Monday Morning eye-opener!
-
http://www.newstatesman.com/200710040028[^] Well worth a read.
Not only does that guy look like my least favorite film maker (so cruel to show us that on a Monday morning), he reasons just as poorly. He rails against the insurace companies because they interfere with his doctors practice of medicine, and proposes government run socialized medicine as a cure. How absurd. There is absolutely no reason to presume the government as payer would interfere any less. Indeed, there is every reason to believe they would interfere more (if past behavior in other government programs is any indicator), be more pedantic and bureaucratic. The example he uses is also quite flawed: The insurance company demanded lab tests to confirm the diagnosis and prescribed treatment. They did so quite rightly, and were protecting the patient in this case: described as an elderly man in less than perfect health. Lamisil poses a significant risk of liver damage in such a case, and likely what they really asked for was blood tests to confirm the subject's liver was sufficiently healthy to tolerate the treatment. The doctor was in fact negligent if he had not performed such a test, but instead done as the article describe and casually prescribed the "routine treatment". In my opinion the real problem with health care in the US is the lack of transparency and real competition: It is almost impossible to get comparative pricing for services, and impossible to get impartial performance evaluations of the various providers.
-
Not only does that guy look like my least favorite film maker (so cruel to show us that on a Monday morning), he reasons just as poorly. He rails against the insurace companies because they interfere with his doctors practice of medicine, and proposes government run socialized medicine as a cure. How absurd. There is absolutely no reason to presume the government as payer would interfere any less. Indeed, there is every reason to believe they would interfere more (if past behavior in other government programs is any indicator), be more pedantic and bureaucratic. The example he uses is also quite flawed: The insurance company demanded lab tests to confirm the diagnosis and prescribed treatment. They did so quite rightly, and were protecting the patient in this case: described as an elderly man in less than perfect health. Lamisil poses a significant risk of liver damage in such a case, and likely what they really asked for was blood tests to confirm the subject's liver was sufficiently healthy to tolerate the treatment. The doctor was in fact negligent if he had not performed such a test, but instead done as the article describe and casually prescribed the "routine treatment". In my opinion the real problem with health care in the US is the lack of transparency and real competition: It is almost impossible to get comparative pricing for services, and impossible to get impartial performance evaluations of the various providers.
-
http://www.newstatesman.com/200710040028[^] Well worth a read.
I checked with my local CVS drugstore last weekend and established that, in
America, 90 Lamisil tablets cost (I'm not making this up) a cool $1,379.99.CostCo[^] offers a Lamisil generic that goes for $43.74 for 90 tablets (without any insurance). This is a wonderful example of why consumer-driven plans are so important for the future of American health care. The author did not bother to shop around for suitable and affordable alternatives and instead assumed that the patient should be entitled to $1,379.99 worth of drugs (CostCo sells the same brand-name $235 less). When the consumer is separated from costs, this sense of entitlement becomes pervasive. Of course, with insurance, there is very little incentive to get the inexpensive generic (at a whopping 97% off) as the patient would likely pay the same or a similar co-pay regardless of which he chose. And people wonder why health care costs are rising so rapidly...
Anybody rape your wife yet? -IAmChrisMcCall
-
You make the impression you are knowledgeable, but in fact you are completely blind. Liver damage from something you pop on your toe-nail HAW HAW HAW
Boy are you dumb. The article talked about lamisil TABLETS not the ointment. from WikiPedia[^] . The tablets may, rarely, cause hepatotoxicity, so patients are warned of this and may be monitored with liver function tests. Alcohol consumption should also be avoided while taking terbinafine. Who's blind here? Did you even read the article you linked in your post? It would appear not.
-
I checked with my local CVS drugstore last weekend and established that, in
America, 90 Lamisil tablets cost (I'm not making this up) a cool $1,379.99.CostCo[^] offers a Lamisil generic that goes for $43.74 for 90 tablets (without any insurance). This is a wonderful example of why consumer-driven plans are so important for the future of American health care. The author did not bother to shop around for suitable and affordable alternatives and instead assumed that the patient should be entitled to $1,379.99 worth of drugs (CostCo sells the same brand-name $235 less). When the consumer is separated from costs, this sense of entitlement becomes pervasive. Of course, with insurance, there is very little incentive to get the inexpensive generic (at a whopping 97% off) as the patient would likely pay the same or a similar co-pay regardless of which he chose. And people wonder why health care costs are rising so rapidly...
