> but people often choose their physician based on skill. This is utterly wrong on the face of it.
Care to explain why? I know plenty of cancer patients who got referrals to several of oncologists, interviewed them, then selected the one they thought was best equipped to treat their cancer.
Quality is only one of the measures patients use to select a doctors, and it would be fine to doubt patients can even gauge quality.
I would tell you location beats quality every day.
Why is insulin not an over the counter medicine? Would having it OTC cause problems on the scale of alcohol? What's the "value add" of having a doctor renew an insulin prescription?
The number of unexplained but apparently natural heart attacks in middle aged people with disgruntled partners would sky rocket. Weight trainers can and probably already do (ab)use insulin to maximize their gains by manipulating blood sugar levels during workouts. self-diagnosed and self-medicated diabetics showing up at hospitals that have no indication of this and pump them full of glucose.
> The number of unexplained but apparently natural heart attacks in middle aged people with disgruntled partners would sky rocket.
Are you saying that insulin has to be prescribed to prevent murder?
> Sure, the stakes are much higher, It's not that, it's that the cancer treatments are non-optional. Optional treatments have the luxury of price comparison and choosing the perfect vendor - cancer waits for no man and it shouldn't be the market deciding whether someone lives or dies.
There is always an option. People die of cancer choosing not to treat it every day in every part of the world. I think opinions like yours above always stem from the naive assumption that all life is worth infinite at any point, so any obstacle to prolong it is a failure. Well, its not. Some treatments are expensive and cost is definitely something to take into account. If you get cancer and the treatment to save you…
I've never heard in a nationalized healthcare system that someones cancer treatment was too expensive, so they should just die.
Why is insulin not an over the counter medicine? Would having it OTC cause problems on the scale of alcohol? What's the "value add" of having a doctor renew an insulin prescription?
You can get novolin-n at Walmart for about $26 a vial without a prescription. I’m a type 1 diabetic and fallback to this when I’m unable to get a prescription.
We ended up finding Novolin N at Walmart, before the Brazil solution, but our Dr. dissuaded us from switching. You probably know this better than I, but the doctor advised us that Humulin N and Novolin N are not interchangeable; while they are the “same” insulin (NPH), the manufacturing process is different, affecting dosage. In our pet’s case, the Dr. had conducted a series of exams to determine Humulin N dosages —…
Interesting, for me (and your dog's mileage may vary), humulin and novolin are interchangeable. I bought humulin at walmart before they switched to novolin but I rarely use NPH. I only need it when either I don't have insurance or I need a new prescription because my insurance decided to switch to another preferred basal insulin. It's easy for me to see any changes since I can monitor my blood sugars but for a dog, that could be a challenge and probably requires a stay at the vet to run tests.
There is always an option. People die of cancer choosing not to treat it every day in every part of the world. I think opinions like yours above always stem from the naive assumption that all life is worth infinite at any point, so any obstacle to prolong it is a failure. Well, its not. Some treatments are expensive and cost is definitely something to take into account. If you get cancer and the treatment to save you…
I've never heard in a nationalized healthcare system that someones cancer treatment was too expensive, so they should just die.
The practice of medicine always had and always will have an economic component.
Countries dont even match their flu-shot vaccination recommendations, let alone multi-million dollar treatments.
I always say this, but reading that makes me think thank God for the NHS in the UK. Health and education should never be a business. The pharmaceutical companies are so strong and greedy in the US they want people on their drugs, rather than look for preventing the problems. They often lambast and send confusing scientific studies out to ensure no alternative therapies succeed over their drugs.
I agree, the pharmaceutical companies in the US use dirty tactics to get their products to market. They put out these clinical trials claiming their product is superior or worse, are behind bogus claims of a cancer link to a drug - I was suspicious when my insurance stopped covering lantus and forced me to switch to levemir.
I agree 100%. The approach I like is what I call "lowest negotiated price". How it would work is that buyers (i.e. insurance companies) could still negotiate for a lower cost, but whatever that cost ends up being is the cost _everyone_ pays. This allows buyers to continue to try to get a better price if they can, while likely making sure the price that is agreed upon is fair to all.
There is evidence that this would actually increase prices across the board. How do we know? Such a system already exists. The price that Medicaid plans pay is either 23% less than the average price paid or the “best price” (if lower). When this was instituted, drug companies actually pulled back on their discounts to non-Medicaid accounts, so as to not trigger the “best price”.
Except Medicaid is contaminated by rebates from the drug companies to the states. That's one of the things that needs to be banned.
I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. This would end this sort of preferred drug shifting, it would end the game of state Medi…
You realize this could potentially increase prices right? Every pricing decision undergoes a cost-benefit analysis. If I know that offering a small account a lower price means everyone gets that price, I’d be willing to lose all business to the smaller account because in the end I get more money. A much better proposal would be no net pricing. The price that everyone pays is public knowledge.
As I said, it would end cost shifting. That would mean those paying the least would now pay more, but I'm not saying to preclude insurance or the like (I'm talking about the price the drug company sells it at, not who pays or the like), I don't see that it's going to be a problem.
I still think the approach I proposed years ago would be a big help: Turn the usual arguments on their head, prohibit all negotiation. Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. This would end this sort of preferred drug shifting, it would end the game of state Medi…
> Drug companies would be required to sell to all customers at the same price. This would end all cost-shifting, it's fair for all and forces the drug companies to actually compete on the end price. Then you only sell the drugs that do profit, and stop making the ones that cost money. You cant make people do what they don't want to do, pharma is no exception. The source of this problem is patent law, importation rest…
You make people do what they don't want to do by passing laws. It is all on our cowardly, selfish, incompetent lawmakers.