YOUR MONEY OR YOUR LIFE!
I remember hearing Jack Benny on radio -- late in the forties, well before TV became available in my home town (Newton, Massachusetts). For those of you who may not have heard of him, Benny played a a vain skinflint whom it pained to part with even one penny. In one skit, Benny was confronted by a coarse-voiced bad-guy who said, "your money or your life!" Benny didn't answer, but there was uproarious laughter from the audience, who well understood the stinginess of his stage character. When the laughter subsided (in a hilarious 8 seconds), the gunman said, "look bud, I said your money or your life!" whereupon an exasperated Benny shouted, "I'M THINKING IT OVER!"
You can hear this classic moment on You Tube -- I just did, and it's still funny. What's not so funny, however, is that in real life, every minute of every day in this country, some poor soul hears from Big Pharma that same demand -- "your money or your life!", and then that unfortunate has to figure out how to get the money that will keep him -- or her -- alive. Too many cannot, and suffer grisly consequences and death.
A well known example is the case of Alec Raeshawn Smith, who had Type 1 Diabetes. He had turned 26 and was thus "aged out" of being covered by his mother's insurance. His mother said he had been shopping for health plans, But could not find one he could afford. When he went to pick up his Insulin and glucose strips, he was told it would cost $1300. He knew that at his salary -- $35000/year (he managed a restaurant) -- he couldn't afford to buy as much as he needed, so he decided to ration his supply, hoping that he could make it last until his next salary check. Four days before pay-day, he died of diabetic ketoacidosis, where you go into a coma, your blood having turned to acid.
According to a recent study at Yale, 1 in 4 Diabetes sufferers have admitted to doing the same thing, though they realized how dangerous it was. Since 2002, the price of insulin has skyrocketed. A vial of insulin which used to cost $40 in 2002 now can cost more than $300. There is no generic.
There are insulins that you can get over the counter -- the old fashioned kind -- for a relatively resasonable price, but they work differently, and unreliably, compared to the expensive versions, one which is tailored to peak faster or another which is tailored to last longer. With these highly refined and tailored versions, you can get an insulin which peaks quickly so it's ready for you to have a meal, or, alternatively one which lasts for a longer period of time when you're between meals. With the old fashioned versions, you have to count on planning your life's schedule and your diet with exquisite precision, and hope for good results, which don't always come. Or you can fly to Canada, where you can enjoy such savings that the first batch you order pays for the plane flight, while the other batches can be just gravy on top of that. And customs, I hear, will let you bring in pharmaceuticals if they are for your personal use. The same applies, they tell me, if you prefer to drive to Mexico. Those countries, like all of Europe, watchfully regulate the price of medicines, lest greedy manufacturers raise the prices to the point where they cause severe hardship.
NOT SO HERE. In this country, profits have primacy, and everything else is secondary -- including people. And in between the manufacturer and the customer, there are a whole string of agents, benefit managers retail outlets, etc, who want their cut, too!
Acquainted with all this, I can understand and sympathize with the irate comments people made to the New York Times article, upon which some of the current article is based:
The cost of insulin is determined by one's drug plan if you're lucky enough to have one. I have an excellent, rolls royce Medicare drug plan and the cost of my Lantus, the only pen on my plan's formulary, is still outrageous.
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During hurricanes and natural disasters people are prosecuted for charging people hundreds of dollars for food and gas but when it comes to medicine, allowing people to die is the actual business model of Pharma.
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My 34-yr. old son with Type 1 since age 18 works all hours of the day and night to make a living and get ahead. When his insulin and supplies keep going up, he never gets ahead. His insurance premiums also keep going up. Some days he comes home tired and wonders why it has to be so hard in America just to stay alive
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I am in an academic Endo practice in WV. The price of insulin has gone up about 225% per unit in the last few years.
Regular insulin and NPH are less expensive than the new insulins but patients have poorer outcomes due to "insulin stacking" phenomena leading to hypoglycemia and death. The donut hole in part D medicare coverage results in the most vulnerable patients reducing their insulin doses and getting complications such as diabetic ketoacidosis and death in the type 1 patients. The type 2 get acceleration of micro and macrovasular complications. This situation should not exist in the U.S. It is time for single payer and universal health care.
