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

#111

Post by cheeky78 » Sat, Aug 03, 2019, 8:01 PM UTC

hestipod wrote: post #54

cheeky78 wrote: post #46

Earlier quoted context omitted.

"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…

>I've lived in countries with universal healthcare and >the quality is sub-par compared to the US/private care. My experience has been the exact opposite. America's healthcare business ruined my life. As a result I have no insurance and have lost the "privilege" to BUY said American healthcare. I struggle with low income options and programs, all insufficient. The only good care I ever got was in Europe. My experienc…

Education can only bankrupt you if you choose to go to an expensive university. This is a complete choice and the overall price is known before you take out a loan. Community colleges are a fraction of the price.

"My experiences with social hospitals and doctors was much better than in the USA where it counts. Places weren't often as fancy looking, but the care was superb. Even the private systems in those countries was far more affordable. a few hundred for an MRI etc rather than a few thousand."

I pay for my own insurance in the US. I only pay a couple of hundred/month and most things are covered. My deductibles are very affordable.

There are plenty of option for low-income individuals and pre-existing conditions are no longer something that will prevent you from getting healthcare.

Even if you get a $100,000 bill, you can call the hospital up and negotiate it down to something you can actually pay.

"Whenever I see comments like yours I just get so upset realizing how it's an unwinnable battle in this country because of these ingrained beliefs."

I feel the same way about your comments. You have this ingrained believe that socialized healthcare is the best solution, when private care clearly has advantages.

The majority of people in the US are happy with their healthcare. There should be some additions, so people that can't afford care can get it, but without uprooting the entire system.

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

#112

Post by Gibbon1 » Sat, Aug 03, 2019, 8:04 PM UTC

imglorp wrote: post #19

I'm having exactly these problems, with exactly these companies: CVS and BC Anthem. Doctor writes prescriptions; some are limited in doses, some delayed, some with no copay, some priced barbarically, and some flat out refused. Then the doctor's office has wizards that help advocate and sometimes that works, sometimes there's a delay, and sometimes never. In all cases, the patient suffers. They are already facing a me…

Was talking with my endocrinologist. She said insurance companies are now limiting the amount of insulin she can prescribe. She'll have a patient who's been doing fine with 30 units a month and the insurance company will cut it to 25. And then to 20.

My theory is specialists, hospitals, insurance and drug companies are trying to swipe everything that isn't nailed down before it all blows up.

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

#113

Post by vbezhenar » Sat, Aug 03, 2019, 8:11 PM UTC

Scoundreller wrote: post #67

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…

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…

Is there strict rules for those death decisions or just some people acting as they want? In the second case level of corruption must be overwhelming.

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

#114

Post by erentz » Sat, Aug 03, 2019, 8:12 PM UTC

sjg007 wrote: post #70

imglorp wrote: post #19

I'm having exactly these problems, with exactly these companies: CVS and BC Anthem. Doctor writes prescriptions; some are limited in doses, some delayed, some with no copay, some priced barbarically, and some flat out refused. Then the doctor's office has wizards that help advocate and sometimes that works, sometimes there's a delay, and sometimes never. In all cases, the patient suffers. They are already facing a me…

I am surprised that this hasn't started a class action lawsuit yet. The insurer through delays is causing harm. I'm guessing it's a contract thing though. One thing to do is if your plan is regulated by the state then immediately start an appeal with your state's department of insurance. There are also advocates at some hospitals and insurance companies. The other thing to do is go to a very large academic cancer cen…

Because most people get their insurance through their employer they are usually self funded plans covered by ERISA. Your only recourse is that provided under ERISA which limits damages to the cost you paid for a treatment that wasn’t covered but should’ve been.

It’s abhorrent. Congress in making this law 50ish years ago essentially took away people’s right to sue and get justice in this instance. It was a huge gift to insurance companies and it needs to be fixed but people only learn about it when they are exposed to it. I wish there were politicians willing to step up and change this particular law.

When people talk about tort reform I think they’re really misunderstanding who such reforms benefit, as in this case it only serves the large companies and allows them to act in bad faith without proper repercussions.

