Controlling Health Care Costs

[billvon 3,073]

>"Mhhh.... well, my shits could be a little more regular. Maybe I DO
>need Zelnorm."

>"I had trouble getting to sleep last night. Hey....what's this Ambien
>stuff? Might as well try it!"

Why would that be bad? I started using ambien for business trips about three years ago. Wish I had found it sooner.

Or - 'Gee, I'm old and my father had a heart attack. Maybe I should use Zocor.' Goes to doctor for statin drug. Doctor sez 'hey, your LDL is 240; we're going to try a diet and exercise first before we start you on a statin.' Guy does so; his LDL drops to 170. Good outcome from a drug commercial - even if he ends up not using Zocor.

I can see drug commercials having effects both ways.

>And yes, I would opt for government research and development of
> new drugs. As far as costs to taxpayers, overall it would be much
> cheaper.

Taxes would go up, so your average taxpayer would see an increase. High-risk people who use a lot of drugs would see their costs go down.

>Health care costs would be lower becuase you are removing the
> marketing/business aspect and focusing on the science.

If you think that a new tax would go 100% towards science - I don't think you've observed many bureaucracies in action! You'd need a director of research, twenty-seven assistant directors, two secretaries for each of them, a travel/entertaining budget for them, a building, health care for them - _then_ you could start hiring scientists. Generally, on a dollar for dollar basis, companies are more cost-effective than the government when it comes to achieving specific research goals.

[Skyrad 0]

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How can we control health care costs that are spiraling out of control?

What do you think of these ideas?

1. Make malpractice a criminal issue, and eliminate any possibility of monetary payouts. At the same time, increase enforcement of medical review boards and stop bad doctors from practicing. This would remove malpractice insurance from the entire industry and reduce costs across the board.

2. Stop the US consumer financing of drug company research through higher drug prices for US customers.

3. Severely limit drug company marketing of drugs, and limit their spending in offices, and on doctors trips and speaking engagements. No more free lunches for every doctors office every day of the year.

4. Shorten the time of exclusivity on new drugs so that cheaper generics are available more quickly.

5. Allow people on the Medicaid 'cusp' to pay for a portion of their bills. Many people quit their jobs just so they will qualify for needed medical care. It's better they work and pay a portion than quit and get it all for free.

Just a few thoughts.....

Being old, I recently had the DRE "finger" test and the PSA blood test done. My GP thought there was a "nodule" and referred me to a urologist. He did his own DRE and said there wasn't a nodule, my PSA was low, I don't have anything wrong, but COME BACK ON FRIDAY FOR AN ULTRASOUND AND NEEDLE BIOPSY".

THAT is a symptom of why health care costs are out of control.

Don't worry it just feels like you're being kicked in the bum, at least thats what the patients used to say.

When an author is too meticulous about his style, you may presume that his mind is frivolous and his content flimsy.
Lucius Annaeus Seneca

[Zipp0 1]

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If you think that a new tax would go 100% towards science - I don't think you've observed many bureaucracies in action! You'd need a director of research, twenty-seven assistant directors, two secretaries for each of them, a travel/entertaining budget for them, a building, health care for them - _then_ you could start hiring scientists. Generally, on a dollar for dollar basis, companies are more cost-effective than the government when it comes to achieving specific research goals.

In my next post I'll outline how we can put an end to this bullshit as well. All we need is a big building, some beakers, a bunsen burner, and about 500 nerdy scientists.

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Chuck Norris doesn't do push-ups, he pushes the Earth down.

[lawrocket 3]

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How can we control health care costs that are spiraling out of control?

What do you think of these ideas?

1. Make malpractice a criminal issue, and eliminate any possibility of monetary payouts. At the same time, increase enforcement of medical review boards and stop bad doctors from practicing. This would remove malpractice insurance from the entire industry and reduce costs across the board.

Bad idea. If a doctor has messed up, and left a person damaged, putting the doctor in jail does nothing to help the victim.

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2. Stop the US consumer financing of drug company research through higher drug prices for US customers.

Bad idea. Who would finance the research? The government? In that case, the cost is the same and Americans would bear it.

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3. Severely limit drug company marketing of drugs, and limit their spending in offices, and on doctors trips and speaking engagements. No more free lunches for every doctors office every day of the year.

I have issues with any limitation on free speech. Let them maket the product as they wish.

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4. Shorten the time of exclusivity on new drugs so that cheaper generics are available more quickly.

Bad idea. Why should other companies benefit from the R&D dollars spent by one company? If you've got a new patented product that you've put time and money into, why the hell should others tag along for a free ride?

