I'm not terribly well clued-up on the US insurance system; are you saying that all US Health Insurance plans will provide open-ended funding for all treatments? Earlier in this thread there was a mention of cheaper plans that didn't cover everything, I'm confused?? I did previously ask what the cost for a plan was too, but I don't think that's been mentioned either.
All of these depend, frankly. You can buy plans that have annual limits (I wouldn't, personally). You can buy plans that don't cover specific things. As far as coverage is concerned, MCOs (managed care organizations) use a variety of measures including:
Referals (you need your PCP to refer you to a specialist)
Fail first (you need to fail a specific drug/treatment before you can be given another)
Prior authorization (Prescribing entity needs to receive advance authorization before they will cover something.)
Formulary tiers (increasing co-pays for certain kinds of drugs; only biologics and brand drugs are relevant for this concern)
etc.
The kinds of utilization management (UM) you're subject to depends largely on the company that you're with. As does your coverage. And how much you pay for your coverage. The different kinds of insurance you can have also vary on this level. For example, HMO plans will provide the same coverage for cheaper, but you're more restricted in the doctors you can see compared to a PPO/POS. If you go out of network on a HMO, your plan wouldn't cover any of it. There are some exceptions (emergency care, for example) to this.
I'm sure that some treatments aren't available through Public health care, but from my personal perspective I think the Public Healthcare provided is bloody good, and is paid for through approx. 6% of my Income Tax; I'm pretty certain I wouldn't get Private insurance for the same amount.
My current health plan (which is a pretty good one, TBQH) costs me about 5.8% of my income. Of course, my company (who receives a tax break for what they contribute) pays a substantial portion of my cost. If you were in the U.S., would you say that you make less than $20k? 40k? 50k? Under health reform, those first two sets of numbers would either have free care (Medicaid, which would also cover all drugs/etc), or subsidized care (in the case of the second number), specifically on the premium. The amount of the premium you pay also affects your co-pays and the formulary tiering for drugs/etc -- it has to do with the actuarial value of the plan. (Essentially how much of the expected cost is paid down by the premium, as opposed to co-pays, deductibles, etc). Additionally, all money that I spend on my health care, including my insurance premium, is deducted from my taxes.
Not because my government pays, but because my government pays I choose not to, because I don't foresee the need (and in addition I doubt I could afford to, leaving me with no coverage in a system that relied on private coverage)
I don't know what you make, but under health reform, I doubt you'd be in a situation where you would be unable to afford coverage.
And while the article you referenced is interesting, and valid to the discussion in general, it's not relevant to me personally, as I'm not in the UK at present.
Can I ask where you are? I'm generally familiar with most health systems, though the UK system (and NICE in particular) gets the most play for us, because that's the international system our clients are most interested in.
//edit
For the record -- one of the reasons I prefer our system is, I can shop the system. I can look at the available health plan offerings, particularly after health reform. I look for the ones that offer the best coverage for whatever condition I have, whether it's the drugs, or the procedures, or what have you. In a system like the UK system, I'm limited to what NICE has authorized.
