Health Care- Condemned to Die

[BLAZER PROPHET]

Not to draw attention to myself, but as some of you know my 29 year old daughter has a terminal illness called Pulmonary Hypertension. Her life is sustained with a medication called Flolan. Due to it's expense ($300,000 per year), the feds pay for it. Some people with PH use what's called 'combination therapy' to stay alive. Now, due to the debt burden of the Canadian single payer health care, this therapy will no longer be available to thousands of people with various maladies like PH.

They will now die as a result of this decision.

I wonder if my daughter will even continue to receive medication under the US Federal Health Care plan, and if so, for how long before she is condemned to die like all those people in Canada.

 

[DennisRodman]

I personally believe if your daughter did not have the condition you may have a different perspective on the matter.

You could argue that 1000 malnourished children in Africa could be sustained by each $300 000, however as a result of the money being used differently means:

"They will now die as a result of this decision."

"Those kids are condemned to die"

 

[e_blazer]

I personally believe if your daughter did not have the condition you may have a different perspective on the matter.

You could argue that 1000 malnourished children in Africa could be sustained by each $300 000, however as a result of the money being used differently means:

"They will now die as a result of this decision."

"Those kids are condemned to die"

And this kind of thinking is exactly what is wrong about government run healthcare. It takes it from being an insurance plan, where our premiums guarantee the health coverage of ourselves and our families, and turns it into an entitlement plan where politics decide how the money is spent. I'm all in favor of charity and even government involvment to help pay for those who can't afford health insurance on their own, but I do not want Pelosi & Co. deciding what kind of coverage my family gets.

 

[jlprk]

I'm sorry about your daughter's condition. My mind wants to do the arithmetic. If thousands in Canada cost $300,000 (American dollars) per year, then it takes 3333 Canadians to cost $1 billion per year. If they average age 29 like your daughter with about 40 years left, it's a $40 billion decision in Canada.

The US has 10 times the population of Canada, so we're approaching 4/10 of a trillion dollars. If they average only 20 years left, it's 2/10 of a trillion.

Tough decisions. To what degree do you think that decision-makers should be motivated by profit, and to what degree should they have a wider field of view?

 

[yakbladder]

And this kind of thinking is exactly what is wrong about government run healthcare. It takes it from being an insurance plan, where our premiums guarantee the health coverage of ourselves and our families, and turns it into an entitlement plan where politics decide how the money is spent. I'm all in favor of charity and even government involvment to help pay for those who can't afford health insurance on their own, but I do not want Pelosi & Co. deciding what kind of coverage my family gets.

First of all, most of the public won't even notice as they'll be on a private health care system.

Secondly, you'd rather have stockholders deciding the coverage for your family? At least with a government run plan you'd be able to elect people who can decide what type of coverage you'd get, and I can almost guarantee you'd get more coverage with a party that's willing to spend some money to achieve it rather than hoping to shrink it back to zero.

 

[yakbladder]

Not to draw attention to myself, but as some of you know my 29 year old daughter has a terminal illness called Pulmonary Hypertension. Her life is sustained with a medication called Flolan. Due to it's expense ($300,000 per year), the feds pay for it. Some people with PH use what's called 'combination therapy' to stay alive. Now, due to the debt burden of the Canadian single payer health care, this therapy will no longer be available to thousands of people with various maladies like PH.

They will now die as a result of this decision.

I wonder if my daughter will even continue to receive medication under the US Federal Health Care plan, and if so, for how long before she is condemned to die like all those people in Canada.

BTW, BP, Where's the link to this information? I'm interested in reading more about this.

 

[BLAZER PROPHET]

And this kind of thinking is exactly what is wrong about government run healthcare. It takes it from being an insurance plan, where our premiums guarantee the health coverage of ourselves and our families, and turns it into an entitlement plan where politics decide how the money is spent. I'm all in favor of charity and even government involvment to help pay for those who can't afford health insurance on their own, but I do not want Pelosi & Co. deciding what kind of coverage my family gets.

Or, ho lives and who dies based on political agendas.

 

[BLAZER PROPHET]

BTW, BP, Where's the link to this information? I'm interested in reading more about this.

I was reading about it in a newsletter I get on PH. Apparently several thousand people with various illnesses in Canada are being cut off from life sustaining medicine due to the cost. I suppose one might find something on Google.

 

[BLAZER PROPHET]

I personally believe if your daughter did not have the condition you may have a different perspective on the matter.

You could argue that 1000 malnourished children in Africa could be sustained by each $300 000, however as a result of the money being used differently means:

"They will now die as a result of this decision."

