On Tue, 16 Sep 2008 15:58:22 -0400, Ed Huntress wrote:


"Curly Surmudgeon" wrote in message
. ..
On Tue, 16 Sep 2008 13:55:31 -0400, Ed Huntress wrote:


"Curly Surmudgeon" wrote in message
. ..

snip


Lets not get sidetracked into the health insurance debate for it masks
the underlying problem. The fundamental problem is that our health
care system has been hijacked by corporate powers making healthcare
too expensive.

Nonsense. The main thing that makes it so expensive is that medical
technology marches forward, not backward, and there's always more stuff
to
apply to medical problems -- increasingly expensive stuff.

That is one factor but there are many others such as malpractice
insurance but the overriding component is that a corporate monopoly has
seized control of the industry at large.

Sure, Curley, malpractice insurance is a factor, and there are many other
factors. It's not a single thing that's done all of it. But if you spend
some time sorting out where the costs are you'll see that most of it boils
down to the fact that doctors can -- and do -- employ more expensive
drugs, procedures, and so on.

That's what I was attempting to communicate, there are many factors, but
the underlying commonality is corporate monopoly of the health care
industry.

Technology has brought down the costs of some treatments but it's
increased the cost of many more, and added hundreds, or thousands, of
completely new ones. Couple that with the malpractice insurance mess,
which leads to excessive testing and so on, and all of the technology is
simply employed more. Just amortizing an MRI machine results in
incredible costs for an MRI. I think my last one was $880, and took
maybe 30 minutes of machine time and the time of two technicians. It's a
multi-million-dollar machine and they charge shop time on amortization,
just like in a machine shop. g In the old days, they'd just apply an
educated guess to what's wrong in that joint or brain.

Not my point.

Meantime, here's another one: I have a nice new insulin pump with
feedback sitting in a box next to me, to be stuck into/onto me tomorrow.
It cost $6,000. 35 years ago I had a 25-cent syringe and a $10/month
bottle of insulin, and that was it, pard'. Pumps didn't exist. Neither
did home blood-glucose monitoring. I just took a stab at it --
literally. g I got lucky and survived it with my limbs, kidneys, and
eyes. Good luck for me.

And if you weren't forced to have health care would you have paid for the
pump? Note, I've designed medical instrumentation. One product is not
too dissimilar to your insulin pump, it took a blood sample from a drip
line and tested for lactate acid giving real time results. I am very
familiar with the industry.

And it marches forward because people will pay for it, as an
alternative to living in misery or dying.

That substantiates my point. Let me give an example:

My daughter had her first yeast infection. A simple anti-fungal yeast
prescription was all that was required yet the doctor/hospital demanded
a pregnancy test (she was/is virgin), blood panels, hormone tests, etc.
running the price up to $4,600. Then they wanted to negotiate. Note
that not a single curative action was taken.

Right, but that's only marginally a "corporate powers" issue. That's
mostly a "we don't want to be sued" issue. Take it up with the tort
reformers. We can sure use some tort reform.

I don't think it is a tort issue but a corporate hospital trying to fleece
patients. The outcome was that we paid to prevent a negative credit
rating then sued in small claims recovering almost all the charge. The
judge read the riot act to the hospital agent.

Now, if you want to know what I do when I suspect a doctor/hospital is
just running up my costs to keep the cash flowing to their own lab, I
tell them "please write a prescription for the test procedure, and I'll
check around to see where I want it done." Then I go look up the
procedure and see if I really want to have it done at all.

Do you have health insurance? Most people take everything they can get
when the price is subsidized by insurance, a different situation arises
when cost is out of pocket.

Most hospitals, particularly, are in desperate cash-flow situations now.
It's not greed that drives it. It's their survival.


In Argentina no prescription is required, just a visit to a local
pharmacy with a short discussion to an educated pharmacist and a $7
prescription which I mailed to her. Cured the infection in 3 days.

