patrick.net

There is no doubt that America is in serious need of health care reform. But why on earth would you want that reform to model something that sucks like the system in Canada? Why shoot for mediocrity?

Kevin:
Your father shouldn't have to rent an 02 tank (concentrator/portables) on his own. He needs to have sats below 89% on room air, and medicare will pay for it. If he meets that qualification, he gets it (even with a Medicare HMO). Call another DME company and they'll help with it; Medicare pays most of the cost but there is a co-pay I believe.

Danville woman asserts that alternative medicine cures all evils and that all we need is catastrophic coverage- Bullshit! If one only practices alternative medicine, they'll surely need that catastrophic coverage. Not saying that alternatives don't work, but denying the leaps & bounds we've made in our medical care in the past century is just plain nuts. Please tell Kevin's dad that he doesn't need oxygen, but he needs some oil rubbed on him or needles stuck in him as they wheel him into the ER with respiratory failure.

I wrote some articles on hospice/end of life care on the nursing home forum. Talk about millions of dollars spent on medicare services! Some hospice care is warranted, but hospice providers have figured out how to twist the system to their advantage. They'll sign on anyone whether they need it or not, whether they benefit or not - but the hospice will benefit. I worked for a national hospice and, after showing a family around, the manager asked me if I "made the sale." As if a patient were a piece of meat. Ugh!

Our system is horribly broken. Why not try to fix it, without the help of the insurance companies? The idea of keeping private but also offering public means that insurance companies will dump every patient that costs them money - the govt will help them.

Kevin,

you need to find a doctor who knows how to work with Medicare for your dad. My FIL is completely capable of living without oxygen, has no COPD, he drives around on his own, but he got the rental completely paid for by Medicare for 5 years already. He just complained about not being able to sleep well at night and got Medicare to foot the bill.

Another friend of his has been on Medicare-paid oxygen for 12 years, looked completely healthy to me except for wheel chair bound. I guess it takes doctors that know how to manipulate the loopholes.

For my FIL's case, there is zero co-pay, everything paid for by Medicare. The oxygen company delivers the tank every 2 weeks. He often brags about how much he cost the Medicare.

Kevin,
you need to find a doctor who knows how to work with Medicare for your dad. My FIL is completely capable of living without oxygen, has no COPD, he drives around on his own, but he got the rental completely paid for by Medicare for 5 years already. He just complained about not being able to sleep well at night and got Medicare to foot the bill.
Another friend of his has been on Medicare-paid oxygen for 12 years, looked completely healthy to me except for wheel chair bound. I guess it takes doctors that know how to manipulate the loopholes.

And people wonder why we are screwed...

It is his wife’s right to keep getting pregnant and keep getting miscarriages or risk her life, whatever, let her be. The fact that she is knowingly doing this while under insurance is a form of abuse, because she knows insurance will pick up the bill, which will increase premium for everyone else.
So rhvonlehe1 is a phony conservative who is no different from the Democrat leeches who just want to abuse the hell of the system. His liking of his insurance is because he can abuse it to death.
Insure means guarding against potential risk. If the risk is already there, it is not insurance, it is straight cost. I guess Mr. “Conservative” Blue Collar doesn’t care about this as long as he gets what he wants. Basically his “conservative principal” is, I like everything that works to my favor, and fuck the fairness principals.

There will never be absolute fairness. In theory, the closest thing to that would be no insurance at all. Pay as you go. Are you suggesting that?

But you raise an interesting point. In fact, I know many employers "subsidize" if you will those who have families by paying a larger amount towards their premium. Am I going to feel bad about having 2 or 3 kids? Not likely. Is that an F.U. attitude? Perhaps to you.

I like having private insurance because I have greater degrees of freedom as a consumer. Yes, there are bean-counters who try to ration things. But this is kept in check because there is competition among insurers. If our plan gets too expensive or the coverage gets too limited, our employer can choose another one that is more cost-effective.

