Healthcare Reform the Under-Medicated Society: Essay

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6% of GDP in 2002; in America, they were 14.6%, or almost double Britain's expenditure" (Klein 2005). However, this frugality means that bypass surgery, dialysis, and medications in general are much more rarely prescribed in the U.S. than in the UK. While there is frequent criticism that the U.S. is overmedicated as a society, the opposite is likely true in the UK. In other words, is unlikely that people are so much healthier in England vs. The U.S. To justify certain statistical disparities in care: the rate for coronary bypass surgery in the UK is 20% less than it is in the U.S.

To address the problems of under-medication, recently there has been a proposal to allow drug companies in the UK with "innovative" medicines to bypass the current screening process for cost-effectiveness, as a way of expanding care. The companies could sell the drugs to the NHS at a higher price than is customary "under a fast-track procedure to be proposed next week by the Office for Life Sciences (OLS)" (Bosley 2009). The NHS, because of cost as well as safety concerns, is highly reluctant to approve new drugs and grant them coverage. The British system blocks sales of expensive drugs to the NHS that it deems to be only of limited benefit, but patients with chronic and rare diseases have protested this policy -- as has the pharmaceutical industry. Patient advocates argue that the current method of drug approval and cost scale of the NHS denies patients life-saving drugs and makes pharmaceutical companies reluctant to launch new drugs in the UK because 25% of the global market is influenced by the UK price, and the UK market is so low-cost (Bosely 2009).

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The National Institute for Health and Clinical Excellence (known ironically as 'Nice' in the UK) currently assesses every new drug before it enters the NHS system. While on the surface, this may seem similar to the American Food and Drug Administration (FDA), the parallel is not perfect. Nice must ensure that the new drug offers "value for money before it can be used in the health service," not simply efficacy and safety (Bosely 2009). Critics of the new proposal to 'fast track' drugs and circumvent Nice through OLS argue that Nice had not been lax in facilitating the entry of critically needed drugs. This new policy could result in fewer scarce NHS funds to 'go around' meaning less money for more necessary procedures and drugs that could help more people. However, it is likely the proposal to bypass Nice-approval for many medications will pass, given that there is both a strong economic as well as a medical argument for doing so. On one hand, a more welcoming attitude to the pharmaceutical industry would help revive the UK economy, and many new types of drugs in the field of genetic medicine may work on people with a certain genetic make-up but not on others. Nice has been reluctant to approve drugs that are only needed by or useful for a small segment of the population and has drawn criticism for doing so, given the emotional power of patient advocates who are angry that they or their loved ones have been denied what they consider life-saving care (Bosely 2009).

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