"Those kids are condemned to die"

Since I know you mean no disrespect with your first comment, I wanted to tell you I take no offense. That said, you are 100% wrong. I would feel the exact same way I do about it now. For the Canadian federal government to pass judgment as Lord God and say, "this year, those 20,000 people from age 2 to 80 that suffer from the following illnesses are to be denied life sustaining medicine and die" is as wrong and evil as there could possibly be. I would never condemn people who still have the ability to live life without assistance save medicine to die- mothers, fathers, children... You might be able to, but I cannot. I believe in life and living.

As to your thoughts about letting those Canadians (and Americans to follow when our federal health care plan is in place) citizens die as government passes the sentence of death upon them is also grossly incorrect. If the feds are going to produce the money for their citizens to live, they sure as hell aren't going to send the money to Africa for starving children. The two are mutually exclusive.

The issue here is that a single national healthcare plan, and those who run it, can and will pronounce death sentences on people as they choose based on political philosophy as well as things like simple budget cuts or at the behest of special interest groups. If you think this is proper, then I have great sympathy for you and what would be a deeply twisted mind and sense of morality.

 

[Denny Crane]

I'm sorry about your daughter's condition. My mind wants to do the arithmetic. If thousands in Canada cost $300,000 (American dollars) per year, then it takes 3333 Canadians to cost $1 billion per year. If they average age 29 like your daughter with about 40 years left, it's a $40 billion decision in Canada.

The US has 10 times the population of Canada, so we're approaching 4/10 of a trillion dollars. If they average only 20 years left, it's 2/10 of a trillion.

Tough decisions. To what degree do you think that decision-makers should be motivated by profit, and to what degree should they have a wider field of view?

Two points.

First, the insurance company pays because it has a contract to do so. The contract can and should be enforced in the civil courts. Government insurance is no contract.

Second, $300K/year is $6M invested at 5%. That $6M is a pretty safe investment, unless you're investing in what Barney Frank pushes you to invest in.

 

[e_blazer]

Secondly, you'd rather have stockholders deciding the coverage for your family? At least with a government run plan you'd be able to elect people who can decide what type of coverage you'd get, and I can almost guarantee you'd get more coverage with a party that's willing to spend some money to achieve it rather than hoping to shrink it back to zero.

Insurance companies have to live by the terms of the policies they issues. Stockholders don't have a say.

 

[yakbladder]

Insurance companies have to live by the terms of the policies they issues. Stockholders don't have a say.

And how would a policy w/ the government be any different? From what little research I've done so far on BP's post, there were two issues:

A) These people were on the "assisted" government sponsored health plan, so they weren't paying for a supplemental private plan or even the base govt. health plan.
B) These people got treatment that technically wasn't even covered. It would be like you going to the doctor and saying "I need laser pigment treatment to get rid of some spots", getting it for ten weeks and then having it shut off when the insurance company realizes they don't cover it - except the insurance company would try and get the money back. Do you think that insurance companies would act any differently? (And yes, BP, I realize there is a huge difference between laser pigment treatment and this combo therapy).

My point is it's ridiculous to think profit-motivated companies would act any differently.

It also begs a question. There are many, many, MANY different types of national health care. They are all different. I strongly encourage you, for example, to see the Frontline special on national health care systems. So why when something goes wrong in one country do the pro-privatization health care people get to cherry pick and say "See! See! Our national health care will do this"...BS... Suppose ours is like Switzerland? Suppose our is like any one of a number of countries that are consistently rated higher above the board in quality of care?

It'd be like me pointing to the Albanian fire department accidently setting fire to a hospital and going "See! See! With a government paid fire department they'll burn down New York!"

 

[MARIS61]

Now, due to the debt burden of the Canadian single payer health care, this therapy will no longer be available to thousands of people with various maladies like PH.

I don't know what this sentence means.

Can you explain the connection with Canada, and who it is that's supposedly with-holding the drug.

My search turned up no availability problems at all for Flolan, but did show that many times PH is caused by Fen-Phen and the makers of that drug have liability for treatment expenses.

 

[BLAZER PROPHET]

I don't know what this sentence means.

Can you explain the connection with Canada, and who it is that's supposedly with-holding the drug.

My search turned up no availability problems at all for Flolan, but did show that many times PH is caused by Fen-Phen and the makers of that drug have liability for treatment expenses.

The newsletter I have states that due to budgetary problems the Canadian health care system is going to cut out patients who receive various expensive combination drug therapy for various illnesses.

As to PH & Feh=Phen, my daughter's is 100% idiopathic. On a Monday, she ran 5 miles. By Thursday of that week, she could not walk across a room without passing out.

 

[Sug]

Prophet is your daughter currently on disability? If so I assume that she is currently on Medicare and that you may also have a supplemental plan. If we have more information, maybe we can all put our heads together and figure out a solution.

 

[jlprk]

$300K/year is $6M invested at 5%. That $6M is a pretty safe investment, unless you're investing in what Barney Frank pushes you to invest in.