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5. Allow people on the Medicaid 'cusp' to pay for a portion of their bills. Many people quit their jobs just so they will qualify for needed medical care. It's better they work and pay a portion than quit and get it all for free.

Why not just get rid of Medicaid? Medicaid does go after people to collect. Say you own a house and you get treatment from Medicaid. Medicaid conveniently places a lien on your home.

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Just a few thoughts.....

Look - there are but two ways to decrease the costs of health care. The first is to ration it, which means that it is not available to anyone on demand. I don't think anybody would look at that as a great option.

The second way is to lessen the quality of health care. I don't think anybody would find that to be a great option.

There is three main things that people want in healthcare: 1) Afforability; 2) Quality; and 3) Availability.

You can have any two, but not three. You can have quality healthcare that is affordable, which will be rationed. You can have quality healthcare that is available to all, which will be expensive. You can have affordable healthcare that that is available to all, which will have low quality.

You just can't have all three. The tension is irreconcilable. However, processes can make the system more efficient. Over 25% of healthcare costs are billing, administration. If it went back to a cash-based system instead of billing codes, etc., a lot of people will be out of work and healthcare costs will drop dramatically.

My wife is hotter than your wife.

[peregrinerose 0]

Patients don't seem to understand that their health is in their control more than their doctors... I was at first adamantly against the drug commercials, until I realized that they were encouraging patients to ask questions and taking control over their own health care instead of just blindly doing whatever the doc says.

Do or do not, there is no try -Yoda

[billvon 3,073]

>Look - there are but two ways to decrease the costs of health care. The first is to ration it . . .

>The second way is to lessen the quality of health care.

Those aren't the only two options. There are a lot of countries out there that have better health care (as measured by average lifespan and infant mortality rates) and who spend less per patient than we do. There's something to be learned there, if we don't mind swallowing our pride and learning from someone else.

[Zipp0 1]

No lawyers in my thread.

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Chuck Norris doesn't do push-ups, he pushes the Earth down.

[rehmwa 2]

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All we need is a big building, some beakers, a bunsen burner, and about 500 nerdy scientists.

that's your answer to everything

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Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[wmw999 2,544]

Overall more attention to preventive measures, including healthy lifestyle, would go a long way towards reducing the need for some of the healthcare that's currently needed.

We Americans don't like people to tell us to quit smoking, eat healthy, and exercise. It's our fuckin' right to eat whatever we want to, and smoke, and watch TV and drive whatever we want to -- it's hot/cold out, dammit, and we're Americans with the freedom to do it.

But in the long run it does add to the healthcare bills. We have illnesses that barely used to exist due to lifestyle. Of course, increasing longevity also means stuff goes wrong that never had the opportunity to before, but that's a different issue in some ways.

Our health costs are our responsibility in the large sense. Individually we can't control our heredity, but if more people are healthy, fewer kids will be overweight, fewer people will need the cholesterol and diabetes drugs, and overall healthcare costs go down. Not for everyone, but for society as a whole.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[kallend 2,106]

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Being old, I recently had the DRE "finger" test and the PSA blood test done. My GP thought there was a "nodule" and referred me to a urologist. He did his own DRE and said there wasn't a nodule, my PSA was low, I don't have anything wrong, but COME BACK ON FRIDAY FOR AN ULTRASOUND AND NEEDLE BIOPSY".

THAT is a symptom of why health care costs are out of control.

Don't worry it just feels like you're being kicked in the bum, at least thats what the patients used to say.

The needle biopsy, in addition to being expensive, carries significant risk of infection, and leads to extensive bleeding from two orifices. The NIH says that it is performed far more often than the symptoms would warrant.

...

The only sure way to survive a canopy collision is not to have one.

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[Zipp0 1]

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Bad idea. If a doctor has messed up, and left a person damaged, putting the doctor in jail does nothing to help the victim.

It prevents him from harming other people and punishes his negligence. This is why we have jails. Putting wife beaters in jail doesn't make their wife's bruises heal any faster, but they still go to jail.

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Bad idea. Who would finance the research? The government? In that case, the cost is the same and Americans would bear it.

Good idea. Costs would be less. No marketing, no big executives, no free lunches for doctors, no more waiting in doc offices while reps detail them about drugs.

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I have issues with any limitation on free speech. Let them maket the product as they wish.

We limit them already. There are many laws governing what drug makers can and cannot say about their product. For instance, they cannot talk about off-label uses.

