Merantes

I was just talking with a friend in the insurance industry who also advises government on some matters of public health policy. He was telling me about an idea that I find simultaneously very interesting and very frightening. Let me say at the outset that I do not think there is currently much support for this idea.

The idea concerns a plan for national health care coverage. To keep cost down and presumably increase overall public health, many preventive and treatment treatments would be made mandatory. It might look something like this: annual check ups and dental exams would be mandatory. So would many vaccinations. If a person had high blood pressure they would have to take hypertension medication; if they had high cholesterol, then taking a statin would be required. People who failed to comply would be cut or have their premiums raised.

The idea, of course, is to reduce costs by detecting and preventing medical conditions before they become serious and thus more costly.

Another part of plan would be to collect a massive patient database in order to judge which treatments were more effective and to identify factors that correlate with both health and specific diseases. This info would be used to refine future health care treatment strategies. This info might also be sold to pharma -- with personal identifying info removed -- to help them identify new disease targets, better tailor new medicines to specific types of patients, and more. The money earned from selling this info would be used to further reduce the premiums paid by the individual. University researchers would have access to this info for research purposes.

If you look at only the medical aspects of this plan, it probably would improve public health, allow us to learn more about disease biology, and help in drug development. However, this plan would be an incredible intrusion on personal freedom. More than it would be worth in my opinion.

Your thoughts?

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What's up, Doc?

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Libre

With government money comes government control.

chu chu rocket

My opinion out of my political preferences is that it is my body, and no constellation of people should be given the power to force me to take pills against my own will.

However, I like the suggestion that you could get low premiums if you followed a regular check up schedule, and had great patient compliance. I think that would be extremely beneficial for public health. The plan should include training and healthy eating, with low premiums as additional motivation. Great idea, actually. How come the government has to join in on that suggestion, how come you don't use that as a business idea, and start an insurance company offering insurance on those terms?

Bowerbird

Hey!! I live and work in a national health care and we would not STAND for this kind of treatment - no way no how.

Besides - how the !#@#! are you going to police people taking pills? Let us just start with Joe and Jane Citizen here - it is actually easy enough to take a pill a day but when you start getting up to 2 and 3 - well it becomes easier and easier to forget - just ask anyone if they have completed EVERY course of antibiotics they were ever prescribed.

Then there is the difficulty of the homeless/mentally ill/ forgetful and just plain gormless. Those who cannot afford medication or who COULD but it would mean giving up smoking or drinking (and as much as I would like to see those people look after themselves - well unfortunately we will always have people who do not think it will happen to them)

Finally there are those who are resistant or genetically unable to process the meds. For example essential hypertension is VERY difficult to control often needing multiple medications - and unfortunately there are health care practitioners out there who love to be in control of patient's lives and who will not believe that the meds they are prescribing are at fault - so the poor patient ends up being reported even though they have done nothing wrong except not responded to the medication in the way the medico thought they should.

Genetic variance is huge - 1/3 Europeans do not metabolise Codiene - it is like taking water for them. Are people who genetically do not respond to the tablets also to be discriminated against because they did not improve the way the medico thought they would?

Finally of course there are the side effects. It is all very well to insist that a patient take their Beta Blocker for blood pressure but one side effect, especially for men, is impotence - and frankly I do not blame a guy for telling his doctor to shove those pill where the sun does not shine if they are causing a problem like that

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