I am curious to know if you or some relative actually has CF or if you are merely talking out your ass? I have CF and so does my oldest son. There are countries in Europe with better life expectancy, quality of life, etc for CF than the US has. And that is just the tip of the iceberg for the criticisms I have for your ridiculous statement. So just wondering here if you are merely pulling out inflamatory bs just cuz or if you or some relative happen to be in the 5% of CF patients who have the right alleles to potentially benefit from this specific drug.

I'm not sure where the hostility is coming from.

Although Kalydeco has been approved, it is unavailable in the UK to most of the patients who qualify for it as it is undergoing a "pricing assessment".

My argument is two fold: 1) Measure such as "life expectancy" are a poor indicator of the quality of health care one receives. 2) Although the US healthcare system has many problems, it covers many, many drugs, often used to treat serious illnesses such as CF and cancer that aren't covered by countries that have single payer systems.

So I take it you disagree?

You are the second person on HN to describe me as hostile. I am not. Feverish and crabby perhaps, but not aimed at you. Sorry.

I have gotten off 8 or 9 prescription drugs. I strongly disagree with measuring quality of life by how doped to the gills you can get on someone else's dime. And the measure you dismiss as "blunt" -- longevity -- has its good points as a rule of thumb measure. Stuff that kills usually isn't exactly good for your quality of life prior to killing you.

The drug in question is designed to help a tiny portion of the CF population which is an "orphan disease" to begin with. It is deadly and involves a lot of suffering, so it is a "dread disease". I think using a new drug that has the potential to help a mere 1500 Americans as your example because of the strong emotions associated with "saving" someone from something so awful amounts to a bullshit example.

Also, I worked for an American insurance company for five years. My diagnosis automatically disqualified me from some of their policies. So I suspect the reason American companies claim to cover this drug is because American rules are designed such that people with CF have trouble getting coverage at all. I was an industry insider for five years. I know how they make their money. Spending jillions on a small number of very needy people is not how they line their shareholder's pockets.

Most likely, they won't pay for it in England in part because that would involve actually paying that ridiculously high annual bill because I believe they have some form of national coverage. The American companies may list it as a covered medication, then do everything in their power to not cover any of the mere 1500 Americans with the alleles it is supposed to help. Plus the initial reports were spindoctored to boost company stock. There is a certain amount of hype surrounding this drug. It is generally a bad example to give as some kind of "proof" that Americans have it better.

I also have multiple relatives who have or have had cancer. For brevity's sake, suffice it to say I am not as impressed as you are with the American approach to treating it.

> things like "access to the latest technology/drugs"

That's not actually a valid measure. It is based on the assumption that newer=better. Because of how the US drug market works, as soon as a patent expires, the companies will work hard to discredit older treatments and find new patentable ones, including statistically invalid manipulation of the research data.

> "overall survival from first diagnosis of cancer" the US comes out on top in many, many areas despite the lack of uniform coverage.

While that is true (as far as I know), it comes out on top but not by a significant margin; and the base cancer and diabetes rates are much higher. This may or may not be attributable to the US health system, but I'm sure it does have a part (In the US, you get a pill for everything. In most single payer health systems, you get dietary and exercise advice before you get a pill for something chronic).

> if you're a cystic fibrosis patient and can't afford the $300K/yr for the drug Kalydeco because the NHS doesn't cover it (although nearly every insurance company in the US covers),

Well, Mz just commented about this specific example. I'm somewhat familiar with the Israeli single payer system (I have relatives that unfortunately had to use it extensively) - and it covers every single proven life saving treatment (life extending treatments are covered depending on a cost/benefit model). I don't know what their exact definition for proven is - but the Doc I talked to said it was reasonable (FDA approved, at least 1 year on the market since approval, and a few other similar requirements).

And the most important thing? With the exception of Canada, I think every single payer country lets you have supplemental private insurance if you want, for those live extending treatments, and e.g. if you want to be treated in a private/hotel hospital, or in a different country of your choice.

The dichotomy of "single payer vs. private" is a false one, just like public schools don't eliminate private schools - it just establishes a baseline that everyone has access to, and requires the private industry to deliver significantly more value.