Anybody rape your wife yet? -IAmChrisMcCall
Actually, my insurance company would insist that the doctor justify his choice of the NON-generic, and would recommend substituting the generic. It likely would not pay for the non-generic in any case, since it would classify the problem as cosmetic. The article AndyDense linked to is absurd. There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it. Furthermore, it can have no impact on the cost of patented drugs, which are sold in a non-competitive marketplace. The only possible government tool there would be to mandate price controls, and that would likely affect availability of new drugs - why would pharma companies spend the R&D dollars if they can't get those big profits to pay for all the failed experiments...
-
Boy are you dumb. The article talked about lamisil TABLETS not the ointment. from WikiPedia[^] . The tablets may, rarely, cause hepatotoxicity, so patients are warned of this and may be monitored with liver function tests. Alcohol consumption should also be avoided while taking terbinafine. Who's blind here? Did you even read the article you linked in your post? It would appear not.
That was obvious from the article, but if tests were made for every possible side-effect nothing would get done. But as you say it was the good ol' insurance companies just looking out for their red-necked boy. Where would we be without them. I suggest you give some thought to the bigger picture instead of latching onto something insignificant in order to give the impression the complete article was without merit. Go back to sleep America. - Bill Hicks.
-
Actually, my insurance company would insist that the doctor justify his choice of the NON-generic, and would recommend substituting the generic. It likely would not pay for the non-generic in any case, since it would classify the problem as cosmetic. The article AndyDense linked to is absurd. There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it. Furthermore, it can have no impact on the cost of patented drugs, which are sold in a non-competitive marketplace. The only possible government tool there would be to mandate price controls, and that would likely affect availability of new drugs - why would pharma companies spend the R&D dollars if they can't get those big profits to pay for all the failed experiments...
Rob Graham wrote:
Actually, my insurance company would insist that the doctor justify his choice of the NON-generic, and would recommend substituting the generic. It likely would not pay for the non-generic in any case, since it would classify the problem as cosmetic.
Yeah, I saw that it's usually considered cosmetic in your Wikipedia link.
Rob Graham wrote:
The article AndyDense linked to is absurd. There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it. Furthermore, it can have no impact on the cost of patented drugs, which are sold in a non-competitive marketplace. The only possible government tool there would be to mandate price controls, and that would likely affect availability of new drugs - why would pharma companies spend the R&D dollars if they can't get those big profits to pay for all the failed experiments...
Well, the current system essentially uses the insurer as the payer, thus substituting the individual and separating the beneficiary from direct cost. Like a socialist system, there's very little incentive to shop around, which places enourmous and largely unnecessary demand pressures on the entire system. It seems as though consumer-driven plans (e.g. Lumenos) are maturing to the point that they are becoming sensible and actually could have a real effect on costs.
Anybody rape your wife yet? -IAmChrisMcCall
-
That was obvious from the article, but if tests were made for every possible side-effect nothing would get done. But as you say it was the good ol' insurance companies just looking out for their red-necked boy. Where would we be without them. I suggest you give some thought to the bigger picture instead of latching onto something insignificant in order to give the impression the complete article was without merit. Go back to sleep America. - Bill Hicks.
AndyKEnZ wrote:
Go back to sleep America
What I find amazing is that the greatest human rights disaster on the planet appears to be American health care. :rolleyes:
The only conspiracies that concern me are the ones I am completely unaware of. By the time I find out about it, its probably a done deal. Nothing in the entire universe is more useless than morality without authority. A morality free of hyprocrisy is no morality at all.
-
That was obvious from the article, but if tests were made for every possible side-effect nothing would get done. But as you say it was the good ol' insurance companies just looking out for their red-necked boy. Where would we be without them. I suggest you give some thought to the bigger picture instead of latching onto something insignificant in order to give the impression the complete article was without merit. Go back to sleep America. - Bill Hicks.
AndyKEnZ wrote:
That was obvious from the article, but if tests were made for every possible side-effect nothing would get done.
If tests were not made for every possible side-effect, the doctor would be sued. :rolleyes:
Anybody rape your wife yet? -IAmChrisMcCall
-
Actually, my insurance company would insist that the doctor justify his choice of the NON-generic, and would recommend substituting the generic. It likely would not pay for the non-generic in any case, since it would classify the problem as cosmetic. The article AndyDense linked to is absurd. There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it. Furthermore, it can have no impact on the cost of patented drugs, which are sold in a non-competitive marketplace. The only possible government tool there would be to mandate price controls, and that would likely affect availability of new drugs - why would pharma companies spend the R&D dollars if they can't get those big profits to pay for all the failed experiments...
Rob Graham wrote:
doctor justify his choice of the NON-generic
In the USA, is there more money to be made by doctors by prescribing such expensive products rather than the generic substitutes? If so, where do these doctor's morality lay (if it is a case of morality) - is it in his/her bank balance or in his/her patients best interests ?
