Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

npr.org

Post reply on HN
Print view View original

161–170 of 369 posts

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#161

Post by peteey »

mbostleman wrote: post #70
porphyrogene wrote: post #18

Earlier quoted context omitted.

The publication is NPR so that it is US news goes somewhat without saying. However, this is something that Americans need to understand is exceptional for a nation of its resources.

So what is the solution? More than 42% went all in with the constraint being their personal assets. If that constraint was lifted, then what would the next constraint be? Obviously the additional assets would come from other people, and probably not voluntarily (which is a different issue), but what would be the limiting factor then? Also, I assume the new pool of assets would be available not just to the 42% that we…

The socialization of the insurance market puts the citizens paying at the mercy of the healthcare industry.

Wouldn't it make more sense to socialize the healthcare industry itself? Our tax dollars pay for much of the education and hospitals. Are we entitled to ownership?

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#162

Post by cletus »

chaosbutters wrote: post #61
cletus wrote: post #34

In Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cau…

doesn't matter who is president in 2020, if the senate isn't blue. And right now, it doesn't look like the senate will even hit 50/50.

So there's a lot I could say about this.

First is an example. As much as I, personally, liked (and continue to like) Obama as a person and as much as I agree with most of his policies, at the end of the day he was a pretty ineffective president. Why? Because he could get hardly any legislation passed (Obamacare aka the Affordable Care Act being the principle counterexample). He was a president who ruled by executive order.

The White House is the largest and loudest bully pulpit in the country, by far. You can point to Congress and call them obstructionist but the buck stops with you as president to move your policy agenda and change the national debate. And Obama just wasn't effective at that.

Again, with one exception. It used to be a fairly popular opinion in the US that health coverage was for those with jobs, basically. That still is the position of a significant portion of the population but it's not as popular as it used to be. Obama did change the national debate on this such that the question became how we should provide health coverage and not whether we should.

Go back a decade or more and the Bernie Sanders coverage-for-all policy platform would've relegated him to being a minor player in the primaries, not taken seriously. The fact that he was as prominent a figure as he was is in no small part due to Obama changing the debate on health care (IMHO).

The second thing I'll say is that nothing lasts forever. Demographics change. Opinions change. California voted for Reagan. Twice. It used to be a competitive state. Now it's safely Democratic. Florida used to be safely Republican but (largely due to migration from the Northeast) but now it's a battleground state.

Let's just say that at some point Conservatives get what they've been hoping for: Roe v. Wade overturned in the SCOTUS. It could happen. Largley though the "damage" has been done already. It won't be illegal. It'll just be a state issue. Many states will legallize it the next day. New York for example has already made moves to enshrine the legality of abortions in state law. Now this will suck for particularly poor people in Alabma but in a way Alabamans will get the state government they seem to want.

So let's say that happens. The problem then for Conservatives is they've lost a defining and unifying (for their base) issue. One can argue they're better off politically this way as they'll fracture in the aftermath.

I see the current Conservative bent as a desperate last gasp for what is a majority (in their respective states) that's in decline. A lot of damage can be done before this naturally remedies itself but we're not headed to a dystopian Handmaid's Tale future either.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#163

Post by dontreact »

5trokerac3 wrote: post #133
cletus wrote: post #34

In Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cau…

The United States currently has the highest 5 year survival rate for all cancers combined. I think it's a fair question to ask if that would continue to be the case in a MFA system for 300 million patients. Considering what a disaster the insurance marketplace was, I'm very skeptical. Edit: what I mean by "disaster": when it launched, the site completely crashed for over a month and then, when it finally came back up…

The U.S. actually has worse health outcomes overall than Japan and France who both have universal coverage (through different systems)

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#164

Post by toomuchtodo »

rayiner wrote: post #135
gregcrv wrote: post #92

Earlier quoted context omitted.

From https://en.m.wikipedia.org/wiki/Prescription_costs “A study has placed the amount spent on drug marketing at 2-19 times that on drug research” Maybe this should be reduced first?

The wikipedia article misstates the figure in the underlying paper. The underlying paper is talking about "basic research" not R&D. I.e. it doesn't count money spent on e.g. making improvements to use of known molecules, it doesn't count the cost of bringing a new molecule to market, it doesn't count the cost of testing, etc. That's a non-sequitur. Companies have no incentive to spend any more on marketing than they…

Only in America and New Zealand are pharmaceuticals permitted to be marketed directly to consumers. Does the rest of the world not innovate?

We’ve tried the free market way, let’s try it the “rest of the developed world way” next.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#165

Post by aantix »

cletus wrote: post #138
JamesBarney wrote: post #65

Earlier quoted context omitted.