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Bad idea. Why should other companies benefit from the R&D dollars spent by one company? If you've got a new patented product that you've put time and money into, why the hell should others tag along for a free ride?

FUCKING GREAT IDEA!! Profit needs to be removed as a health care incentive.

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Why not just get rid of Medicaid? Medicaid does go after people to collect. Say you own a house and you get treatment from Medicaid. Medicaid conveniently places a lien on your home.

I know someone who just got pregnant and had no health care. She quit her job to get free care. With her job, her and her husband made JUST over the limit where free care kicked in. I'd rather she work and help pay the bill.

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Look - there are but two ways to decrease the costs of health care.

Look, there are many, many more ways than two.

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Chuck Norris doesn't do push-ups, he pushes the Earth down.

[rehmwa 2]

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The needle biopsy, in addition to being expensive, carries significant risk of infection, and leads to extensive bleeding from two orifices.

one's butt and the doctor's nose?

...
Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[lawrocket 3]

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Place all liability on the doctor would be a better solution.

It's the system we have now. So we should maintain the status quo?

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If he screws up he should lose everything.

No, he shouldn't, unless it is appropriate. If the doctor screws up but causes no harm, the doctor shouldn't lose a cent. if the doctor screws up by prescribing a medicine that the history indicates that the patient has an allergy, but is rapidly treated, the doctor should lose very little.

A doctor should not "lose everything" over a little mistake.

My wife is hotter than your wife.

[kelpdiver 2]

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For example, AIDS meds rake in well over 1 billion dollars per month yet very little of these profits go into research and next to none is use to find a cure. The pharmetcutical companies latched onto this cash cow and cares nothing at all about finding a cure.

Knowing people who are doing the research at Gilead, I beg to differ. Considerable effort in play, and they successfully (cooperating with another company) got the prescription down to a single pill a day. While not a cure, it will increase the effectiveness and reduce the number of people developing resistant strains because they couldn't follow the XXX pills a day regimen effectively.

[lawrocket 3]

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Bad idea. If a doctor has messed up, and left a person damaged, putting the doctor in jail does nothing to help the victim.

It prevents him from harming other people and punishes his negligence. This is why we have jails. Putting wife beaters in jail doesn't make their wife's bruises heal any faster, but they still go to jail.

Actually, taking their license away does the same thing. Prison time should be limited to those like Kevorkian.

Making professional negigence a crime is tough. By the way, malpractice and assault and battery are different things. Wife beaters don't negligently BEAT their wives. They do it on purpose. If a doctor is harming patients on purpose, then jail him/her.

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Bad idea. Who would finance the research? The government? In that case, the cost is the same and Americans would bear it.

Good idea. Costs would be less. No marketing, no big executives, no free lunches for doctors, no more waiting in doc offices while reps detail them about drugs.

Costs would be less? For a goverment that spends $100 on a "strong tight container" (aka "cardboard box"). No marketing - I can see reasons for that? No big executives? In the federal bureaucracy? No free lunches for doctors? No waiting while reps detail them? Compare a wait in a doctor's office to waiting at the DMV for an example of government responsiveness versus private.

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I have issues with any limitation on free speech. Let them maket the product as they wish.

We limit them already. There are many laws governing what drug makers can and cannot say about their product. For instance, they cannot talk about off-label uses.

Yes, for good reason. It's about truth in advertising. Perjury isn't protected speech. And as far as limiting free speech, yeah, we've got it. "If two wrongs don't make a right, try three."

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Bad idea. Why should other companies benefit from the R&D dollars spent by one company? If you've got a new patented product that you've put time and money into, why the hell should others tag along for a free ride?

FUCKING GREAT IDEA!! Profit needs to be removed as a health care incentive.

Then nobody will do it. You don't have to worry about the cost of a cold-fusion engine for your car. You won't be shelling out ANY money for one any time soon because they are not available.

Take away profit, and you kill the business - except a black market. Somehow, removing the ability to do business in the sale of certain "pharmaceuticals" like marijuana, cocaine, heroin, etc., has caused the price to escalate dramatically because a black market will exist.

Cuba has had huge black markets for a very long time now.

As another aside, governments are all about profit! Guess why Congress is passing a law that has the effect of extorting up to 20 billion from oil companies? Is it to make fuel more affordable? No. Is it to decrease dependence on foreign oil? No. It is to get their meathooks on $20 billion.

Yeah, let's leave economics to the government. We've seen where that gts us. google "deficit."

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Why not just get rid of Medicaid? Medicaid does go after people to collect. Say you own a house and you get treatment from Medicaid. Medicaid conveniently places a lien on your home.

