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.
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.
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.
BTW, Taiwan is not the PRC. In the PRC, you are pretty much on your own when it comes to health care and costs.
Quote from: MarkShot on June 14, 2012, 08:42:05 PM
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 :( >:(
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...
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!
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.
Quote from: MarkShot on June 14, 2012, 07:05:45 PM
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.
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.
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.
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.
I could probably get better health care in prison then as a free man.
Quote from: OJsDad on June 14, 2012, 10:20:19 PM
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.
Quote from: Staggerwing on June 14, 2012, 09:19:33 PM
Quote from: MarkShot on June 14, 2012, 08:42:05 PM
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.
Quote from: Centurion40 on June 15, 2012, 08:59:05 AM
No system is perfect. Greed and waste are universal constants, no matter what system is being used.
+1
Which is why I prefer the private marketplace. Competition forces companies to mitigate their greed and incompetence. Having a single payer, especially the government, removes the competition and allows the bad to flourish unchecked.
My only issue with a purely private system is that poor and almost-poor suffer, in that if they cannot afford private insurance or they cannot afford to directly pay for services then they suffer or die where other who can afford treatment get to reduce suffering and extend life.
If I was raised in that all-private medical system, then I'd think nothing of it. But I wasn't and my conscience prevents me from seeing it as an acceptable way to go. Everyone should have access to the same basic level of healthcare, and the only way (AFAIK) is to have a government-run system- with all of its many faults. I see it as civilized.
That being said, I hate a system that is unable to provide timely service to those in need and suffering AND prevents citizens from accessing private medical treatments. Therefore the public system should permit a parallel private system for those who can pay for immediate service. For example, here in Canada (Nova Scotia), if someone is suffering from chest pains and the family doctor suspects a heart condition, the doctor can refer the patient to a Cardiologist. The patient might end-up waiting months to see the Specialist, and then more weeks and months before all of the tests could be completed, and then more weeks/months for a surgery date. Sure it's all good medical service, and sure it's all free to access, but what's the good if you die or have a heart attack while you are waiting the months to get served and treated?
Quote from: Centurion40 on June 15, 2012, 09:23:41 AM
...
That being said, I hate a system that is unable to provide timely service to those in need and suffering AND prevents citizens from accessing private medical treatments. Therefore the public system should permit a parallel private system for those who can pay for immediate service. ...
There are problems with this too. Doctors will probably drift to the "pay for service" side of things as that's where the money will be, leaving a shortage for the "free" services. If the Gov. tries to match pay level to private sector, everyone's taxes go up.... etc.
There are no easy solutions to this in any country but I'd like to think that Canada has the best compromise.....
Quote from: Bison on June 14, 2012, 11:37:43 PM
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.
I think that might have been a request from our gorenment. The concern up here was that US demand would out strip our supply and Canadians wouldn't be able to buy drugs locally...
Quote from: Bison on June 14, 2012, 11:37:43 PM
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.
It isn't all the government's fault, the pharmaceutical companies have the leverage to force higher costs due to near monopolies of their formulas. See MarkShot, the reason why they would not allow you to be treated by those three drugs alone was that the formula for mixing the drugs is proprietary to the pharmaceutical company and thus that is what gets sold. There used to be compounding pharmacies where the local pharmacist would sell you exactly what you talked about - three drugs mixed into one - but that is largely dying due to regulations and being driven out my pharmaceutical companies protecting their mixes. So, Bison is in part right, but these regulations are coming at us at the behest of private corporations.
Be leery of Mexican and Canadian meds. I wouldn't make the blanket statement that they are "cheaper" for the same thing. A large proportion of these are knock-offs.
I had a similar story, Mark. I went to a urgent care clinic because I had a really terrible sinus infection. I don't have any prescription coverage (but I will soon) and the weird doc there prescribed some allergy meds and a simple antibiotic for me. The Allergy meds were something like $150 each for a months supply... but you had to take it constantly for over a month or it would have no result! He told me that the med would go generic and possibly OTC in August. Once the pharmaceutical company no longer has a monopoly on the formula, the cost will drop to something like $20 for a month or less. ::)
Quote from: son_of_montfort on June 15, 2012, 10:54:48 AM
....
