Healthcare & rationing

MSimon · Post by **MSimon** » Fri Sep 11, 2009 7:38 pm

Of course Big Pharma is for government control of medicine. They have been promised a big payoff by those writing the bill.

TallDave · Post by **TallDave** » Fri Sep 11, 2009 7:41 pm

I can't think of anything in life that is more 'material' than whether a particular action you take or decision you make will end your life.

Which, again, has nothing to do with whether you need to understand how it works in order to buy the right one.

You don't need a degree in mechanical engineering to understand using washer fluid in your brake fluid reservoir could kill you.

Which is it Dave? Is the doctor trustworthy or not?

I trust him not to kill me, since he has a large incentive professionally to avoid such an outcome. I don't rely on his being up to date on what treatments are available, since this has relatively little impact on him.

Next, I'd like to point out that these guys seem to think we need healthcare reform.

They've agreed to support it in exchange for only limited price controls, in a Faustian bargain they will probably regret. First they came for the insurance providers, but I did not speak out because I was not an insurance provider...

TallDave · Post by **TallDave** » Fri Sep 11, 2009 7:52 pm

First, I believe it was you that pointed out in another thread that the Human Genome project, as undertaken by the government, was overtaken by a privately funded project that was more successful. I think the conclusion you were alluding to then was that the government should have just left the research to the free market.

I don't think it was me, nor does it matter for purposes of being an example of good basic science funded by the government, even if others were more successful.

Second, the publicly funded research in question here is not public domain. The manufacturer of that drug has a monopoly. If the compound were in the public domain then competition would likely have pushed the price down considerably.

Please try to follow the argument. The drug is not public domain, but the knowledge of the receptor or gene the drug affects may be. That is the type of generally unprofitable research the government can do, and should fund.

The company may have tried hundreds of drugs aimed at that receptor before they found one that worked well enough with acceptable side effects such that there is a commercial market for it. They then have a monopoly on the product for some number of years, without which all that work would be pointless.

This is called "productizing" an idea. The government does not do this very well, which is why Intel and AMD make chips while the gov't funds semi research.

Skipjack · Post by **Skipjack** » Fri Sep 11, 2009 8:17 pm

BTW you would be surprised how hit or miss Doctors are re: medicines. For many conditions it is: try this and tell me how well it works.

So your doctors are much worse than ours, I see. Because here they dont do such a thing.
You know the basis for the decision on what treatment is the correct one should be a diagnosis. Once you have made a diagnosis, there are one or more potential paths for treatment. Depending on multiple circumstances (patient condition, progress of the illness, potential side effects, counter indications with other medication the patient takes, etc), the doctor will then prescribe on or the other medication, or a combination of multiple medications. Yes some trial an error can happen, since patients can react differently to a kind of treatment. E.g. I was taking Acemin to lower my bloodpressure, but it caused me rashes (between one in 100 and one in 1000 react with that side effect). There really is no way to predict that. When I told him about the reaction, the doctor prescribed Lannapril instead. Gone was the rash.

MSimon · Post by **MSimon** » Fri Sep 11, 2009 8:45 pm

So your doctors are much worse than ours, I see. Because here they dont do such a thing.

It probably means they have a narrower range of medicines to work with.

For instance side effects for a given drug can vary from person to person. You might want a number of medicines available for a given condition to try to find one with acceptable side effects for a given patient. If your doctors are not doing that they are practicing bad medicine.

Of course fewer drugs in the pharmacy is cheaper.

Skipjack · Post by **Skipjack** » Fri Sep 11, 2009 9:09 pm

Did you read my entire post?

E.g. I was taking Acemin to lower my bloodpressure, but it caused me rashes (between one in 100 and one in 1000 react with that side effect). There really is no way to predict that. When I told him about the reaction, the doctor prescribed Lannapril instead. Gone was the rash.

MSimon · Post by **MSimon** » Fri Sep 11, 2009 9:10 pm

Skipjack wrote:Did you read my entire post?

E.g. I was taking Acemin to lower my bloodpressure, but it caused me rashes (between one in 100 and one in 1000 react with that side effect). There really is no way to predict that. When I told him about the reaction, the doctor prescribed Lannapril instead. Gone was the rash.

No.