So, did she have this infection in the US or in Argentina?

In the USA, she's still in college.

Health Care is essentially unavailable in the US without insurance.
That is hijacking health care holding Americans hostage.

Actually, that's not the case. Emergency rooms can't refuse you, and
many people use ERs as their primary-care physicians. Then the rest of
us pay for it.

True but the root cause is that health care insurance is unavailable at
rational cost. Kaiser for my wife and I would be $1600/month in the USA
and is about $25 in Argentina.

There's always a ready market for new drugs and new medical
technology.

True, and sometimes the costs are justified. But recognize that a full
60% of new drugs are governmentally subsidized through university
research then turned over to pharmaceuticals for manufacture and
distribution with but a bare tithe to the university while Abbott et.
al. gains usuary profits on our own tax dollar.

sigh I'm well aware of how that works. My last job in a medical
communication agency involved a drug on which Sanofi-Aventis had paid
something like $135 million in development costs, and $110 million in
pre-approval marketing costs (which was paying my salary). Then the FDA
decided not to approve the drug. So my company laid half of us off. d8-)

The basic research on that drug was not from a university, however. I
know that a lot of the basic research is done in universities. What you
may not know is that the testing that the pharma companies have to go
through after some basic-science lab makes a discovery often costs ten
times more than the basic research.

I'm familiar with the problem. The FDA should be an advisory, not
regulatory, agency. All the special interest groups like, encourage,
support, and fund that evil.

Note that I've actually been through the FDA approval process. Not
responsible but as an independent contractor responsible for adhering to
the requirements on glucose monitors, inhalation dispensers and patient
monitoring systems.

Generics, Canadian, and other sources are often 90% cheaper.

Of course. Generics just ride on the research, testing, post-marketing
studies and marketing that was done for the original drug. All they have
to recover is manufacturing costs and quality-control reporting. In
Canada, they have price controls and just refuse to allow the drug
companies to amortize research and development. The Canadians, and the
French, and the Brits, and everyone else knows that they can collect
those costs in the US.

How long do you think a pharmaceutical should have a monopoly? Is 17
years not enough? And do you believe that a patent monopoly gives the
right to blackmail public health?

Don't jump to the conclusion that I'm a socialist. Neither am I a greedy
capitalist extremist. There is a large grey area to discuss.

Don't like it? Talk to your congressman. The money has to come from
somewhere, or nobody will have any new drugs.

Ha! My congressman is John Doolittle. I've tried to consult him
previously and been denied because I didn't contribute to his campaign
funds. He is now about to be tried for corruption.

Placer County, California is about 40% Mor(m)on and they own the political
process.

Health care insurance is just another facade by those who have
plundered our economy. Have you tried to get a doctors appointment
without insurance?

Ask Larry.

Non responsive.

Oh, Larry is quite responsive, and he has no insurance. He's the one to
ask.

I have no US insurance and refuse to bankrupt ourselves paying. It's
impossible in California to get a doctors appointment without insurance
and it's actually cheaper to live in Argentina and commute back and
forth getting my healthcare there. It more than pays for transportation.

I've had insurance without a break for decades, excepting one gap of a
few months when my COBRA ran out and I was having trouble getting new
insurance. (My doctors knew it, and took me anyway.) So I don't know
what it's like now.

You are one of the lucky, many cannot get insurance because they are under
employed, unemployed, homeless. This transitions into the quality of care
issue too. Another factor we've not discussed is the costs caused by AMA
monopoly of providers. Midwives and alternative treatments have
essentially been banned to create a monopoly. Then there is the FDA
making many drugs prescription only. In fact some years ago the FDA
stated that they would have made many current over the counter drugs a
prescription item if they had it to do over. They are now trying to
rectify that by regulating vitamins, minerals and even tobacco.

It's a complex topic. We agree that there is no one cause, unless you
agree with me that governmentally mandated monopolies are the root cause.

--
Regards, Curly
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