Tier 4 Health Care! Epic Loot for Epic Prices!
http://www.nytimes.com/2008/04/14/us/14drug.html
No one knows how many patients are affected, but hundreds of drugs are priced this new way. They are used to treat diseases that may be fairly common, including multiple sclerosis, rheumatoid arthritis, hemophilia, hepatitis C and some cancers. There are no cheaper equivalents for these drugs, so patients are forced to pay the price or do without.
Let me put a personal face to the article. I'm one of those people. Since starting on Humira a few years ago, I've been able to live without my old regimen of taking high doses of pain medication every day at the cost of my stomach's health and elevated risk of cardiac failure. Pain meds also do nothing to halt the progressive nature of my disease, instead purely treating the pain symptoms and ignoring the ongoing damage to my body. Humira stops my body's immune system from attacking my body by inhibiting the production of a specific range of proteins (antibodies).
It's not an exaggeration to say that, for me, Humira is essentially a miracle drug.
My medication would cost me ~$1600 per month without health insurance. It's caused me to stay at my job just to keep my health coverage rather than take a more flexible job (without insurance) that would allow me to more effectively pursue my studies.
Right now 10% (according to the article) of health insurance providers have migrated to the Tier 4 pricing plan. Eventually they'll all spread to that, as it's more profitable for them. When that happens, all I can do is thank God that I don't have a terminal illness -- just one that will eventually all but cripple me and leave me dependent upon public assistance when I can no longer work.
Hell, just toss me in the f*cking Soylent Green vat now and be done with pretenses.
All you currently healthy people who don't see a problem here, good luck. I hope you have the fortune to stay that way until our "health care" system is overhauled so that you're not punished even further for having the misfortune of being sick.
I mean that. I wouldn't wish my forseeable future on anyone else, and I'm not even as bad off as those with potentially terminal illnesses.



This is just pathetic. I feel for you, Far, and everyone else who's well being is nothing more than a profit margin to these assholes. It feels like we've gone back in time 2000 years, when people thought the sick were sick because they were sinners and the prosperous were the blessed. What the hell is the point of health insurance when they won't cover the cost of essential medications? Yeah, it might not be the most profitable thing for them to do, but that's their goddamn JOB. If they didn't like the figures they should've tried car insurance.
It's especially nice for this to catch on as we move into a recession. I guess those insurance companies have to pay their mortgages too.
NOTE: This is not a doodle bug.
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I have a son who was born premature, and also has Myotonic Dystrophy. He was in the NICU for nearly 5 months before he could come home. The bill for his first 30 days in the hospital came to nearly $250,000. I hate insurance companies with a passion. I hope the policy makers for these companies burn in a special place in hell.
I apologize, I can't even think about what these companies are allowed to do to people without seeing red.
XBox Live: OldMud
Move to Canada.
Elysium wrote:
Danjo wrote:
Or just smuggle drugs from Canada.
I remember the debate in Congress regarding the pill company scaremongering of "unsafety of Canadian pharmacies". Probably the most priceless soundbite from that whole exchange was Minnesota Governor Jim Pawlenty's "Show me the dead Canadians. Where are the dead Canadians?".
There is only an up or down--up to a man's age-old dream, the ultimate in individual freedom consistent with law and order--or down to the ant heap totalitarianism,... those who would trade our freedom for security have embarked on this downward course.
I submitted this link to Fark and they put it on the main page. Here's one particularly good post from the discussion on it (note that he is responding to someone who claimed that he'd spend $300,000 on treatment recently and that people who are nailed by this should quit complaining or change their insurance plan, and snarkily said that there's "no free lunch"):
NOTE: This is not a doodle bug.
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Tim Pawlenty. I like him. I got to listen him speak when he visited Iraq after my brigade was extended. He seems like a pretty smart guy.
And remember, the Japanese aren't commercially whaling. They're conducting "research". Like "researching how delicious this whale is". - Paleocon
I thought so too until he went all green on me.
I don't exactly blame him for the recent gas tax hike, but we're in a really crappy time for new hemorrhages of tax dollars, and he's been pushing some of them himself.
"Also, I have four legs and am covered in wool. Baa!" *Legion* reveals his inner furry.
