Topping up again

April 25, 2007

In an interesting new take on the approach to top-up payments in the NHS, reported in the Times HERE, A leading insurer has started a policy in which patients will be able to pay an amount equal to their age per annum, for which they will bee guaranteed access to £50,000 worth of cancer drugs if they are licensed but not available on the NHS. An interesting proposition? Well yes, but lets look at the exclusions. If you have cancer-not eligible. If you are over 65-ditto If any relative has developed cancer under 65 ditto. So in fact I think this is a bit of a loss leader to try and get people to take up their more inclusive policies, when they realise how little advanced cancer treatment is available on the NHS. But of course they have a real incentive to promote the top-up approach as it will potentially save them huge amounts of money compared to wholly private treatment

Including my fees!

Lola-break out the Lafite 61. I think I may need a drink. Speaking of top-ups lets go for a spin. I may have to sell the Bentley




  1. Hi Mens Sana,
    this is a very serious argument, and the whole thing is so tangled that it is impossible to separate the wheat from the chaff.

    How can £300 a year private health insurance offer better health care than £1500 a year per man woman and child – or the £90 billion NHS budget.

    I appreciate £3000 a year could.
    But the maths are simple – we’ll use all the resources to treat (the half) those who can pay £3000 a year or £60 a week private health insurance, or whose employer offers BUPA … and ignore the other half who do not half disposable incomes of £60 pw never mind £60 per week to pay for health care.

    We are enslaving one third of the population to working (or not) just to pay for rent & health care.
    Well that is a sort of choice –

    The next thing we’ll have DNA profiling. If you have a certain congenital disease or develop a certain condition – your premiums will go up or you may be refused insurance. Serve them right in a way – they’ll have no nhs (which they helped dismantle) to go screaming to for treatment.

    Oddly enough people in the false belief that if you can pay you can buy treatment or longevity – will be trapped by their own greed – when ‘Society’ decides to exterminate those with certain diseases, health and mental health conditions or from certain racial profiles. This is 1940s germany – except those who are creating it are Thatcherites (yes Blair) and those who most strongly believe in capitalism and market (the quest for profit) rules the economy.

    Not wanting to be alarmist, but some people believe it is Nature’s way – just that people are being hoodwinked by their own selfish greed.

    Everyone accepts there are only good jobs (and jobs for life) for half the people, good houses and affordable homes for half the people, good education for half the people, good health care for half the people. And everyone thinks (hopes) they are worthy to be included in that half.
    The other half are expendable slaves or golems.

    This whole ethos of society is most clearly evident in an unmentionable part of the world – the crux of the matter – where physics becomes reality.

    No point in me raving about how society CAN build decent homes (mobile phones, laptops & plasma tv) for everyone, and decent health care for everyone – when clearly the will is missing to aim for the ideal.

  2. The argument is quite simple. People (or families) are willing to pay £3000 a year health insurance –

    but they want the resources of the £90 billion NHS to be used to offer them better treatment.
    Sod sharing with the half who cannot (or do not) PAY.

    Hmmm interesting – but if we had twice as many doctors and surgeons and specialists and nurses for the £90 billion – we’d have more than enough to treat everyone.

    And if the people employed by the NHS, the State or Cambridge University were developing drugs for the good of the people (instead of searching for profit)
    We’d be able to provide enough drugs for everyone.

    I repeat even if I knew how to cure cancer I would not tell the medical profession or the pharmaceutical industry – let them carry on lying to people – and searching in the dark.

    Luther protested against the Churches indulgences
    Well what is the pharmaceutical industry and the medical profession doing but offering longevity for those who can pay – or places in ‘heaven’ to those able and willing to pay (the Church) – and misery or hell for those who cannot? hmmm I SEE!

  3. Ok All joking aside.
    Mens Sana how many cancers are ‘curable’
    I don’t mean bening tumours which can be removed, treated or contained
    I mean once they become malign.

    Is there any difference between cancer & dentistry. If you don’t need dentistry colgate will give you a white smile. If you need a little dentistry, colgate can still help you keep a smile – but if you need serious dental intervention – it will only get worse if untreated – and even treatment can’t always save your teeth.

