What's new
By:
USCHO Fan Forum

This is a sample guest message. Register a free account today to become a member! Once signed in, you'll be able to participate on this site by adding your own topics and posts, as well as connect with other members through your own private inbox!

  • The USCHO Fan Forum has migrated to a new plaform, xenForo. Most of the function of the forum should work in familiar ways. Please note that you can switch between light and dark modes by clicking on the gear icon in the upper right of the main menu bar. We are hoping that this new platform will prove to be faster and more reliable. Please feel free to explore its features.

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

Status
Not open for further replies.
Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish said:
I don't think any (sane) person has suggested that technology has been "suppressed." The concern was that our vibrant culture of innovation might stagnate under a centralized command-and-control structure compared to a decentralized entrepreneurial one (the kind that has produced so much of that "steady march of new technology" to which you referred and which has amazed me as well).

Was it Surowiecki in The Wisdom of Crowds who wrote "while one person might be smarter than anyone else, that person can never be smarter than everyone else" or something like that? Bureaucrats will never produce better results by fiat than a free market will by curiosity and continuous innovation. No one innovates without some kind of incentive to do so, especially if they are punished for "breaking the rules" if they try.
Click to expand...

I am just trying to be a bit pragmatic about this. I would argue that if the data behind a device or treatment is strong enough, bureaucracy does not pose a significant burden. I often find those entrepreneurs with weaker data are often the most vocal critics of the FDA. But then again, they have their shareholders to answer to, not ethics or patients.

I would also argue that if anything, we should be more stringent moving forward towards approval. Most of the low hanging fruit of modern medicine have been consumed so I think it is reasonable to expect a bit more information into the safety profile before approval. For instance, one would have to clearly demonstrate advantages of a new statin since the ones on the market already have a proven benefit and a well known safety profile. Because of this, the threshold of "you need to be so tall to ride this ride" for new statins should be higher.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish said:
one of the biggest problems with PPACA is that it freezes technology into a static model and stifles innovation because of the centralized command-and-control structure.
Click to expand...

FreshFish said:
I don't think any (sane) person has suggested that technology has been "suppressed."
Click to expand...

Well, you're right...no sane person has suggested it...
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

An anecdote (I know, I know) that people should look into is the NovoTTF-100A for treatment of GBM. I think it may serve well as a case study for the topic at hand.

http://www.fda.gov/MedicalDevices/P...rances/Recently-ApprovedDevices/ucm254480.htm

It was approved in stages throughout the ACA rollout. It is very expensive (around $20,000 a month) but is able to extend the life of a very untreatable disease (according to best data at this point). It is not covered by insurance automatically but physicians at our institution have had relatively minimal trouble getting it approved for those patients that it should benefit.

We had a very good discussion at a recent grand rounds regarding the role of the FDA, company, insurance, hospital, physician, and patient throughout the whole process.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

WisconsinWildcard said:
As I personally see the steady march of new technology into medicine, I really would have to see some numbers that suggest that the most promising medical technology is being suppressed.

For a near meaningless anecdote (because hey, I really dislike most of 'em), in the OR today I saw not one, but two novel technologies being implemented. And this is far from an extraordinary day.
Click to expand...

How about dangerous psychedelics being FDA approved, but natural effective cures, such as plants, are being outlawed?
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

WisconsinWildcard said:
An anecdote (I know, I know) that people should look into is the NovoTTF-100A for treatment of GBM. I think it may serve well as a case study for the topic at hand.

http://www.fda.gov/MedicalDevices/P...rances/Recently-ApprovedDevices/ucm254480.htm

It was approved in stages throughout the ACA rollout. It is very expensive (around $20,000 a month) but is able to extend the life of a very untreatable disease (according to best data at this point). It is not covered by insurance automatically but physicians at our institution have had relatively minimal trouble getting it approved for those patients that it should benefit.

We had a very good discussion at a recent grand rounds regarding the role of the FDA, company, insurance, hospital, physician, and patient throughout the whole process.
Click to expand...

Thanks for the link-fascinating. Would of course like it even better if the cost for treatment was well below that number but as usual my biggest concern is addressed, doing what is in the best interest of the patient to relieve or lengthen life.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Rover you really make some of the most childish remarks on this site. Really pathetic.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

dxmnkd316 said:
Way to act like an adult
Click to expand...

Boo hoo hoo. If you don't like it join the sewing circle message board. In the meantime conservatives get what they deserve out here, which is really the only standard that matters.
 
Status
Not open for further replies.
Back
Top