-
Actually, my insurance company would insist that the doctor justify his choice of the NON-generic, and would recommend substituting the generic. It likely would not pay for the non-generic in any case, since it would classify the problem as cosmetic. The article AndyDense linked to is absurd. There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it. Furthermore, it can have no impact on the cost of patented drugs, which are sold in a non-competitive marketplace. The only possible government tool there would be to mandate price controls, and that would likely affect availability of new drugs - why would pharma companies spend the R&D dollars if they can't get those big profits to pay for all the failed experiments...
-
Actually, my insurance company would insist that the doctor justify his choice of the NON-generic, and would recommend substituting the generic. It likely would not pay for the non-generic in any case, since it would classify the problem as cosmetic. The article AndyDense linked to is absurd. There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it. Furthermore, it can have no impact on the cost of patented drugs, which are sold in a non-competitive marketplace. The only possible government tool there would be to mandate price controls, and that would likely affect availability of new drugs - why would pharma companies spend the R&D dollars if they can't get those big profits to pay for all the failed experiments...
My employer offers plans with both hard and soft generic options. With the soft generic plans as a customer I could get the brandname at my choice for only an extra few $'s in the copay, with the insurance company eating the overwehlming majority of the additional cost.
-- If you view money as inherently evil, I view it as my duty to assist in making you more virtuous.
-
I checked with my local CVS drugstore last weekend and established that, in
America, 90 Lamisil tablets cost (I'm not making this up) a cool $1,379.99.CostCo[^] offers a Lamisil generic that goes for $43.74 for 90 tablets (without any insurance). This is a wonderful example of why consumer-driven plans are so important for the future of American health care. The author did not bother to shop around for suitable and affordable alternatives and instead assumed that the patient should be entitled to $1,379.99 worth of drugs (CostCo sells the same brand-name $235 less). When the consumer is separated from costs, this sense of entitlement becomes pervasive. Of course, with insurance, there is very little incentive to get the inexpensive generic (at a whopping 97% off) as the patient would likely pay the same or a similar co-pay regardless of which he chose. And people wonder why health care costs are rising so rapidly...
Anybody rape your wife yet? -IAmChrisMcCall
Red Stateler wrote:
The author did not bother to shop around for suitable and affordable alternatives and instead assumed that the patient should be entitled to $1,379.99 worth of drugs (CostCo sells the same brand-name $235 less). When the consumer is separated from costs, this sense of entitlement becomes pervasive.
How do you feel about the sense of entitlement that allows a pharmaceutical company to charge more than $10 per pill for a pill that costs about 0.5 cents to manufacture? Is corporate entitlement okay while individual entitlement is not?
-
AndyKEnZ wrote:
Go back to sleep America
What I find amazing is that the greatest human rights disaster on the planet appears to be American health care. :rolleyes:
The only conspiracies that concern me are the ones I am completely unaware of. By the time I find out about it, its probably a done deal. Nothing in the entire universe is more useless than morality without authority. A morality free of hyprocrisy is no morality at all.
-
That was obvious from the article, but if tests were made for every possible side-effect nothing would get done. But as you say it was the good ol' insurance companies just looking out for their red-necked boy. Where would we be without them. I suggest you give some thought to the bigger picture instead of latching onto something insignificant in order to give the impression the complete article was without merit. Go back to sleep America. - Bill Hicks.
AndyKEnZ wrote:
But as you say it was the good ol' insurance companies just looking out for their red-necked boy.
Well AndyDense, I can't think of an appropriate response to such a stupid, bigoted statement. You have ZERO experience with health care in the US, but are willing to believe everything said in an article by a professional propagandist, including completely absurd reasoning. Then, after you have embarrased yourself with a stupid response, you have to compound the damage by minimizing your stupidity by claiming your error was insignificant and resorting to name calling. You represent European liberals quite well. Te article was entirely without merit. Not only did it present a completely absurd example, but it exaggerated (quite severly) the cost issue (check current pricing for Lamisil generics). It then reasoned from this absurd example that changing the payer from p[rivate to public would fix everything (presenting no evidence on how that could possibly effect the pricing of patented drugs -likely since it could not). It implied that such a change would lessen interference (dubious at best, given the governments past record for intrusiveness). And you are intellectually vapid enough to suggest I need to see the bigger picture! What a joke!
-
Red Stateler wrote:
The author did not bother to shop around for suitable and affordable alternatives and instead assumed that the patient should be entitled to $1,379.99 worth of drugs (CostCo sells the same brand-name $235 less). When the consumer is separated from costs, this sense of entitlement becomes pervasive.
