tag:blogger.com,1999:blog-7476621888383604834.post8020148969907573660..comments2024-02-15T03:26:38.897-05:00Comments on Health Care Organizational Ethics: Topping-up: Medical Ethics, Equity, and Rationing, in the National Health ServiceJim Sabinhttp://www.blogger.com/profile/03087828142188534542noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-7476621888383604834.post-37427571161315160202008-02-26T01:39:00.000-05:002008-02-26T01:39:00.000-05:00Jim--By the same token, Eliot Spitzer wants to tax...Jim--By the same token, Eliot Spitzer wants to tax illegal drugs in the state of New York! Makes sense. --Ericerichttps://www.blogger.com/profile/16137189911651175163noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-20583132947717722252008-02-24T11:05:00.000-05:002008-02-24T11:05:00.000-05:00Hi Eric -Thanks for raising an important question....Hi Eric -<BR/><BR/>Thanks for raising an important question. It is not at all theoretical. Some people have argued, for example, that since the risks of smoking are well known, collective funds should not pay for treatment of smoking-induced diseases. But while I see explicit rationing as consistent with the core values of health care, I would not favor having the health system simply turn people away for dumb choices (starting to smoke in 2008) or bad luck (as you correctly suggest could happen in the Avastin example). For tobacco, taxes on the product to offset the costs its use generates (paid for by the user, the producer, or both) would be a better way to go.<BR/><BR/>In terms of the NHS, I could picture it developing a policy - by an an open process, with opportunity for critique and appeal, that (a) allowed for the possibility of topping-up, but (b) made clear that the NHS would be entitled to seek recovery of costs it incurred in responding to complications of the kind you envision. <BR/><BR/>By chance this morning's Boston Globe has a front page article on the cost of rescuing foolhardy winter hikers, with the headline "[New Hampshire] seeks to recoup costs from 'negligent' adventurers." <BR/><BR/>Best<BR/><BR/>JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-43563031201636062682008-02-22T19:26:00.000-05:002008-02-22T19:26:00.000-05:00Jim--What if she got, let's say for argument's sak...Jim--What if she got, let's say for argument's sake, toxic epidermal necrolysis due to the Avastin (I don't know if such a side effect has been reported), for example, and had to spend two weeks in hospital. Should the NHS pay for treatment of side effects of drugs that it won't cover?<BR/>On the other hand, if she took an herbal remedy and suffered a side effect, should NHS pay for the treatment of that? <BR/>Or, what if she just didn't tell what she was taking. --Ericerichttps://www.blogger.com/profile/16137189911651175163noreply@blogger.com