Are you American with advanced breast cancer? Your insurance company says no drugs for you too!

Many won't cover lapatinib/Tykerb either because it's still under patent and not available as a generic yet (not before 2017 even). I know my ins. company won't.

Most of our interaction with the healthcare apparatus however is not critical or end-of-life care. Doctor visits, ER visits, etc. are entirely a different matter when you compare the experience here with the experience my friends in the UK report - for instance, I was unfortunate enough to wind up in the ER a little while back while on business travel in an "out of plan" (US) city - it cost me thousands. In the UK the same situation would have cost me nothing above and beyond the regular taxes shared with everyone.

There has been a lot of focus on end-of-life and critical care in the US debate - it's expensive, scary and already out of control. It is doubtful that any solution will fix that in one stroke. There is no proposal on the table from the conservative/industry side of the debate either that addresses it - in fact, we can already see how the industry handles these patients now - generally with a big middle-finger salute. Can't be much worse than that, anyway.

That is my point. Some people put NHS on a pedestal as if it some sort of perfect font of service freely available to all no matter what.

In fact they are not much different than the insurance agencies. You have 'x' number of dollars and it can only spread around so far.

Again you have a case where if it was the insurance agency denying the claim due to the expense people would be hollering. When it is the government people excuse it and even defend it - at least here on Plime they do.

As you said some insurance companies may not cover it, but most will. Also other European countries provide it. This is simply a case of rationing, something that is inevitable and inescapable despite some people's claim that it won't.

Personally I would say that as bad as rationing is, the bigger problem, the larger evil is the fact that the medicine costs 1,600 a month.

Clearly there is no such thing as a perfect font of service freely available to all no matter what. No arguments there. I think more people, though, simply point to it and say "it's not perfect, but it has some advantages we don't have with the private system." I think the focus should be on how we can learn from the good things and not copy the bad things. No preexisting conditions would be a good start.

Only partly true. They are very different in some key ways, like preexisting conditions and the way doctors are incented to provide care, etc.

Totally true. No system or proposed system so far really gets at the core of that.

People are denied access to Tykerb in the US, and I have never seen anyone holler about it yet on Plime. Only hollering about the NHS and Tykerb.

Yes, it is covered by some of the big companies. Too bad those of us with "preexisting conditions" are denied the opportunity to switch to those providers. I have hypertension - totally controlled by simple inexpensive meds - my BP is normal - but that's enough to keep me stuck on a crappy plan that I can't get out of. That's a broken system.

Granted, what the NHS is doing is a form of rationing. No argument there. This is a case though (expensive end-of-life care) where *every* system, public or private, has to do some form of rationing or go broke. Again, the difference to focus on is at the other end of the care spectrum, where the public plans tend to excel (and the private plans tend to suck).

This is a tough one. No doubt big pharma could bring prices down. But developing drugs is a damn expensive business, and it's just that - a business. It's a bit of a double standard to promote free-market health insurance on one hand and slap free-market pharma with the other.

Let me amend this statement - "People are denied access to Tykerb in the US..."

Strictly speaking, no one is "denied access" to Tykerb. You can get it if you are wealthy enough, no matter where you are. It's just whether everyone else is going to help you pay for it or not (which would be the case with private or public insurance systems).

Surely the pharmaceutical industry wouldn't benefit from pushing stories like this out to the media.

I really don't think I'll ever bother reading any article posted from the dailyfail again.

"Hello, Ace Pharmaceuticals, how can I help you?"

"Hi, I've been using your 'last chance drug' lapatinib for the last three months and my free trial is up. I'm going to die if I can't have more of it but I can't afford it. Can I have a coupon for more?"

"Sorry ma'am, we can't do that."

"Oh. Okay, guess I'll go die now."