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My response to all of this is if we could have medicare for all, universal healthcare or single payer -- whatever you want to call it -- none of us would have to hear Big Pharma tell us: "Your money, or your life!"
Dio
If you'd like to leave a comment, please click on the "number of comments" link. The comment box will appear, and you can share what you think. Thanks to these comments, I already have learned a lot!
According to a recent study at Yale, 1 in 4 Diabetes sufferers have admitted to doing the same thing, though they realized how dangerous it was. Since 2002, the price of insulin has skyrocketed. A vial of insulin which used to cost $40 in 2002 now can cost more than $300. There is no generic.
There are insulins that you can get over the counter -- the old fashioned kind -- for a relatively resasonable price, but they work differently, and unreliably, compared to the expensive versions, one which is tailored to peak faster or another which is tailored to last longer. With these highly refined and tailored versions, you can get an insulin which peaks quickly so it's ready for you to have a meal, or, alternatively one which lasts for a longer period of time when you're between meals. With the old fashioned versions, you have to count on planning your life's schedule and your diet with exquisite precision, and hope for good results, which don't always come. Or you can fly to Canada, where you can enjoy such savings that the first batch you order pays for the plane flight, while the other batches can be just gravy on top of that. And customs, I hear, will let you bring in pharmaceuticals if they are for your personal use. The same applies, they tell me, if you prefer to drive to Mexico. Those countries, like all of Europe, watchfully regulate the price of medicines, lest greedy manufacturers raise the prices to the point where they cause severe hardship.
NOT SO HERE. In this country, profits have primacy, and everything else is secondary -- including people. And in between the manufacturer and the customer, there are a whole string of agents, benefit managers retail outlets, etc, who want their cut, too!
Acquainted with all this, I can understand and sympathize with the irate comments people made to the New York Times article, upon which some of the current article is based:
The cost of insulin is determined by one's drug plan if you're lucky enough to have one. I have an excellent, rolls royce Medicare drug plan and the cost of my Lantus, the only pen on my plan's formulary, is still outrageous.
--------------------
During hurricanes and natural disasters people are prosecuted for charging people hundreds of dollars for food and gas but when it comes to medicine, allowing people to die is the actual business model of Pharma.
--------------------
My 34-yr. old son with Type 1 since age 18 works all hours of the day and night to make a living and get ahead. When his insulin and supplies keep going up, he never gets ahead. His insurance premiums also keep going up. Some days he comes home tired and wonders why it has to be so hard in America just to stay alive
--------------------
I am in an academic Endo practice in WV. The price of insulin has gone up about 225% per unit in the last few years.
Regular insulin and NPH are less expensive than the new insulins but patients have poorer outcomes due to "insulin stacking" phenomena leading to hypoglycemia and death. The donut hole in part D medicare coverage results in the most vulnerable patients reducing their insulin doses and getting complications such as diabetic ketoacidosis and death in the type 1 patients. The type 2 get acceleration of micro and macrovasular complications. This situation should not exist in the U.S. It is time for single payer and universal health care.
--------------------
My response to all of this is if we could have medicare for all, universal healthcare or single payer -- whatever you want to call it -- none of us would have to hear Big Pharma tell us: "Your money, or your life!"
Dio
If you'd like to leave a comment, please click on the "number of comments" link. The comment box will appear, and you can share what you think. Thanks to these comments, I already have learned a lot!
Your money or your life:
ReplyDeleteIndeed !
A Systematic Review and Meta-Analysis of Studies Comparing Mortality Rates of Private For-Profit and Private Not-For-Profit Hospitals. P.J. Devereaux, et al CMAJ May 28, 2002; 166 (11) concluded that "...There is a significantly increased risk of mortality in private for-profit hospitals as compared to private not-for-profit hospitals in the US." In the summary discussion the authors reasoned that [Quote):
"The increase in mortality in private for-profit institutions may be attributable to the fact that investors expect a return on their investment, and the institutions indeed have a fiduciary responsibility to their investors, first and foremost.
As a consequence, when dealing with patients for whom the reimbursement rate is similar (eg. Medicare fee schedules), monies that would otherwise be spent on patient care must be siphoned off as profit, reducing either quality of care"
In Related Articles/Posts Canadian Doctors for Medicare have documented an entire archive of study for over a decade now, indicating that "
"...evidence shows that private, for-profit health care produces worse patient outcomes than nonprofit care, and they order more unnecessary tests and procedures."
see: http://www.canadiandoctorsformedicare.ca/Publications/the-problem-with-profit-driven-health-care.html.
