Posted on 03/19/2008 1:39:17 PM PDT by Incorrigible
It happened in the case of my friend.
He was a long-haul trucker for Schneider, making a really good income, when he was diagnosed with congestive heart failure, the result of chemo he had when he got non-Hodgkins lymphoma thirty years earlier. The chemo had destroyed his heart.
Well, the doctor told the DMV that he had CHF, so they yanked his CDL.
He couldn’t get health insurance as he now had a prior health condition, and he wasn’t employed any more, so he didn’t have insurance that way.
He lost his house, his truck, everything he owned. He ran up $200,000 in credit card bills paying for the many operations. The hospitals forgave a lot, as did the doctors, but he still ran up huge bills for medical needs.
He applied for disability. The doctor told him he’d make it, as he’s in stage 4 heart failure, and is in really, really bad health, but it’ll take a year to get any payments, and another year before they pay for any operations.
This, for a proud man who’s been a trucker since he was 21, and has paid extremely high taxes for many decades.
I’m in kind of the same way, although I am healthy, with one exception. I have high blood pressure, which is fine as long as I’m on medication. But because I have high BP, and am self-employed, no one will give me health insurance.
I make a fairly good income, within middle-class ranges, yet just to see a doctor and pay for visits and meds it’s difficult to do.
In the last two months I had very bad flu. I saw the doctor three times, at $175.00/visit, and got medication of $200.00, plus blood test at $225.00.
I ended up spending almost $1,000.00 for a simple case of flu. God forbid if I ever get heart disease (my cholesterol is only 170, so I’m okay there, hopefully) or cancer. If I do, I have no way to pay the hundreds of thousands of dollars that will be needed to survive.
I know there’s some Freepers who say it’s our duty to die if we cannot get health insurance, but that’s really not the answer, not in a civilized country.
There really has to be a better way for things to work with keeping people healthy and alive in this day and age.
Ed
The whole "prescription" scheme is adding many billions of dollars a year to the cost of health care in this country. You need $100 (or you need your insurance company to spend $100) to see a doctor to write a prescription for something you can easily figure out on your own that you need (in many cases because it's the same medication, for the same condition, that you were taking when you had insurance). You also need transportation to the doctor. And time off work, if you're working.
THIS is the number one thing that people fighting socialized medicine should be focusing on. What kind of "free" country is this, when an adult can't just walk into a drug store, say what they want, plunk down the cash, and get it? The list of medications that genuinely pose a danger to PUBLIC health and safety -- the only legitimate reason for government to restrict access to drugs -- is actually very short, and those are the only ones that should require any kind of professional intermediation to obtain.
Could you please add me to your ping list?
Or you can just establish a good relationship with your doctor. My wife’s doctor writes her scrips without seeing her all the time, she’s worked with him a while, he knows what kind of ailments she tends to get and has learned that she’s good at self diagnosing. So she can call him up say “I have a sinus infection” and he has his nurse call in the scrip to her favorite drug store.
Most prescription medications are pretty intense. Between their own side effects, the dangers when you take too much, the dangers when you take too little, and the reactions many of them have to other drugs there’s actually a very good reason to have some level of supervision.
Done.
Another of our employees was just out of school and had fully absorbed all the politically correct views of her college campus. She was mad because her premiums were so much more than those of a man the same age. I gave her the obvious explanation, which is that young women her age tend to have babies. She said that was discriminatory, because men make babies, too. My response: 1) men don't incur any medical bills for their part of baby making process; 2) I don't make the rules; and 3) quit griping and be glad I didn't hire a man to do your job because he's cheaper to insure.
Thanks!
I see your point, but in my case I went through four tyopes of meds for my HBP before I found one that worked.
The ACE inhibitors made me dizzy and feeling like I was going to pass out all the time. The Beta-Blockers made me cough all the time, the channel-blocker had another bad effect.
Finally we tried an ARB. It works great, the side effect isn’t as bad as the others, only bad thing is it’s kind of expensive.
If I had just gone in to a drug store and said “give me something to stop my HBP, they prolly couldn’t have worked so effectively at finding something that works.
Ed
I’m not suggesting that people should never see a doctor, but:
1) Doctors are largely going on guesswork (and on pharma salespeople’s pitches), when prescribing and don’t have nearly as much time to figure out all the details of what your new symptoms and other conditions are and how that might dovetail with the different possible side effects of several possible medications for your new complaint. And they are constantly prescribing antibiotics without doing a culture to determine whether there’s really a bacterial infection present (as well they should be, and that’s why they do it!). With the Internet, people without medical training can be remarkably effective at researching their symptoms, test results, and the pros and cons and various medications that might be helpful. You can check for drug interactions at http://www.drugdigest.org/DD/Home (and no doubt other sites as well).
