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Comment by Aurornis | Hacker News Reader

Step therapy is required in countries with universal healthcare, too.

It can actually be harder to get access to new therapies in countries with universal healthcare because they’re more uniform and strict in what they allow.

For a relatable example: The UK just raised the age of eligibility for COVID vaccines all the way up to 75 years old: https://www.mirror.co.uk/news/health/covid-russian-roulette-... Contrast this with the US where COVID vaccine coverage is a basic expectation of health insurance for all ages. And that’s for a simple, cheap medicine without step therapy! It doesn’t matter if your doctor thinks you need it, the rules are set from the top.

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> Step therapy is required in countries with universal healthcare, too.

This is something Americans with strong opinions about healthcare but little time spent researching it never seem to know.

To be honest, given the issues with the NHS, the UK isn't the best example to use for a "universal healthcare" system these days.

> the US where COVID vaccine coverage is a basic expectation of health insurance for all ages

That wasn't a sure thing this past year and there's always a risk it won't be next year. (https://www.pbs.org/newshour/health/fact-checking-rfk-jr-s-c...)

Worth noting that "eligibility for COVID vaccines" is for "free at the point of delivery" NHS treatment - you can still get it elsewhere at any age. Boots (a major chain of pharmacies) do it for £98:

https://www.boots.com/online/pharmacy-services/covid-19-vacc...

It can be harder, but it's specific to the country/system. Here it Taiwan you can walk into any clinic with stock and get a (NHI covered) vaccine any time.

There are other things to complain about of course, but the rules for what's covered ate generally logical. Non-covered medication is affordable to, which helps.

Sorry but this not actually true.

THe most appropriate treatment is required, not "step therapy". For antibiotics this makes sense, as last mile, powerful antibiotics need to be used sparingly.

The same with cancer, it'll be treated according to the requirements of the cancer, with guidance from nice about the most effective therapy.

Is it perfect? no.

Does it lead to mistakes? yes.

It is better than american style insurance denying care based entirely on price? 100%

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