I disagree that we abuse insurance. Lance Armstrong had a 40% chance of survival when his cancer spread to his abdomen and brain. We probably should have denied him treatment with those odds. He definitely abused insurance, using your logic. The fact is, if you're trying to get people to stop having children or stop people from getting expensive procedures or trying to treat cancer claiming that they're soaking the system, you're in a minority.

I think we share some common ground, though. I think that former CEO from United Health (can't remember his name) who pulled in $150M over several years should be demonized. He was running a non-profit for Pete's sake. So no I'm not Polyanna thinking private insurance is perfect. I just think competition keeps prices under control better than a government-only option. And I will continue to cite the fact that we have current government obligations that are massively underfunded: social security and medicare. We should figure out how were going to pay for our current obligations before adding new ones.

Bottom line - the government cannot afford to take over health care. It has already made promises that it is not able to keep. Besides, the plan this administration had put forward still leaves millions uninsured - at huge cost. This is according to the congressional budget office:

"Enacting the proposal would result in a net increase in federal budget deficits of about $1.0 trillion over the 2010–2019 period. Once the proposal was fully implemented, about 39 million individuals would obtain coverage through the new insurance exchanges. At the same time, the number of people who had coverage through an employer would decline by about 15 million (or roughly 10 percent), and coverage from other sources would fall by about 8 million, so the net decrease in the number of people uninsured would be about 16 million. – CBO Analysis"

We do abuse insurance. In fact, I see endless amounts of commercials aimed towards senior citizens that actively promote them on TV to use their Medicare to pay for treatments and products like wheelchairs. Any senior citizen watching this will naturally say to themselves, "I better go get my free wheel chair". My father is a physician. We know plenty of doctors who design business plans entirely on the ability to deliver treatments where Medicaid pays high premiums. This is the failure of Single Payer Systems. You create a giant piggy bank of money and everyone figures out how they can defraud millions from it. As far as private insurance goes, I know plenty of people who regularly defraud it by leeching off other people's prescription plans and getting their prescriptions written in their name. The concept of 3rd party transactions is the problem altogether. It's the same reason securitization of mortgages ultimately failed. The key to quality health care is the firm establishment of the doctor patient relationship. This can only be done through freedom of choice. Healthcare is going to cost money out of everyone's pocket regardless of what system we have. If you want universal coverage, then you MUST implement a system in which the individual is fiscally responsible for how his/her money is spent. This cannot be done through price fixing. It cannot be done through full nationalization. And it cannot be done through a single payer system. Singapore has accomplished this by forcing their citizens to divert funds to a health savings account that the individual is in full control of. They have freedom of choice and if they do decide to opt for the government option, they still have to pay significant copays. The truly poor are the only ones who get free healthcare but they get it from the government only, which is still forced to compete with a private system that has delivered competitive low prices through market forces. Rather than establishing some stupid totalitarian rule over the healthcare system as nearly every other nation in this world has done, Singapore simply violates their citizen's individual freedoms by forcing them to save money. In terms of violations of civil liberties, I'm not too offended by a country that forces their citizens to save money.

? said:
Kevin,

you need to find a doctor who knows how to work with Medicare for your dad. My FIL is completely capable of living without oxygen, has no COPD, he drives around on his own, but he got the rental completely paid for by Medicare for 5 years already. He just complained about not being able to sleep well at night and got Medicare to foot the bill. Another friend of his has been on Medicare-paid oxygen for 12 years, looked completely healthy to me except for wheel chair bound. I guess it takes doctors that know how to manipulate the loopholes."
---------------------------------
My reply:
Medicare requires that a patient's Oxygen Saturation Rate (sats) are 89% or less on room air - meaning that the patient, while not on Oxygen, de-sats to a rate that is dangerous to his/her health. There is no requirement that the patient have Chronic Obstructive Pulmonary Disease (COPD) - many diagnoses can cause sats to be low enough to qualify.

