The PPACA Thread Part III - Let's have a healthy debate!

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

True. But not having insurance equals potential disaster. So it's step one.

A better step would be actually spending the money and resources on finding cures. Frankly I'm convinced that those dollars are kept down on purpose because chronic care makes a lot of people a lot of money.

Broken clock is accurate twice a day in terms of your second paragraph. Why prevent something for $1 when you can treat it for $14 each week for the rest of the person's life?

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

It's still better than not having insurance, though.

Isn't that what Medicaid and Medicare are for, though? Or are we going to end up in another cliff debate?

[FadeToBlack&Gold]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Frankly I'm convinced that those dollars are kept down on purpose because chronic care makes a lot of people a lot of money.

Alex Jones called, he wants his narrative back.

It's silly to suggest that if, for instance, a cancer cure were to be found, that big pharma would suppress it. To the contrary, it would be the news story of the century, and whichever pharma giant discovered it would surely figure out how to price it in such a manner as to rake in trillions of dollars.

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Alex Jones called, he wants his narrative back.

It's silly to suggest that if, for instance, a cancer cure were to be found, that big pharma would suppress it. To the contrary, it would be the news story of the century, and whichever pharma giant discovered it would surely figure out how to price it in such a manner as to rake in trillions of dollars.

Is that why marijuana, at least a special not-so-high blend that actually cures stuff, is still illegal, while pharmaceuticals, which have dozens of side effects and cause more problems than they solve, are not only legal, but heavily promoted?

It's not Alex Jones BS, either. Remember the Nasal Screen guy on Shark Tank?

[joecct]

True. But not having insurance equals potential disaster. So it's step one.

A better step would be actually spending the money and resources on finding cures. Frankly I'm convinced that those dollars are kept down on purpose because chronic care makes a lot of people a lot of money.

Cures or prevention? Cures are or can be expensive. Prevention is often cheap.

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Cures or prevention? Cures are or can be expensive. Prevention is often cheap.

Cures stop the ailment in its tracks. Prevention just kicks the can down the road. Cures is preferable, but I believe Dr. Day did speak of the preference of the global elite for the peasants.

[WisconsinWildcard]

Re: The PPACA Thread Part III - Let's have a healthy debate!

What I am seeing and hearing and reading about is something different, and perhaps raises even more concern, and that is the consolidation of medical practices. My former physician's practice was a stand-alone group, now it is part of a much larger network. From an economic point of view, that makes sense, because all of the overhead regarding medical records is consolidated into one IT platform. To a certain extent there are advantages, I can now go on-line and view my chart myself, for example.

I think this is a different issue than the claim that doctors are flocking from medicine due to bureaucracy, but it is a worthy issue to discuss. I think it is difficult to appreciate all of the benefits and I will just leave it at that.

One obvious concern is data security, it seems like we cannot keep determined hackers out of anything these days.

A worthy concern. The systems I have worked in take huge measures to secure data. Nothing is perfect, there will be leaks. I would make the argument again that the benefits vastly outweigh the risks.

Or you can have a rigid system like the VA that had one HIPPA violation on google docs and thus banned the use of gmail/docs/etc for everyone at every VA.

Doctors in my experience want to practice medicine, and their rational response to demands for more and more paperwork is to outsource, which in turn leads to an even larger and more rigid bureaucracy.

They do. Most EMRs are based on the way paper charts worked. If they were designed only by the generation using them exclusively, not those used to paper charts, they would be a decade or so ahead right now. They are a relatively new technology and it will take time to work out the kinks. I think you underestimate how fluid some of these programs are. The major EMRs are undergoing constant change (except maybe CPRS (VA)).

The upside, however, is tremendous. Admin waste is actually only about 17% of medical waste by the last figures I saw (brought up today in a meeting actually) of the 500-700 billion dollars in estimated medical waste. Most of it is unnecessary tests followed by fraud. Both of these can be significantly cut down through EMRs.