How do you feel about the sense of entitlement that allows a pharmaceutical company to charge more than $10 per pill for a pill that costs about 0.5 cents to manufacture? Is corporate entitlement okay while individual entitlement is not?
Ed Gadziemski wrote:
How do you feel about the sense of entitlement that allows a pharmaceutical company to charge more than $10 per pill for a pill that costs about 0.5 cents to manufacture? Is corporate entitlement okay while individual entitlement is not?
It makes me feel roughly as bad as this[^]. Just like software, the real cost is in R&D, which is an expensive (and unlike software, high-risk) venture. Novartis, which manufactures Lamisil, has a significantly lower return on equity than Microsoft, Oracle or Google.
Anybody rape your wife yet? -IAmChrisMcCall
-
But, of course. Doesn't the International Brotherhood of idiots,totalitarians,communists and humaninists (IBITCH) have any thing else to worry about aside from the state of health care in the "richest country on the planet"?
The only conspiracies that concern me are the ones I am completely unaware of. By the time I find out about it, its probably a done deal. Nothing in the entire universe is more useless than morality without authority. A morality free of hyprocrisy is no morality at all.
-
Rob Graham wrote:
There is no way one can draw the conclusion that substituting the government as payer would alone decrease the cost. In all liklihood, it would increase it.
Priceless, thanks.
Explain how. The Federal bureaucracy has a rather bad record here; Medicare costs relative to private insurance bear that out. Try doing a little fact checking before you expose your ignorance.
-
AndyKEnZ wrote:
But as you say it was the good ol' insurance companies just looking out for their red-necked boy.
Well AndyDense, I can't think of an appropriate response to such a stupid, bigoted statement. You have ZERO experience with health care in the US, but are willing to believe everything said in an article by a professional propagandist, including completely absurd reasoning. Then, after you have embarrased yourself with a stupid response, you have to compound the damage by minimizing your stupidity by claiming your error was insignificant and resorting to name calling. You represent European liberals quite well. Te article was entirely without merit. Not only did it present a completely absurd example, but it exaggerated (quite severly) the cost issue (check current pricing for Lamisil generics). It then reasoned from this absurd example that changing the payer from p[rivate to public would fix everything (presenting no evidence on how that could possibly effect the pricing of patented drugs -likely since it could not). It implied that such a change would lessen interference (dubious at best, given the governments past record for intrusiveness). And you are intellectually vapid enough to suggest I need to see the bigger picture! What a joke!
Rob Graham wrote:
Not only did it present a completely absurd example, but it exaggerated (quite severly) the cost issue (check current pricing for Lamisil generics).
Shame you didn't get past the first bit. "The result in 2007 is that 47.7 million often relatively prosperous, middle-class Americans have been caught in the trap in between, unable to afford health insurance or land a job that comes with it." "The average yearly cost of a family insurance plan purchased by employers is now $12,106, plus an additional $4,479 paid by the employee;" "Britain spends just $2,560 per citizen on health care, Australia $3,128 and France $3,191" "Put more brutally, the US ranked 22nd in infant mortality (between Taiwan and Croatia), 46th in life expectancy (between St Helena and Cyprus) and 37th in health system performance (between Costa Rica and Slovenia). In the "efficiency" ratings, the US came last. More American women are dying in childbirth today than were decades ago." "18,000 Americans die unnecessarily every year because they have no medical insurance." "It is probably too late for that poor old fellow patient of mine, but the patent on Lamisil finally expired last June and 90 generic tablets can now be had for a bargain, er, $362." See if you'd read more of the article you'd know how ridiculous you appear. "why is it that America, the world's richest nation, provides such shamefully lousy health care for its people?" It's not big deal to me here in Europe, but when you get the chance, you've got to contribute to the soapbox man.
-
Red Stateler wrote:
The author did not bother to shop around for suitable and affordable alternatives and instead assumed that the patient should be entitled to $1,379.99 worth of drugs (CostCo sells the same brand-name $235 less). When the consumer is separated from costs, this sense of entitlement becomes pervasive.
How do you feel about the sense of entitlement that allows a pharmaceutical company to charge more than $10 per pill for a pill that costs about 0.5 cents to manufacture? Is corporate entitlement okay while individual entitlement is not?
It is not a sense of entitlement that allows this price gouging, but rather the absence of transparency. It is difficult for the consumer here to do any price comparison, and there is little motivation when someone else is paying. There is another issue here with the high cost of patented drugs, but that is a different argument and has no easy solution (price control is not a solution, too many unintended consequences possible).