One example why health care is so f**k*d *p!

[MarkShot]

You can tell I am upset here.

My wife, after a endoscopy biopsy, is diagnosed with gastritis (inflammation of the stomach lining) due to a common bacteria.

The doctor prescribes a drug Pylera for this.  This drug costs $500 USD for a 10 day supply.  We pay around $250 as a result of our drug plan.

I get home to read the notes on this stuff.  This drug is made of three other drugs:

(1)  Metronidazole - a generic antibiotic.

(2)  Tetracycline - a generic antibiotic.

(3)  Bismuth subcitrate potassium - pretty much over the counter Pepto-Bismol

So, the reality is that my wife could have been treated for this condition with the identical drugs for probably $20 instead of $500.

Finally, who is guilty here for this travesty?

(1)  The Pharmaceutical company which bundles 3 drugs together so that they get a 14 year exclusive patent on a brand name drug which they push to doctors/patients with their army of reps and advertising.

(2)  The GI Specialist who as a doctor feels it is not his job to know the cost of anything.  This is between patients, his billing department, insurers, etc ...  (We'll assume that he is honest and receives no perks and doesn't own stock in pharmaceutical company.)

(3)  The pharmacy/pharmacist who failed to alert me to the fact that this could have been handled with a script for two generic antibiotics and an OTC medication.  I did explicitly ask if there weren't any less expensive alternatives and was told that there weren't.  I asked, because I had already looked up the gastritis on the Internet, and it seemed treatment is no big deal.

It's all so pathetic.

[junk2drive]

Let us know how they do it in China so we'll know what to expect when they take over.

We have no insurance and the wife has a chronic condition that we pay for every month. Trying to survive until Medicare kicks in and hope for the best.

[MarkShot]

I don't know what the Supreme Court will decide. But I believe if you are uninsured for 6 months than you can get much cheaper insurance through the Federal government. I never really tried that, since you also have risk bankruptcy.

National health insurance in Taiwan costs less than $100 USD/month for two and includes dental as well. Care is suppose to be pretty good as well.

[MarkShot]

BTW, Taiwan is not the PRC. In the PRC, you are pretty much on your own when it comes to health care and costs.

[Staggerwing]

BTW, Taiwan is not the PRC.

...and hopefully never will be!

My eldest son is profoundly disabled and has a gastrostomy. He is fed through a device which is inserted through his abdominal wall into his stomach. This device is basically a piece of plastic smaller than your thumb but costs over $250 and has to be replaced once a month. The device also requires an extension tube that costs about $50 and is only usable for a few days so we need at least 5-10 of them a month. My private insurance has refused to pay for this because it is a 'pre existing condition' based on his premature birth. Luckily (if you want to look at it that way...  :(), since he is also profoundly mentally disabled (and it was NOT EASY establishing this >:() he qualifies for Medicaid and they will pay for the items. I have no idea how people who currently fall through the cracks between private and public healthcare get by. I sincerely feel for them though, I do.

As an aside, because of my son's medical costs due to his premature birth my old employer almost had his entire company's health plan cancelled. My political views tend to be all over the place but, when it comes to health care, I look upon out badly regulated For Profit System as a form of Rape. As an Irish pop star sang a while back- "The Rich stay healthy, the Poor stay sick."

:o :( >:(

[junk2drive]

I work in home medical supplies and equipment. I know what you mean.

I've been a non union righty my whole life but the older I get, the farther left I lean.

When I read of all the money the USA gives to other countries and think of all the cuts in Medicare and Medicaid, it makes me crazy. I don't have insurance for that either...

[MarkShot]

I am one who often falls through the cracks due to a congenital defect and an artificial heart valve.

Although not the only factor, this is a major factor why I am leaving the land of my birth.

My wife says that universal healthcare is a basic human right in a developed country. She doesn't understand how the USA can blather on about human rights and not offer this to its citizens. Or why it is okay that we have no children, but pay taxes to educate children while at the same time no one wants to pay to cover someone else's health misfortune.

Oh, I should mention under Taiwanese national healthcare I will be covered wherever I go in the World provided that I reside in Taiwan at least 6 months of the year.

Right now, I cannot even cross New Jersey's borders and see a doctor!

[OJsDad]

You guys should try being on the inside of the healthcare industry and see that waste that is hosted on us by the government.  My company now spends millions a year to report on if we buy a cup of coffee to any kind of healthcare provider, whether it is a doctor, tech, or someone in administration. 

The IT systems that I work on are classified as a medical device by the FDA.  Once an item is considered a medical device, the costs go up exponetionally.

[Mr. Bigglesworth]

You can tell I am upset here.

My wife, after a endoscopy biopsy, is diagnosed with gastritis (inflammation of the stomach lining) due to a common bacteria.

The doctor prescribes a drug Pylera for this.  This drug costs $500 USD for a 10 day supply.  We pay around $250 as a result of our drug plan.

I get home to read the notes on this stuff.  This drug is made of three other drugs:

(1)  Metronidazole - a generic antibiotic.

(2)  Tetracycline - a generic antibiotic.

