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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

#321

Post by nostromo »

cwkoss wrote: post #316
nostromo wrote: post #205

Earlier quoted context omitted.

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.

There is no moral way for a pharma company to increase demand for its product.

That's silly.

If I have a cure for X. And if you have X but don't know about my cure -- perhaps you don't even know a cure is possible -- it's a net good for me to tell you about my cure for X. And how do I tell you if there are millions of yous I'm trying to reach? Via marketing.

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

#322

Post by nostromo »

hwillis wrote: post #258
nostromo wrote: post #205

Earlier quoted context omitted.

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 .

It doesn't matter how much gets spent on marketing in relative terms. If it were 99% of the budget, but R&D was larger in absolute dollars, then that'd be a net positive.

Marketing increases revenue. A portion of revenue goes to R&D. Ergo, more marketing means more revenue available for R&D.

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

#323

Post by cwkoss »

nostromo wrote: post #321
cwkoss wrote: post #316

Earlier quoted context omitted.

There is no moral way for a pharma company to increase demand for its product.

That's silly. If I have a cure for X. And if you have X but don't know about my cure -- perhaps you don't even know a cure is possible -- it's a net good for me to tell you about my cure for X. And how do I tell you if there are millions of yous I'm trying to reach? Via marketing.

That's an even sillier steel-man.

Consumers are not good at making informed pharmaceutical choices on their own, and the idea that magazine advertisements showing smiling old people does anything to inform them is laughable.

Also, pharma doesn't market cures, they prefer to market long-term treatments that are recurring funding streams.

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

#324

Post by burkaman »

5trokerac3 wrote: post #180
burkaman wrote: post #171

Earlier quoted context omitted.

That's a cherry-picked stat. Most health outcomes are worse in the US than other rich countries with universal healthcare. There are many studies and charts you can search for, here's one: https://jamanetwork.com/journals/jama/article-abstract/26746...

1. This entire article and thread is about cancer, so I'm not cherry picking. If anything the broad "health outcomes" is a diversion from the main subject. 2. What percentage of poorer "health outcomes" are due to the US's ~33% obesity rate and overall horrid diet and have nothing to do with care or access?

You're right about 1, sorry.

Obesity and diet are very much related to care and access. If you can't afford to go to the doctor unless you're dying, nobody is going to tell you when your cholesterol is getting too high and you should adjust your diet, or your blood sugar is getting into the warning zone, or whatever.

We have such high obesity because we don't focus enough on preventative care, and lots of people can't afford preventative care even if they want it.

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

#325

Post by CurrentlyYouDo »

bluesroo wrote: post #245
madengr wrote: post #202

Earlier quoted context omitted.

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.

On top of the yearly exemption, you have a lifetime exemption in the US of $11.18M.

Currently you do. At a recent visit to my estate planning attorney he said it's likely that will be cut in half in the next few years. I don't recall whether it was because there's a time limit on that particular part of the law that's going to run out, or because it was likely the ruling parties would switch and they would vote it back down. But either way just remember that it can change in either direction at just about any time.

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

#326

Post by [deleted] »

throwaway5752 wrote: post #317
billforsternz wrote: post #292

Earlier quoted context omitted.

On the weekend my 83 year old mother in law fell and broke her ankle. One hour ambulance ride to a metropolitan ER. Examination and diagnosis by a trauma specialist and an orthopedist. X-ray. Moonboot applied, a night in hospital as community team were assigned to make her adjustments to her apartment for recovery period. Physiotherapist consultation and ongoing support. No insurance. Total cost zero dollars. In New…

I am breaking my word replying, but madeofpalk and you highlight something I failed to distinguish in my comment. I'm talking about "bill" in the sense of summing up the cost of services rendered, like a check in a restaurant. Not policy talk about how is responsible for paying it. All that care for your grandmother (who I hope is okay) isn't zero dollars. It is thousands or tens of thousands of dollars, but she didn…

[deleted]

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

#327

Post by billforsternz »

throwaway5752 wrote: post #317
billforsternz wrote: post #292

Earlier quoted context omitted.