2) Doctors often wildly misdiagnose symptoms and end up prescribing medications that are useless or worse. If people were more in the habit of doing their own research, self-diagnosis, and drug selection, they’d be much better equipped to challenge doctors who are going down the wrong path. Things that aren’t common knowledge now would become common knowledge, promoting a culture in which people know how to take care of their own health, and how to decide when it’s time to consult a medical professional.
You might well have been able to try out the same array of blood pressure medications on your own, and land on the right one just as soon if not sooner. And you can be sure that if you’d tried out some ACE inhibitors that you got from a friend and they made you dizzy and light-headed, and headed to a doctor, you’d have been given a lecture about “This is why it’s important not to try to treat yourself; only a doctor can determine what medication will be safe and effective for you.” And your family and friends would like have given you the same lecture. Never mind that, as you found out, things like this happen all the time when doctors prescribe medication.
But at any rate, now you know what works. Why should you need to see a doctor to get a prescription for it? The real reason is that health insurance companies and promoters of government-paid medical care and the bulk of the medical profession WANT the medical care industry to be a gazillion dollar industry. More jobs for them! Read up on the recent research on the effectiveness of aspirin vs. Coumadin as a blood thinner. The overwhelming majority of people who have been taking expensive prescription Coumadin, with prescriptions obtained via trips to the doctor paid for either out of pocket or via insurance or via the taxpayer, would have gotten results at least as good from plain old aspirin.
50 years ago I worked for a funeral home in Alabama where the owner paid in cash each week, the full amount with no deductions. Then he made you stand there and pay him back, out of your stash of cash, the various things he had to withhold and deduct. If you made $100 he would give you the $100 plus his part of the benefits and the matching SS funds, etc. Then he would point out to you that it cost him, say, $110 of his money to have your working for him, but then he would take back the deducts and when he was through, and you had only $70 or whatever the amount, he made sure you understood that although you only got $70 your payday cost him $110. It was very effective!
“What kind of “free” country is this, when an adult can’t just walk into a drug store, say what they want, plunk down the cash, and get it? The list of medications that genuinely pose a danger to PUBLIC health and safety — the only legitimate reason for government to restrict access to drugs — is actually very short, and those are the only ones that should require any kind of professional intermediation to obtain.”
Oh? What about the dangers that it would pose to you? Not that, by your argument, should I be concerned. You and your family would be looking for someone to blame when you croak due to the Angioedema from the Hypertensive medication or find yourself in a hypoglycemic coma from the $5 diabetes medication; Both medications you demanded from the pharmacist, because, hey, this is a free country, and you know what’s best for you, and it sure ain’t a public health concern.
The point I’m trying to make about your point is that this is a familiar theme we see on this board, the libertarian argument to its’ logical end. Many talk about the privileges extended in such a society, but very few lead off with owning the responsibility and the resulting consequences.
“But at any rate, now you know what works. Why should you need to see a doctor to get a prescription for it? The real reason is that health insurance companies and promoters of government-paid medical care and the bulk of the medical profession WANT the medical care industry to be a gazillion dollar industry. More jobs for them! Read up on the recent research on the effectiveness of aspirin vs. Coumadin as a blood thinner. The overwhelming majority of people who have been taking expensive prescription Coumadin, with prescriptions obtained via trips to the doctor paid for either out of pocket or via insurance or via the taxpayer, would have gotten results at least as good from plain old aspirin.”
I was totally with you until this paragraph (I’m an Internist) as the more educated patients are the better.
Private insurers and gubmint health insurance have very little incentive to channel patients into doctors offices. This is intuitively correct, and in practice is certainly true. Doctors are the ones who have the incentive for return visits. You end up balancing it, but trust me, there are plenty of patients who would see a doctor weekly if allowed, and most are thrilled to have a responsible patient who can intelligently and succinctly communicate over the phone, as to whether something works or not. There is a large shortage of primary care providers currently.
The Coumadin business gave you away as someone who is getting bad information (and unsound economics). Coumadin has long been a generic (Warfarin). The risk of bleeding is many-fold greater than that of aspirin. There are also some select conditions where there are clear numbers to support the superiority (survival, events) of coumadin over aspirin (prosthetic valves, afib). The monitoring is expensive. Medicare reimbursement for an in office check by fingerstick (vs. a tube of blood) is $7. The reagents/supplies cost me $5 per test, and then add the time it takes for an assistant to do the “procedure.”
The final point is that if I were to make a list of medications that I hate dealing with, number one would be coumadin, and most doctors would feel the same. It’s all risk, no profit, just a bad deal all around. I cannot wait until there is an alternative.
You are correct that there are many conditions where aspirin would be nearly or as good as coumadin. There is no incentive for a doctor to choose coumadin over aspirin (as explained above). The implication that this is some type of health care ruse with all parties involved to grease hands is preposterous, and you shouldn’t mislead readers with your armchair doctoring and conspiracy garbage. You should find a better source and then sound it off with someone who knows health care, prior to spouting off.
