6 mo old infant taken off life support thanks to law signed by Gov. Bush

[DanS]

Er we offer all kinds of transplants including heart - we were one of the countries that pioneered that.

And that is covered under your medicare system? If not, why not?

And who is making the decision ultimately about coverage?

[Alexander's Horse]

Its fully covered

[Imran Siddiqui]

But if you want to see riots in the streets of Australia, try and introduce that managed care system here.

Wasn't there an NHS scandal in Britain a few years back where doctors were unplugging old patients because of the cost as well as the medical situation? Or am I think of Canada?

[DanS]

Who decides on what life saving treatments are covered and is cost considered in their deliberations?

[Alexander's Horse]

It would be a scandal if that happened.

No system is perfect.

[KrazyHorse]

Originally posted by DanS
Who decides on what life saving treatments are covered and is cost considered in their deliberations?

Cost is not an issue in matters of life and death, at least where I come from. Doctors will perform any and all life-prolonging procedures independent of cost. Extraordinary measures may be discontinued depending on the wishes of the patient or next of kin (depending on the state of the individual) in consultation with the attending physician.

[Alexander's Horse]

Originally posted by DanS
Who decides on what life saving treatments are covered and is cost considered in their deliberations?

The cost question doesn't arise because all lifesaving procedures are covered

[DanS]

I think it extremely likely that some life-saving or life-prolonging treatments are unavailable in your systems. The government must control its costs in some fashion.

[Alexander's Horse]

Oh okay - don't believe me - just make it up yourself

[DanS]

I know how you save money...

From The Guardian...

Public patient? It's gruel for you!

by Peter Mac

The funding crisis facing NSW public hospitals took a Dickensian turn this week with the news that patients in Sydney's southern and eastern hospitals, other than those on special diets, will be served soup and plain bread instead of sandwiches for lunch, and cereals and toast instead of a hot breakfast.

The area's acting Chief Executive Officer, Mr Barry Shepherd, said that the meal changes might save millions from the current hospital food bill, which would then "allow us to deliver more health care".

The meal changes reflect the desperation of public hospital administrators who are attempting to shave dollars off their running costs rather than cut medical services because of inadequate funding for public hospitals.

Professor John Dwyer, head of medicine at Sydney's Prince of Wales Hospital asked: "How far do we have to go to save money if we can't afford to feed
the patients properly?".

Ambulances were recently advised to redirect all but life-threatening cases away from Sydney's five biggest public hospitals because of a shortage of
beds.

As reported in last week's Guardian, Sydney's Westmead Hospital is considering "persuading" some of its public patients to pay part of the cost of their stay in hospital.

The Australian Senate's Community Affairs Reference Committee is currently holding an inquiry into public hospital funding. The Doctor's Reform Society (DRS) has applied to make a submission to the enquiry.

The National President of the DRS, Dr Peter Davoren, last week described the meal change proposal, and government policies for public health funding
in general, as "strawberries and champagne for the rich, soup and a roll for the rest".

He criticised the Federal Government's cuts to public health funding, and called for the $1.5 billion private health insurance rebate to be allocated directly to public health.

Dr Davoren noted that "... the Federal Government only spends $6 billion a year on public hospitals, so the $1.5 billion spent on the rebate would provide a significant boost to public health funding if used for this
purpose instead.

"The fact that the South Eastern Area Health service is considering putting its patients on war-time rations so they can afford to buy penicillin and plaster is an indictment on public health funding in Australia today."

DRS Vice-President Dr Con Costa condemned a recent suggestion by the Australian Health Insurance Association that the Medicare levy be raised to 6.4 percent of taxable income.

He commented: "This is absurd. There'd be more than enough money to pay for Australia's health care if we didn't have to prop up the failed private health insurance industry with public money."

[DanS]

My internet research indicates that Australia's public hospital service manages costs mostly by limiting provisions for non-life threatening procedures to the available budget. If this is so, then are the queues long?

[Sava]

He commented: "This is absurd. There'd be more than enough money to pay for Australia's health care if we didn't have to prop up the failed private health insurance industry with public money."

I liked this part.

[Alexander's Horse]

In the news today.