I guess this thread is about solving Prophet's individual problem, and I should post elsewhere about the overall issue. I was just saying that it appears it will cost 4/10 of a trillion dollars to keep the Americans with this "combination therapy" problem alive for the rest of their lives (based upon his estimate of thousands of "combination therapy" Canadians needing $300,000 per year).

(4/10 of a trillion = $1B per year in Canada times 40 years times 10 times the population in the U.S.)

The investment necessary to pay the $10B per year in the U.S. for whatever number of years (40 or 20, it doesn't matter) at 5% is $200B. With an average life expectancy of 40 years, your investment perspective reduces the number to $200B from $400B. It can go the other way. The investment way of looking at it increases the number to $200B from only $150B if average life expectancy is, say, 15 years ($1b x 15 years x 10 times the population in the U.S.) So the investment is on the same order as the long-term cost, so it doesn't change my original post. Both ways of looking at it will cost a significant fraction of a trillion dollars to give 33,333 Americans full lives.

I guess another thread is the place to ask, which set of managers should decide who lives and dies? Elected ones who feel sorry for people, so they put the country into more debt? Or ones motivated by profit who are more constrained by budgetary limits? What I find misleading is to say that private managers don't make life and death policy decisions.

 

[maxiep]

I guess another thread is the place to ask, which set of managers should decide who lives and dies? Elected ones who feel sorry for people, so they put the country into more debt? Or ones motivated by profit who are more constrained by budgetary limits? What I find misleading is to say that private managers don't make life and death policy decisions.

You're missing a key difference. There are hundreds or thousands of insurance companies, each making an individual decision. There is one government. And how do you know it will be the elected folks with compassion who will make the decision? It's more likely to be an appointed board of people whose decision can't be overturned.

The fundamental issue you're missing is that it's not the government's business what I choose to do with my body. In this country, I decide.

 

[Sug]

You're missing a key difference. There are hundreds or thousands of insurance companies, each making an individual decision. There is one government. And how do you know it will be the elected folks with compassion who will make the decision? It's more likely to be an appointed board of people whose decision can't be overturned.

The fundamental issue you're missing is that it's not the government's business what I choose to do with my body. In this country, I decide.

You still can, and even after the bill does become law nothing will change for the majority of people.

 

[maxiep]

You still can, and even after the bill does become law nothing will change for the majority of people.

Oh, dear. You really don't believe this bill is a slippery slope toward a single-payer system? Your naivete is stunning.

Think chess, not checkers. I've explained it before. The truth is out there for all to see. Even leading proponents of the bill have come out and said the same thing.

 

[Sug]

Oh, dear. You really don't believe this bill is a slippery slope toward a single-payer system? Your naivete is stunning.

Think chess, not checkers. I've explained it before. The truth is out there for all to see. Even leading proponents of the bill have come out and said the same thing.

I hope it is, but at the same time I also understand that there will always be private healthcare in the United States for those that choose to pay for it out of pocket.

 

[maxiep]

I hope it is, but at the same time I also understand that there will always be private healthcare in the United States for those that choose to pay for it out of pocket.

And who do you think will be able to pay for it out of pocket? The same people who buy it in countries with socialized medicine--the very wealthy. The rest of the populace will be left with no choice but to take what the government decides they should have. That's not America.

 

[jlprk]

You're missing a key difference. There are hundreds or thousands of insurance companies, each making an individual decision. There is one government. And how do you know it will be the elected folks with compassion who will make the decision? It's more likely to be an appointed board of people whose decision can't be overturned.

The fundamental issue you're missing is that it's not the government's business what I choose to do with my body. In this country, I decide.

I don't know what that means. Here's what I've seen. You need a $100,000 operation to repair the XYZ using the ABC method, DEF permutation. Your policy covers XYZ and in some cases, ABC, but DEF is usually with the PQR permutation. Specific regulations must be interpreted. Auditors will check the decisions later, after you're either dead from them, or alive.

My point is that no matter what contract you think you have in writing, I have managed the money for an HMO. Their human decision-makers follow budgets (that I made) to make sure that the insurance company or medical provider doesn't go under.

Do you get a helicopter from the general hospital to the specialist hospital? Maybe, if your cost hasn't surpassed the normal range. Things like that can be excluded when necessary. Expedited appointments, verification checkups, a costlier experienced doctor for a more serious case, etc.

A government committee might make life or death decisions? Private insurance companies and private hospitals have committees and auditors doing that, the same as government already does. And if you ask critically who made a certain decision, they draw together and say, we did it as a group. You can't find the hospital's decision process. (I tried, in my mother's case.) You don't have any choice to choose your insurance company after it's over. And it's only then that you have learned what you needed to know. The more a neutral party like the government (or a private regulator) forces out the information in advance, the more true choice of companies we will have.

