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

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

#251

Post by JamesBarney »

EliRivers wrote: post #137
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.

I wonder if, even with a reduction in new drug development, cheaper healthcare would nonetheless work out as a net win. If all the drugs that currently exist getting much cheaper would improve people's lives (both now and into the future) to a degree that outweighed the benefits of continuing R&D at the current pace.

For sure and this is my point. Not that reducing pharmaceutical costs is bad, just that it isn't a free lunch.

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

#252

Post by dragonwriter »

lotsofpulp wrote: post #232
dragonwriter wrote: post #226

Earlier quoted context omitted.

> The unofficial doctors union restricts funding for residency spots No, they don't, unless “unofficial doctors union” is a misleading way of referring to the US Congress (which has way more lawyers than doctors) which funds many of those spots through Medicare (but also some through the VA.) > You can be a doctor in the UK at 24, and in the US, you're at least 30. You can have an MD, having graduated from high schoo…

I was referring to the Accreditation Council for Graudate Medical Examination being staffed by doctors: https://www.aafp.org/news/education-professional-development... https://www.washingtonexaminer.com/thanks-to-doctors-there-a... You don't need to be at least 30, but since most new doctors are that old, I assume there's a reason that's stopping them from becoming doctors earlier, therefore also restricting supply:…

> I was referring to the Accreditation Council for Graudate Medical Examination being staffed by doctors

They aren't anything like a union and don't control funding for residency slots, so if that's what you were referring to, it doesn't justify your claim.

> You don't need to be at least 30, but since most new doctors are that old, I assume there's a reason that's stopping them from becoming doctors earlier

Most choose separate undergrad and medical programs (not B.S./M.D. programs), and on average are entering those programs later than four years after a high-school graduation at 18 — mean age for starting med school is 24. [0]

But, in any case, you've now shifted to a claim about averages from one about minimuns, and the bulk of the issue you are pointing to occurs before entering medical school, so the fixes would need to be in secondary and undergraduate education; people starting medical education at 24 aren't going to be doctors at 24 (the ideal you contrastes the US to) unless you give them a medical license just for signing up, which is probably not a beneficial reform.

[0] https://www.usnews.com/education/blogs/medical-school-admiss...

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

#253

Post by 01100011 »

It's not just the billing that sucks. It's also the care, or lack thereof, in the health care system.

I remember taking my friend to a Dr. visit when he had a brain tumor. The parking was confusing, with signs threatening fines of hundreds of dollars for parking anywhere near the building(this was at UCSD in La Jolla). This was at a cancer center, where you'd expect they'd prioritize access for patients. He went in for an eye exam, and the doctor was getting extremely agitated because my friend had problems communicating and performing a few tasks as quickly as the doctor wanted. Very few people in the hospitals seemed equipped to handle someone who had problems seeing, walking and communicating.

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

#254

Post by mywittyname »

nostromo wrote: post #205
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?

This is flawed thinking. But it's very popular flawed thinking, so you're certainly not alone. :) If marketing has a return on investment (and it does) then marketing spend also increases money available for R&D . Marketing and R&D are not pieces of a fixed pie. Marketing spend grows the entire pie and provides additional dollars for the company to spend on R&D.

It does provide a perverse incentive to research drugs with high market potential over those with live saving potential.

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

#255

Post by ams6110 »

rtkwe wrote: post #248
sbov wrote: post #203

Earlier quoted context omitted.

Don't go to the ER for a sprained thumb. Unless its an actual emergency, go to urgent care. I live in a pretty expensive area of California and they still only charge $95 per person they see. And our insurance covers it completely. And rightly so, they would much prefer a $95 bill to a $14,000 one. With kids we go a couple times per year. They definitely have saved us a lot of money and time.

As other have said urgent care isn't everywhere and closes so it's not entirely by choice that people wind up in the emergency room for non emergency things. Beyond that it's hard to know sometimes what's emergency and what isn't until you have a doctor look at what's happening.

OK but a sprained thumb is not something that can't wait until morning. Take a couple of Advil and put some ice on it.

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

#256

Post by mywittyname »

EliRivers wrote: post #137
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.

I wonder if, even with a reduction in new drug development, cheaper healthcare would nonetheless work out as a net win. If all the drugs that currently exist getting much cheaper would improve people's lives (both now and into the future) to a degree that outweighed the benefits of continuing R&D at the current pace.

We can supplement this by improving funding for research in public universities. This will probably provide a better bang for the buck than our current method anyway.

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

#257

Post by AnIdiotOnTheNet »

justwalt wrote: post #234
rayiner wrote: post #105

This came up last year when it was discovered that Leon Lederman had to sell his Nobel Prize to pay for cancer treatments. But there is more moral complexity to this issue than people appreciate. Cancer treatment is inherently expensive; it just doesn't seem that way in some other countries because the government pays from the outset. But I don't think that's necessarily moral, compared to something like Medicaid, wh…

I would think the average person would feel slimy/predatory buying someone else’s Nobel prize. Unless it’s the case of a friend offering to help out, but then why not just lend the money without the collateral?

Could have been a museum or something.

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

#258

Post by hwillis »

nostromo wrote: post #205
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?

This is flawed thinking. But it's very popular flawed thinking, so you're certainly not alone. :) If marketing has a return on investment (and it does) then marketing spend also increases money available for R&D . Marketing and R&D are not pieces of a fixed pie. Marketing spend grows the entire pie and provides additional dollars for the company to spend on R&D.

> Marketing and R&D are not pieces of a fixed pie. Marketing spend grows the entire pie and provides additional dollars for the company to spend on R&D.

You're talking like marketing extracts money from the ground as if it's a raw resource. If 10x as much is spent on marketing as RD then the money spent on pharmaceuticals is making better drugs.

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

#259

Post by JamesBarney »

milesvp wrote: post #132
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.

I’ve never bought this argument about r&d for drug companies, and I have even less faith in the argument after learning recently that much of this r&d is used to modify an existing drug, not to make it better, but to essentially earn another patent on said drug and keep it out of the public domain for longer. Couple this with the fact that there is a large focus on designer drugs, and dependency rather than curative…

One reason there isn't a focus on curative drugs is the current drug system won't pay for it. In an ideal world if it costs 10 million dollars to treat an HIV patient over ten years we should be willing to spend 5 million on a curative drug. But when this actually happens as seen with a hepatitis cure everyone freaks out about the price drug. And thus we can't have nice things.
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