    How many cancers & tumours can be vaporised.
    How many cancers & tumours can be treated with a change of diet.
    How experimental (still) is most chemotherapy. A real relation (result) between Clinical Trials and drug therapy success. Or is it best not disclosed?

    PS – I presume you would still get your fee whether from the NHS or the private sector. Or are you suggesting your services are indeed the type of services the private health sector cannot afford and would not be interested in providing?

    Hmmm – having to give up the convertible
    will that be more painful than giving up Lola?

  4. Mens Sauna there is no reason why you should not develop an Insurance scheme and the problem of uninsurable risks is one the industry is well used to coping with in all sorts of ways . Seems a good idea to me .

  5. ..and don`t think you are fooling me . There really is a Lola isn`t there……

  6. NM of course you are right about the uninsurable risk, but reducing this to a level where you will only provide a service to the very low risk cases is really a case of catering for the worried well. There’s nothing wrong with it, and for a few it will be a valuable service, but it won’t address the problems of the vast majority of the people who might benefit from these treatments as they would be ineligible for the insurance

  7. NM, Its a mixed up muddled up shook up world…

  8. So Q9 in answer to the less serious point-I guess there will always be people who will spend their lives dreaming of how good the world would be if everyone was altruistic and worked for the benefit of all. These people are important, often creative and sometimes innovative thinkers, and we need them. There are also people who accept that human nature is not all good, and many or even most people are at least partly and often mostly driven by self-interest. These people are also important because they make things work and create solutions for how we live in todays society. We need both kinds, but they are different people, and changing from one to the other is, I guess , not a common road. So there you are Q9 is Ying, Mens Sana is Yang. We need each other and can get along just fine but some things we won’t agree on!

    In answer to your more serious point:-it depends on the cancer. About 80-85% of people who develop breast cancer can be cured, compared to around 5-10% of lung cancer and about 2-3% of pancreatic cancer. Some cancers such as lymphoma, leukemia and testicular cancer can be cured by chemotherapy alone. And the figures are rising, partly due to earlier diagnosis, partly due to better surgery and partly through better drugs and supportive care. So for me it is worth it

    But you are right, dental health is a very important cause of national morbidity and should have a much higher priority. Remember Alan Milburn “Everyone will have access to an NHS dentist”


  9. And of course Lola will still love me when I am poor



  10. Mens Sana,
    poor dentistry not a cause of morbidity

  11. Funny how we can keep people alive longer
    oh yeah but you will be toothless
    and you may be blind
    and you may not have much mobility because those hip replacement jobs are not quite as good as they ought b
    and you may not remember who you are because of Alzheimers

    But be glad we can prolong your life
    or is it prolong your suffering and pain.

  12. PS – What do they do with patients treatment in the US when their health insurance runs out …

    after 6 days, or six weeks, or six months, or however long the insurers are willing to pay for?

  13. Poor dentistry certainly is a cause of morbidity, in the medical sense (ie it makes you ill)

    Actually we do try very hard to assess how people’s quality of life is affected by our treatments. It is very difficult, though.

    In the US its not usually a problem if you are on welfare as the state pays. The problem is people on low incomes who are not eligible for Medicare. They are absolutely bankrupted by medical treatment. It is a disgrace

  14. “In the US its not usually a problem if you are on welfare as the state pays. The problem is people on low incomes who are not eligible for Medicare. They are absolutely bankrupted by medical treatment. It is a disgrace”

    I REST MY CASE. They get what they deserve.
    Those who like the US model should stop and think.
    But greed thrives on people thinking they will be the lucky ones who will always have a job, decent pay, that their homes will continue to increase in value, and they’ll never get sick – and they begrudge a free healthcare sustem for all

    Yet continued privatisation of hospitals and health care, following the American Model – will lead to the same consequence or result in Britain.

    Mind you if those on welfare in the US get the same standards of health care, as the standard of dentistry available to those on welfare in the uk.

    I can only pray – I never fall sick!
    Or should I say – rather be dead than be bled to death

  15. Q9 I sincerely hope no-one proposes an American model of healthcare in this country, for the reasons you describe

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