I'm all for universal coverage too. But reducing the profits of pharmaceutical companies well reduce the money they have for r&d dramatically. This will slow down the speed of pharmaceutical development. So I think it needs to be paired with reforms to the FDA to reduce the go to market costs for drugs.

Pharmaceutical companies spend way more on marketing than research. If drug companies are willing to sell the exact same drug in Canada or the UK or Germany or France for less than a percent (in some cases) of what they sell it here for then why can't US insurance companies, hospitals and consumers buy it for that price? There's no reason other than an artificial monopoly. You'll note that I didn't say "anywhere" and…

>Pharmaceutical companies spend way more on marketing than research.

Because who cares if you've made a breakthrough product and no one knows about it?

>why can't US insurance companies, hospitals and consumers buy it for that price

Because profits for future R&D has to come from somewhere? And if everyone is lined up for a discount, future R&D will suffer.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#166

Post by chimeracoder »

ranie93 wrote: post #79
cletus wrote: post #34

In Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cau…

I think the current friction in free flow of medication across borders is not unwarranted. I'm thinking of Thalidomide as an example. https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey

> I think the current friction in free flow of medication across borders is not unwarranted. I'm thinking of Thalidomide as an example.

That's a completely different situation.

Currently, if an American pharmaceutical company produces a drug in the US and exports it to another country, people in the US cannot purchase it from foreign suppliers, even though it's both FDA-approved and produced by the same manufacturer. This dramatically raises the prices of drugs in the US.

Allowing imports of FDA-approved drugs from both domestic and foreign manufacturers would reduce prescription costs in the US greatly.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#167

Post by deisner »

Sharlin wrote: post #86
deisner wrote: post #23

"But none of these is her most gnawing, ever present concern. That would be the convoluted medical bills that fill multiple binders, depleted savings accounts that destroy early retirement plans and so, so many phone calls with insurers and medical providers." Is it like this in other OECD countries? I ask because I'm told that we in America have "the best health care system in the world."

No, it is definitely not. Whoever tells you that is either lying, ignorant, or in denial.

My question was slightly sarcastic, but primarily sincere, in that I want to hear first-hand accounts from cancer patients in other OECD countries.

Rudy Guliani said this in a campaign ad [1] when he was running for U.S. president in 2007-2008. I also recall him saying this in one of the Republican debates. When my (now) wife, who is German and has also lived in Denmark, heard this she couldn't help laughing.

[1] https://www.cbsnews.com/news/giuliani-ad-chances/

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#168

Post by onetimemanytime »

cletus wrote: post #34

In Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cau…

If health care for all reduces prices and total cost, then yeah. Otherwise, the cost will cripple the government, and by extension taxpayers. Right now they can declare bankruptcy and just don't pay (at a great cost, no doubt) but the government will have to pay. Cancer is a fact of life,38.4% will get it in their life https://www.cancer.gov/about-cancer/understanding/statistics and unless costs are dramatically lowered any plan will be bankrupt.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#169

Post by chimeracoder »

flexie wrote: post #136
cletus wrote: post #34

In Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cau…

And that's the essence of this: In the developed world, this is all but a US specific issue. Cancer and other life threatening diseases rarely bankrupt Europeans, Canadians, Australians, Kiwis, Japanese etc.

> Cancer and other life threatening diseases rarely bankrupt Europeans, Canadians, Australians, Kiwis, Japanese etc.

Sure, but they're also dramatically less likely to survive the cancer than Americans are at a population level. There have been multiple long-term studies on cancer survival rates that have demonstrated this.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#170

Post by Sahhaese »

5trokerac3 wrote: post #133
cletus wrote: post #34

In Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cau…

The United States currently has the highest 5 year survival rate for all cancers combined. I think it's a fair question to ask if that would continue to be the case in a MFA system for 300 million patients. Considering what a disaster the insurance marketplace was, I'm very skeptical. Edit: what I mean by "disaster": when it launched, the site completely crashed for over a month and then, when it finally came back up…

I wonder how much of that is down to better/earlier diagnosis \* ? My experience with the NHS is that diagnostics in general isn't great because it's essentially a money-sink, you have to push very hard for a diagnosis a lot of people get a diagnosis privately before going back to the NHS for treatment.

Once diagnosed however I've never had any problem getting top quality treatment. This is an anecdote, of course, so I'd be interested to see the statistics.

\* Or even over-diagnosis? It's "easy" to have a high 5-year survival rate if you push removal of tumors that may well have been benign.

Post reply on HN