Re:Did Insurance Fire Brigades let uninsured buildings burn?
by pas on Monday December 19, 2022 @06:14PM
(#34059215)
sincere question about medical costs of that cancer survival: it seems like a standard thing to compare. if we just look at the non-experimential stuff, is there something interesting? are US treatments better? even if adjusted for costs? can we even compare them somehow? purchasing power parity, sure, and cost breakdown of states/regions, differences in coding, market sizes and thus market efficiency, regulatory compliance costs, cancer base rate (age, obesity, socioeconomic status, air quality, other factors) ... ?
Re:Did Insurance Fire Brigades let uninsured buildings burn?
by jandrewrogers on Monday December 19, 2022 @07:27PM
(#34059875)
Poor people in the US don't pay for their cancer treatments, the government does. They broadly use the same medical facilities as everyone else wherever they live, which do vary with locale. Some rural backwaters may not have the most advanced tech, you have to go to a city for that.
The segment of the US with most challenging cost problems are the lower-middle class. Not poor enough for the government to pay for everything while also being at risk of having little or no insurance. For people comfortably in the middle-class and up, this is much less likely to be the case.
The overall story is complicated. Demographics and health matter (not great in the US). The US medical system is profligate about speculative and preventative diagnostic tests which catch more cancers earlier (at great cost). But also early access to rapidly improving cancer treatments. It all blends together into the top-line numbers.
The US, quite famously, generally has the highest cancer survival rates in the world. The standard bearers for cancer survival rates in Europe have traditionally been Switzerland and France, which are close to the same level as the US. A decade ago in the UK there was a public outcry when studies showed it had one of the poorest cancer survival rates in the developed world; in the well-known Lancet study, survival rates in the US were 50% higher than the UK.
The UK has improved their cancer survival rates significantly over the last decade in response to those studies but it isn't near the top tier.
In the US, everyone gets essentially the same cancer treatments, even if they are poor. The economic stratification occurs around enrollment in experimental cancer treatments, by virtue of needing to be located where experimental therapies are being tested. Experimental therapies are a big deal in the US because most state-of-the-art treatments are developed and tested there before being widely available. If you want to enroll in experimental cancer treatments outside of where they are being tested, you need to have the economic means to travel there. I personally know people on welfare in the US who survived Stage 4 cancer because they happened to live where highly effective experimental cancer therapies were being tested, making it readily available to them.
The US lives a little bit in the future for state-of-the-art cancer treatments. I know several people that survived cancer in the US thanks to experimental therapies that are now standard therapies. It usually takes a while for these to propagate to other parts of the world.