I know someone who just got pregnant and had no health care. She quit her job to get free care. With her job, her and her husband made JUST over the limit where free care kicked in. I'd rather she work and help pay the bill.

I agree. If you can't feed them, don't breed them. Isn't it a shame hat there is a system set up to reward people for this? Isn't it a shame that people abuse it like this?

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Look - there are but two ways to decrease the costs of health care.

Look, there are many, many more ways than two.

[lawrocket 3]

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>Look - there are but two ways to decrease the costs of health care. The first is to ration it . . .

>The second way is to lessen the quality of health care.

Those aren't the only two options. There are a lot of countries out there that have better health care (as measured by average lifespan and infant mortality rates) and who spend less per patient than we do. There's something to be learned there, if we don't mind swallowing our pride and learning from someone else.

I understand that. Are there long-term solutions, though?

Medicare was created by the feds because it was understood that private insurance companies could not insure the elderly at the market rates for everybody else. Therefore, the government stepped in to create an insurance plan that offered market-level services at below market-rate prices. It is running dry.

There's a word to describe the near future for any entity that offers market-level services for below market-level prices - "bankrupt." The PBGC is one of these government services that insured pensions for below market prices. It's in need of a bailout.

Flood insurance? The government does a great job with that by insuring the uninsurable risk, but limiting its payout.

Imagine if the whole medical system was based on the thought of offering market-level services at below-market prices.

My wife is hotter than your wife.

[kelpdiver 2]

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Look - there are but two ways to decrease the costs of health care. The first is to ration it, which means that it is not available to anyone on demand. I don't think anybody would look at that as a great option.

The second way is to lessen the quality of health care. I don't think anybody would find that to be a great option.

There are so many more options, the most obvious being promotion of better health, and reducing administrative costs. But neither are a matter of snapping the fingers.

Promotion - I'd start by defunding any public schools that don't do PE every day. At this point I think it's become more important than achievement testing. Fire any principal where the PE happens but no one is exerting themselves.

Adults are obvious much harder to force to do anything without getting totalitarian about it. But perhaps the costs of not are getting high enough.

Efficiency - has the same problem simplifying the tax code would have. Aside from creating inequities, it would de employ a lot of office clerks. A LOT of people.

[Zipp0 1]

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I agree. If you can't feed them, don't breed them. Isn't it a shame hat there is a system set up to reward people for this? Isn't it a shame that people abuse it like this?

FEEDING them is not the problem. The problem is a pregnancy costs between 5-$30,000 in hospital bills. By your sick logic, only the rich or those with great coverage should have children.

This person did not want to quit her job, but it was the only way to pay the bills and get any kind of care for her unborn child.

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Chuck Norris doesn't do push-ups, he pushes the Earth down.

[NCclimber 0]

Another big ticket item that no one wants to discuss is the treatment of terminally ill patients. Boatloads of money is spent on people who are on the way out. As organs begin to fail, we hook 'em up to costly machines. Heart surgery on the infirm, who are failed in other ways? Have at it.

Looking at the actual costs of care, treating people who are on the way out, this is a huge piece of the pie.

No doubt, this opens up an ethical/moral pandora's box, but the costs are real and significant.

[billvon 3,073]

>Are there long-term solutions, though?

I think one of the best things about the US is that we pick and choose what parts of other systems to use. Ballot initiatives? Pure democracy. Central government? Republic. CDC? Police? Highways? Air traffic control? Socialist. National park system? Communist.

Given that, I think we should institute an official two-tier system. Have a socialist system that will take care of everyone and provide basic primary care, emergency care and ER care and cover you up to a certain explicit standard, one that is proposed, voted upon and approved by the people. An example:

Emergency care due to car accident/skydiving - covered.
Reconstructive surgery to fix your femur - covered.
Reconstructive surgery to fix your face - not covered.

Intron A/Rebetron treatment for Hep C - covered.
Liver transplant - not covered.

HIV NRTI's/NNRTI's/PI's/FI's - covered.
HIV experimental drugs - not covered.

Prenatal checkups/vitamins/amnio - covered.
Artificial insemination - not covered.

Life support for critical injuries - covered.
Life support for ongoing chronic health problems (i.e. old age) - not covered.

Basically take what works in other countries (universal coverage for the common stuff) and keep the parts of our system that work (capitalist incentives for new drug development/new procedure development/elective surgery/radical procedures.)

[freethefly 6]

Why Effective Clinical Trials are a Must
A Microbicide Flunks the Test
Trials testing cellulose sulfate gel as a microbicide to prevent HIV transmission when applied vaginally have been discontinued due to preliminary findings that it might actually increase HIV risk.

