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I write about America’s health care system, and I got caught up in it

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Re: I write about America’s health care system, and I got caught up in it

#51

Post by agumonkey »

cmmeur01 wrote: post #18

Used to do these “pre-authorizations” for Humana and wanted to kill myself after a week. Seniors write in about how they’re eating dog food to pay for their medicine, I forward the letter to insurance doctors, who deny it because they “have to try these 3 drugs before you can get what works”. Made me realize this whole country is broken and those at the top are morally bankrupt.

There's an absurdity about our time in that we have data, data analysis, extreme communication yet the efficiency and refinement of policies are still limited by the same bottlenecks.

Re: I write about America’s health care system, and I got caught up in it

#52

Post by text70 »

AuthorizedCust wrote: post #41
kemiller2002 wrote: post #38

Earlier quoted context omitted.

It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.

That’s exaggerated. Generics are well known to be effective, and exceptions are unusual. Here’s some commentary to that effect, talking about research to the contrary: https://www.health.harvard.edu/staying-healthy/do-generic-dr... It’s reasonable to expect people to exhaust lower cost alternatives, that are reasonably expected to work, before stepping up costs.

Speaking of genetics, screening for the genetic profile of variable liver enzymes for known mutations and their associated drug interactions could actually save on the shotgun approach to dispensing medicines.

The problem is, you won't be able to hammer down the health of the patient to the lowest cost option, only the most effective.

Re: I write about America’s health care system, and I got caught up in it

#53

Post by tragictrash »

epmatsw wrote: post #46
tragictrash wrote: post #39

Earlier quoted context omitted.

What twisted fucked up naive world view does this come from. These people are poor, vulnerable and sick. You should be ashamed of yourself. Why don't I throw you in a cage, and then you can try voting for someone to advocate for your release. The point is the seniors need help now, not being told to go organize. The healthcare system is broken, and until you get sucked into it, you don't understand the extent of it.…

I think the point was that seniors as a demographic generally vote for politicians that don’t support those policies, against the wishes of the majority of the rest of the population.

Yeah, but that doesn't mean we should be denying care to anyone.

Why is it so hard to say the healthcare system is broken instead of blaming the seniors.

That dude's throwaway is doing real damage by normalizing the deflection of blame onto the patient.

Re: I write about America’s health care system, and I got caught up in it

#54

Post by lil_dispaches »

Health Insurance is a political scam of epic proportions. There is no indemnity involved. It is not real insurance. You don't use insurance to pay a monthly bill, you have it for black swan events. Nor should insulin be 1000/mo, on paper or otherwise.

The whole thing is performance politics to distract from the "insurance" companies running everything from medicine regulations to your kids playgrounds (so they don't hurt themselves and need care).

Re: I write about America’s health care system, and I got caught up in it

#55

Post by katbyte »

makomk wrote: post #43
kemiller2002 wrote: post #38

Earlier quoted context omitted.

It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.

Thousands of dollars per patient times many different patients and drugs quickly adds up to a substantial proportion of all healthcare spending. Countries with universal healthcare have specific programs in place to move people over to generic drugs for exactly this reason, or at least the UK does - along with policies that intentionally give people less effective treatments if the better ones are a lot more expensiv…

Bc Canada it just covers the equivalent generic cost, if you want to get brand you pay the difference, can be 5$, can be 50$

Re: I write about America’s health care system, and I got caught up in it

#56

Post by syki »

refurb wrote: post #31
cmmeur01 wrote: post #18

Used to do these “pre-authorizations” for Humana and wanted to kill myself after a week. Seniors write in about how they’re eating dog food to pay for their medicine, I forward the letter to insurance doctors, who deny it because they “have to try these 3 drugs before you can get what works”. Made me realize this whole country is broken and those at the top are morally bankrupt.

Why is that broken? Even systems with universal healthcare have rules like this. Why use a $1000 per month branded drug unless you know the $5 per month generic drug doesn’t work?

In all healthcare systems some form of rationing occurs since there aren’t enough resources to provide the best care to everyone. A system that rations care based on ability to pay or on wether or not your employer is generous is immoral. It is also immoral to profit off of denying someone care. Tough decisions have to be made and financially rewarding a company by denying care is despicable.

Re: I write about America’s health care system, and I got caught up in it

#57

Post by lotsofpulp »

lil_dispaches wrote: post #54

Health Insurance is a political scam of epic proportions. There is no indemnity involved. It is not real insurance. You don't use insurance to pay a monthly bill, you have it for black swan events. Nor should insulin be 1000/mo, on paper or otherwise. The whole thing is performance politics to distract from the "insurance" companies running everything from medicine regulations to your kids playgrounds (so they don't…

Health insurance in the US has an in network out of pocket maximum of $8,700 for individual and $17,400 for families:

https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...

With the recent laws regarding mandatory coverage of emergencies while out of network, it seems to qualify for the definition of “insurance”, as you are protected from expenses above $17.4k per calendar year per family.

The fact that most Americans probably cannot afford this is a separate matter, but it is more insurance than it has ever been in the US.

Re: I write about America’s health care system, and I got caught up in it

#58

Post by SamoyedFurFluff »

AuthorizedCust wrote: post #41
kemiller2002 wrote: post #38

Earlier quoted context omitted.

It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.

That’s exaggerated. Generics are well known to be effective, and exceptions are unusual. Here’s some commentary to that effect, talking about research to the contrary: https://www.health.harvard.edu/staying-healthy/do-generic-dr... It’s reasonable to expect people to exhaust lower cost alternatives, that are reasonably expected to work, before stepping up costs.

Part of the issue is that insurance companies often “reset” this process. I know a friend with really hyper specific health conditions that requires a fairly expensive, experimental treatment. They need this because they’ve tried everything already. But sometimes the insurance company seems to forget that they already tried everything, and refuses to pay and tries to get them to go through it all over again, a process which destroys their ability to function and leaves them seriously disabled for months at a time.

This also happens if the employer switches insurance.

So no it isn’t as innocent not as simple as saving costs for generics. This makes sense for the first time the patient seeks treatment. This doesn’t make sense if the patient already has a treatment plan that works and the insurance company decides they want to do the whole pony show again, fucking in peoples life for months.

Re: I write about America’s health care system, and I got caught up in it

#59

Post by [deleted] »

tragictrash wrote: post #53
epmatsw wrote: post #46

Earlier quoted context omitted.

I think the point was that seniors as a demographic generally vote for politicians that don’t support those policies, against the wishes of the majority of the rest of the population.

Yeah, but that doesn't mean we should be denying care to anyone. Why is it so hard to say the healthcare system is broken instead of blaming the seniors. That dude's throwaway is doing real damage by normalizing the deflection of blame onto the patient.

[deleted]

Re: I write about America’s health care system, and I got caught up in it

#60

Post by agumonkey »

nine_zeros wrote: post #37

Price aside, the biggest problem with American health care system is the administrative black hole at every stage. Wife was on some serious (and expensive) medical treatment. After many months, the medical provider was at the final stages of the treatment. As usual, the provider needs insurance approval for arcane codes that constitute that segment of the treatment. Get this, the medical provider applies for approval…

Some countries have been jumping so far ahead. IIRC Slovakia, Iceland have ultra lean administrative processes in lots of places. Minutes instead of days or more, and non hassle. UK has some of that too.

France is starting.

Someone in the US should get funding for this. It's a 300M people's "market".

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