(3)  Bismuth subcitrate potassium - pretty much over the counter Pepto-Bismol

So, the reality is that my wife could have been treated for this condition with the identical drugs for probably $20 instead of $500.

Finally, who is guilty here for this travesty?

(1)  The Pharmaceutical company which bundles 3 drugs together so that they get a 14 year exclusive patent on a brand name drug which they push to doctors/patients with their army of reps and advertising.

(2)  The GI Specialist who as a doctor feels it is not his job to know the cost of anything.  This is between patients, his billing department, insurers, etc ...  (We'll assume that he is honest and receives no perks and doesn't own stock in pharmaceutical company.)

(3)  The pharmacy/pharmacist who failed to alert me to the fact that this could have been handled with a script for two generic antibiotics and an OTC medication.  I did explicitly ask if there weren't any less expensive alternatives and was told that there weren't.  I asked, because I had already looked up the gastritis on the Internet, and it seemed treatment is no big deal.

It's all so pathetic.

You should point this out to your doctor. He made the prescription, he should know what is in it.

[MarkShot]

I had been a systems consultant at Pfizer World HQ in NYC many years ago for the RX side of the business. I did not work on lab data, but rather decision support systems and compensation review systems for management. Obscene greed and excesses were readily apparent that well demonstrated that such cultures are not solely limited to the derivative trading floors of investment banks on Wall St.

I do believe in capitalism ... Yet, somehow, morality must be introduced into the game. There must be a motivation for capital to concentrate and achieve great works. But the great works must be more than just wealth creation/transfer. They must benefit the society at large as a better a life.

[Bison]

Government law and regulation regarding pharmaceuticals share a huge portion of the blame for medicine costs.  When you can get the same medicine in Mexico or Canada cheaper even when its made in the US explains a lot of the issue.  Several years ago Montana attempted to make it legal to cross the border to purchase prescription drugs, but got a heavy handed slap down from the Federal government.

[MarkShot]

I have talked about such things with a number of doctors. I don't know why but topic of money is somewhat dirty and unprofessional to them.

Surely my wife's doctor knows what is in this Pylera. Now, if we had a different medical plan, then maybe our responsibility would only be $10.

Still someone would be paying for this clever trick by McKesson Pharmaceuticals to gouge the public; either corporate employee benefits and employees, or private consumers. Thus, the bottom line is the doctor prescribes this drug does the society a disservice. After being fairly impressed with his medical expertise, I am now disappointed with him in a larger context. Note: he is a department head at a major hospital. So, it is even worse.

This thread is not the only case I have encountered. Just last week, I think two unnecessary procedures were done on me to pad a bill. But the story I recount in this thread is so blatant and clear that I think my case is valid even though I don't have medical training.

[GDS_Starfury]

I could probably get better health care in prison then as a free man.

[LongBlade]

You guys should try being on the inside of the healthcare industry and see that waste that is hosted on us by the government.  My company now spends millions a year to report on if we buy a cup of coffee to any kind of healthcare provider, whether it is a doctor, tech, or someone in administration. 

The IT systems that I work on are classified as a medical device by the FDA.  Once an item is considered a medical device, the costs go up exponetionally.

+1

My wife switched us to the Obamacare plan a year early in order to get prepared for it.

The result? Not good. I now have to learn how to properly bill medical visits - something that doctor's offices usually hire specialists to do. Oh, and the extended release blood pressure medicine I take? It costs more than the immediate release (which isn't as good for you).

Oh, and I just got the bill for lab results. $600. Why? Because I didn't have the foresight to ask if it could be sent to a different lab. (Who knew?)

Those of you not yet on the new plan may never get to know the joys of how messed up things will be if the law is overturned. But I can tell you now, the changes I'm seeing aren't good.

[Centurion40]

BTW, Taiwan is not the PRC.

...and hopefully never will be!

My eldest son is profoundly disabled and has a gastrostomy. He is fed through a device which is inserted through his abdominal wall into his stomach. This device is basically a piece of plastic smaller than your thumb but costs over $250 and has to be replaced once a month. The device also requires an extension tube that costs about $50 and is only usable for a few days so we need at least 5-10 of them a month. My private insurance has refused to pay for this because it is a 'pre existing condition' based on his premature birth. Luckily (if you want to look at it that way...  :(), since he is also profoundly mentally disabled (and it was NOT EASY establishing this >:() he qualifies for Medicaid and they will pay for the items. I have no idea how people who currently fall through the cracks between private and public healthcare get by. I sincerely feel for them though, I do.

As an aside, because of my son's medical costs due to his premature birth my old employer almost had his entire company's health plan cancelled. My political views tend to be all over the place but, when it comes to health care, I look upon out badly regulated For Profit System as a form of Rape. As an Irish pop star sang a while back- "The Rich stay healthy, the Poor stay sick."

:o :( >:(

You could move to Canada and all of those costs would probably not be passed onto you (honestly I don't know, some treatments/costs are excluded).  However your taxes would higher.

No system is perfect.  Greed and waste are universal constants, no matter what system is being used.