A Brief Summary of a British Health Care Policy

According to The New York Times (seen via Megan McArdle and Marginal Revolution):

One such case was Debbie Hirst’s. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist’s support, she decided last year to try to pay the $120,000 cost herself, while continuing with the rest of her publicly financed treatment.

By December, she had raised $20,000 and was preparing to sell her house to raise more. But then the government, which had tacitly allowed such arrangements before, put its foot down. Mrs. Hirst heard the news from her doctor.

“He looked at me and said: ‘I’m so sorry, Debbie. I’ve had my wrists slapped from the people upstairs, and I can no longer offer you that service,’ ” Mrs. Hirst said in an interview.

“I said, ‘Where does that leave me?’ He said, ‘If you pay for Avastin, you’ll have to pay for everything’ ” — in other words, for all her cancer treatment, far more than she could afford.

Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.

Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.

There's a simple way to summarize the story of Debbie Hirst's attempts to obtain Avastin: The British are treating health care the same way Americans are treating primary and secondary education. It's all or nothing. Either you send your child to a public school or you pay for schools twice. Either you only use the NHS or you pay for health care twice.

Addendum: On a second thought, the British policy is even worse. At least we don't prohibit evening and weekend schools. On a third thought, that still means the primary learning environment is still state-run.