[WisconsinWildcard]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Alex Jones called, he wants his narrative back.

It's silly to suggest that if, for instance, a cancer cure were to be found, that big pharma would suppress it. To the contrary, it would be the news story of the century, and whichever pharma giant discovered it would surely figure out how to price it in such a manner as to rake in trillions of dollars.

A perfect example is the new Hep C drugs. Offer a cure for a previously incurable disease and the drug companies stand to make truckloads. Interesting ethical debate in the medical community over this as they are very effective but very expensive (upfront costs but probably save money over chronic Hep C care).

[WisconsinWildcard]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Cures stop the ailment in its tracks. Prevention just kicks the can down the road.

Kick the can down the road? If you prevent yourself from becoming diabetic through diet and exercise(assuming you were dealt a hand that allowed this)...how is that kicking it down the road?

[WisconsinWildcard]

Re: The PPACA Thread Part III - Let's have a healthy debate!

It's still better than not having insurance, though.

Exactly. Medical bills are the number one cause of bankruptcies in the US.

[joecct]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Would $2.8 billion help?

https://oig.hhs.gov/oas/reports/region2/21402006.asp

[dxmnkd316]

Re: The PPACA Thread Part III - Let's have a healthy debate!

True. But not having insurance equals potential disaster. So it's step one.

This.

[St. Clown]

Re: The PPACA Thread Part III - Let's have a healthy debate!

A perfect example is the new Hep C drugs. Offer a cure for a previously incurable disease and the drug companies stand to make truckloads. Interesting ethical debate in the medical community over this as they are very effective but very expensive (upfront costs but probably save money over chronic Hep C care).

I found this story to everyone's favorite news site around here via a google search

tl;dr: It's cheaper to take the $84,000 course of pills to cure the disease than it is to use the lower-per-unit-priced chronic treatment.

Published October 11, 2014 • Associated Press
WASHINGTON – Federal health officials have approved a daily pill that can cure the most common form of hepatitis C without the grueling pill-and-injection cocktail long used to treat the virus.

But the drug's $1,125-per-pill price is sure to increase criticism of drugmaker Gilead Sciences, whose pricing strategy for an older hepatitis drug has already drawn scorn from patient groups, insurers and politicians worldwide.

...

It's another breakthrough for Foster City, California-based Gilead, which analysts expect to bring in billions of dollars in new sales. The company says the new drug will cost $94,500 for a 12-week supply. About 40 percent of patients may be able to take the drug for eight weeks, reducing the price to about $63,000.

...

Gilead executives say Harvoni's price is actually slightly lower than the current standard treatment: Sovaldi plus a cocktail of two other drugs, which the company estimates comes to $95,000 for 12 weeks, on average. Despite such explanations, the new drug's approval is sure to renew scrutiny of prices for life-saving drugs.

Members of the Senate have already asked Gilead to hand over documents detailing its decision to price Sovaldi at $84,000 for one 12-week regimen.

...

"Insurers must be willing to invest in the long-term health outcomes of their patients. They can't just look at it as an immediate cost," said Gilead Vice President Gregg Alton in an interview with The Associated Press.

...

Company studies submitted to the FDA showed that Harvoni cured between 94 and 99 percent of patients across three trials of 1,500 patients with various stages of the disease.

[FlagDUDE08]

Re: The PPACA Thread Part III - Let's have a healthy debate!

Kick the can down the road? If you prevent yourself from becoming diabetic through diet and exercise(assuming you were dealt a hand that allowed this)...how is that kicking it down the road?

Replace prevention with treatment.

[FreshFish]

Re: The PPACA Thread Part III - Let's have a healthy debate!

It's cheaper to take the $84,000 course of pills to cure the disease than it is to use the lower-per-unit-priced chronic treatment.

funny how no one criticizes Apple for selling gadgets at higher profit margins than drug manufacturers, eh?