Just One of the States that has Cut Funding
Small State, Big Problems
Seventy noisy AIDS advocates converged on the Rhode Island State House today to protest nearly $1 million in proposed funding cuts to state AIDS services.

Yup, They Really Care
L.A. Patients Turned Away
HIV positive Los Angelenos are turned away from health care in shockingly high numbers, according to a study released by the Williams Institute on Sexual Orientation Law and Public Policy.

Who Said it is Not About Prrofits?
Thailand Smacks Down Another Drug Patent
The Thai government agreed today to license generic versions of HIV med Kaletra (lopinavir/ritonavir), prompting a protest from patent-holder Abbott Laboratories.

As if Abbott gives a Damn
Students to Abbott: Do Not Pass Go
Two dozen students from the Student Global AIDS Campaign dumped bags filled with Monopoly money at Abbott Laboratories today to protest the high cost of HIV med Kaletra/Aluvia (lopinavir/ritonavir) in the developing world.

Hoping for New Customers?
Pfizer Sued Over Viagra Ads
The AIDS Healthcare Foundation filed a lawsuit against Pfizer today, claiming that the pharma giant encourages recreational use of its erectile dysfunction drug Viagra, thereby increasing unsafe sex and fueling new HIV infections.

It is a Shame
D.C. Free Clinic Closes Its Doors
After nearly 40 years of operation, the Washington Free Clinic is closing its doors today, citing “today’s administratively burdensome healthcare environment” as the reason for the shutdown.

As of January 8, 2007...
U.S. AIDS Aid Falls Short
If Congress doesn’t move quickly to approve 2007 funding for the Presidential Emergency Plan for AIDS Relief (PEPFAR), 100,000 people may lose their lives, according to U.S. Global AIDS Coordinator Mark Dybul.

Abbott; The King of Gouge
A Kaletra Conspiracy?
Documents reviewed by the Wall Street Journal confirm AIDS advocates’ suspicions that Abbott Laboratories hiked the price of Norvir by 400% in December 2003 in order to improve sales of Kaletra, according to a story in today’s paper.

To Hell with Mercks Patent
Thailand Breaks a Drug Patent
The Thai government has issued a compulsory license for production and importation of an inexpensive version of second-line HIV med Efavirenz, without consulting the drug’s patent-holding maker, Merck.


AHF Decries Loss of $100M in Unspent Ryan White Funding


Just bad Management
Today's Deadline Requires Unspent CARE Act Funds Be Returned to Feds, While
AIDS Services Are Cut Back Nationwide; Nation's Largest AIDS Group Calls for
Swift Reauthorization and Reform of CARE Act to Address Inefficiencies

LOS ANGELES, March 31 /PRNewswire/ -- AIDS Healthcare Foundation (AHF) the
largest US-based AIDS organization today decried the loss of $100 million in
unspent Ryan White CARE Act (RWCA) funds which are set to revert back to the
Treasury today. The CARE Act, which is the premier federal funding source for
HIV/AIDS treatment and services nationwide and a lifeline for more than half a
million Americans, is reauthorized every five years; however the bill expired
in September 2005 when Congress failed to take action on it. March 31st, a
full six months after the CARE Act's expiration, triggers the mandatory return
to the federal government of nearly $100 million in unspent CARE Act funds by
states and eligible metropolitan areas (EMA) nationwide. This development
comes at a time when AIDS advocates are alarmed that lifesaving HIV/AIDS
services are being cut due to lack of funds in jurisdictions across the
country.
AHF is calling for the swift reauthorization and reform of the Ryan White
CARE Act to ensure the most efficient use of scarce CARE Act resources. AHF
believes the bill must be updated in order to make the current law more
responsive to the needs of underserved and emerging HIV/AIDS populations; it
must also place a higher priority on funding primary medical care for the now
chronic, but treatable medical condition. Last month, the 'Ryan White CARE Act
Amendments of 2006' (SB 2339 -- Coburn/Weldon) was introduced to bring about
this much-needed reform. It was recently co-sponsored by Senator Richard Burr
(R, NC), who sits on the Senate HELP Committee and whose state has been forced
to implement waiting lists for its AIDS Drug Assistance Program. AHF strongly
urges Congress to pass this urgently needed legislation.
"It's utterly criminal for funds to go unspent while CARE Act programs
nationwide continue to be under-funded and people languish on waiting lists
for lifesaving treatment," said Michael Weinstein, President of AIDS
Healthcare Foundation. "This clearly illustrates the need to restructure the
Act to allow for a more flexible and equitable distribution of funding,
ensuring that resources reach those most in need."
According to the U.S. Health Resources and Services Administration (HRSA),
the federal agency responsible for administering the CARE Act, $100 million of
CARE Act funds went unspent and an astounding $80 million was spent on
"planning and evaluation" during a recent two year period. While precious
resources continue to be spent on layers of bureaucracy, CARE Act programs are
being cut back across the country. In fact, 33 of 51 jurisdictions received
cuts to their 2006-2007 CARE Act funding and many of those are being forced to
cut direct patient services as a result. Both Los Angeles and Jacksonville,
Florida -- two regions where AHF provides care and services -- will see
significant RWCA Title I cuts; LA is facing a $1.9 million cut, which
represents a 5.3% decrease in funding, while Jacksonville faces a 2.2% funding
decrease. In some cases, these cuts to patient services are occurring in
states that are now returning unspent funds.
"A number of patients on the waiting list for Kentucky's AIDS Drug
Assistance Program -- funded by the CARE Act -- passed away despite the fact
that the state had hundreds of thousands of dollars in unspent CARE Act funds.
For anyone to lack access to lifesaving treatment in our resource-rich country
simply due to such an antiquated funding mechanism is truly a national
embarrassment," added Weinstein.