That was the last straw for me and Clintons attempt at health care reform. There were parts of it that would make people inelgilble for treatment here if it was found out they had work done outside of the US.
Gamer Tag: Rantyr
Those drugs are only cheap in other countries because American's pay so much for it. If we stop paying for, they will either pay more, or the drug will never exist. If we start importing those drugs at reduced prices, the prices will go up.
While I am empathetic to your condition Scry, there is no such thing as "Universal Health Care". There is only so much money, so many doctors, so many chemists, etc. They have to be rationed. You could pay for a lot of medication by refusing to put an 80 year old grandmother in the ICU for months (thus sentencing her to die). I am very glad that I don't have to make decisions like that.
Someone in my life will likely die soon from arthritis (eating her liver). The personal face of disease tears at the fabric of emotional stability. I can only imagine the folks who have to pass these death sentences avoid human contact as much as possible, or go insane.
You're right that we pay far more than any other country for drugs. This isn't something that you should be OK with because it means that we're basically getting bent over (and we don't even a courtesy reach-around).
Please don't bring up the "if we don't charge an arm and a leg for drugs we won't be able to afford any more research" argument. Pharmaceutical companies spend twice as much on sales and marketing as they do on research and development.
And what do they market? Certainly not live saving drugs, because doctors already know about those. They spend the money promoting wang pills, cures for nervous legs, and numerous other Madison Avenue named "syndromes" (all with easy-to-remember three-lettered acronyms for you to ask your doctor about).
And let's not forget the 20%+ in profits Big Pharma makes each year (double the profit margin of the much hated oil companies).
This is pretty much what it boils down to: because we treat health care as a profit center, the market has judged that the well-being of millions of people (including your grandmother) is much less important than even a single extra percentage of profits that will benefit only a small handful of investors.
Agreed. The pharma companies seem to want it both ways. They want deregulation on their industry and restrictions on where folks can buy their goods. They are only pro Free Market where it suits them.
If we are going to rely on the market mechanism to determine the effectiveness of drugs and the needs for them (as pharma seems to be indicating by their insistance on heavy advertising and superfluous wang pills), shouldn't it follow that the market should be allowed to operate on the consumer level as well?
If the products they are pumping out are so inefficient as to rely on a captive audience that is forced, artificially, to pay a premium, one or both of two assumptions is clearly wrong: 1) the market is a utile mechanism for determining logical public health policy or 2) the products that pharma are putting out are appropriate for a market in which consumers have real choice.
I, personally, think the answer is all of the above.
There is only an up or down--up to a man's age-old dream, the ultimate in individual freedom consistent with law and order--or down to the ant heap totalitarianism,... those who would trade our freedom for security have embarked on this downward course.
Let's also remember that it's much more profitable to treat a disease than cure it. That's why so much money goes toward AIDS retrovirals and so little toward a vaccine.
NOTE: This is not a doodle bug.
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It's also more profitable to do charity events for awareness, than it is to actually try to find a cure for
On the other hand if you do invent a cure for and you are the only company that has it, and have exclusive rights to it for 5 years, its a freaking goldmine. As long as you are the only company that has it.
"Also, I have four legs and am covered in wool. Baa!" *Legion* reveals his inner furry.
I completely agree. The Medicare Prescription Act was a perfect example of that. Wal-Mart negotiating with its suppliers to get the lowest cost is pure American capitalism at its best, but the federal government doing the same for drugs is considered as dirty socialism.
They get the rights for 20 years and they've gotten pretty good at figuring out weasely ways to artifically extend that protection well past that limit by slightly altering the formula, changing the packaging, combining it with other drugs, or a number of other legal loopholes.
They advertise penis pills because they make monstrous profits off of them. Are you really going to criticize them for selling something that the public obviously wants? People also need food to survive. I'll bet they spend a lot more on advertising than on food research as well. Those bastards. Hamstringing companies that have the nerve to turn large profits by selling large amounts of high demand products is an adventure in socialism. Check Britain's NHS or Venezuela in general for how that turns out.
Government involvement (Medicare, etc.) and wanton consumerism (medical insurance) took the "market" out of health care a long time ago. What other insurance do lots of people actively use repeatedly? If people used their car or homeowners insurance like they use medical, they'd be living without in short order, or paying through the nose. Thanks to intervention, that doesn't happen in medical.
