Cancer patients are being denied drugs, even with prescriptions and insurance • Hacker News Board

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#91

Post by DanBC » Sat, Aug 03, 2019, 7:13 PM UTC

cheeky78 wrote: post #46

tasty_freeze wrote: post #36

One entirely maddening thing is that the ACA was labeled as having "death panels" that would decide who lives and dies. That phrase was powerfully effective in making large group of Americans strongly oppose the ACA. Even if they knew nothing else about the ACA, they knew they didn't want death panels. But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them. It…

"But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them." It's not inflammatory when it's true. When the government runs our healthcare, choices are removed and someone else gets to decide if you should get surgery needed or not...and many times this is life or death. At least now, if a cancer patient gets denied drugs, they can go to another doctor or get a se…

> At least now, if a cancer patient gets denied drugs, they can go to another doctor or get a second opinion.

You can do this in any country with government provided healthcare by either going private or travelling to a different country.

> I've lived in countries with universal healthcare and the quality is sub-par compared to the US/private care.

Sure. The US spends more than anyone else on healthcare, but has worse life expectancy. https://ourworldindata.org/the-link-between-life-expectancy-...

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#92

Post by ShroudedNight » Sat, Aug 03, 2019, 7:13 PM UTC

someguydave wrote: post #65

alistairSH wrote: post #42

Earlier quoted context omitted.

Fine, guys. It's your money... Except it's not their money. It's all of our money, as the whole point of insurance is pooling resources to hedge against any individual risk. Not that I blame you - the implementation of some policies is completely asinine.

The only fair way to distribute rare goods is to the highest bidder

This is landing squarely in Poe's law territory.

Notwithstanding, this is only possibly true under a model where everyone initially has equal opportunity. A weak requirement that is almost certainly insufficient, and yet one we have already failed miserably at.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#93

Post by mnm1 » Sat, Aug 03, 2019, 7:14 PM UTC

mevile wrote: post #45

If you're an employer in California and want to choose a provider that will not have to deal with this you might want to consider offering Kaiser to your employees. There's benefits and drawbacks, but one of the big benefits is that they're vertically integrated and the doctors, labs, pharmacies are all part of the same organization. I would think that would help avoid this specific type of situation. The big drawbac…

In that case the pharmacy might not be a problem but the doctors will delay the tests for cancer even for existing cancer patients allowing a relapse to grow unchecked for months to save Kaiser money. That's what happened to a friend of mine. So fucked regardless just to save some money.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#94

Post by caseysoftware » Sat, Aug 03, 2019, 7:16 PM UTC

taneq wrote: post #79

surfmike wrote: post #51

Earlier quoted context omitted.

You mean like the National Institutes of Health?

Yes, but more. You guys spend eleventy billion dollars on fighter jets with questionable hovering capability, can't you spend like four billion on nobody having cancer ever again?

Well hell, if you know it's going to be $4B to eradicate cancer, it should be easy to put the plan together and get funding. You'll save everyone billions forever.

Why are you screwing around on Hacker News?

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#95

Post by [deleted] » Sat, Aug 03, 2019, 7:18 PM UTC

someguydave wrote: post #65

alistairSH wrote: post #42

Earlier quoted context omitted.

Fine, guys. It's your money... Except it's not their money. It's all of our money, as the whole point of insurance is pooling resources to hedge against any individual risk. Not that I blame you - the implementation of some policies is completely asinine.

The only fair way to distribute rare goods is to the highest bidder

[deleted]

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#96

Post by specialist » Sat, Aug 03, 2019, 7:20 PM UTC

tasty_freeze wrote: post #36

One entirely maddening thing is that the ACA was labeled as having "death panels" that would decide who lives and dies. That phrase was powerfully effective in making large group of Americans strongly oppose the ACA. Even if they knew nothing else about the ACA, they knew they didn't want death panels. But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them. It…

Every possible system will have some kind of rationing.

I'm okay with the notion that tough choices have to be made. Especially if the rules are clear ahead of time.

But that's not the system we now have. The default answer is "no" and patients have to fight to get to "yes".