I can go on forever with what is wrong. I will also say that there is a lot of good being done. Yet, what you get depends on how much money or insurance you have.


In reply to Lindsey
Place all liability on the doctor would be a better solution. If he screws up he should lose everything.

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I'd be real damn picky about who I chose to treat. Difficulty with access to medical care would take on a whole new meaning.

If you are not sure of your ability, then maybe you should be picky. The way I see it, is if someone is going to cut into my body, they better damn well know what they are doing. No ifs, ans or buts about it. When I was a railroad inspector, I would had been hed criminally responsible had I missed a defective rail and someone had died due to me missing a defect that was clearly on the UX/EMF readout tape. I was damn sure of my ability to perform a test and was highly recommended by the company and often requested by railroad lines. I want the same in a doctor. Nothing less.

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Okay. Get out your pencil and make a list of HIV meds available 10 years ago, 15 years ago, and now. I think there are very few illnesses that as much effort has been put into treating....with as much progress as has been made with HIV/AIDS. In my experience, the docs who treat people with HIV are some of the MOST caring of all.

I am very aware of what has came on the market and also know that many of the meds are copies and/or combinations combined. I will, however concur with you and retract my statement that many HIV doctors are uncaring. I will still say that HIV is a cash cow and that it is a shame that some have latched on to it solely for that purpose.

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BTW....your bitterness is showing, and has just lumped you into that group who wouldn't get the time of day in under that plan you were talking about

Should I not be pissed? After all it is my life that is in danger. I lost my insurance more the 5 years ago and along with it I lost my meds. The state of Missouri dropped me from medicaid and raised my spend down (I paid just a portion of what they are are requesting now. It was never free.) Last year I was given but 2 doctor appointments. One in March to have bloods taken for lab and one in September to hear the results. I have yet to hear the results as I cannot afford the spend down. After my house payment ($465.00), I have little left over and what is left goes to paying on my out of pocket portion of the March appointment, utility bills, some food (killed 2 does last deer season so I am set up good as for meat. Two bullets well spent.) and a few other neccesary items that are needed. Medicare is no longer available to me. Private insurance? There is not a company that would touch me. I have tried and my casewoorker has looked into it. I have given up alot. Last year I did only 10 jumps. Down from averaging more than 100 jumps a year. My car is broke down. My house needs repairs. But, I still have hope and do try has hard as I can. Believe me, I try not to be bitter, yet after all the tax dollars that I pay out, I am pissed to see it go out of this country to places like Iraq when those dollars should be used to help Americans. After all, it is our money.

In reply to Peregrinerose
A simple mistake that does not cause a major health is not the problem. A mistake that results in losing the wrong leg or death is a major issue. Would you just say "Oh well, doctors are just human, no harm done" if a mistake was made and your child died due to a doctor not being able to perform his/her job correctly? You most likely would sue him/her into the bowels of hell instead of letting them off of the hook. I realize that they are human but, they are not operating on your car, they are operating on your body and for this they should be held to the highest standard. You screw up my body because you are incapapble. I will sue the hell out of you.

