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Comment by onraglanroad | Hacker News Reader

> someone has to approve or deny healthcare. Every universal system does it too, but by government policy instead of corporate decision

That's another lie you've been told and believed.

With Universal Healthcare the government just provides the funding. Medical decisions are made by Doctors.

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Nonsense. In every nationalized healthcare system there is care rationing performed by government bureaucrats. Regardless of a doctor's opinion on medical necessity, some treatments involve long waiting lists or third-party reviews or are simply unavailable. That might be preferable to our current system in certain ways but let's not pretend that there are no trade-offs.

For example, let's say you're in England and your doctor decides you need Enhertu or proton beam therapy. That decision is meaningless because the NHS won't pay for them.

The lie you're believing is that the decision is made by government bureaucrats.

See my other reply in this thread.

>With Universal Healthcare the government just provides the funding.

And what makes you think that they fund everything? I support universal healthcare as well (I'm literally Canadian), but I can accept that there are tradeoffs associated with it.

They don't fund everything. They don't fund anything in particular.

They provide the funding and the medical professionals decide how best to allocate that funding for the best results.

It's a bit different in Canada to my situation in Scotland since there is also the choice of private healthcare here if you want to pay more to skip queues etc.

Huh? NICE sets a cost-effectiveness threshold of about £20,000-30,000 per QALY gained from a drug[0]. There was even a controversy where a drug for pancreatic cancer was denied funding for this very reason[1].

[0]https://web.archive.org/web/20110925050527/http://www.nice.o...

[1]https://web.archive.org/web/20151225115559/http://www.pancre...

NICE is an independent body consisting mainly of medical professionals. It's not made up of MPs.

That's exactly my point. How on earth are you still missing this?

I would love to know how universal healthcare works in your head

It's not how it works in my head: it's the reality of how it works here.

To quote from my other reply:

They don't fund everything. They don't fund anything in particular.

They provide the funding and the medical professionals decide how best to allocate that funding for the best results.

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