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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

#261

Post by chimeracoder »

mancerayder wrote: post #236
chimeracoder wrote: post #178

Earlier quoted context omitted.

> 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. They're willing to do that because the US is a much larger market than any of those countries. Most pharmaceut…

They're willing to do that because the US is a much larger market than any of those countries. Most pharmaceutical companies - including European companies - make the lion's share of their profits from the US market. If they couldn't, you'd certainly see the costs for essential medicines increase in European countries. "Willing" is a broken way to look at it. The drug prices are negotiated by the government in the si…

> "Willing" is a broken way to look at it. The drug prices are negotiated by the government in the single-payer systems.

Most countries don't have single-payer systems, and even where that's the case, "negotiated" is the broken term. For essential medications, the supplier always has greater leverage than the purchaser.

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

#262

Post by dontreact »

5trokerac3 wrote: post #210
dontreact wrote: post #197

Earlier quoted context omitted.

I don’t know for sure what the breakdown is. Right now our overall system does little to discourage the obesity epidemic, but in a universal coverage system there would be massive financial incentive to fight it (either the government or insurance companies being forced to provide coverage for all)

Is there perhaps a better way to use resources to fight the obesity epidemic, and massively impact "health outcomes", than a ~$40 trillion complete overhaul of the medical system and hoping that the epidemic is solved by proxy?

I don't know where you get 40 trillion from.

As I mentioned, our costs are significantly higher and our outcomes are worse than 30 other countries who have universal coverage. We should be learning something from the systems in place in other countries. I think you are focusing too narrowly on obesity in particular, when there are many reasons why this is happening.

I would suggest reading this book: https://www.amazon.com/Getting-Health-Reform-Right-Performan...

It was written by William Hsiao, who was hired by the Taiwanese government to advise them on modernizing/reforming their health care system. It does a lot to compare health systems in various countries. I think one underlying thread is how much health systems improve once there is a commitment to universal coverage.

I work in this space and am trying to see what can be done about changing behaviors to make people healthier but it is incredibly difficult, especially when there is so much financial incentive in getting people to behave in unhealthy ways.

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

#263

Post by chimeracoder »

DanBC wrote: post #242
chimeracoder wrote: post #169

Earlier quoted context omitted.

> 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.

You've failed to correct for over-testing, over-diagnosis, and over-treatment which all cause harm. It's worrying that the US places so much emphasis on 5 year survival rates, and not on eg all cause mortality.

> You've failed to correct for over-testing, over-diagnosis, and over-treatment which all cause harm. It's worrying that the US places so much emphasis on 5 year survival rates, and not on eg all cause mortality.

I'm not, if you actually read the research I linked instead of speculating.

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

#264

Post by ranie93 »

chimeracoder wrote: post #166
ranie93 wrote: post #79

Earlier quoted context omitted.

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.…

> [Allow] imports of FDA-approved drugs from both domestic and foreign manufacturers

I agree. I interpreted the OP's comment of "You should be able to legally import them from, at the very least, any NAFTA country and any EU member." to be too lax.

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

#265

Post by justin66 »

wpdev_63 wrote: post #224

Has anyone tried flying to another country for more affordable treatment after the diagnosis? Countries like Germany and some south american countries have much more affordable treatment even factoring in the lodging and flying.

Having to fly to receive treatment seems like it might significantly affect the likelihood of a full recovery. Cancer patients tend to have compromised immune systems and airplanes are filthy.

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

#266

Post by mywittyname »

onetimemanytime wrote: post #168
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 lowe…

People often don't even need to declare bankruptcy. Lots can get away without paying and the hospital will write off the charges without any ill effect.

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

#267

Post by ams6110 »

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.

I don't know about the rest of the world, but bankruptcy in the USA is not really the catastrophe you might think it is.

You can keep a lot of your assets, generally including your retirement accounts, at least some equity in your home, your car, your personal property. Your credit is badly dinged and you'll have trouble borrowing money for a while, but even that is only a temporary setback.

I know people who have gone through it, in once case more than once, and at least from appearances they have a pretty normal lifestyle.

The recovery from a bankruptcy is probably a walk in the park compared to recovery from cancer (not speaking from experience). Ultimately it's just money.

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

#268

Post by chimeracoder »

donaldknuth123 wrote: post #218
chimeracoder wrote: post #198

Earlier quoted context omitted.

> The US is barely in the top among developed nations, and it's not much better than the next 10-15 countries: https://www.wcrf.org/dietandcancer/cancer-trends/data-cancer... . First, you're posting data that isn't relevant: that's the rate of cancer incidence , not the survival rates. That says nothing about how well the cancer is treated. Secondly, it's nonsensical to compare aggregated cancer statistics between co…

1. The data you posted is 20 years old. 2. The data is talking about 5 year survival rates and not actual survival. The US Healthcare system is great at keeping people alive who should have stopped treatment long ago. 3. The US is behind on every other major health indicator, Infant Mortality, Life Expectancy, Cardiovascular Disease, Obesity etc. Cancer isn't the only expensive illness in the US. This thread is overr…

> 1. The data you posted is 20 years old.

It's from a study published 10 years ago. The study was repeated more recently and republished less than a year ago, reaffirming the original results.

> 2. The data is talking about 5 year survival rates and not actual survival. The US Healthcare system is great at keeping people alive who should have stopped treatment long ago.

There is no such thing as "actual survival". 5-year survival rates are the global standard for cancer epidemiology.

> 3. The US is behind on every other major health indicator, Infant Mortality, Life Expectancy, Cardiovascular Disease, Obesity etc. Cancer isn't the only expensive illness in the US.

This thread is about cancer, in response to an article posted about cancer.

> This thread is overrun with Astroturfers.

From the HN guidelines: https://news.ycombinator.com/newsguidelines.html

> Please don't impute astroturfing or shillage. That degrades discussion and is usually mistaken. If you're worried about it, email us and we'll look at the data.

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

#269

Post by ThrustVectoring »

madengr wrote: post #202
shereadsthenews wrote: post #43

I'd like to know where the patient with the $870 MRI bill was seen. My last MRI was billed at over $7500. Before I started treatment for my brain tumor I got divorced for purely financial reasons and gave all my remaining money to my children. USA is so fucked.

Other than cash, how do you give money over $15k without being nailed by the gift tax? Keeping as much money in retirement savings seems wise as those are exempt from liens.

IRAs are not exempt from creditors in all states, FYI. Texas has solid unlimited protection at least, though.

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

#270

Post by rootusrootus »

madeofpalk wrote: post #238
kibwen wrote: post #141

Earlier quoted context omitted.

Fortunately (ironically, sardonically), thanks to the precedents being set by the sitting president, future presidents will be free to declare healthcare a national emergency and divert funds away from, say, the defense department in order to pay for it. A slim majority in the senate and a minority in the house won't be near enough to stop them. The current senate dissolves the checks and balances at their own instit…

> future presidents will be free to declare healthcare a national emergency Well, actually, maybe it is a national emergency? Definitely seems more of an emergency than some wall.

So is climate change. We have lots of emergencies to tend to. It is going to get interesting.
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