It is VERY common for people to de-sat during the night, waking them up and causing their sleep to be disturbed to the point that their health is compromised. There are also diseases & disorders that manifest themselves in a condition called sleep apnea, where the patient stops breathing during the night. There are types of equipment that address this - cpap, bipap, etc. Sleep studies are now required to ensure that the equipment is sufficient to meet the patient's needs. So, merely not being able to sleep doesn't mean that someone will get Oxygen.

It doesn't matter what the doctor says, Medicare & insurance won't pay for these items unless there is independent verification of the criteria that qualifies a patient for these services. At least two providers would be lying if a patient doesn't qualify based on sats. People in wheelchairs often require oxygen because their bodies are unable to draw in enough oxygen to keep them functioning - and the disease that placed the person in the wheelchair may be lung-related. Not enough info.

There are many times that provider's payment is denied, and the equipment company doesn't get reimbursed nor are they allowed to charge the patient. They're out the money, so they're not going to risk getting payment pulled if a patient doesn't qualify. For the most part - because there are some companies out there that totally suck and shouldn't be allowed to operate.

Medicare used to pay rental for these items at a huge cost, never actually buying the equipment. But recent changes mandate that the many pieces of equipment are owned by the patient after the rental charges exceed the purchase cost. The equipment company is required to support the equipment, even if the patient owns it. Seriously - equipment companies are providing O2 portables at no cost to the patient or to Medicare, for free.

While there is some scamming going on, it's harder for equipment companies, doctors & such, to do so. FYI

theoakman - well said.

rhvonlehe1,

most professional athletes do not have commerical insurance, not your standard PPO, HMO packages. Their medical expenses come from sponsorship.

>>And your point is what, exactly? Insurers offer no inherent value — they are middlemen who’s business is based on gambling. They are betting that your premiums will be worth more than any claims you might make.

Honestly, I’d rather just pay hospitals directly (which would drive down prices as a whole) than have insurance companies. Insurance makes sense when you’re using it to “insure” against a catastrophe. Routine health care is not a catastrophe. Why am I paying for “insurance” for routine check ups? How does that make any sense whatsoever? That would be like paying for utility insurance.

Very well put, Kevn. I won't repeat the good things I've seen here. But I'd like to add that if we'd gone with a public health care system all along (back in the 1940s when that almost happened), most of us would find it absurd even to consider privatizing it.

That would be like privatizing law enforcement or fire & safety. Imagine if you needed to fill out paperwork, worry about networks, or make a co-payment just to call a cop or firefighter. And what if you had no coverage?

Health care is a primary need. It's essential to life, and should not be a profit-driven industry. There should at least be a basic public hospital system in place. If we can bail out greedy bankers or fund questionable military actions, we can fund health care.

Anyway, no matter how bad some of you may say other countries' public systems are, I don't think very many of those countries' citizens would want to switch to a system like ours. Our system, as others have mentioned, places a burden on employers and stifles independence. How many would-be entrepreneurs give up or delay their ideas because they don't want to risk losing their health coverage? How many people stay in bad jobs or marriages because of that?

How many would-be entrepreneurs give up or delay their ideas because they don’t want to risk losing their health coverage?

You can count myself, my husband, and numerous friends in that group.

I have actually put my husband on my insurance to help save the small business he works for.

At one time, we did have the #1 health care system in the entire world. It started to deteriorate when the US Government decided it should become an active player. If anyone thinks that physicians wouldn't offer full services year round at any time for half of what people pay in that year for health insurance, they are nuts. Any service that is not insured by insurance companies or the government, such as laser eye surgery, has not only become better but it's also become cheaper over the past 10 years. Not only that, if you open the newspaper, you see physicians actively advertising their prices to attract customers. The proponents of a single payer system conveniently ignore these facts. They ignore that the doctor will charge you more to stich up your forehead when you hit it than they will for performing breast implant surgery. Medicaid, Medicare, and Giant HMOs are the problem.