In reply to all who feel that the government should not use our tax dollars to help us
I see billions upon billions upon billions being wasted to fund a war that was lost at the start. This is every taxpayers money and should be used to benefit us. Not Iraqis or any other country. I lose, you lose, we all lose. Place yourself in the shoes of one who is hoping to live another year and then get back to me.

In reply to Billvon
Bill, I have nothing but the highest regards for you yet I see flaws in some of your statements.

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You would then have doctors who only treated healthy patients with likely good outcomes. People with HIV, cancer, hepatitis etc would not be seen by any doctor. Why risk losing everything to treat a patient who will probably die anyway?

Why provide treatment when treatment is not need? It would be much like a mechanic replacing an alternator that does not need replacing. Treating the terminally ill is much more important. Providing comfort during the end stage of an illness is a high act of compassion. Not providing the treatment is just cruel. Those who know of their illness are well aware of the final outcome. I am near positive that I will die of AIDS complication and would never expect that a doctor should be held responsible for my death if he/she did all that they could do. However, I do see that the current state of healthcare in our country should be held responsible when care could had been given yet withheld solely because of money.

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And when companies hold a drug up in testing for years because of questionable test results, they become "greedy companies who would rather watch people die than let them use life-saving drugs."

If the drugs in question cause death or further complications then they are far from desirable. It is irresponsible for a pharmetcutical company to fast track a drug through the system when all the neccesary safe gaurds have not been reviewed. You want to see an end to the high number of class action suits against pharmetcutical companies? Then we should demand safe medications and stop the "give me now" attitude.

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I thought if you tried to help them it was "drug pushers who push unproven drugs through the system in pursuit of the all mighty dollar."

My answer is in the reply above.

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In 1992, two friends of mine died of AIDS. It was the expected outcome of HIV infection. Nowadays I know a lot of people who have been living with it for decades, and living relatively healthy, fulfilled lives. I'd call that significant progress.

And, I take it, they have insurance or other means to pay for it. It all boils down to money and nothing more.

It is great that there are advances but, what is not great is that over 50% of those known to be infected get little or no treatment at all.
12 years ago I knew nothing at all about AIDS and had never heard the three letters "HIV". Today I am well aware of what is being done in the field of research. I am well aware of the status of care in the US and abroad. I chat daily with a woman who works in the children ward at Olabis Onabanjo Teaching Hospital in Sagamu, Ogun in Nigeria. A lot is being done yet with the technology available today more can be done. Her complaint is that in the villages christian groups are given more of the money to push a religous agenda when that mooney would be better spent on real treatment and preventive care. Healthcare problems are a worldwide concern and it should be as it effects every human on the planet. The question of money is a false curtian as there is money to address the problem. Large portions of profit need to be mandated to address the problems and not used to make someone richer. It is the shame of the worldwide community when profit out weighs human care.

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young

[lawrocket 3]

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Another big ticket item that no one wants to discuss is the treatment of terminally ill patients. Boatloads of money is spent on people who are on the way out. As organs begin to fail, we hook 'em up to costly machines. Heart surgery on the infirm, who are failed in other ways? Have at it.

This is exactly the reason why the elderly are uninsurable in the private market. This is why Medicare stepped in - to pay for these big ticket items.

If the government were to become involved, I have little doubt that once the elderly became past their useful lives, the government would limit healthcare for them to that of a more palliative nature.

My wife is hotter than your wife.

[billvon 3,073]

>Why provide treatment when treatment is not need? It would be
>much like a mechanic replacing an alternator that does not need
> replacing. Treating the terminally ill is much more important.
>Providing comfort during the end stage of an illness is a high act of compassion.

You are confusing two things here. To use your car example - why would a mechanic replace a squeaky alternator that's still sorta kinda working if the car was going to be scrapped in a few days anyway? If anything, that demonstrates that cars and people are not the same, and aren't treated the same by doctors/mechanics.

But back to the original point. Which patient should a doctor risk everything on - a 12 year old girl with a broken leg who will make a full recovery, or a terminally ill man who is going to die and who has a litigious family? If the doctor knows that the slightest error will result in him losing everything, he'd be crazy to risk it for someone who will die anyway. After all, the jury will hear "he was taking care of my poor father, and he DIED."

The riskier you make it for a doctor to care for someone, the fewer doctors will take those risks. Imagine what would happen to firemen if you passed a law that said if a fireman made any mistake at all, he would be liable for all the damage the fire caused. Think we'd have a problem attracting firemen? Think we'd have to pay em more to get enough?

>If the drugs in question cause death or further complications
>then they are far from desirable. It is irresponsible for a
>pharmetcutical company to fast track a drug through the system
>when all the neccesary safe gaurds have not been reviewed.

