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From: R L on 29 Sep 2008 00:49
After my experience with prostate cancer and trying to follow all of the
oncologist's orders I am beginning to wonder why it is necessary for
these medications and scans be be "shockingly" expensive. Is it because
we are at the medical delivery system's mercy? If I did not have
Medicare and my private insurance I would be broke after a lifetime of
frugal living and saving for my retirement.

I could be wrong, but I am getting a raised eyebrow when I heard about
all of the millions of dollars folks donate to cancer research and find
out that when something is developed, it seems to become a patented
pharmaceutical that makes the company a fortune.

God have mercy on the folks who have no insurance......

I know this is a complex problem, and I may be wrong, but I grew up in
the Great Depression era.

From: Steve Kramer on 29 Sep 2008 07:37
"R L" <wa5pdk(a)webtv.net> wrote in message
news:23732-48E05E49-325(a)storefull-3273.bay.webtv.net...
> After my experience with prostate cancer and trying to follow all of the
> oncologist's orders I am beginning to wonder why it is necessary for
> these medications and scans be be "shockingly" expensive. Is it because
> we are at the medical delivery system's mercy? If I did not have
> Medicare and my private insurance I would be broke after a lifetime of
> frugal living and saving for my retirement.
>
> I could be wrong, but I am getting a raised eyebrow when I heard about
> all of the millions of dollars folks donate to cancer research and find
> out that when something is developed, it seems to become a patented
> pharmaceutical that makes the company a fortune.
>
> God have mercy on the folks who have no insurance......
>
> I know this is a complex problem, and I may be wrong, but I grew up in
> the Great Depression era.

Actually, the Great Depression was a boon to people without insurance or
means. That's about the time the U.S. government decided that it was their
job to provide medical charity... but I digress.

As to who is getting the cash, every entity that gets involved gets the
money. The pharmaceutical companies pour a lot of money into research and
production and take a healthy profit. The "charities" step in and provide
assistance to the people who need the pharmaceuticals and to assist in the
research and then they take a healthy profit. Then there are "charities"
like United Way who funnel money to other charities and take a healthy
profit. Then, you have a government who chose to set themselves up as a
charity and they take a healthy profit. Many want them to take on more, for
which they will take more profit. To say nothing of the doctors, doctor's
groups, insurance companies, hospitals, nurses, aids, labs, medical
equipment manufacturers, and on and on and on.

Simplified, the alternative is to remove the government and the charities
and allow the free market to reign. At which time, insurance companies will
drop their rates and increase their coverage and build less skyscrapers.
Pharmaceuticals will drop their rates and probably slow their research and
delay their breakthroughs. Rich people will still live. People who work
and own insurance will still live. People involved in local congregations
of churches will live. All others will die in accordance with their means.

It is, of course, no longer a realistic alternative. No one can turn back
the tide, now. Regardless of which direction we want it to go, the system
will continue to be taken over by additional private and public profit
centers and like a pyramid scheme will eventually collapse under its own
weight.



From: len on 29 Sep 2008 12:53
On Sep 29, 6:37 am, "Steve Kramer" <skra...(a)cinci.rr.com> wrote:
> "R L" <wa5...(a)webtv.net> wrote in message
>
> news:23732-48E05E49-325(a)storefull-3273.bay.webtv.net...
>
>
>
> > After my experience with prostate cancer and trying to follow all of the
> > oncologist's orders I am beginning to wonder why it is necessary for
> > these medications and scans be be "shockingly" expensive. Is it because
> > we are at the medical delivery system's mercy? If I did not have
> > Medicare and my private insurance I would be broke after a lifetime of
> > frugal living and saving for my retirement.
>
> > I could be wrong, but I am getting a raised eyebrow when I heard about
> > all of the millions of dollars folks donate to cancer research and find
> > out that when something is developed, it seems to become a patented
> > pharmaceutical that makes the company a fortune.
>
> > God have mercy on the folks who have no insurance......
>
> > I know this is a complex problem, and I may be wrong, but I grew up in
> > the Great Depression era.
>
> Actually, the Great Depression was a boon to people without insurance or
> means. That's about the time the U.S. government decided that it was their
> job to provide medical charity... but I digress.
>
> As to who is getting the cash, every entity that gets involved gets the
> money. The pharmaceutical companies pour a lot of money into research and
> production and take a healthy profit. The "charities" step in and provide
> assistance to the people who need the pharmaceuticals and to assist in the
> research and then they take a healthy profit. Then there are "charities"
> like United Way who funnel money to other charities and take a healthy
> profit. Then, you have a government who chose to set themselves up as a
> charity and they take a healthy profit. Many want them to take on more, for
> which they will take more profit. To say nothing of the doctors, doctor's
> groups, insurance companies, hospitals, nurses, aids, labs, medical
> equipment manufacturers, and on and on and on.
>
> Simplified, the alternative is to remove the government and the charities
> and allow the free market to reign. At which time, insurance companies will
> drop their rates and increase their coverage and build less skyscrapers.
> Pharmaceuticals will drop their rates and probably slow their research and
> delay their breakthroughs. Rich people will still live. People who work
> and own insurance will still live. People involved in local congregations
> of churches will live. All others will die in accordance with their means.
>
> It is, of course, no longer a realistic alternative. No one can turn back
> the tide, now. Regardless of which direction we want it to go, the system
> will continue to be taken over by additional private and public profit
> centers and like a pyramid scheme will eventually collapse under its own
> weight.