Btw...the ultimate solution to this problem is to stop restricting entry into the health professions fields. We have thousands of kids who go to college wanting to be doctors and they get turned away, some for good reason, others for not so good reason. Many like to argue that we need to weed out the people and can only let our nations brightest enter Medical School. To those people, I would suggest that you actually go visit a medical school and talk to them. You'll find that most of them are average people and realistically, there's nothing that distinguishes them from the majority of people in this country. If you flooded the country with new physicians, you would see prices collapse. Oh yeah, but before you even try that, you have to get the government to stop subsidizing student loans and driving up the price of school.

Oakman, I agree with your points about cheap money driving up prices. Things that are not covered by insurance don't generally see such price inflation (e.g., laser and elective surgeries). The problem with health care is with the insurance model, not with whether the government plays a role.

When insurance or cheap money (as in the case of student loans) is invoked to solve a problem, it only solves that problem in the short term (i.e., improving immediate affordability). Prices rise rapidly when people don't pay directly for things.

In any case, we still need a basic system to cover major medical issues. One that is available to all, not just those with good jobs, money, or special coverage.

Regarding ROI, do we pay more than we should for law enforcement or fire & safety services because the government is involved? I doubt whether having private contractors take over those responsibilities would improve things. I don't want the FD or the cops looking to cut corners.

Health care is not an option. We all need it. The insurance model we use to cover health care makes paying for it especially expensive for individuals and for those without insurance, a population whose ranks are growing.

OO says

For my FIL’s case, there is zero co-pay, everything paid for by Medicare. The oxygen company delivers the tank every 2 weeks. He often brags about how much he cost the Medicare.

Medicare covered everything for my parents' last year, except drugs I think.

BTW, this is a test to see if quoting now provides a quotee name and link back to the quote...

Yes, quotes now have a link above them that shows who is being quoted and from where.

You want to deal with hospitals directly? Easy.

Imagine yourself getting hit by a car, and the ambulance arrives. Before the ambulance people picked you up, they asked you for $1000, or they will not carry you. You want to negotiate? Perhaps not. Then they send you to the closest hospital, which again jacked up the price on you and demand cash payment up front before you get treated at all, even if you are dying. Want to negotiate? I think not.

What I said above is not science fiction. It happens in today's China, where patients pay directly to hospitals.

OO says

You want to deal with hospitals directly? Easy.

Imagine yourself getting hit by a car, and the ambulance arrives. Before the ambulance people picked you up, they asked you for $1000, or they will not carry you. You want to negotiate? Perhaps not. Then they send you to the closest hospital, which again jacked up the price on you and demand cash payment up front before you get treated at all, even if you are dying. Want to negotiate? I think not.

What I said above is not science fiction. It happens in today’s China, where patients pay directly to hospitals.

Kind of like armed robbery, isn't it? "Pay us whatever we demand or you die."

China seems to have a true free market for health care, and it isn't pretty. I'll take a bit more socialism with my medical care, thanks.

For those who want to see medical services advertising the price? Do you think you know what procedures are involved in treating your illness? Do you know the subtlety of going one route vs. another, the short-term and long-term implications? Without yourself being equipped to teeth in medical knowledge, you simply cannot compared price.

I would love the country to be divided in half. Half for those who want free competition in medical service, and please be my guest, back up your claims with action and don't look back. The other half stays with the price fixing and heavy government regulation. We will see which half live much longer.

I'm not a supporter of Privatized Services for Law Enforcement or Fire Safety. Health Care is entirely different. Furthermore, there is a great harm to broadly generalize the field of health care as essential. Surgery on your broken leg? Absolutely essential. Pain medication for your sore back? Not so much. Cream for the sunburn you obtained sitting out by the pool? Absolutely not! Somehow, all these things got lumped into one big ball that a lot of people like to refer to as a fundamental right. I can see the logic arguing for a fundamental right to the emergency room for treatment. I cannot, in good conscience, apply that to the life long smoker who now has Lung Cancer. The girl who sat in the tanning salon too long. The 300 pound guy who eats 6 meals a day. The distance runner who messed up his knee (that's me btw).

