Holiday20310401
 
  1  
Reply Tue 9 Jun, 2009 09:40 pm
@BrightNoon,
BrightNoon;67818 wrote:

1. Is a statistical improvement in health worth sacraficing the health of those at the extremes, such people with rare or expensive to treat conditions who are simply sent home to die?


I have a question that's been bugging me for a long time. Why are certain drugs so expensive?? Is scarcity that big of an impact, or are monopolies just able to get away with it? If we fixed the greed problem then maybe we'd be left with manageable costs so that everybody could benefit with a health plan. Is this too idealistic?
Theaetetus
 
  1  
Reply Tue 9 Jun, 2009 09:46 pm
@Holiday20310401,
Holiday20310401;67877 wrote:
I have a question that's been bugging me for a long time. Why are certain drugs so expensive?? Is scarcity that big of an impact, or are monopolies just able to get away with it? If we fixed the greed problem then maybe we'd be left with manageable costs so that everybody could benefit with a health plan. Is this too idealistic?


Typically, brand name drugs are really expensive. But after time, there is often generics made that are far cheaper, and contain the same active ingredients. I think if we cut out the pharmaceutical industry, and made the drug companies a public entity, the costs would drop drastically. The government is not so concerned about turning a profit so research in the area would probably be pushed towards utility rather than profit potential.
richrf
 
  1  
Reply Tue 9 Jun, 2009 10:22 pm
@Theaetetus,
This is a philosophical forum, so I am loathe to get too much into the medical industry, but I can't help it: Smile

Just today, in the Wall Street Journal, there were two separate articles, one discussing how expensive treatments for heart disease perform no better than the much cheaper alternatives. The other article discussed how expensive diabetes treatments are associated with increased instances of bone fractures and other problems. Recently the pediatrician association finally took a stand against cough syrup for children. They have known for over 30 years, that it has no efficacy, and in fact could create problems, and did nothing about it, until some physicians finally blew the whistle and insisted on taking an unequivocal position. The journals are rife with this kind of stuff. Almost daily, something is written.

Doctors are humans, and the industry they are part of is one that likes to grow in profits. Lots of money are spent by pharmaceuticals to promote their products (often in very a unethical manner), which the industry refuses to address. Rigged studies. Payments to doctors to use their products. Hiring specialists to promote their products under the cover of supposed science, etc. Why? Because there is LOTS of money involved. I just stay away from it.

Rich
Theaetetus
 
  1  
Reply Tue 9 Jun, 2009 10:45 pm
@richrf,
richrf;67888 wrote:
This is a philosophical forum, so I am loathe to get too much into the medical industry, but I can't help it: Smile

Just today, in the Wall Street Journal, there were two separate articles, one discussing how expensive treatments for heart disease perform no better than the much cheaper alternatives. The other article discussed how expensive diabetes treatments are associated with increased instances of bone fractures and other problems. Recently the pediatrician association finally took a stand against cough syrup for children. They have known for over 30 years, that it has no efficacy, and in fact could create problems, and did nothing about it, until some physicians finally blew the whistle and insisted on taking an unequivocal position. The journals are rife with this kind of stuff. Almost daily, something is written.

Doctors are humans, and the industry they are part of is one that likes to grow in profits. Lots of money are spent by pharmaceuticals to promote their products (often in very a unethical manner), which the industry refuses to address. Rigged studies. Payments to doctors to use their products. Hiring specialists to promote their products under the cover of supposed science, etc. Why? Because there is LOTS of money involved. I just stay away from it.

Rich


The problem with the Wall Street Journal is that they have their own interests they are promoting to sell their paper. They cater to the anti-universal health care crowd, and you never see the other side of the argument in their paper, which is fine.

I understand where you are coming from on your stance because I share many of the same views. But as someone pointed out in an early post, countries like Great Britain with universal health care, discriminate against those that have illnesses and diseases caused by life style choices (e.g. the obese person has to wait to be treated for their problems or seek out private care).

What concerns me the most is people like myself. Many people take care of themselves, and do not risk their health due to life style choices, but end up seriously ill and cannot afford the necessary medical treatment for their diseases/illnesses. If I do in fact have cancer, I am not going to risk my life by not going to a doctor to receive the proper care that I need to survive. If I had lung cancer from smoking my whole adult life it would be one thing, but many males in my family died before they were 35 due to lymphoma.