This is complete nonsense. The free market works well in providing
most things but medical care is not one of them. It can play a role,
but only in a suitably structured environment. Also, you are
conflating different things and ignoring the history.

First there is the issue of the market for medical care. The theory
is that patients should choose doctors on the basis of price and
performance, so doctors are forced to lower prices by competition.
But in fact it doesn't work that way because patients are not in a
position to determine which doctors are providing the best care for
the price. Most such decisions are made by doctors, such as in
referring patients to specialists. When you are in urgent need of
care, you are not going to go searching around for the best deal.

Then there is the issue of the market for insurance. An insurance
company must necessarily try to limit its risk. It does this either
by refusing to insure sick patients or by charging premiums beyond the
ability of patients to pay. Even if the insurer is a not-for profit
organization, such as the original Blues were, with the best of
intentions, it will be forced to do that. Otherwise other insurers
will cherry pick the young healthy people, making it much more
expensive to insure the others. Before Medicare, for example, elderly
people found it essentially impossible to get medical insurance. My
mother suffered a stroke in 1987, and we would have had to go
bankrupt to pay for her medical care, if Medicare had not existed.
We are both reasonably healthy and do all the can to take care of
ourselves, but that didn't protect us from prostate cancer, severe
spinal stenosis, gall bladder disease, and a variety of other things
that would have bankrupted us without Medicare.

Insurers are also forced by competitive factors to limit what they pay
out to doctors. So the doctors either have to live with what they
can get or pass on the other costs to their patients.

The point is to share risks and spread the costs. Every advanced
developed nation, e.g., France, Germany, England, Switzerland, and the
other European countries, as well as Japan and Taiwan, has figured out
how to do this by one mechanism or another. Some just make insurance
a government function, but others use a mixture of private and
public. But they regulate insurers so they are not allowed to charge
higher rates to sicker people. That provides an even playing field
so they can compete on other grounds. And all these countries to one
degree or other have strong capitalist systems, but they have figured
out that medical care can't be provided purely by the market. On
major indices of health they do at least as well as we do and for much
less cost. In none of these countries is it possible to go deeply
into debt up to and past the point of bankruptcy because of medical
needs, but in the US, it is one of the most common reasons for
financial difficulty.

It will be difficult to fix what is becoming an unwieldy and expensive
system of care. But we are not going to fix it by being
fundamentalists about the market or any other cherished belief. We
have to figure out what will work and make compromises with what we
might think is best. But in this case, we at least know how other
countries, just as democratic as we are,and in which free markets
operate, have figured out how to do it. Let's try to learn from them
and choose system that fits in with our own values and realities.

From: Steve Kramer on 29 Sep 2008 16:50
"len" <len(a)math.northwestern.edu> wrote in message
news:8df54af5-1749-4e5c-97e0-a0fa301273b1(a)t54g2000hsg.googlegroups.com...
> On Sep 29, 6:37 am, "Steve Kramer" <skra...(a)cinci.rr.com> wrote:
>> "R L" <wa5...(a)webtv.net> wrote in message

>> It is, of course, no longer a realistic alternative. No one can turn
>> back
>> the tide, now. Regardless of which direction we want it to go, the
>> system
>> will continue to be taken over by additional private and public profit
>> centers and like a pyramid scheme will eventually collapse under its own
>> weight.
>
> This is complete nonsense. The free market works well in providing
> most things but medical care is not one of them. It can play a role,
> but only in a suitably structured environment. Also, you are
> conflating different things and ignoring the history.

Damn! I swore I'd never get sucked into one of these arguments here again.

I'll back out and hope for a quick death to the thread.

Sorry.


From: BH on 29 Sep 2008 18:57
I KNEW that you knew better and was surprised that you took that
unattractive bit of bait! :-)

A quick death to the thread would be good.

Best to you,
Burney


>Damn! I swore I'd never get sucked into one of these arguments here again.
>
>I'll back out and hope for a quick death to the thread.
>
>Sorry.
>
RP in 1995 (age 52)
RT in 2000
ADT (Casodex) 10/06 - 8/07
Latest PSA - 0.23
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