We don't have the option of not buying food either. We seem to do just fine and dandy without making it a fundamental right. Realistically, the service of providing basic health care should be dirt cheap. The real cost of providing health care is minute to the prices you see in the industry today. Politcians, physicians, lawyers, and HMOs are looting the public.

theoakman says

Somehow, all these things got lumped into one big ball that a lot of people like to refer to as a fundamental right. I can see the logic arguing for a fundamental right to the emergency room for treatment. I cannot, in good conscience, apply that to the life long smoker who now has Lung Cancer.

True, we should make a distinction between essential and nonessential, personal responsibility and irresponsibility in medical care. It's kind of like the housing thing, where some housing is essential, but staying in your overpriced McMansion is not essential. It was irresponsible to buy it, and the public should not have to pay.

Drawing that line is politically difficult though.

I will look at medical service the other way, how far down it is on the cost and adoption curve.

Cancer drug? Essential, but unaffordable. Nobody can really afford cancer drug if he needs to pay entirely out of pocket. Pain-reliever? Non-essential in some circumstances, but the cost is low enough that we can send everyone a free pack.

For something that is very expensive and unaffordable concerning life and death, and a constant group of people will get it, insurance (government administered or not) is necessary, or only multi-millionaires can afford it. For something that is cheap, regardless of incidence, then the payer should be responsible themselves. For something that is moderately expensive and everyone will have it one way or another, like pregnancy, government should subsidize only partially, but not pay for all.

theoakman,

Good post. I would like to see medical insurance similar to car insurance. One typically buys auto policies to protect from the costs of accidents or unexpected major repairs, but not for routine maintenance. In the same way, I would like to see health insurance cover accidents and unexpected illness, but not routine checkups, shots, childbirth, or other reasonablely expected events. And just like a car warranty requires routine maintenance like oil changes be accomplished, a health policy should require checkups to catch illnesses in the early stages. Smokers, overeaters, drug abuser, should pay higher premiums.

Insurance should be for expenses that can financially wipe people out. Prices for routine services would be less if people spent thier own money. Basic medical care is a cost of living that people should budget for. It is no different than the needs of transportation and food.

OO says

I will look at medical service the other way, how far down it is on the cost and adoption curve.
Cancer drug? Essential, but unaffordable. Nobody can really afford cancer drug if he needs to pay entirely out of pocket. Pain-reliever? Non-essential in some circumstances, but the cost is low enough that we can send everyone a free pack.
For something that is very expensive and unaffordable concerning life and death, and a constant group of people will get it, insurance (government administered or not) is necessary, or only multi-millionaires can afford it. For something that is cheap, regardless of incidence, then the payer should be responsible themselves. For something that is moderately expensive and everyone will have it one way or another, like pregnancy, government should subsidize only partially, but not pay for all.

I disagree on the pain medication issue. Personally, I have chronic pain. My medications are not optional, they're what make me functional. If I had to pay full price at current prices I'd be at over $500 per month. Tweaked back meds optional - if you have any pain, it's serious to you.

The medical profession now looks at four vitals: respirations, pulse rate, blood pressure, and pain level. Don't fuck with my pain meds. And, for people who have a morphine pump, you're talking thousands of dollars each month. Don't fuck with theirs either.

Issues that don't appear to be serious to you are serious nonetheless. A patient who desperately needs open heart surgery can't get it if he has a toothache - because that toothache could cause a bacterial infection that will kill the patient. However, under your proposal he would have to pay for the toothache himself. What if he can't afford it? I know it seems farfetched, but people die because of toothaches combined with comorbidities.

The problem is that medical care shouldn't be optional Period. Who's to say what's serious, and what's not? A sprained ankle might seem like nothing, or it could actually be broken and lead to a systemic infection. However, if he has to pay for the treatment himself, the person might stay home and ice the ankle.