The problem that I have is that I have no insurance as a college student that is past the age that I can be covered under my parents, and I cannot work enough hours at a job that offers insurance. Nor can I afford to pay it out of my pocket, but it is not like any insurance company would cover me knowing that I am going to the doctor knowing that it is highly probable that I have cancer. What I will offer the world comes after I am done with school. There is no reason why the taxpayers of the United States should lose their investment in me as a student due to something that would be curable with proper care. Without medical care, I will likely die, and the taxpayers will be out of whatever money that they kicked in to pay for my schooling. At some point in time, people must realize that it is a waste of money to pay for someone to go to college, but deny them necessary medical care that they need. By having citizens kick in for the care that so many need, they will guarantee a return on the investment they made in the individuals in other ways.
avatar6v7
 
  1  
Reply Wed 10 Jun, 2009 04:46 am
@Theaetetus,
I advise moving to Cuba.
Aedes
 
  1  
Reply Wed 10 Jun, 2009 05:30 am
@BrightNoon,
BrightNoon;67818 wrote:
1. Is a statistical improvement in health worth sacraficing the health of those at the extremes, such people with rare or expensive to treat conditions who are simply sent home to die?
That's the choice that every health department makes in the developing world. My colleagues and I have had one patient who has been in the hospital in a permanent vegetative state for 7 months. His care has cost more than the entire health care budget of many African countries. Resources are finite and you have to make choices.

BrightNoon;67818 wrote:
What are the dangers of giving the government control over every citizens health?
The government will have control over payment, not over health care. And its own crappy decisions in my experience (with Medicare, Medicaid, and the VA) are no worse than those made by private insurance.

BrightNoon;67818 wrote:
2b. Two words, mental health. Imagine the possibilities. Might we have to pass a mental health test to own guns? drive? vote?
This is a nonsequitur. Paying for mental health is one thing, but where is the segue into mass government mental health evaluations? I don't get it.

BrightNoon;67818 wrote:
3. The most obvious problem, where's the money?
The money is already being (over)spent on expensive emergency room care, unnecessary medical costs for smokers, excessive accidents, quality assurance problems, unnecessary testing, ridiculous drug costs, and expensive treatments that don't have a supportive evidence base. The government foots a LOT of this money.

---------- Post added at 07:32 AM ---------- Previous post was at 07:30 AM ----------

Holiday20310401;67877 wrote:
Why are certain drugs so expensive??
Some really and truly are expensive (I had a baby with infant botulism and it cost around $30,000 a dose to treat the child with botulism immune globulin). However, they are generally expensive because people can pay for them. Just like college tuitions -- they're expensive because people can get loans. In Canada, with a single payer system, drug companies cannot charge so much. When possible I prescribe generic drugs to save the patients and the system some money, so long as it's therapeutically equivalent to do so.
Khethil
 
  1  
Reply Wed 10 Jun, 2009 05:39 am
@avatar6v7,
I'd like to express my feelings and thoughts on this issue:

  • First off, it's my firm belief that if any people empower any government entity to administer its business, there's nothing more central - more vital - to our own interests than the services that enable us to "stay alive". Further, for all the things people empower their governments to administer, how is our ability to live less important than anything else governments do?


  • Secondly, given human propensities for greed, avarice, deception and piggery, I can't imagine why anyone thinks its a 'good idea' to have medical care a For-Profit endeavor.


  • Righteous indignation; pointing the finger at the lazy and self-destructive then decreeing "I'm not paying for fatso over there" is a poor excuse. Virtually everyone, whether due to poor health habits, congenital defects or happenstance, has a good chance of being subject to health problems. One might take it on good advice to not be berating the sick for the likelihood that one day they have fingers in their face. Or you could realize that, depending on where you live, you're likely already paying for such people in other ways; you also probably pay for fire protection (you don't always need), police protection (you could excuse your way out of) and/or traffic facilities (that you might not use).


  • Medical care isn't something anyone can do, and those who've been fortunate (and conscientious enough) to stay safe and healthy can't justifiably profess, "I'm healthy! You can be also!". There are too many variables, too many factors beyond ones' control. I've seen a number of self-healthy folks who've discovered themselves ill beyond the means to pay for after long bouts of patting themselves on the back, thinking this will last forever. Think you've got all this under control? Its an illusion - one I hope we're all fortunate enough to maintain.


  • If you'd like to point to failed medical scenarios in countries who DO have national health care; please keep in mind two things: 1) Any system administered by people has its flaws, debacles and despots. Look for a flaw in any system and you'll find it - guaranteed. This therefore proves nothing. -and- 2) How such a nationalized system is administered is as different as whatever country you're talking about. The flaws and accidents in one can't rationally be attributed to all.

I fear that the country I live in is still far too backward, too bitter with self-righteous posturing and combating the "free lunch"-fallacy to really embrace the fundamental need and compassion necessary for nationalized healthcare. What's more, a country built on greed and consumption isn't likely any time soon to give up such a large, fat cash cow.

Thanks
richrf
 
  1  
Reply Wed 10 Jun, 2009 08:03 am
@avatar6v7,
avatar6v7;67946 wrote:
I advise moving to Cuba.


According to the WHO statistics, in Cuba your life expectancy is just about the same as the U.S., however they spend about $550/capita on health insurance while in the U.S., it is close to $16,000/person. It is interesting, as one wades through the statistics, there does not seem to be any correlation between cost and health. However, other data shows a very strong correlation between lifestyle and health.

