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Comment by vinceguidry | Hacker News Reader

So, if some company creates a really really expensive medical treatment, are they all of a sudden on the hook to providing it to the whole nation?

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Yes? In an ideal society the company would create the treatment and the government would foot the bill for the citizens, followed by costs lowering over time as new advancements are made.

There are already a bunch of extremely expensive treatments for diseases and afflictions that affect a small portion of the population. Some of which are fatal if not treated. Should they be expected to just die because the treatment is as you said 'really really expensive'?

The first country that does that, I'm going to move to and make a $1,000,000 treatment that doesn't work and wait for the first idiot to get the government to pay for it.

People need to appreciate how hard fraud is to circumvent in anything where government largesse is involved.

A large amount of countries already exist that do that. Cancer treatments can easily cost that amount depending on the cancer, never mind some of the more esoteric diseases. You argue that it's easy to 'fraud' the government in this case, ignoring the amount of regulation and steps that have to be taken in order for a treatment to actually be put into practice.

And you conveniently ignored my point on how what you suggested is essentially advocating for people to die if a treatment is too expensive.

You're not getting my point. I never said governments shouldn't pay for medical care. I'm saying there's a line where it needs to stop, and asking where it should be drawn. Sure, let's pay for cancer treatments. How much, exactly?

I posited a hypothetical scenario, which can get extremely real if we start looking at real situations of benefits fraud, and asked you how we should deal with that. Are you really saying that the government should just pay whatever I want to charge for my service that doesn't work? If it does work, can I charge the government whatever I want to provide it?

What you're not understanding here is that this, and every other example of asking the government to do things, is manipulable by humans and thus is an adversarial process. Because the government isn't God, it doesn't have truly unlimited resources.

Your question posits a scenario that is fairly rare, and assumes that it's common enough that it's an issue. You again ignored my direct rebuttal in the parent comment as well, which was that there is large amounts of regulation that goes into making sure that a treatment actually works and is effective.

The original argument was never about 'should the government pay for fringe treatment that is not confirmed to work' but rather 'should the government pay for people who have fringe diseases or issues'. Your hypothetical scenarios and arguments have been drifting from the latter and into the former.

That's one of the challenges countries with public healthcare have been facing recently, along with generally skyrocketing medication costs, when medication is covered by the system (Canada has haphazard coverage, from Québec which has total coverage to many provinces which have none). New treatments are opt-in, so once in a while someone with a rare disease will be denied coverage due to the expensive nature of their treatment, or its unavailability in the jurisdiction. Until 2017, there was only one clinic in Canada which did sex re-assignment surgery, in Montréal, so out-of-province patients who want the procedure have to go jump through a lot of hoops to get covered by their own province and have the whole trip covered by their provincial healthcare system.

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