Who is forcing anyone to buy anything? Define "logical public health policy", because every time I see that being used, it looks a whole lot like, "People who need health care should be guaranteed to get it inexpensively and immediately, no matter what the cost." You seem to be arguing that just because a company made a drug, everyone who wants it should be able to afford it, and screw the company if they actually want to make money.
It could also be related to:
1) Adults who have the money and are interested are far more likely to be seeking a cure for what they already have than prevention.
2) There are plenty of other ways not to get AIDS, all of which are cheaper than developing, manufacturing, and distributing a vaccine. You can't catch AIDS just by being in a room with someone who has it, unlike smallpox, influenza, etc.
The government doing that is why us non-Medicare folks pay through the nose for every prescription we get. Low Medicare reimbursement drives doctors and hospitals out of business, further raising costs. Government spending is not "the market", it is the government taking my (and your) money and spending it where they think it ought to go.
And why are we blaming retarded drug patent laws on the drug companies again? Did they enact the law?
Bought and paid for.
A little out of date, this uses 2005 numbers, but I'm sure the trend hasn't reversed yet.
EDIT: The more Updated Version was just a couple clicks away. Time to update my bookmarks!
Politely rude. Briskly vague. Firmly uninformative.
So the answer to government prostitution is more influence for the government to whore out? Government inadequacy and corruption is not a good argument to bring to a "the government ought to do something" discussion.
LilCodger,
I'm going to disagree with you because the need for drug patents is very much a factor of government, but I disagree with you on why it is. You have public health issues in there too, if the drug companies could not have to report what is in their medicine there would still be an incentive to make the drug, but look at aspirin. It isn't exactly a money maker compared to Viagra, simply because pretty much anyone can make it.
let's take a hypothetical case where you invest billions of dollars into researching something, and it turns out that you can make each pill for $.50 in materials that are relatively common, just not used together before. This pill needs to be taken daily, and it is completely effective when taken daily. How much should you charge for this pill? How long do you think it will be before someone takes your pills and figures out what is in them? then what do you do?
Don't get me wrong drug companies are greedy, they are businesses- the whole point of their existance is to make money (which by the way goes out to all the shareholders, much like oil companies do) and as much of it as possible.
"Also, I have four legs and am covered in wool. Baa!" *Legion* reveals his inner furry.
If I'm reading you correctly, you think I am arguing against patents. I am not. I am against long patents, much in the way I am against indefinite copyright. I was simply trying to contradict that medicine patent issues were primarily a drug company creation.
Folks already work around patents. The PPI market highlights that well. Prevacid, Prilosec, and Nexium are really frickin' close to the same thing.
I am also amazed at how so many people will point to governmental issues in medicine as "failures in the market", and then continue on with "government run medicine for everyone is the only answer!!!"
Fedaykin98 wrote:
Healthcare should be seen as a matter of public safety. Why do we treat lifesaving services differently just because we call them 'police' or 'fire'? Or are fire departments and police departments just more evil socialist ideas?
I never minded piracy. Anyone who minds about piracy is full of sh*t. Anyone who pirates your game wasn't going to buy it anyway! -Warren Spector
Because there is essentially unbounded demand for healthcare. Regardless what a person's beliefs on universal healthcare are, at some point lines must be drawn - we cannot afford to provide for all medical procedures.
Xbox Live: StaatsM
Why can't we do the same for healthcare? If I fall down and break my arm, why can't I just call a government ambulance and get it fixed? It's not that we don't have the money - we give farmers billions to grow crops no one will eat, oil companies millions in subsidies that they don't need, police billions fight the drug war and the military billions to bomb people halfway across the planet.
Why can't we provide at least basic healthcare as well?
I never minded piracy. Anyone who minds about piracy is full of sh*t. Anyone who pirates your game wasn't going to buy it anyway! -Warren Spector
I think we're on the same page here. Check out what you originally quoted:
This a valid concern, particularly in a country where citizens seem to think they should enjoy a high level of services and a low level of taxes. This is a huge financial and logistical concern. How do we pay for it? What level of service do we provide? Preventative care? Full board quadruple bypass, cutting edge life-extending care?
Beyond that, we want a system that both encourages and rewards the advancement of medicine without bending the taxpayer over to do it. What is that system?