Skipjack · Post by **Skipjack** » Fri Sep 11, 2009 9:44 pm

Ok, well you should have, because then you would have seen that your argument was invalid.

MSimon · Post by **MSimon** » Fri Sep 11, 2009 11:47 pm

Skipjack wrote:Ok, well you should have, because then you would have seen that your argument was invalid.

I might say your attitude towards marijuana is similar.

BTW if I made the same argument you did why would it be invalid according to your lights? Seems odd.

TDPerk · Post by **TDPerk** » Fri Sep 11, 2009 11:51 pm

Quote:
BTW you would be surprised how hit or miss Doctors are re: medicines. For many conditions it is: try this and tell me how well it works.

So your doctors are much worse than ours, I see. Because here they dont do such a thing.

Skipjack, you have this completely wrong, and for the reason MSimon gave. If your doctors aren't doing this, it's because they are not as able to treat diease as ones who can do it.

Probably because it is cheaper.

Like drugging patients who are checkboxed onto their deathbed, so they are unconscious and easier and cheaper to deal with.

choff · Post by **choff** » Sat Sep 12, 2009 5:00 am

Did anybody else see 'The Constant Gardener'

choff · Post by **choff** » Sat Sep 12, 2009 5:24 am

Then there's this.

http://articles.mercola.com/sites/artic ... fects.aspx

A lot of the new drugs cost more than old drugs that have less side effects.

In my province, unless the current regime has squashed it, we had a reference based drug plan. Doctors were encouraged to use the cheapest drug that could do the job, with allowed for exceptions, cost saver, generic or not.

What would make for great TV comedy if it wasn't real are the new drug ads that look all warm and fuzzy while they go through all the side effects.
They must be on drugs while they make them, it makes tobacco products look just as safe.

Skipjack · Post by **Skipjack** » Sat Sep 12, 2009 8:52 am

Skipjack, you have this completely wrong, and for the reason MSimon gave. If your doctors aren't doing this, it's because they are not as able to treat diease as ones who can do it.

Huh?
I have no idea what you are trying to say. I already gave Msimon an example that prooved him wrong. Our doctors are very capable and we do have a selection of drugs that do the same thing. I can tell you at least 3 PPI products and 2 blood pressure lowering products that I have taken myself in the last 4 months. I am currently taking 2 different thrombocyte aggregation inhibitors at the same time (both are absorbed into the blood through a different way to make sure at least one of them always works).

TDPerk · Post by **TDPerk** » Sat Sep 12, 2009 1:35 pm

I have no idea what you are trying to say. I already gave Msimon an example that prooved him wrong.

You gave him an example that at best said in that case that those doctors were no better then here. When a medication works for a patient, they stick with it, when it doesn't, they try something else.

That's the best light to put on it.

Here's a different and I think a more accurate light to put on it.

http://pajamasmedia.com/blog/considerin ... r-stories/

And this:

http://www.telegraph.co.uk/health/healt ... cheme.html

And this:

http://www.dailymail.co.uk/news/article ... k-out.html

And this:

http://www.telegraph.co.uk/health/healt ... tions.html

And I can't find a link to it right now, but I recall the parents of a quite mentally disabled girl in the UK, which child had just passed away from the NHS' incompetence, that it was a very sad thing it was almost like losing a child.

Checkbox and by the book medicine as exemplified in the first link of this post is great for saving money, so are one size fits all medical approaches.

But they are second rate medicine, and likely not even as good as you are paying for.

TDPerk · Post by **TDPerk** » Sat Sep 12, 2009 1:50 pm

I should add I know two people who came here (US) with cancer--their spouses were American--one a Canadian who ultimately went back north to die (after he lived four years longer than the Canadian doctors said he possibly could, or would treat him for) and a Brit who lived 8 years longer than the NHS said he should have. I was a co-worker to the British gentleman, and the NHS had written him off, they would give nothing further than palliative care.

He came here and was promptly given his second surgery for an (astrocytoma, sp?). He went on to have two more.

He raised his children for those 8 years into their late teens, he wrote good code, he helped his mother deal with his father's passing.

One of the ways the NHS saves money is by ensuring people have shorter lifespans than needs be.

That's not good healthcare.

They come here to be able to live as they are best able.

They stay at home to die.