Date: Sat, 30 Mar 2013 00:26:09 -0400
From: "Mike B." <yahoo at omniphile.com>
To: WSFA members <WSFAlist at KeithLynch.net>
Subject: [WSFA] Re: Tackling Concerns of Independent Workers
Reply-To: WSFA members <WSFAlist at KeithLynch.net>

On 3/29/2013 10:37 PM, Keith F. Lynch wrote:
> "Mike B." <yahoo at omniphile.com> wrote:
>> Ok, I guess health care triage where they tell those over a certain
>> age (56 in one report) who needs dialysis that they can't have
>> dialysis because there aren't enough machines and they are being
>> reserved for those with more life ahead of them is ok with you?
>
> Do you have a cite for that?  According to
> http://www.nhs.uk/conditions/Dialysis/Pages/Introduction.aspx
> "Most people who have dialysis are over 65 years of age."

The specific percentage that is denied access to treatment has varied
over time, and public outcry over figures like the one I gave has
resulted in the age limit moving upwards, but the point that dialysis is =

rationed in the UK system, and that age is used as a factor in deciding
who will, and who won't, be given lifesaving treatment, with cost also a =

big concern in the UK, is easily supported:

-----

http://books.google.com/books?id=5548m4Ad1joC&pg=PA37&lpg=PA37&dq==
dialysis+rationing+UK+kidney&source=bl&ots=PipJEKqMIa&sig=9UyPGOe4h=
kDI4Da6hBiek2eb1t8&hl=en&sa=X&ei=6mVWUfX6HuGoiALGlYD4Dw&sqi=2&ved=
=0CGYQ6AEwCA#v=onepage&q=dialysis%20rationing%20UK%20kidney&f=fal=
se

"...Even more striking was the decline of age-based rationing in
Britain.  In 1980 few people over the age of fifty, and almost none over =

age sixty were dialyzed in Great Britain. ..."

-----

http://econpapers.repec.org/article/eeesocmed/v_3a49_3ay_3a1999_3ai_3a9_3=
ap_3a1169-1182.htm

"Paradoxically, the most effective covert rationing was achieved under
the British NHS which ostensibly provides free care for all, while the
uncentralised market system in the US gave way, on this issue, to almost =

universal state-subsidised provision. Under the British system, the most =

cost-effective options for renal care tended to flourish, but some
patients were turned away. Physicians have been held responsible for
complying with covert rationing: this paper suggests that early gearing
towards socially-useful survival filtered back to selection at primary
level, possibly continuing long after specialists wished to expand."

----

http://ndt.oxfordjournals.org/content/18/10/2122.full

"In 2000, 10% (n=E2=80=89==E2=80=891465) of dialysis patients in Englan=
d were 75 years
of age or over, and 28% (n=E2=80=89==E2=80=894103) were over 65 [2]. Th=
ough the number
of elderly patients has increased in recent years, the acceptance rate
to RRT is still lower than in other European countries [3]. Lack of
resources, distance to renal units, regional imbalances in service
provision and implicit rationing are factors that restrict access to RRT =

[4]. Findings from a strategic review of renal services in the UK
estimate that 1% of total health expenditure is currently being spent on =

RRT and that double this amount will be required to provide RRT to all
patients who could benefit from treatment [5]. "

----

Some of those links include numbers for the US for equivalent
periods...and the US rates are all substantially higher.

-- Mike B.