What I see some saying here is that only government decision-makers make life or death decisions. But the same decisions must be made by any managers, whether government or private. What that has to do with your right to do with your body whatever you want, I do not understand. Catchy slogan, though. Millions of people will be swayed by it.

 

[TradeNurkicNow]

And who do you think will be able to pay for it out of pocket? The same people who buy it in countries with socialized medicine--the very wealthy. The rest of the populace will be left with no choice but to take what the government decides they should have. That's not America.

It is now, apparently. Huh.

 

[Denny Crane]

I guess this thread is about solving Prophet's individual problem, and I should post elsewhere about the overall issue. I was just saying that it appears it will cost 4/10 of a trillion dollars to keep the Americans with this "combination therapy" problem alive for the rest of their lives (based upon his estimate of thousands of "combination therapy" Canadians needing $300,000 per year).

(4/10 of a trillion = $1B per year in Canada times 40 years times 10 times the population in the U.S.)

The investment necessary to pay the $10B per year in the U.S. for whatever number of years (40 or 20, it doesn't matter) at 5% is $200B. With an average life expectancy of 40 years, your investment perspective reduces the number to $200B from $400B. It can go the other way. The investment way of looking at it increases the number to $200B from only $150B if average life expectancy is, say, 15 years ($1b x 15 years x 10 times the population in the U.S.) So the investment is on the same order as the long-term cost, so it doesn't change my original post. Both ways of looking at it will cost a significant fraction of a trillion dollars to give 33,333 Americans full lives.

I guess another thread is the place to ask, which set of managers should decide who lives and dies? Elected ones who feel sorry for people, so they put the country into more debt? Or ones motivated by profit who are more constrained by budgetary limits? What I find misleading is to say that private managers don't make life and death policy decisions.

The insurance companies are one of the largest institutional investors, if not the largest. I don't know for sure what % of their premiums collected (yearly) get paid out for claims, but I'd guess some smallish fraction. Their whole reason for being is to invest and use the returns on the investments to pay out annuity kinds of arrangements.

Your figuring is fine except for discounting the aggregate of the premiums collected over years. They only have to invest that $6M one time, years ago...

As far as who decides who lives or dies, that should be the patient's choice, or spouse/family in the case the patient is braindead or something.

 

[maxiep]

I don't know what that means. Here's what I've seen. You need a $100,000 operation to repair the XYZ using the ABC method, DEF permutation. Your policy covers XYZ and in some cases, ABC, but DEF is usually with the PQR permutation. Specific regulations must be interpreted. Auditors will check the decisions later, after you're either dead from them, or alive.

My point is that no matter what contract you think you have in writing, I have managed the money for an HMO. Their human decision-makers follow budgets (that I made) to make sure that the insurance company or medical provider doesn't go under.

Do you get a helicopter from the general hospital to the specialist hospital? Maybe, if your cost hasn't surpassed the normal range. Things like that can be excluded when necessary. Expedited appointments, verification checkups, a costlier experienced doctor for a more serious case, etc.

A government committee might make life or death decisions? Private insurance companies and private hospitals have committees and auditors doing that, the same as government already does. And if you ask critically who made a certain decision, they draw together and say, we did it as a group. You can't find the hospital's decision process. (I tried, in my mother's case.) You don't have any choice to choose your insurance company after it's over. And it's only then that you have learned what you needed to know. The more a neutral party like the government (or a private regulator) forces out the information in advance, the more true choice of companies we will have.

What I see some saying here is that only government decision-makers make life or death decisions. But the same decisions must be made by any managers, whether government or private. What that has to do with your right to do with your body whatever you want, I do not understand. Catchy slogan, though. Millions of people will be swayed by it.

That's a lot of writing just for complete gibberish.

 

[TradeNurkicNow]

lol

 

[MARIS61]

That's a lot of writing just for complete gibberish.

Seems clear and concise to me.

Maybe you're having a stroke.

Smile in the mirror. Is your smile crooked?

 

[maxiep]

Seems clear and concise to me.

Of course it does. Of course it does.

 

[TradeNurkicNow]

lol

 

[BLAZER PROPHET]

Prophet is your daughter currently on disability? If so I assume that she is currently on Medicare and that you may also have a supplemental plan. If we have more information, maybe we can all put our heads together and figure out a solution.

Yes, she is. The feds pay for her Flolan. However, this could change when our health care is 100% under the control of the Feds. We hope not, but I think it is a distinct possibility.

Also, is't not as if she is bed-ridden. Sometimes the side effects of the medication make her so for a couple of days, but other times she has enough energy to do some housework or get out and do a bit of shopping... so while it sustaines her life, it's not as if she lives in a coma.