While the Canadian Physicians are studying the for profit system for evidence based evaluations and answers. the American utilitarian myth of a private profit
motive delivering the best service for the least cost, is an argument that does not stand up to these studies (or to our direct experiences with medical markets). Call it diverted, perverted or distorted incentive, the attention to prioritizing profits over people has rational medical apologists rationalizing elite rationing as market efficiency, and calling this the finest medical system in the world (that money can buy; we presume). Managed care, that was created and designed to distribute "risk" to the population now ostensibly has an economic role of redistributing "risk" out of medical practice in ROI terms (return on investment). rather than alleviating the risk of catastrophic cost from illnesses for individuals, families and the working communities, larger To Big to Fail insurance operations distribute profits and create dark pools of wealth interests that actually raise the "cost" (price) of medical care to the patient, while rendering the cost to scale for delivery itself. So when the medical expert speaks of cost, it is not patient cost (price), it is cost/medical ratios, where the amount actually spent on the medical side is reduced (for profit), and costs are necessary expenses. Healthcare rationing in the United States exists in various forms. By definition, Access to private health insurance is rationed on price and ability to pay.
Your Money or your life? But who will Pay? They say...
ReplyDeleteThe "middle man" "business" construct of HMOs (and their counterparts) is only several decades in the making. The manipulations become more hidden:
(see: https://www.verywellhealth.com/how-health-care-rationing-in-the-us-affects-even-you-1738482; by Elizabeth Davis, RN Updated 10/13/17)
"Health care rationing in the United States isn’t as blatant as saying “No, you’re not allowed to have this health care service.” Instead, U.S. health care rationing is more subtle and usually presents in one of two forms:
(1) Limiting access to certain types of health care or health care providers.
(2) Increasing barriers to health care in order to discourage frivolous use, expensive care, or care that isn’t medically necessary."
Jessica Schorr Saxe has made some very insightful commentary in an article she presented entitled: Why the profit-driven market model doesn’t work in health care.
(Quoted partially):
"Healing medicine has been practiced for over 2000 years, and scientific medicine for more than 100. The perception of medicine as a business is relatively new.
We now view medical care as a commodity, much as we view buying shoes"
Read more here: https://www.charlotteobserver.com/opinion/op-ed/article50323570.html#storylink=cpy
"A for-profit system creates perverse incentives. Insurance companies make money for investors when they provide less care. For-profit medical institutions have troubling outcomes. Investor-owned hospitals are more expensive. Death rates are higher in for-profit hospitals and dialysis units.
Drug companies make more profits when they sell newer drugs, still patent-protected. This leads to promotion of new drugs as safe, such as rofecoxib (Vioxx), an anti-inflammatory. After being widely prescribed, it was linked to thousands of deaths.
This incentive to promote new drugs obscures the fact that it is generally better to take an old drug rather than the glittery new drug being promoted.
Also obscured is the fact that often non-drug treatments are superior. For instance, exercise is often as effective a treatment for depression as antidepressant medications.
Read more here: https://www.charlotteobserver.com/opinion/op-ed/article50323570.html#storylink=cpy
Read more here: https://www.charlotteobserver.com/opinion/op-ed/article50323570.html#storylink=cpy
[and Jessica Schorr gives us a final retort to consider]:
"Though the market model is pervasive, it does not apply to everything. Some services remain public goods such as police protection, fire protection, and education. I posed this question to our audience: Why do we view health care as different from education, to which most of us believe all children are entitled?"
Read more here: https://www.charlotteobserver.com/opinion/op-ed/article50323570.html#storylink=cpy
Jessica Schorr Saxe is a Charlotte family physician and the chair of Health Care Justice – see her full article here:
https://www.charlotteobserver.com/opinion/op-ed/article50323570.html
Dr. Schorr's conclusions are irrefutable. The real question is: How is this obscene system allowed to continue? The answer is MONEY-- the money contributed by the profiteers to elect politicians who will vote their way. Our Congress, I fear, is wholly owned and paid for -- not by the people, but by the corporations whose money elected them. Corporate greed -- in this case the greed of Big Pharma and Big Insurance are mainly to blame in this.
ReplyDelete