As I’ve said probably many times in previous posts, I have a huge admiration for every other developed country in the way they have developed processes unique to their cultures to limit how much they spend on healthcare. If you’re interested in learning more how Britain, Germany, the Netherlands, and Belgium manage 4 example health conditions, here is a link to a fascinating article.
The article is very detailed, so I won’t try to repeat it here. Their 2 major conclusions were: 1) In all 4 countries, contextual factors are actively integrated in the decision documents, which are achieved in deliberation. In other words, quantitative and qualitative inputs are used to arrive at final payment and coverage decisions. 2) The decisions that lacked a publicly accessible justification of the final decision document raised questions on the decisions’ legitimacy.
My overall conclusion about the tolerance of other developed country populations – John and Jane Q Public — for these decisions is that they are comfortable knowing that somebody in their country is wrestling with these issues that they don’t want to think about. They assume that the experts are arriving at their decisions in the spirit of the public good and are not making recommendations based on personal or political motives. These researchers legitimately raise the concern of transparency. My guess is that even if some of the deliberations and discussions were made public, most people in those countries wouldn’t bother to read them or give them a second thought.
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