If your choice is the experimental drug or death, shouldn't _you_ have a say in making that call? I agree that drug testing should be thorough, but in some cases I can also see a benefit to fast-tracking drugs to patients who will otherwise die.

>Large portions of profit need to be mandated to address the
>problems and not used to make someone richer.

The problem there is that if no one can make decent money off drug companies, they will not have the money to investigate new drugs. We all have a hand in this. Every time you pick a better-performing mutual fund or stock over a poor performer, you are ensuring that the companies that care for things other than profit will not survive.

[kelpdiver 2]

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Hoping for New Customers?
Pfizer Sued Over Viagra Ads
The AIDS Healthcare Foundation filed a lawsuit against Pfizer today, claiming that the pharma giant encourages recreational use of its erectile dysfunction drug Viagra, thereby increasing unsafe sex and fueling new HIV infections.

Isn't all use of Viagra recreational?

And how is Pfizer to blame for people's choices on safe sex practices? The condom will stay on better with a hard on anyway.

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If you are not sure of your ability, then maybe you should be picky. The way I see it, is if someone is going to cut into my body, they better damn well know what they are doing. No ifs, ans or buts about it. When I was a railroad inspector, I would had been hed criminally responsible had I missed a defective rail and someone had died due to me missing a defect that was clearly on the UX/EMF readout tape.

The human body is a hell of a lot more complex than a railroad. Even if you expect perfect consistency (no errors) from a doctor, the data available to them is not always complete.

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I see billions upon billions upon billions being wasted to fund a war that was lost at the start. This is every taxpayers money and should be used to benefit us.

Irrelevent tie-in. Besides, sadly all those billions are in the form of new debt. Without the war we'd just be much closer to a balanced budget.

[freethefly 6]

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But back to the original point. Which patient should a doctor risk everything on - a 12 year old girl with a broken leg who will make a full recovery, or a terminally ill man who is going to die and who has a litigious family? If the doctor knows that the slightest error will result in him losing everything, he'd be crazy to risk it for someone who will die anyway. After all, the jury will hear "he was taking care of my poor father, and he DIED."

It would be wiser to treat the broken leg and let those who are seriously ill die. But, it would be less than human. In cases such as the terminally ill when the final outcome is death, safeguards need to be in place to protect the doctor, providing that the doctor did all that he could to provide care and comfort. Are there any sort of waivers to relieve a doctor of financial/criminal responsibilty if he did perform to his abilty? None that I have heard of. But, in cases where it is obvious that a surgeon made a mistake that should had never been made, the surgeon needs to answer to that mistake. In todays world, a mechanic will quickly lose his job if he performs less than desirable. The same should be held in all professions. Would you employ an AFF instructor who continued to lose students due to faulty instructions that resulted in injury or death? If you are in the business of maintianing human life, you best be 100% sure of your ability.

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If your choice is the experimental drug or death, shouldn't _you_ have a say in making that call? I agree that drug testing should be thorough, but in some cases I can also see a benefit to fast-tracking drugs to patients who will otherwise die.

Then the use of waivers that are legally binding should be in place stating that the drug in question has not been fully tested and that you and you alone are responsible for any outcome that is less than desirable. That, I can live (or die) with.

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The problem there is that if no one can make decent money off drug companies, they will not have the money to investigate new drugs. We all have a hand in this. Every time you pick a better-performing mutual fund or stock over a poor performer, you are ensuring that the companies that care for things other than profit will not survive.

Define decent money. Is it fifty thousand per year, one hundred thousand per year, one million per year or is it higher. There has to be a cut off point somewhere. Or is that just a means to cripple free trade by setting a cut off point? How is that we came to a point that the standard of care is motivated solely on its ability to generate huge salaries. There are plenty of doctors that have chosen to work in rural areas that pay far under one hundred thousand a year when they could had easily taken positions in areas that pay far above what they recieve now. I see them as the doctors who place compassion far above country club status. They truely are what is right in the healthcare field. Yesterday, I saw a report on the news of a doctor who often pays for his patients medications, he performs many duties at no charge and always goes out of his way to help anyone in need. He is the poster boy of compassion and he cares nothing at all about recognition for what he does. Much like Doctors without Borders. All healthcare professionals should take an example from these people.
Honestly, when the cost of training and research continues to spiral up far above what it should be nothing will ever be done to provide treatment to the many who are in need and cannot afford it. All of the bickering in the world is not going to come to a conclusion as it only divides and provides no real solutions. In the meantime people who could had been help only hold on to hope.

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young