Monday Morning eye-opener!
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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
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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.
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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 ?
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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...
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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?
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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.
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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.
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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!
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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
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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.
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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.
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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.
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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).
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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.
AndyKEnZ wrote:
"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."
Rob Graham already thoroughly discredited this guy and I showed proof below that his toenail fungus could have been cured for just 3% of the price this author is claiming. And now he is lying. It's true that at any given moment there is just shy of 50 million Americans without health insurance, but his characterization of that group is simply a lie. The large majority of those without health insurance are between jobs or between enrollment periods at work and will have insurance within a couple of months. Of the remainder, the majority tend to be young and healthy and have no need for insurance (and therefore reasonably decline the extra cost). Where did they get this guy?
Anybody rape your wife yet? -IAmChrisMcCall
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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.
AndyKEnZ wrote:
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"
So if we take France's $3191 per citizen, and multiply by the average US family of 4 we get $12,764 which doesn't seem so bad in comparison to the US $16,585. I would challenge those figures as well, knowing my own rates to be about $12,000 combined... And how will making the US Federal government the payer change one IOTA of this? Adding the presently uncovered (many by choice, not inability to pay) can only increase the cost (to someone). The only difference is that the "premiums" will turn into "taxes", and the administrator will change from a private company with a vested interest in doing business efficiently to a Federal Bureaucracy that has none. As I said. It is without merit. it argues for a "cure" that is not supported by it's own description of the "disease". Go to sleep Spain. We neither need nor want your advice.
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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 ?
There have been a very few cases of Physicians taking kickbacks from Pharma companies, but that is extremely rare and hardly worth the mention. In most cases it is simple ignorance or laziness on the MD's part. They don't always know which drugs have generic equivalents, and often haven't the time to check. They are heavily targeted with advertising (including copious quantities of free samples) by the Pharma companies, so are likely to be aware of the "drug of the moment" which is bound to be a patent drug. Add to that that they know the patient isn't paying, and that they likely don't know the price themselves. All that is left to bring some order to this chaos is the insurer, who intercedes when cost or appropriateness seems out of line. MDs know this too, so in many respects, they just depend on the insurer to raise a red flag if something is out of line. The real question here is whether substituting a bureaucracy for the insurer would help at all. Would they also monitor cost and appropriateness aggressively? Would they be subject to inappropriate influence by lobbying or bribery? After all it's not their money they are administering, it's "just tax revenue".
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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.
dan neely wrote:
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.
This is what I have. Brandnames are $20 co-pay; generics are $10-15, depending on the drug tier.
The early bird who catches the worm works for someone who comes in late and owns the worm farm. -- Travis McGee
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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
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. 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. Unless I'm reading this wrongly the "$1,379.99." price is from before the patent expired and the drug manufacture could charge what they liked. Your right, now it's more accessable the price has dropped considerably. Tha author, at the time, did shop around, he still idn't find the cheapest figure but did point out it is much cheaper now the patent is gone.
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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. 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. Unless I'm reading this wrongly the "$1,379.99." price is from before the patent expired and the drug manufacture could charge what they liked. Your right, now it's more accessable the price has dropped considerably. Tha author, at the time, did shop around, he still idn't find the cheapest figure but did point out it is much cheaper now the patent is gone.
originSH wrote:
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. 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. Unless I'm reading this wrongly the "$1,379.99." price is from before the patent expired and the drug manufacture could charge what they liked. Your right, now it's more accessable the price has dropped considerably. Tha author, at the time, did shop around, he still idn't find the cheapest figure but did point out it is much cheaper now the patent is gone.
If he pointed out that the generic was "er, $362", then he was wrong as CostCo has it for under $50. Of course, Wikipedia also lists Fluconazole[^] as another cheaper alternative (which was available at the time and is roughly $26 for 90 tablets) to Lamisil. As I pointed out, his assumption that the cost is fixed and high (for what amounts to a cosmetic problem anyway) is erroneous and is something that can be fixed by empowering the consumer. -- modified at 11:56 Monday 8th October, 2007
Anybody rape your wife yet? -IAmChrisMcCall
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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. 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. Unless I'm reading this wrongly the "$1,379.99." price is from before the patent expired and the drug manufacture could charge what they liked. Your right, now it's more accessable the price has dropped considerably. Tha author, at the time, did shop around, he still idn't find the cheapest figure but did point out it is much cheaper now the patent is gone.
originSH wrote:
Tha author, at the time, did shop around, he still idn't find the cheapest figure but did point out it is much cheaper now the patent is gone.
No, the author did not shop around, but rather chose the highest price he could find to make his point. Your observation is correct, but there were generic substitutes available for the same application prior to the patent expiration, and the patented drug was available for less than cited. Lamisil is the trade-marked name for Terbinafine hydrochloride. Diflucan is a less expensive alternative that has been available for some time. The article is fraught with exaggeration and sophistry, not the least of which is comparing per person costs with US per family insurance premiums without calling attention to the differing basis, let alone the fact that one is cost the other price.