On the weekend my 83 year old mother in law fell and broke her ankle. One hour ambulance ride to a metropolitan ER. Examination and diagnosis by a trauma specialist and an orthopedist. X-ray. Moonboot applied, a night in hospital as community team were assigned to make her adjustments to her apartment for recovery period. Physiotherapist consultation and ongoing support. No insurance. Total cost zero dollars. In New…

I am breaking my word replying, but madeofpalk and you highlight something I failed to distinguish in my comment. I'm talking about "bill" in the sense of summing up the cost of services rendered, like a check in a restaurant. Not policy talk about how is responsible for paying it. All that care for your grandmother (who I hope is okay) isn't zero dollars. It is thousands or tens of thousands of dollars, but she didn…

I did understand your point, and I could have been clearer by using the word "bill" rather than "cost". Obviously there was cost. In New Zealand cost is not something that a person suffering sudden trauma has to worry about. I am glad you agree this is a good model.

I have another story that is cancer related. Four years ago I had cancer surgery, in the private system. The public system judged that I could wait a month or two (our system isn't perfect), but I was fortunate to have health insurance and elected to be treated immediately. After a few days at home I awoke in the most excrutiating pain imaginable. I was just able to stagger to the phone to call for an ambulance. I would judge it was less than five minutes before I heard the wonderful siren of an approaching ambulance with well trained paramedics and their lovely lovely morphine. It turned out I had a relatively rare complication, a urinoma, my resectioned kidney was leaking urine into my abdomen. Ambulance care (google "Wellington Free Ambulance" it's a wonderful thing), ER assessment, CT scan, stent insertion to help the kidney heal, five days in hospital. Total cost: Who knows, probably astronomical. Total bill: zero dollars.

I love capitalism, I'm a true believer. But I believe even more in a compassionate society and it seems to me that means not using capitalism as a solution to all problems. It makes total sense to have a model that relieves victims of sudden medical trauma from financial stress and spreads the cost across society. The victims are not well placed to play the role of rational economic actors.

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

#328

Post by lotsofpulp »

sbov wrote: post #290
koolba wrote: post #289

Earlier quoted context omitted.

If you have a deductible you’ll be on the hook for the whole cost which could be $100-150. The bill would need to round trip to the insurance company first. In contrast if you have not met your deductible and say you’re paying cash, it’s often cheaper as the cash price is something like $75. I got in an argument once at an urgent care on this topic. I asked how much they would bill my insurance (“ We can’t/won’t tell…

I had a hospital pull this on me when I was looking to get something done. They said we can't get the cash price because you can only get that if you don't have insurance, even if you know your insurance doesn't cover it, and it's illegal to not have insurance so we must have it, so no cash price.

Talking to people in the healthcare field about billing and money can make people murderous, logic, chain of reasoning, the English language is all in a state of flux.

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

#329

Post by JamesBarney »

rndgermandude wrote: post #320
JamesBarney wrote: post #271

Earlier quoted context omitted.

Evidence that if the profits of new drug drops significantly that the money spent on R&D on those new drugs will also drop? Imagine the government decides to tax 80% of all revenue from all technology companies forever. Do you think funding for startups would increase, stay the same, or drop? The obvious answer is drop, but what type of evidence would you expect to support this statement. A study of people taxing tec…

Worst straw man I saw in a long while. PS: >The obvious answer is drop No. You "feel" it is "right" and "obvious" even, and it might as well be if we really did that experiment, but humans are pretty bad at predictions.

What is your argument that it wouldn't affect R&D spending?

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

#330

Post by nradov »

rarecoil wrote: post #240
nradov wrote: post #179

Earlier quoted context omitted.

For non-emergency imaging studies it's worth shopping around. Prices really can vary by a factor of 10× between facilities in the same area. For those with private insurance, most major insurance companies offer some sort of cost estimator on their web sites which allow members to see which radiology centers are cheaper. (I do appreciate that this is a bad experience for patients.)

I needed an MRI a few years ago, and my insurance provider actually called me to tell me about insurance-preferred imaging centers, and how much the out-of-pocket cost would be at those centers vs. the one my MRI was initially scheduled at.

Yes some payers will check the stream of incoming X12 278 Prior Authorization messages for expensive procedures and then attempt to steer members toward lower cost options. This helps to hold down costs for the healthcare system as a whole.
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