the book, citizens of countries with national health care systems do not have an entitlement to health care. The only country in the world that provides an entitlement to any health care service is the United States, whose citizens are legally entitled to kidney dialysis treatment. Citizens of other countries are not entitled to any particular treatment."

Again, this is quite an extraordinary and outrageously incorrect analysis of the situation. Citizens of most countries with National systems DO indeed have a LEGAL entitlement to receive health care. As far as I know the United States does NOT give a person the same kind of legal entitlement. If I needed kidney dialysis, whether I was in the UK (my country of origin) or here in Finland (my country of resettlement) I absolutely WOULD get access to dialysis if it significantly prolongued my quality of life and without payment as I have both a legal entitlement to health care needed to preserve life AND I have a legal right to transfer my entitlement right to any EU country just by moving there and making it my home. And I can do this whether I am still earning and paying taxes (which is how I pay for dialysis services whether I use them or not) OR EVEN if I am temporarily out of work and not paying taxes. A person in the US EITHER has to have the money to pay for it, OR an insurance policy which covers the cost OR is entitled under a national or local program for dialysis according to his or her personal financial circumstances. And even then probably has to pay something towards it. The US citizen is NOT guaranteed to have any one of these things. The ONLY right guaranteed to a person in the United States is that no one can prevent that access, because the constitution guarantees a right to life (though not necessarily the means to pay for it). That's not a very strong right compared to the rights given in other countries. Could someone in Canada, or Europe be denied access to dialysis? Certainly not. We have the same rights as Americans not to have treatments denied that would save a life. That kind of right is similar protected either by constitutional law or by other national laws or by Article 2 of the European convention on human rights.

Do you know how the book argues its case?--Tom (talk) 10:59, 11 December 2007 (UTC)

An entitlement is a legal right. And if I have a legal right to receive it, then I also have entitlement to receive it. Under what basis are US citizens "entitled" to receive dialysis that citizens in the UK are "not entitled"? --Tom (talk) 12:37, 13 February 2008 (UTC)

Equality under national systems / The "Myth" care on the basis of need and not ability to pay

Re the claim The elderly, minorities, and rural areas are all discriminated against in national systems. This is what the Acheson report concluded

The weight of scientific evidence supports a socioeconomic explanation of health inequalities. This traces the roots of ill health to such determinants as income, education and employment as well as to the material environment and lifestyle.

In other words, the main causes lay OUTSIDE the Health Service. It definitely DID NOT CONCLUDE that the system actively discriminates against people. But it did call for steps to be taken for positive discrimination to FAVOUR certain disadvantaged groups.

We RECOMMEND that as part of health impact assessment, all policies likely to have a direct or indirect effect on health should be evaluated in terms of their impact on health inequalities, and should be formulated in such a way that by favouring the less well off they will, wherever possible, reduce such inequalities

The main recommendations beyond this fell on the wider political arena such as the social security system, the education system, and steps to improve opportunities for the disadvantaged in policies connected to employment, training, mobility and transport, and food policy.

It most definitely DID NOT SAY that treatment available on the basis of need rather than ability to pay is a myth or that National Health is a failure and we need to replace it with something else. That would be a complete distortion.

RELATIVELY, the distance between rich and poor DID get wider between 1950 and 1990. You have to understand that the deprivations of war in the 1940s and 1950s such as food and petrol rationing, and in many cases, bad housing, were shared by large swathes of the population, both blue and white collar workers. As the housing stock became renewed and rationing ceased, everyone was better off. But RELATIVELY the richer got better off faster than the poorer did. Hence the relative inequalities worsened. Clearly, if access to health care was distributed on the basis of wealth or employment (which fortunately, in the UK it isn't) one could easily conclude on the basis of the findings from the Acheson report, that health inequalities in the UK would be very very much worse. --Tom (talk) 13:47, 11 December 2007 (UTC)

kidney dialysis

I am puzzled about the claim that kidney dialysis is an entitlement in the U.S. On what basis is this an entitlement? I can find no reference to support such a claim.--Tom (talk) 22:16, 13 February 2008 (UTC)

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