ACA Repeal/Replace: Progressives Face Moral Dilemma

[Ragnarök_62]

Warren Dew Wrote:With respect to the bipolar, though, it isn't an argument for any form of third party payer, either employer or government.  People can afford $20 a month out of pocket.  And once a mental condition has been identified and a working solution found, one doesn't really need frequent doctor's visits just to renew the prescription; once every three months should be more than enough.

1. To get back to the gist of the original post, I wasn't confining the discussion to just bipolar. The total cost of my meds for that disease is about $70.00/month for several meds. That isn't really a problem because that's covered by say my forgoing pay TV. 

2. The meds cost that price due to health insurance which probably keeps the price down. That's where the problem is. If the system were left to its own devices I'd have some problems.
a. I'd be locked out of health insurance entirely because of the pre-existing condition proviso.
b. Even if I could get health insurance without the Obamacare subsidy, I could not afford it.
c. That is where I have a supply/demand mismatch that "free enterprise" and the current oligopoly supporting regulations impose. Notice, I'm stating a pox of both houses. Perhaps the med price would work out if I could import the meds from Canada/Mexico. I know for a fact that Big Pharma's whores in Congress just sucked some more dicks recently... I mean hell, both my Senators were in the whore crowd, I remember that vote, and I'm gonna vote for whoever is up against them next time. As for Dr. visits, I have to actually see the shrink every 3 months and get stuff like followups/blood work, etc. I'm not sure how the person you know's condition runs, but it's different. There isn't a blood test to determine how things are going, like say an A1c test for diabetes. Anyhow, at both of our ages, there's other preventative stuff like colonoscophies which I had in 2016, vaccinations, etc.
d. I also fail to see how no 3rd party handles catastrophic stuff like an auto wreck, getting cancer, etc.

Warren Dew Wrote:Bipolar is, if anything, an argument against third party payer.  I have a long time friend who is bipolar; she's also now a successful patent attorney with a PhD and a law degree.  When she first went to a psychiatrist, she was diagnosed with depression and put on Prozac, which was then on patent and moderately expensive (several hundred dollars a month).  It took years for her to be switched to lithium, which worked much better for her.  Why?  Because there's big pharma advertising money behind patent medicines and the associated diagnoses, so doctors know about them and tend to prescribe them, and there's no pushback from the patients on cost.

I see another way. There are already copays and a formulary with my insurance plan. I don't see why a formulary list can't fix the desire for overpriced crap. That's why I choose generics Warren. I also tell my docs that I'm income limited. My guess is that Big Pharma also bribes docs to "sell" their stuff. So... I think Medicare for all, cojoined with sufficient copays would work. I'm glad your friend made out better than I did. I got messed up bad during an outsourcing hack job at my last employer in 2008. The Great Recession along with most likely age discrimination kept me out of IT for a couple of years and then as usual one becomes worthless with a huge hole in the resume which sinks you in IT. Would getting reskilled work? I doubt it since I took the safest route by getting back to Oklahoma where I could at least stay housed and fed working some minimum wage job. There's also the lack of IT jobs here and I rather doubt as this age I'd get any sort of payback for tuition/online learning, etc.

Quote:This despite the fact that her father was bipolar and had been on lithium most of his life, so the doctor should have known to look into it.

One of my nephews got lucky because his doc asked the question about relatives with bipolar. He got the right diagnosis straight away.

Quote:If patients bore more of the costs, they would push back more on expensive medicines, and doctors would mention the cheaper - and more effective - medicines earlier in the process.

1.  Copay structure should fix the first and I don't have no idea on doctors' skills.

Quote:I do agree that our present medical system is terrible at identifying and helping people who aren't neurotypical.  What's needed is removal of the stigma for mental conditions - a stigma I really don't understand in the first place - and maybe a culture where annual mental checkups are considered as normal as annual physical checkups.  Then maybe these conditions could be caught earlier in the process and people could more easily adjust.

Mental checkups. Yes, that is a good idea. It would do wonders in Oklahoma since what we have now results in a higher prison population from self medication and the such like.