Also, http://randomreality.blogware.com/ and the NHS blog doctor for what the NHS looks like from the inside. It’s an organisation that provides excellent medical care – when it is allowed to do so, and when it’s not having its time wasted by the public.

There are those on the left, or at least agrees with much of MM is trying to accomplish, who believe his sledgehammer-and-smirk is probably more counter-productive since he’s sooooo willing to offend the mighty (to afflict the comfortable——which is his #1 modus operandi), rather than comfort the afflicted, which is what his guise it. Whether it’s true or not, he certainly comes across as having much more fun throwing the stones than picking up the downtrodden.

And I’ve made these similar comments on other blogs, so some will recognize them … but two hours with coke and a popcorn is really the only and appropriate venue for MM.

http://oracknows.blogspot.com/2005/12/when-is-cancer-care-futile.html

“Part of the problem is, of course, that there are limited resources, and the public health question is whether we should be putting so many resources into “hopeless” cases. The reality is that Sontag underwent a bone marrow transplant only because she had the money to pay for it if her insurance company didn’t come through. She had to put up a $256,000 deposit before the Fred Hutchinson Cancer Center would proceed to treat her. Only a small percentage of the population could afford that; anyone of lesser means would have had to fight his insurance company while precious time ticked away, making a tiny chance infitessimal.

But the real problem here is that the areas where advances are most needed are exactly in these “futile” cases. Advances are made when doctors and their patients push the envelope and try to cure diseases that, at the time, have a very low (or seemingly nonexistent) chance of cure, sometimes at high cost, both in money and in risk. …”

http://washingtontimes.com/article/20070630/COMMENTARY/106300004/1012

reminded me of aspects of this debate that I find odd. In the article he talks as if the US is the only place to do clinical trials, which is bizarely shortsighted given the number of European clinical trials, admittedly there is a lot of good quality medical research done in the US, but that is due to generous US government (NIH) funding to a large extent.

A idea is that US drug costs fund all pharmaceutical research, again partly driven by the bizarre view that all big pharmaceutical companies are American (obviously false), and the more difficult to disprove view that somehow the US healthcare consumer is paying for global drug R&D through their high costs, and everyone else is free-riding on the back. I don’t know whether this is true, I doubt it, and I’m surprised that rightwing low tax types don’t want to redistribute some of these healthcare costs back to the Europeans and their socialised medicine if this is really the case – very altruistic of them.

For a start (although even if this were not the case they still would not do a BMT) the NHS is organised along a sort of internal market with a purchaser/provider split.

I grabbed this off a random website which gives an introduction to the UK’s private health insurance system:

Unless the drug has been approved for use by the NHS in England and Wales, by the Institute for Health and Clinical Excellence, your insurer is unlikely to approve its use. The problem is that the Institute’s brief is not simply to decide whether a drug works, but to carry out a cost/benefit analysis to ensure that the benefits to the nation outweigh the financial costs of using it in the NHS. Not an easy brief – and one that has placed the Institute under scrutiny for the extended delays in drug approval.

(In this quote I think “insurer” means private insurer, and “drug” can also mean “treatment”). so the upshot is that if the NHS won’t treat you for it for free, no-one will. The UK private health system has essentially incorporated the NHS’s cost-control system in order to keep its own costs down.

(However, having said that – if the NHS was funded at twice it’s current level, I reckon it would be able to afford almost any treatment. So probably if the NHS was receiving as much money as is pumped into the US system, England would be a much prettier place – all those dolly-birds would be getting face transplants on the NHS!)

I don’t think you understand what a bone marrow transplant is.