ACA Repeal/Replace: Progressives Face Moral Dilemma

[David Horn]

(01-26-2017, 06:57 AM)Warren Dew Wrote:

(01-25-2017, 05:19 PM)David Horn Wrote: You have an ailment that your fee-for-service doctor indicates is rheumatoid arthritis.  He recommends Humera.  Are you good with that?  If so, start shopping.

You're having a heart attack, and need: a hospital, a cardiologist and emergency transport.  Start shopping.  

I actually had symptoms of arthritis a few years ago.  Based on advice from a diet discussion group I participate in, I made a simple dietary change and it went away.  Occasionally I cheat on the diet change and it comes back temporarily, reminding me why I made the change.

This was of course free so tell me again why I'm paying for a doctor who can't spell "Humira"?  That said, if I loved my nightshades so much I was willing to pay lots of money to keep eating them, and I didn't mind the side effect of taking a medicine that made me more vulnerable to infectious diseases, I could spring for the Humira or ask the doctor if there was a cheaper generic immunosuppressant.  In my experience, doctors are really good about suggesting inexpensive substitutes when they know their patient is paying for his own drugs; from a market perspective, it isn't really any different from asking the help in the grocery store which antioxidant to take.  The drug situation is more expensive due to regulation that supports prices for big pharma and the associated lack of competition, of course, but once price competition was introduced to the drug market, the prices of even brand name drugs would come down tremendously.

Let me save you the look: all immuno-suppressants are still on-patent or so expensive to replicate for so few customers that they have no competition.   Worse, none of them can be given without strict oversight, since they are essentially invitations to secondary diseases.  Even more to the point, they have efficacy limitations, so one needs to be replaced with another after its effectiveness declines. 

And fwiw, I'm not a doctor.

Warren Dew\ Wrote:None of which means that people who are willing to make the simple, free, and effective dietary change should be forced to subsidize the people who insist on eating quasipoisonous foods, especially if the latter insist on using expensive brand name drugs instead of inexpensive generics.

My wife is alive today due to Remicade, another of those immuno-suppressant drugs.  She's had Crohns Disease for almost 40 years, and has avoided the need for surgery -- the other option for these patients after the run-of-the-mill drugs no longer do any good.  She hates Remicade, but will use it until it fails.  The next tier is more expensive and the one after that is experimental.

Warren Dew Wrote:For the heart attack, I would probably have purchased emergency medical insurance, the same way I have a AAA membership in case my car stops working.  On the other hand, fee for service also works; my father had his heart attack in Beijing; payment was negotiated in time for surgery, and he is still alive 12 years later.  Or, with price competition, my medical insurance company might do studies into Pauling's theory of heart disease, and I might have an inexpensive preventative that's even more effective than aspirin, which by itself can prevent many heart attacks and treat some others.

Which begs the point.  Most heart attacks are unexpected events -- typically affecting those totally unaware that they are susceptible.  The same applies to strokes.  Cancer is even worse.  You can't "prevent" them all by being alert and having check-ups.  I have a close friend who was diagnosed with colon cancer 4 months after getting a clean bill of health on his colonoscopy.  Shit happens.