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Journal elmegil's Journal: Healthcare Choices 10

Journal by elmegil
Heard snippets of a Bush speech this morning, claiming that under Kerry's plan, medical choices will be taken from the patient and doctor and given to the government.

Clearly that would be a bad thing, if it were true. But the real problem here is that medical choices have already been taken from the patient and doctor and given to...the insurance industry. Why that's any better is a complete mystery to me.

For those who doubt, here's a prime example. My wife suffers from chronic allergies. She has been on antihistamine medicine for as long as we've been together (>10 years). For a long while in the recent past, that was Allegra and Allegra-D (the decongestent was needed in the morning to prevent snot induced vomiting, but wouldn't let her sleep at night). She had tried Claritin before arriving at Allegra and it was completely useless for her, but the Allegra did the trick effectively.

So then Claritin goes generic/OTC. Understandably, MY prescription for Claritin becomes null and void and it's no longer covered by my insurance. I don't have a problem with this, because claritin OTC is effective for me when I need it (only seasonally) and the generics are cheap enough. HOWEVER, at the same time, for no discernable reason, suddenly Allegra moves from being an "approved" or "preferred" drug (I can't keep the stupid terms straight) to being on the "not preferred" list. Which means instead of a $20 copay for a month's medicine, I would be looking at a $40 copay. But of course, Zyrtec, another antihistamine, IS still a preferred drug at the previous price. So we switch, because doubling our medicine bills every month isn't really an option.

Luckily for my wife (and our budget), Zyrtec is also effective. However, this was clearly a case of the insurance company making changes intended to drive consumers to a particular drug in this space--leaving the doctor and the patient pretty much out of the loop, unless of course if the patient is well off enough to be able to absorb a 100% increase in costs. Which the majority of people obviously enough are not.

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Healthcare Choices More

Healthcare Choices

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  • But the real problem here is that medical choices have already been taken from the patient and doctor and given to...the insurance industry. Why that's any better is a complete mystery to me.

    Insurance companies can still compete. Uh, like companies can still compete against Microsoft. But I don't see anyone calling for the government to buy out Microsoft. Anyways, when the government socializes health care like Kerry wants to do, you lose choice for ever. Now you only lose choice of what the insurance

    • Insurance companies can still compete. Uh, like companies can still compete against Microsoft.

      I am glad you qualified that. :-)

      I'm definitely not interested in single payer, but I could see some regulation on the insurance industry being a good thing. I think that the insurance industry is a lot more to blame for rising medical costs and stupid decisions than, say, frivolous lawsuits etc. Which isn't to say there are no such things, just that their impact is overstated to justify driving up rates and pus

      • I think that the insurance industry is a lot more to blame for rising medical costs and stupid decisions than, say, frivolous lawsuits etc.

        I agree with that. Insurance does cause medical costs to rise, because you spread the cost around to thousands of people so there's more money available. With more money available, that makes more healthcare desirable. Except I don't think I said that clearly.

        The problem is though, that we can't start with that issue. What are we going to do about it? We could s

        • Medical malpractice insurance is approximately 1% of the cost of healthcare.

          Want to know the profit margins enjoyed by some prominent, publicly-traded insurance companies last year?

          Medical insurance is so bad and evil that I don't have any. I watched my parents spend multiple hours on the phone for every non-scheduled doctor's visit, and no less than one hour for each scheduled one, just to get things paid correctly. My time's worth more than that. So I have catastrophic, long-term ailment insurance th
    • Insurance is a game of shared risk. The more people you have involved, the cheaper the cost to all...

      But we're not talking insurance, are we? We're talking health care.

      I'll just segue into hyperbole, why do you want poor people to suffer and die?
      • Personally, I'm talking insurance. There's no way you're going to elminate the insurance industry by government fiat, if for no other reason than they have too much influence. Even if you could, I'd argue that'd be a bad thing. I think the industry needs reform, by force if necessary, much more than the legal profession and "tort reform". How we back the prices down from today's levels, I have no idea, but at least without the insurance industry working to make more and more profit it'll help keep a lid
  • The HMO that my dad has through work has a very short list of approved drugs, everything else we have to pay near full price for. So whenever I get sick (I seem to get the most exotic perscriptions) we have to look through the list to see if it's ok, and then switch to something else that IS approved (or preferred).
    • My last illness that needed treatment my doctor wrote a scrip - not covered by my plan, $109. So I went back to my doctor with the list of drugs in that category approved by my insurance and he ID'd one and changed the scrip.

      His comment when I said the first one isn't covered? "Oh, that is covered by ANYBODY's insurance." !!! - I don't think its a coincindence that everytime I see this doctor at least one Pharma salesperson gets to go in and see him during the time I'm in the waiting room.

      So its not just
      • Absolutely. Insurance and PharmCo's are definitely corrupting influences on the process. I am rather proud to have overheard the drug reps sitting in my doctors' (my wife and I see different doctors in the same practice) office complaining about how hostile this office is to them--you'd think they'd have better sense than to bitch in front of the patients that they can't push our doctors around :-).
        • Remember that for every buck spent on R&D, there's 4 spent on marketing.

          That pretty much sums up the problem. After all, if the drugs are equivalent, the only way to increase your share of the market is to market the shit out of it.

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