Be leery of Mexican and Canadian meds. I wouldn't make the blanket statement that they are "cheaper" for the same thing. A large proportion of these are knock-offs.
....
I know (hope?) you didn't mean that the way it sounds.... cheap "knock off" drugs from Canada not worth the cheap money.....
Just to be clear - Yes, many drugs here are generic brands. Yes they are cheaper. They work just as well and are just as safe as anything that costs 3x as much.
There are some knock offs smuggled across the border from Canada to the US. I'm not talking about what Canadians can get in their pharmacies, but what Americans - who think they are ordering Canadian meds - are actually getting. If you are an American who can drive to a Canadian pharmacy then you are safe. But a lot of people get suckered by ordering online.
As to Canada being a Third World Country... well... I've seen your wild expanses of nothing and heard 40's stories about Newfies... ;)
Quote from: son_of_montfort on June 15, 2012, 11:06:02 AM
There are some knock offs smuggled across the border from Canada to the US. I'm not talking about what Canadians can get in their pharmacies, but what Americans - who think they are ordering Canadian meds - are actually getting. If you are an American who can drive to a Canadian pharmacy then you are safe. But a lot of people get suckered by ordering online.
As to Canada being a Third World Country... well... I've seen your wild expanses of nothing and heard 40's stories about Newfies... ;)
People the world 'round can get shafted by mail order durgs, even Canadians ordering online from the US. ;)
I'll take the wild expanses of nothing over the US concrete jungles any day..... as for the Newfies..... well you got me there. ;D
Quote from: son_of_montfort on June 15, 2012, 11:06:02 AM
There are some knock offs smuggled across the border from Canada to the US. I'm not talking about what Canadians can get in their pharmacies, but what Americans - who think they are ordering Canadian meds - are actually getting. If you are an American who can drive to a Canadian pharmacy then you are safe. But a lot of people get suckered by ordering online.
That is how people end up snacking on aborted Chinese. Never buy meds off the net.
Quote from: Barthheart on June 15, 2012, 11:14:04 AM
I'll take the wild expanses of nothing over the US concrete jungles any day..... as for the Newfies..... well you got me there. ;D
Concrete zoo. A fairly famous anthropologist mathematician made the comment back in the 70s that humans are not designed to be packed into cities. It causes all kinds of problems. The only place where you can see animals held from spreading out to where they are comfortable is the zoo. Cities are human zoos.
One thing I want to clarify. The drug Pylera was made of two antibiotics commonly sold and prescribed independently for various conditions. Reasonable medical documentation on the Internet cites treatment of gastritis by administration of both individual drugs concurrently. And the third is basically an over the counter product that anyone can buy without a doctor's RX.
Part of the reason I start this thread, is that the abuses I cited in the original post were so blatant that one could not convincingly argue that there is any other reasonable perspective. Additionally, I was confident that there is no medical argument that could be made to explain what happened.
So, this is not a question of a pharmacy producing a formulation. It is just writing two scripts for generic antibiotics and buying an over the counter product. $20 USD versus $500 USD ... the complicity of many parties who fleece either the end consumer (via direct payment or higher premium) or corporate benefit premiums.
I really don't think there is any excuse.
This is just about as blatant as the home buyer who got an interest only/no money down/no doc loan, and the bank/lender which pushed it, and the investment house which changed it into a CDOs and traunches, and the insurer which issued swaps to insure the debt with no cash reserves to cover the loss, and the ratings agency that labeled it AAA investment grade. It all stinks!
Well, I wonder why the doc did that? Ease of ingestion? Or perhaps he figured the insurance would take care of it?
Because medicine is compartmentalized. Most noticeably it is compartmentalized by system. So, pity the poor patient who has a problem that cuts across systems.
But this goes beyond biology. Money and the cost of delivering health care is also outside of the box. Other people handle that.
But the insurance paying 25X in excess of what is needed to treat a condition is not free. That's an illusion. The money has to come from somewhere ... like premiums you or your employer must pay.
so what Ive learned from this thread is that Canadians are generic American knock offs that are cheaper to sleep with.
Market value sets the price, except if an up-and-comer is looking to under-cut the competition in order to secure a larger, stable market share.