Rich

---------- Post added at 09:05 AM ---------- Previous post was at 09:03 AM ----------

Theaetetus;67892 wrote:
The problem with the Wall Street Journal is that they have their own interests they are promoting to sell their paper. They cater to the anti-universal health care crowd, and you never see the other side of the argument in their paper, which is fine.


I hear what you are saying, but this was simply a report from an American medical journal. Not editorial. You can find these reports online via google.

Quote:
I understand where you are coming from on your stance because I share many of the same views. But as someone pointed out in an early post, countries like Great Britain with universal health care, discriminate against those that have illnesses and diseases caused by life style choices (e.g. the obese person has to wait to be treated for their problems or seek out private care).


I prefer this approach.


Rich
0 Replies
 
hue-man
 
  1  
Reply Wed 10 Jun, 2009 08:12 am
@Theaetetus,
Theaetetus;67316 wrote:
As someone in the United States that can not afford both tuition for college and health care, I wonder why the U.S. cannot get on the boat with the rest of the developed world and offer health care to all of their citizens. I have read most of the argument for and against universalized health care, and the arguments against it appear to be little more than rhetoric propagated by the insurance and pharmaceutical industry. There is much chatter as well from people that seem to think that the government would not be effective at running a health care plan. Why is the government trusted with running the military, but cannot be trusted to run health care?

So I ask, why should we, or why shouldn't we have universalized health care so all Americans can receive the care they need regardless of pre-existing conditions. Other things to consider: is it moral for people to profit from health care? Why is health care in this country tied to employment? Why are people so concern with an increase in taxes when it means that there would be less out-of-the-pocket expenses associated with health care? What is the best form of paying for health care?


I want universal health care too, but I'm concerned about government run healthcare because I've heard bad stories about the bureaucracy causing problems. Obama's plan sounds good; with a mixed healthcare system that provides affordable health insurance for everyone and continues the medicare and medicaid programs.

---------- Post added at 10:15 AM ---------- Previous post was at 10:12 AM ----------

richrf;67888 wrote:
This is a philosophical forum, so I am loathe to get too much into the medical industry, but I can't help it: Smile

Just today, in the Wall Street Journal, there were two separate articles, one discussing how expensive treatments for heart disease perform no better than the much cheaper alternatives. The other article discussed how expensive diabetes treatments are associated with increased instances of bone fractures and other problems. Recently the pediatrician association finally took a stand against cough syrup for children. They have known for over 30 years, that it has no efficacy, and in fact could create problems, and did nothing about it, until some physicians finally blew the whistle and insisted on taking an unequivocal position. The journals are rife with this kind of stuff. Almost daily, something is written.

Doctors are humans, and the industry they are part of is one that likes to grow in profits. Lots of money are spent by pharmaceuticals to promote their products (often in very a unethical manner), which the industry refuses to address. Rigged studies. Payments to doctors to use their products. Hiring specialists to promote their products under the cover of supposed science, etc. Why? Because there is LOTS of money involved. I just stay away from it.

Rich


That's capitalism for you; the good old American way.
0 Replies
 
Aedes
 
  1  
Reply Wed 10 Jun, 2009 09:33 am
@Khethil,
Khethil;67962 wrote:
given human propensities for greed, avarice, deception and piggery, I can't imagine why anyone thinks its a 'good idea' to have medical care a For-Profit endeavor.
In my mind the real problem with for-profit health care is that people make bad decisions. A fairly local hospital in southern Virginia did that a couple years ago, and began to cut unprofitable services, lay off staff, and the result has been patients heading for the hills.
RDRDRD1
 
  1  
Reply Wed 10 Jun, 2009 12:39 pm
@Theaetetus,
hue-man, if it's bureaucracy you fear you need to open your eyes to the enormous, administrative costs of the private healthcare industry. It's been studied to death and administrative costs in a public system, even leaving the private industries' profit element aside, are far greater in private healthcare.

In public systems, the doctor (of your choice) determines what you need and prescribes the best options - medicines, therapy or surgery. In the private system the doctor's determination is then subject to review and negotiation with an insurer whose bottom line is making profit. Then there's the inevitable billing nightmare with each insurer using different forms and codes causing the physician to have extra staff trained to handle that bureaucracy,

By the way, some Canadians really don't want public healthcare in the United States. One factor that swings some employers to relocate to Canada is being liberated from the cost of providing private health insurance to employees. If you folks go our route we could just lose that competitive advantage. GRRR.
Theaetetus
 
  1  
Reply Wed 10 Jun, 2009 12:56 pm
@Theaetetus,
About $400 billion is wasted on medical care in the U.S every year due to administrative costs, incompetence, corruption, inefficiency, etc. Forming a single-payer system could make the process run much smoother with less waste. When health care is not for profit, there would be a much greater push to make the system more efficient to cut costs.
0 Replies
 
Aedes
 
  1  
Reply Wed 10 Jun, 2009 01:14 pm
@RDRDRD1,
RDRDRD1;68060 wrote:
In public systems, the doctor (of your choice) determines what you need and prescribes the best options - medicines, therapy or surgery. In the private system the doctor's determination is then subject to review and negotiation with an insurer whose bottom line is making profit.
That's not true, my decisions are reviewed and scrutinized FAR more heavily by Medicare auditors than by any private insurance company -- it's not even close.