I'm saying that currently people who have no idea as to what is serious or medically necessary are making decisions, just as you are proposing an asinine payor system. Prices for routine services wouldn't cost less if people paid out of pocket - routine services wouldn't be an option for many people and they would end up sicker & costing the system more. It's stepping over dollars to pick up pennies.

Health Insurance shouldn't be for profit. HMO's shouldn't be rewarded for keeping costs down by denying benefits. Lobbyists shouldn't be paid high dollars to ensure legislation is beneficial to their clients. Fat should be cut, fraud should be prosecuted to the fullest extent of the law.

Healthcare shouldn't be optional. Period.

theoakman says

At one time, we did have the #1 health care system in the entire world. It started to deteriorate when the US Government decided it should become an active player. If anyone thinks that physicians wouldn’t offer full services year round at any time for half of what people pay in that year for health insurance, they are nuts. Any service that is not insured by insurance companies or the government, such as laser eye surgery, has not only become better but it’s also become cheaper over the past 10 years. Not only that, if you open the newspaper, you see physicians actively advertising their prices to attract customers. The proponents of a single payer system conveniently ignore these facts. They ignore that the doctor will charge you more to stich up your forehead when you hit it than they will for performing breast implant surgery. Medicaid, Medicare, and Giant HMOs are the problem.
Btw…the ultimate solution to this problem is to stop restricting entry into the health professions fields. We have thousands of kids who go to college wanting to be doctors and they get turned away, some for good reason, others for not so good reason. Many like to argue that we need to weed out the people and can only let our nations brightest enter Medical School. To those people, I would suggest that you actually go visit a medical school and talk to them. You’ll find that most of them are average people and realistically, there’s nothing that distinguishes them from the majority of people in this country. If you flooded the country with new physicians, you would see prices collapse. Oh yeah, but before you even try that, you have to get the government to stop subsidizing student loans and driving up the price of school.

Elective surgery should certainly be competitive and offered on the free market -- without ANY insurance involvement.

But most hospital visits are NOT elective. I do not have any choice whatsoever in an emergency situation. Have you ever had a doctor tell you how much something was going to cost before they administered the treatment?

A hospital charges, on average, around $30 for a bag of saline. Yeah, that's $30 for a bag of sterile saltwater that costs them less than $0.25 directly from the manufacturers. Have you ever been told the price of saline in a hospital?

The single payer system can be exploited somewhat, but it can only be exploited so far. The hospitals can't just charge whatever they want.

I just got another bill from the hospital where my son was born over 4 months ago. Despite having maxed out my supposed annual out of pocket limit, I'm now getting a $389 bill for some tests they ran on my son. Apparently the per-person deductible still applies to him, so I have to pony up another $300 this year. I've already paid over $200, so I'll most likely only have to pay $100 more, but I'm still getting the bill from the hospital.

How is this system NOT broken? Why am I getting a bill FOUR MONTHS after the last time we were inside the hospital? Why do I have to call the hospital, the insurance company, and the billing company that the hospital contracts out to just to resolve what should be a very cut and dry service?

Every single thing that they do in a hospital is detailed electronically and filed a few minutes. Bills are sent to insurance companies electronically. There is no rational explanation for why I get a bill 4 months after the fact that is clearly more than I owe other than fraud.

This system is completely and fundamentally broken, and it can not be 'fixed'. It must be replaced with something better -- just about anything would do.

Elliemae, the only reason your pain meds cost so much is because the government makes them. In a free society, your pain meds would cost the same as tylenol. Trust me...I'm a chemist. There's nothing magical about your pain meds that make them more expensive. This is a classic case of the government breaking your leg and then giving you a crutch. Once they supply you with the crutch, they somehow convinced you that you wouldn't be walking without them.

Amen, Kevin.

Your comment about elective surgery is amusing to me. Elective surgery is any surgery that isn't emergent. For instance, if a patient needs his gallbladder removed and is in horrible pain & distress, this is probably elective because it can be scheduled for a future time. Breast reduction surgery is usually elective too, even though the woman may suffer horrible back pain, deformity and skin ulcers.