Acetaminophen is the leading cause of acute liver failure requiring transplant in the US, and yet any kid can walk into a drug store and buy it off the shelf, no questions asked. This is the sort of thing that should arouse suspicion that the prescription requirements for a huge array of drugs are not based on a need to protect us from ourselves. Wasn’t that long ago that you couldn’t get Claritin without a prescription. And long after the FDA had declared it safe enough to be non-prescription, maker Schering-Plough kept fighting like hell to stop it from being changed to non-prescription status, because they couldn’t make nearly as much money that way.
People buy lots of medications just because their doctor prescribed it and their insurance company picks up so much of the cost that it ends up being as cheap to the patient as non-prescription drugs out on the open shelf. Of course that’s one of the reasons that insurance coverage is so expensive, but most people have employer-paid health insurance and see little or none of that cost — the salary they were quoted when they were offered the job already had the massive insurance tab deducted. Pharma companies make oodles of money on this scam. They, and the physician lobby, push the “but you could hurt yourselves” line because it’s very profitable for them, not because it’s better for your health.
I’m not suggesting stuff like vancomycin should be non-prescription, but probably at least 95% of the current prescription drugs should be non-prescription. Most people have enough common sense not to buy and take something that’s covered with warnings about its dangers without doing some research — in many cases including consulting with a physician — to find out if it’s really likely to do them more good than harm. And people who don’t have that much common sense are the same ones who will pop 10 times the maximum recommended dose of acetaminophen because smaller amounts didn’t make their massive hangover headache from Friday night drinking go away fast enough, and it’s already sundown on Saturday and almost time to start drinking and “partying” again.
As for aspirin vs. warfarin/coumadin, there are a lot of people getting the latter who ought to be getting the former, and testing of the relative benefits always seems to be specific to preventing some particular type of vascular event. If the research says warfarin is better at preventing a type of event that a certain patient appears to be at risk for, then warfarin is prescribed, usually without regard to the other factors, not least of which are the effects of telling elderly people to avoid green leafy vegetables. Both of the doctors who have prescribed warfarin (always referred to as “coumadin” due to the lasting effects of pharma sales rep indoctrination) for my now 85 year old father warned him to avoid leafy green vegetables, apparently strongly enough that he almost never eats any at all, but never mentioned that this sort of diet is likely to lead to folate deficiency and that folic acid supplementation is indicated. The effects of long-term folate deficiency don’t overlap much with the adverse events for which warfarin vs. aspirin are tested, and aren’t factored into the choice if the choice is based on published research. And when warfarin really is the better choice, it should certainly be supplemented with non-prescription folic acid, but somehow that non-prescription stuff always seems to get forgotten.
No, I don’t think that the whole medical profession and the whole pharma industry are just big conspiracies to get our money. I’ve benefitted a great deal from both, but especially when I added my own research and judgement to that of physicians, and pursued a course of treatment “against medical advice”. However, the “medical/pharma/government industrial complex” is very susceptible to abuse due to the combination of overwhelming third party payment and third party decision-making. This susceptibility attracts a lot of the sort of people who want to exploit it, and we should be on guard against laws and policies that make that easier, and that encourage people to be sheep-like, and rely on the government-licensed professionals for everything.
From your own profile page: “In casinos, the odds of surviving a cardiac arrest is over 50%. In contrast, the odds of surviving cardiac arrest in a hospital, according to this new study, is only 34%”. You left out the main reason behind that statistic, namely that hospitals rely on non-automated defibrillators that only physicians are authorized to use. In a casino, a gaming floor staffer grabs an AED and saves your life, but in a hospital a nurse stands by waiting for a doctor and a giant unautomated defibrillator to arrive — often too late to save your life — because only the doctor is deemed expert enough to do such things.
Plus....did you know that blood pressure meds only cost something like pennies to manufacture for a month’s worth.....
You didn’t really address my concerns, but it is less important to me after reading what you wrote, nothing of which I have a problem with. You’ve obviously done much of your homework, and you might be surprised to find how much of a delight it is for your physician to know you have looked into these things thoughtfully.
However, you’d have to admit that you cannot be counted as the rule, but very much the exception. My post was for the purpose that it seemed you were implying what was best for others/US healthcare, at large. You chose not to address my complaint, and I stand by it: While you may be your (and your family’s) best caretaker, your recommendations, while perhaps decreasing overall cost, are not wise and very likely not in any random patient’s best interest. Therefore you should refrain from making even indirect specific health recommendations. Furthermore, your explanations belie your understanding of basic economics.
Also, there are many good possibilities why cardiac arrest favors the gamblers. It is unfortunate and revealing that you chose the one that you did. Some doctor must have buggered you good, once upon a time.
My brother is a truck driver and seems to be able to get new jobs easily, and lose them just as often. There’s something else going on IMHO.
The other thing is someone with insulin dependent diabetes has no business operating heavy equipment, so darn straight they should pass a physical. Those dang greedy employers, doncha know. Puhleeze.
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