Chemists face drug price cuts
Steve Lewis, Chief political reporter
March 22, 2005
CONSUMERS can look forward to cheaper prescription medicines under Howard government plans to shake up the "closed shop" pharmacy sector and cut mark-ups on drugs.

Cabinet will today debate plans to slash the margins enjoyed by chemists, in an attempt to rein in the costs of the $6.2billion Pharmaceutical Benefits Scheme, which is growing by about 11 per cent a year.

The plan will cut generous wholesale and retail margins on big-selling medicines such as arthritis drug Celebrex, asthma medicine Ventolin, reflux drug Meprazol and the cholesterol-fighting Zocar.

Ministers expect this will flow through to cheaper prices for millions of patients who regularly visit chemists for prescription drugs.

But it will put the Government on a collision course with the influential Pharmacy Guild of Australia, one of the most aggressive lobbying outfits in Canberra, which represents 5000 community pharmacies.

The guild has already convinced the Government to stop giant retailers Woolworths and Coles Myer from operating chemist outlets in suburban chains.

Health Minister Tony Abbott will bring forward the submission to cabinet today, with senior ministers keen on taking the fight up to the pharmacy sector.

Peter Costello, in particular, is understood to be keen to inject further competition into pharmacy, amid concerns that it operates as a "closed shop".

This will be done as part of a new five-year pharmacy deal, due to come into force from July 1.

PBS-listed drugs are now subject to a 10 per cent mark-up at wholesale, while chemists also mark up the price of medicines by 10 per cent and are entitled to charge a "dispensing" fee for every prescription completed.

A range of other ancillary charges means the price of a drug is often greatly inflated once it is handed over the counter to the consumer.

Cabinet will today discuss streamlining these arrangements, aiming to reduce the margins that pharmacists impose on drugs.

It will also undermine the profits of wholesalers, who have already warned the Government that this might lead to a "serious compromise" of the national medicines policy.

The Treasurer suggested last December that the wholesale margin should be cut to just 5 per cent, prompting drug wholesalers to engage political lobbyists to try to blunt this campaign.

Senior ministers believe the pharmacy sector can easily absorb tighter margins, though the Government is already bracing for a backlash from the well-connected sector.

The guild and the Government have enjoyed a cosy relationship in recent years, with John Howard an important ally against the incursion of Woolworths and Coles Myer into the sector. Last year, the guild praised the Prime Minister's intervention after he backed plans by NSW Premier Bob Carr to exempt pharmacies from national competition rules.

"Australian pharmacists and their 40,000 employees can now look forward to a future in which they can continue to provide personalised counselling and service without the threat of being swallowed up by corporations which are almost solely concerned with achieving results for their shareholders," guild president John Bronger said last May.

But just last week in Canberra, the peak doctors lobby launched a savage assault against the pharmacy organisation, demanding an overhaul of present arrangements.

Australian Medical Association president Bill Glasson called on the Government to "end this madness".

"We cannot afford to have wasteful payments, and the protective walls must be lifted from community pharmacy," Dr Glasson said.

http://www.theaustralian.news.com.au/common/story_page/0,5744,12621008%255E601,00.html

Notice this is actually about market reform and removing monopolies?

Keeping drug prices low is integral to our system. That's one area where a lot of money is saved. Pensioners pay only a few dollars no matter how expensive the drug is. Others pay a set amount, a fraction of the drug cost in most cases.

Of course if you want to continue to pay through the nose for drugs Dan, be my guest

[DanS]

Don't I know it. The rest of the world is leaching off of the innovation created in our system. The drug companies know whose market will bear the price -- the US to the tune of about half of all sales worldwide.

If the US government enforced a "negotiated" (i.e., non-market) price, then we would be paying a lot less for drugs. On the other hand, probably nobody would step up to the plate to replace drug company R&D funding.

So far, we've made the strategic choice to bear the price, in the expectation that eventually all of the innovators would be US-based. Besides, who wants to be without new drugs just because of the deadbeat Euros, Canadians, and Aussies? But who knows if this situation will prove sustainable and ultimately successful for us. I guess we've got the top 3 of 5 companies...

[Az]

Don't I know it. The rest of the world is leaching off of the innovation created in our system.

*worldssmallestviolinplayingtheworldssaddestsong*