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

#115

Post by DoreenMichele » Sat, Aug 03, 2019, 8:12 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?

I have a relative who works at the CDC and has had cancer multiple times. Before life and money got in the way, we used to talk regularly on the phone. She bitched a lot about how 99 studies out of 100 were variations on a theme because that's where the funding was. There was very little that was genuinely new and innovative.

I don't know how to solve that.

I've been getting myself well (different condition) for years when that's not supposed to be possible. I'm quite open about that on the internet. I get attacked for talking about it and called crazy. I'm told "Produce studies backing up your claims" when there are none. No one is latching on to my story and going "What if she's on to something? Maybe we can do a study that will open up new treatment modalities for patients!"

I don't think it's as simple to solve this as you think it is. I don't know what needs to happen to break the herd mentality where humans don't seem to want to give any credibility to anything not already proven, which actively interferes with being able to prove anything new.

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

#116

Post by pteredactyl » Sat, Aug 03, 2019, 8:34 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…

True. However, there's a difference between death panel singular and death panels plural.

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

#117

Post by robocat » Sat, Aug 03, 2019, 8:38 PM UTC

hestipod wrote: post #100

ta0987 wrote: post #84

Earlier quoted context omitted.

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 mo…

New Zealander here, and I will speak about cases I have direct experience of (and project a little based on what I've read in media).

Firstly, our social healthcare is actually pretty good for emergency procedures.

But there is only so much money budgeted per year for healthcare, and everyone in need competes for that limited pool, so there is a variety of ways care can be delayed or denied.

"Elective" procedures like hip and knee replacements can have long delays (queues) and seemingly odd requirements. One friend was "too" young: they had to wait for years in severe pain because they "shouldn't" need their hip replaced yet. Another acquantance had a record of hurting their knee as a young child: so they were not covered by ACC for knee replacement even though it was a ridiculous excuse in circumstances. Once a procedure is approved, you get reasonable treatment, and it is free.

There is a certain amount of gaming of the system - if you can find a sympathetic specialist you can jump the queue a bit. However that is a zero sum game, and it benefits those with time, intelligence and contacts (and screws some minorities).

Pharmac has a yearly government budget, and they choose which treatments can be afforded. We do the same with roading - cost benefit analysis is done for all roadworks and the best get funded until the fixed budget is met (small country, so one main roading department).

It is interesting that our two biggest healthcare insurers (maybe covering 80% of private insurance) are non-profit co-operatives: all premiums are either paid out in care or pay administration overhead. I think overhead works out to be about 10%. Fantastic system: pay premiums and don't get sick is winning, getting payouts is often actually losing. It's like a socialist system for everyone that has some disposable income. Private healthcare premiums are extremely cheap compared to the US e.g. "the premium for a member aged 0-21 years on our most popular plan, Wellbeing Two, is just $9 a week", and "Pay for 2 kids, the rest are free*"; you can see what is covered by that plan here: https://www.southerncross.co.nz/Portals/0/Society/EFulfillme...

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

#118

Post by pteredactyl » Sat, Aug 03, 2019, 8:39 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…

True. And your employees will not have the choice to see a doctor outside of Kaiser's vertical integration. Even if necessary. Further, since they are all vertically integrated they will necessitate care that is in line with their system.

I've heard good and bad, mostly bad, from Kaiser. But it's hard to tell objectively given the current system and how people interact with it. Personally, I had a not so great experience.

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

#119

Post by jki275 » Sat, Aug 03, 2019, 9:00 PM UTC

hestipod wrote: post #100

ta0987 wrote: post #84

Earlier quoted context omitted.

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 mo…

So the fact you haven't heard any anecdotes means other people's experiences are invalid?

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

#120

Post by jki275 » Sat, Aug 03, 2019, 9:02 PM UTC

jdsully wrote: post #103

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…

> Of course, you're always free to pony up your own cash to pay for a treatment that isn't covered by your insurance With the big caveat that you cannot pay for "higher quality" of any services that are covered even if you want to.

And of course that assumes one can afford the treatment, which for non-covered treatments can be hundreds of thousands of dollars.