Secondly, no one tells me what I can and cannot do. Ever. I do what I think a patient needs, and if an insurance company opts not to pay for it, I can nearly always get it payed for by insurance if I document it well enough or (if necessary) talk to a medical director at the company.
0 Replies
 
RDRDRD1
 
  1  
Reply Wed 10 Jun, 2009 02:03 pm
@Theaetetus,
That may be the American experience, Aedes, but look elsewhere to single-payor systems in Europe for example. Medicare plainly doesn't fall within the ambit of a national, universal public healthcare system.
0 Replies
 
Aedes
 
  1  
Reply Wed 10 Jun, 2009 02:21 pm
@Theaetetus,
But it's one of the few circumstances in which you can compare the two side by side. You can't do that in a country that ONLY has one or the other. Medicare covers so much of healthcare that it basically sets the price for nearly all services (certainly inpatient services and drugs). Private insurers tighten their pocketbooks the second Medicare does.

Furthermore, at least according to the long series on foreign healthcare systems that NPR produced last year, doctors in Europe sounded a whole lot more constrained than my colleagues and I feel here. In Germany (one episode that I recall from the NPR series) doctors earn a crappy living, work horrendous hours, have to make housecalls (which adds a lot of unpaid travel time), and have severe limitations on their services. Their depression and attrition rates are far higher than in the US.
avatar6v7
 
  1  
Reply Thu 11 Jun, 2009 03:25 am
@Aedes,
I agree the medicare system is very poor, but thats because it runs alongside such a vast and integral private sector. In the UK we spend half the percentage of our GDP on public healthcare than the US does. The NHS has it's problems, but they have been mainly brought about by the governments insistence on bringing in private investors who have actually driven up costs and reduced the quality of service, all in the name of 'choice'- we risk drifting towards a more consumerist, and more expensive, healthcare system, because a supposedly left-wing party has decided to change it's stripes.
hue-man
 
  1  
Reply Thu 11 Jun, 2009 08:28 am
@Aedes,
I found some articles about the pros and cons of a single payer health care system versus a for profit health care system.

Health care in Canada - Wikipedia, the free encyclopedia

For solutions on health care, look to Europe, not the U.S.

Canada's healthcare saved her; Ours won't cover her - Los Angeles Times

10 Myths About Canadian Health Care, Busted | Physicians for a National Health Program
richrf
 
  1  
Reply Thu 11 Jun, 2009 08:31 am
@hue-man,
Hi,

It seems like Obama is seeking to combine options for government insurance with private sector insurance. Possibly a good compromise. Unfortunately, for me, it looks like he wants to force everyone to have insurance. I rather not, and hopefully, this part of his plan is derailed. I think that anyone who wants insurance, should be able to get it, as long as people such as myself, don't have to participate if we don't want to. I'll have to write to my senators on this one.

Rich
0 Replies
 
Aedes
 
  1  
Reply Thu 11 Jun, 2009 08:35 am
@avatar6v7,
avatar6v7;68224 wrote:
I agree the medicare system is very poor, but thats because it runs alongside such a vast and integral private sector.
I didn't say it's very poor. It's actually not that bad. And the private insurances often do whatever Medicare does, because Medicare has such strong negotiating power.

avatar6v7;68224 wrote:
In the UK we spend half the percentage of our GDP on public healthcare than the US does.
The UK has its own problems, one of which being among the lowest pediatric vaccine coverage and highest rates of vaccine-preventable disease in the entire developed world. Why is that?
Theaetetus
 
  1  
Reply Thu 11 Jun, 2009 08:38 am
@Theaetetus,
I have a feeling that the government option will be much like the one that is being expanded in the next month here in Wisconsin. We have had a program for families with children and the elderly for years now, and now they are expanding it to adults without children. There are co-pays, but it appears they will never go above $300 per year. That eases my current concerns, because I should now have some form of health insurance next month.

I think that the best option at the moment is to have both the public and private sector competing. If the private sector cannot compete with the public plan in time, let insurance companies dissolve. Regardless, there needs to be major health care reform, and the best idea may be trying different ideas to better plan for the future.
0 Replies
 
 

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