As long as definitions can be manipulated, such as emergent and elective and serious and not-for-profit, our system will continue to deny benefits.

Cancer drugs are not essential. In fact, they literally kill you. You'd be surprised at how many people wish they didn't get cancer treatment. If you think water boarding is bad...try chemo...

If you think healthcare is just fine the way it is, please take a look at this woman's presentation of her adventure in healthcare. She had an infection, which was treated. It took her two years to even determine fair and reasonable charges so that she could pay her bill. It is fascinating, and quite useful if you should ever need to determine the industry standards for hospital charges.

http://www.youtube.com/watch?v=wRsBFACxbB4

theoakman says

Cancer drugs are not essential. In fact, they literally kill you. You’d be surprised at how many people wish they didn’t get cancer treatment. If you think water boarding is bad…try chemo…

Oh, you are so correct. But they're not supposed to make you better. They're supposed to kill the cancer - but the side effects are horrible and often extend the quantity of life, not the quality. There are some exceptions.

I do believe that my pain meds are cheap for the manufacturer. My point was that when someone asserts that pain isn't important, they're wrong, wrong, wrong, wrong, wrong. Pain is important, it keeps people from functioning, it reduces the quality of life for some people, and it costs big bucks in disability payments. I do believe in some alternative treatments - but when someone tells me that "Pain medication for your sore back? Not so much" (as in, not so important) they've obviously never tweaked their back, resulting in a herniated disk. Or the sore back that is actually kidney involvement...

Our system needs to be rebuilt from the bottom. Healthcare needs to be available to everyone. The current system of people with non-emergent conditions being forced to go to the ER if they're uninsured sucks. People even get turned away from insta-cares (aka doc-in-the-boxes) if they're uninsured, even if they have cash.

theoakman says

Elliemae, the only reason your pain meds cost so much is because the government makes them. In a free society, your pain meds would cost the same as tylenol. Trust me…I’m a chemist. There’s nothing magical about your pain meds that make them more expensive. This is a classic case of the government breaking your leg and then giving you a crutch. Once they supply you with the crutch, they somehow convinced you that you wouldn’t be walking without them.

Oh, right, that's why generics cost less than 20% of name brand drugs -- because the government makes the name brand ones!

I'm fully supportive of the rights of pharmaceutical companies to make money on their investments, but this argument is pure and utter bullshit. Most medications are incredibly cheap to manufacture (with some exceptions, like vaccines). It's the huge amount of research needed to find new medications that is being paid for.

Your comment about elective surgery is amusing to me. Elective surgery is any surgery that isn’t emergent. For instance, if a patient needs his gallbladder removed and is in horrible pain & distress, this is probably elective because it can be scheduled for a future time. Breast reduction surgery is usually elective too, even though the woman may suffer horrible back pain, deformity and skin ulcers.

Yes, when I said 'elective' I was referring to what normal, rational people call 'elective' procedures, not what the medical industry would refer to as 'elective'. Sure, you could CHOOSE not to have that brain tumor removed, after all...

Perhaps I should have used the term 'not medically necessary'. I'm all for a free market in nose jobs.

Cancer drugs are not essential. In fact, they literally kill you. You’d be surprised at how many people wish they didn’t get cancer treatment. If you think water boarding is bad…try chemo…

I'm sure I would be 'surprised' by how many people 'wish' they didn't get cancer treatment. I know I would personally rather have a tumor-induced aneurysm than chemo!

Cancer treatment is harsh and invasive because, frankly, we don't have any better options. You can die a slow and painful death from the cancer, or you can take the treatments, and maybe suffer. If you're lucky you might get cured.

Kevin - I agree with you on many points. But, for purely entertainment reasons, do you think that the ideal medical system should pay for botched plastic surgery. As in, Michael Jackson? And, of course, I have to wonder if they'll give him the perfect face in his casket that he longed for all his life. He's the classic case of Body Dysmorphic Disorder, as is Jocelyn Wildenstein (the cat woman).