We can provide anything we want really, but lines must be drawn unless we plan to continue to rack up debt. I, personally, am not willing to entertain the idea unless it's agreed we'll pay for it up front (rather than by borrowing the money).
Xbox Live: StaatsM
I think you may want to take a long look at how many police forces work, they aren't there to stop crime (that's just a happy side effect for the populace), but to deal with them after the fact.
Also the populace most certainly does not feel that way about law enforcement, if you put a cop on every corner 24/7 people (and not criminals) will complain about it.
Also you argue against the point you appeared to be trying to make when you said you don't pay for a guard to sit otuside your door all the time, why not? Don't you feel your home and family are worth being protected? I'd almost love to have the free cash to pay the local police to have a marked squad sit outside your house for a month, just to see if you still felt that way. I doubt you'd still feel that way after the first week or so.
But back to health care, why should people who don't get the same service all have to pay equally(I sincerily doubt the government is going to bother with "risk groups")? It's a stastical fact that those living in more rural areas get inferior health care compared to their city dwelling brethren simply because they have less access to a hospital (you are much more likely to get a transplant if you live in the city for example).
"Also, I have four legs and am covered in wool. Baa!" *Legion* reveals his inner furry.
My mom has MS and though i forget the number offhand, her monthly medication is over a thousand. My brother's cancer drug to suppress nausea during chemo costs in the thousands just for a 30 day supply. I dont remember how much of it is covered.
Reading this article, just reminds me how the whole insurance/pharmaceutical industry seem on cusp of extortion. They are in a unique position to ask their customers to put a price on their life / quality of life.
Insurance may have started with that concept of spreading the cost for the benefit of all, but like everything else these days, its more about profiting and stockholder ROI.
Damn, what a pessimistic start for the day. I'm glad I read the article though.
Xbox Live: Irongut | Playstation ID: Irongut_GWJ
That's a bit of a straw man. The vast majority of industrialized countries don't seem to have a problem have logical public policy debates on the limits of public health infrastructure. Yes, they often involve painful comprimises, but almost without exemption, they manage to provide better public health infrastructure at a fraction of the cost the average American spends.
So it might mean that they have fewer penis pills and that elective procedures like botox might cost a bit more. Who really cares?
There is only an up or down--up to a man's age-old dream, the ultimate in individual freedom consistent with law and order--or down to the ant heap totalitarianism,... those who would trade our freedom for security have embarked on this downward course.
Not my argument, but it sounds like you are throwing the baby out with the bathwater. Your question was
But back to the insurance issue: An insurance policy is a gamble. The issuer gambles that the client will pay more than they use, and the client gambles that what procedures they might need are covered by their plan. Ideally this setup should be as close to a zero-sum equation as possible, the client never paying more than the combined output of the combined needs of that issuers pool of clients. Instead Issuers are charging inflated costs and posting profits. Casinos without the flashing lights and free cocktails... and when someone loses they might die. Yay! Now we find that the dealers are changing the rules in their favor to continue posting profits despite rising costs which their contracts with their clients SHOULD obligate them to cover using the previously agreed upon client contribution scale. This is like a casino running the numbers and figuring out that they pay out too much on the black-jack table and deciding to no longer pay out on anything over a Full-House. It only affects the big-winners, so the majority of people will never notice... but if you happen to score a big hand I'm sure you'll be pissed because the deal was "I win, you pay."
Rezzy, equating serious illness with winning big at the casinos since 2008!
EDIT DISCLAIMER: I pulled 25% out of my ass. In an industry where they get to make up their own numbers about cost, production, development, that number could be ANYTHING! And they'll be able to show you the ledgers to prove 10%, 2%, 50%... whichever is more advantageous at the time.
Politely rude. Briskly vague. Firmly uninformative.
I think my take on it is more likely.
1) We're still not talking about a cure, we're talking about treatment. The extraordinarily expensive "cocktails" you hear about which slow or stop the progress of the disease or maybe even reverse some of the damage still cannot cure it.
2) There are more than 60,000 new cases of HIV in the US annually. In South Africa, more than 21% of the population is infected. I really don't think anyone is so satisfied with prevention that they feel a vaccine or cure is unnecessary, particularly when our own government only funds abstinence-only programs.
NOTE: This is not a doodle bug.
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