ACC pays out more than $11,000 for sunburn "injuries"

[Banditbandit]

Did you have to kick your bitches out of bed to get to work then? What was your cut?

"You must spread ..." Naaa .. just at the time I had friends living in what you might call the underbelly ... pretty much lived there myself ...

[mashman]

Start with a list of health interventions and their costs in one hand and a budget in the other.

Order interventions, (treatments, surgery etc) according to cost per quality unit (X relative improvement in health over Y time), best value at the top.

Start ticking from the top down until you run out of budget. That’s your list of publicly funded services, and that's roughly the model our funding was originally set up from.

Since then every fuckwit with an agenda has kicked and screamed about the lack of funding for a particular intervention juuust a little below the budget cut-off line. The local member goes to bat for his constituents, press calls alongside righteously indignant lobbyist and sick child, the crowd goes wild and there’s questions in the house. Ministers don’t like questions, calls for enquiry to stall further bad press. A year later the report falls onto the minister’s desk. He ignores it. Original crew discover report has been received and file a slew of OIRs. In the face of increasing pressure in election year the minister institutes a policy change and the intervention everyone’s bitching about gets funding approval.

Now, here's the question: Which previously funded intervention with a better claim to that funding has been flicked off the list in order for that to happen?

Repeat the rabble rousing a dozen times a year and what do you think that list would look like? All because it’s politically untenable to simply say: “I’m sorry, but we can’t afford the drug for that illness.”

Ahhhhh yes, I remember you giving me a wee slap when I banged the Herceptin drum last year or the year before. Sometimes you do make sense ... and I often use that as an example when explaining NOW to people .

As you say, a politician can't just come out and say that there ain't enough cash, coz some bugga may realise that that means people get to die... and that doesn't seems to sit well with civilised folk. I understand the practicalities of the decisions that need to be made, but you can bet yer arse I'd be dancing up and down if it were one of mine.

Ta muchly for explanation.

[mashman]

"You must spread ..." Naaa .. just at the time I had friends living in what you might call the underbelly ... pretty much lived there myself ...

Where you the rent collector

[Ocean1]

Ahhhhh yes, I remember you giving me a wee slap when I banged the Herceptin drum last year or the year before.

Ah yes. Herceptin. It was already funded, for a different class of treatment, for a different group, under it's originally intended prescription regime. The original intended use was as an early intervention treatment, costing a few tens of thousands of dollars for a regular course with a history of moderate success. Enter a study that demonstrates that a very small percentage of more advanced cases benefited from massive doses of Herceptin. That class of intervention wasn't funded. Hence the uproar. Not fair: they're getting it and I'm not!

Remember the original funding model decision criteria involved a best-bang-for-your-buck element? The new treatment was successfull for very very few cases, and the treatment course was indeterminant. The cost of that course amounted to several hundred thousand dollars a year. I don't know where the money came from to fund that, but I look at the system's routine failure to supply services they should be and I can't help but wonder.

Nah, fuckit, I know full well why they decline treatments they're supposed to cover.

[mashman]

Nah, fuckit, I know full well why they decline treatments they're supposed to cover.

Well don't stop there FFS...

[Ocean1]

The list's too long, they've promised to deliver more than the budget can support.

Instead of saying clearly what they can do and getting it done they've now got to reduce spending across the whole list of services. The way that happens is the waiting list gets long enough that it's too late for enough people so that the demand fits the supply. They either die on the waiting list or they get sick enough that they fall into another category, usually a category that's far more expensive to treat, and for them the cycle starts again.

The overall upshot is that the budget is spent far less effectively than it should be, far more people are left without the care they need than would be the case if they refrained from using the health budget to buy votes.

And I don't know how you fix it, other than writing it down clearly, along with a few other agreed rules of governance as part of a proper constitution. One the ellected riffraff can't fuck with.

[mashman]

The list's too long, they've promised to deliver more than the budget can support.

Instead of saying clearly what they can do and getting it done they've now got to reduce spending across the whole list of services. The way that happens is the waiting list gets long enough that it's too late for enough people so that the demand fits the supply. They either die on the waiting list or they get sick enough that they fall into another category, usually a category that's far more expensive to treat, and for them the cycle starts again.

The overall upshot is that the budget is spent far less effectively than it should be, far more people are left without the care they need than would be the case if they refrained from using the health budget to buy votes.

And I don't know how you fix it, other than writing it down clearly, along with a few other agreed rules of governance as part of a proper constitution. One the ellected riffraff can't fuck with.

That or make the whole lot private eh. Decisions decisions... glad someone else gets to make them

I know how to fix it, amongst other things ... aye, tis a tricky one. Perhaps it's time to start having laws that can only be changed by a democratic vote of the population, but even at that it's a serious can of worms given what popular opinion pushes as sense these days.