I think that, to create the ideal medical system, we need to start from scratch. And (here's a unique idea), ask the medical providers about how they'd fix the system. I know that I have my ideas. Imagine asking a doctor how to best treat his patients - I'm sure that paperwork for billing (charting sucks!), dealing with pre-authorizations, arguing with case managers... and getting back to actual medical treatment rather than cramming in as many patients as possible in a day would be a huge part of that picture.

I would be happy if I never again had to tell someone that they're not eligible for treatment because of a lack of insurance - and that they'll have to wait a couple of years for Medicare. If they can hang on that long, they might have a chance.

I was in an argument last week over the cost of drugs, and anyone who defends the rigging of the American market always puts the cart before the horse. Drug companies charge as much as they can. Period. Its got nothing to do with recouping the cost of R&D. Often the drug was "discovered" during the search for something else. They may pour billions of unsuccessful $ into hair loss pills or breast enhancement cremes but that's only because the payoff is there. They would do it anyway. Better to let 100 kids die than waste money where there is no market. I can accept that. But what I can't accept is the way we're cajoled into paying more than our fair share.

They charge what the market will bear. Its just so infuriating we put up with it. We don't have to take this.

There is a typical "conservative" response to the government doing anything other than bombing brown people: "We can't do that! We will fail! It won't work because at least one person will steal/take advantage or die!"

I have great health care. My wife's a teacher/state worker. However, for the first 10 years of our lives we either had no insurance or paid $600-1000/month for phone tags and preventative care. I mean preventative in the sense that they prevented giving us any healthcare. When I broke my ankle I had to beg for an xray. The doctor told me to "ice it for 2 weeks" and then "ice it for another 2 weeks" .

All-in-all this is another ploy to get an employer expense off the books of the corporations and back on the backs of the underclass where it belongs. They used to pay us enough to take care of ourselves. Then came insurance where we are all basically spreading the costs around, borrowing from a younger generation. Now they're balking on health care, after abandoning pensions/retirement.

I'd say we're all about 30 years away from being employees of the federal government, and we'll be hired out to corporations needing work.

knewbetter says

There is a typical “conservative” response to the government doing anything other than bombing brown people: “We can’t do that! We will fail! It won’t work because at least one person will steal/take advantage or die!”

How can we view any of your other statements as rational after reading this? You just called nearly half the population a bunch of genocidal racists. *sigh*

Kevin says

Oh, right, that’s why generics cost less than 20% of name brand drugs — because the government makes the name brand ones!

I’m fully supportive of the rights of pharmaceutical companies to make money on their investments, but this argument is pure and utter bullshit. Most medications are incredibly cheap to manufacture (with some exceptions, like vaccines). It’s the huge amount of research needed to find new medications that is being paid for.

That's where you are COMPLETELY off base. It's not the research that is the major cost burden. It's the half a billion dollar hoop the FDA forces you to jump through to get it approved. Consequently, they were forced to enact Orphan Drug legislation for drugs used to treat ailments that only affected a small amount of people. Lets face it, no one will spend half a billion dollars to treat a thousand people. Somehow, we manage to not kill anyone with those drugs despite the fact that we don't have the 500 billion dollar hoop to jump through. R&D does cost money to develop drugs. It's a fraction of what it costs to get it past the FDA, who are a bunch of lunatic morons.

Elliemae, I completely disagree on pain. I went 4 years waking up not remembering what it felt like to be without pain. I messed up both my knees. My back always hurts. I had severe plantar fasciitis for 4 years which prevented me from standing for extended periods of time for nearly 2 years. You have the right to purchase treatment. Not the right to treatment. And you certainly do not have the right to have the government force others to pay for your treatment, especially if you have money of your own. For the truly poor and disabled, fine create a small safety net. For middle class Americans? Hell friggin no.

"The government makes medicine? That’s funny, because I thought it was pharmaceutical companies. Are we still talking about America?"
Do me a favor. Stuff it...I didn't say the government makes medicine. I said they make it expensive.