The real kicker is even people within the system (eg nurses, techs) struggle to get proper insurance and healthcare. If insiders are getting screwed, what chance do the rest of us have?

(FWIW, I've been denied various life saving treatments, scripts, etc. multiple times. I'm fortunate to have had multiple angels in my life who've gone to bat for me. eg FHCRC fredhutch.org)

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#97

Post by dmoy » Sat, Aug 03, 2019, 7:22 PM UTC

taneq wrote: post #79

surfmike wrote: post #51

Earlier quoted context omitted.

You mean like the National Institutes of Health?

Yes, but more. You guys spend eleventy billion dollars on fighter jets with questionable hovering capability, can't you spend like four billion on nobody having cancer ever again?

NCI alone has a budget of like $5-6B/yr.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#98

Post by [deleted] » Sat, Aug 03, 2019, 7:23 PM UTC

sorokod wrote: post #87

Scoundreller wrote: post #82

Earlier quoted context omitted.

UK has a set of standard guidelines for how to treat diseases with proven drugs, and only pays for those (like the insurance company in the article being rigid about its guidelines). People complained that their doctors weren't allowed to go off-track and make up special treatments for their special patients that went against guidelines (like the patients in the article). Because it's political suicide to deny "What…

And this relates to the article how? Ultimate, what is described is an insurer tying to minimize the payout on a claim same as they have been doing from the dawn of time except here it's particularly nasty as people suffer and die.

[deleted]

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#99

Post by Scoundreller » Sat, Aug 03, 2019, 7:23 PM UTC

sorokod wrote: post #87

Scoundreller wrote: post #82

Earlier quoted context omitted.

UK has a set of standard guidelines for how to treat diseases with proven drugs, and only pays for those (like the insurance company in the article being rigid about its guidelines). People complained that their doctors weren't allowed to go off-track and make up special treatments for their special patients that went against guidelines (like the patients in the article). Because it's political suicide to deny "What…

And this relates to the article how? Ultimate, what is described is an insurer tying to minimize the payout on a claim same as they have been doing from the dawn of time except here it's particularly nasty as people suffer and die.

The beef in the article seems to be "We're not paying for it, because it's not in our guidelines" vs. "Doctor thinks this patient is more special than the guidelines"

Where in the article says that the insurance provider was trying to minimize the payout on the claim?

Insurance companies really hate paying for things that don't work (or have a low likelihood of working). Even more than paying for something expensive that works.

The article is really annoying, because Treatment A didn't work, and they wanted to skip Tx B and go right to Tx C. Tx C worked, but the article never named any of the drugs, so we can't evaluate the validity of this guideline. We just have one anecdote of one event where doctor was ultimately right (because nobody runs to the LA Times when they were in-the-wrong).

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#100

Post by hestipod » Sat, Aug 03, 2019, 7:25 PM UTC

ta0987 wrote: post #84

Scoundreller wrote: post #67

Earlier quoted context omitted.

Canadian here. We also have decision makers that decide what gets covered or not. It's stupid not to. We shouldn't plunder health care funds on $1m per year of life saved interventions when you can spend that on 100 interventions costing $10k per year of life saved. It works pretty well (something like 15th longest life expectancy). Of course, you're always free to pony up your own cash to pay for a treatment that is…

Logically, yes... But an acquaintance with Canadian relatives told me he knows a middle aged single man that was denied a knee replacement he needed because of these trade-offs. Left with decades to live, partially disabled, because: "Old? No family? Well fuck that guy then."

Every time this discussion comes up people tell stories of "things they heard" but I hear very little first hand experience that validates them. I have had discussions in the past with my very right wing relatives about social healthcare and quality of life abroad (where I have lived and they have not) and they always had a pocket full of stories they heard from someone that undid anything I said in their minds. A more recent one was a supposed tale from a Danish immigrant to the USA who had told them how terrible the quality of life is in Copenhagen (a city while not perfect as none are, that is consistently rated as one of the highest qualities of life in the world) and how America is objectively better in every way which validated their world view. If people cannot even be realistic about the life on the ground...nothing ever changes.