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Steyr AUG wrote:

Time to find an employer with a better health plan?

Yeah, man! Easy peasy!

yep,

i have lost about 5grand to a former "pre-existing" condition.  the freemarket makes everything better!

that would be sarcasm.

Steyr's hooked up with some kind of gov. health care deal so he can be smug.

i'd put pressure on your employer. if they were honestly shocked, they should work to resolve the situation. if HR, or whoever is in charge of the plan there, makes the call to the HMO they'll get a better story than you will. they're the true customers of the HMO, and they can do something about it.

The New Guy wrote:

Farmerkev wrote:

I feel for you FM. You might want to talk to your doc or the pharmaceutical company that makes that drug. They might be able to help you out with free or reduced cost.

And what about other people in his boat? The pharm company can't give everyone a discount, because they have to make a profit. And god forbid they lose revenue...

Health care is a problem that requires compromises from both sides to effectively solve.

Maybe my tin foil hat is on too tight, but... If you think about it, health care companies don't have an interest in people being healthy. If nobody was sick, they wouldn't be getting any money. From an economic standpoint, sick people are good for the health care companies.

And it makes me sick that people become billionaires by having people pay for lifesaving drugs. I understand that R&D costs money, but to turn around and demand that your CEO gets paid millions of dollars and therefore you extort sick people is wrong.

And another thing: What about very rare diseases, like progeria. Why are we devoting R&D to things like Viagra (if you can't get it up, I'd take that as a sign that you shouldn't be having sex) when people are dying. My brother-in-law has muscular dystrophy, and every damn Viagra and Cialis ad says (to me anyway) "Some old fart getting it up is more important than developing a drug to cure or treat MD and save this kid."

Durg companies can't profit off of curing things like MD, because as soon as it's cured, the market is diminished. And god help you if you have something even more rare. But convincing people they have a disease with advertisements and selling overpriced drugs is profitable, and so that's where the pharmaceutical companies invest their money. Because, after all, a business exists to maximize profits.

This isn't really related to non-covered drugs, but health care here in general.  My girlfriend had gotten strep throat and the sore throat hadn't gone away totally about 3 weeks later, so she thought she ought to go in and get it checked to make sure it wasn't something more serious.  Twice she tried to call and make a doctor's appointment.  The first time after waiting on hold for over an hour she hung up, and the second time she actually got through after 40 minutes (the nurse she talked to said that friday afternoons are pretty slow, which aparently explains the short wait).  After going through a screening process to make sure she actually had something worthy of seeing a doctor about, she was told to go to an urgent care center.  The nurse said that it would probably be best just to go to the urgent care center regardless because it's easier to get in there.

I haven't had to really utilize a doctor much since college (about 5 years ago) and at that time I sorta had carte blanche access to our team docotor (i.e. walk right into his personal office and he'd take care of me next) so I don't know if what my girlfriend experienced is normal these days, but it certainly seems messed up to me.  The fact that you can't call your doctor and set up an appointment in the next couple of days, let alone even get ahold of him in many cases seems like a pretty messed up system.  And it's not like she has some smurfy health care, she works for one of the largest law firms here in PDX, which has aparently been ranked among the best places to work in Oregon many times.

I personally think that the normal market forces that streamline other industries do not work the same way in the health care industry.  For whatever reason they aren't making the product cheaper and better for the consumer.

menglish wrote:

Twice she tried to call and make a doctor's appointment.  The first time after waiting on hold for over an hour she hung up, and the second time she actually got through after 40 minutes.

The fact that you can't call your doctor and set up an appointment in the next couple of days, let alone even get ahold of him in many cases seems like a pretty messed up system. 

I personally think that the normal market forces that streamline other industries do not work the same way in the health care industry.  For whatever reason they aren't making the product cheaper and better for the consumer.

Hum, so, your "girlfriend" needs to find a new doctor.  I also live in the Portland area, and have never encountered that type of delay in my handful of doctor communications.

You can't take one example at one provider and assume the whole system works (or, doesn't work) in that way.

As for the last point, the health care system does indeed seem to be different, but a lot of that has to do with the high costs in the system.  Socializing the medical industry might help, but maybe there isn't a silver bullet in this case.  Its kinda like complaining that good lawyers are too expensive....all the school and training required, and the high demand....the cost will be high to the consumer.  Or something.

The New Guy wrote:

Here's another thing to ponder: Say a company has $10 million to spend on new drug research. There are only 84,427 people in the US with muscular dystrophy (assuming 1/3500 has MD and there are 295,494,806 in the US), so to recoup the development costs they would have to charge $118 per cure. I can't find how many people have impotence, but seven million viagra prescriptions have been written since it was introduced in 1998. So to recoup the cost of developing an impotence drug, they only have to charge a $1.42 per treatment. And since more people have impotence, and since it's not nearly as risky from a legal perspective, which one do you think they'd rather invest in? The one that's more likely to see higher returns; the impotence drug.

I'd much rather see illness be a drain on the economy than an economic stimulant, which is why I support socializing health care.

I have a hard time criticizing the capitalist motivations of drug companies (at least on this issue.  The refusal to allow generic drug production in africa is another story).  I think the major problem with drug manufacturers is the direct to consumer advertising, which does work to drive up costs.  Virtually everyone who got a prescription for one of the cox 2 inhibitors (vioxx, etc) should have been taking advil instead.  There was no additional pain reduction benefit from the fancy drugs over the over the counter drugs.  But because people saw the ads and bugged their doctors, they got the fancy drug.

obtuse wrote:

I have a hard time criticizing the capitalist motivations of drug companies (at least on this issue.  The refusal to allow generic drug production in africa is another story).  I think the major problem with drug manufacturers is the direct to consumer advertising, which does work to drive up costs.  Virtually everyone who got a prescription for one of the cox 2 inhibitors (vioxx, etc) should have been taking advil instead.  There was no additional pain reduction benefit from the fancy drugs over the over the counter drugs.  But because people saw the ads and bugged their doctors, they got the fancy drug.

But you would agree that the capitalist motivations of drug companies do not serve to promote research into medications that help small segments of the population.

Until you've tried to console a ten-year old who was crying because he didn't want to die, or until you've seen a wonderful, smart, happy kid go from walking to standing to being in a wheelchair full time in under three months and the health insurance company standing by denying funding for a power wheelchair, you can't begin to understand my outrage. That someone, somewhere is profiting from the pain and suffering of my 12-year-old brother-in-law is sickening.

obtuse wrote:

The alternative is no one helping him cuz there's no way to make a living at it.

There's a difference between paying a doctor $50K/year to be a doctor and paying an HMO or Pharma executive millions of dollars a year to not do anything but maximize profits.

obtuse wrote:

Steyr AUG wrote:

The New Guy wrote:

And what about other people in his boat? The pharm company can't give everyone a discount, because they have to make a profit. And god forbid they lose revenue...

Because without revenue they wouldn't be in business, then where would people get their meds.

Given the profit margin that most pharma (and other health care products) companies make, a discount wouldn't affect greatly their ability to turn a profit.

Pharma companies have to return a much higher margin.  If they did not, investors would not have an incentive to take on the additional risks of being involved in the industry (low barriers to entry for generics, extremely long product pipelines, heavy corporate governance, etc).