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Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by Waterluvian on Sunday October 21, 2018 @04:52PM (#18270177)
It is just insane to me that you have a medical issue and you're calling around for quotes. I know we have had this conversation to death for decades now but it just makes me so angry.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by johnpowell on Sunday October 21, 2018 @06:46PM (#18270802)
I was diagnosed with Oropharyngeal Cancer 39 days ago. Keeping up with the appointments alone has been bad enough. I am not sure how I would deal with this if I had to shop around for the best deal.

-I went to urgent care for some swelling on my neck that escalated quickly. 45 minutes later I was getting a MRI. This was on a Friday. They called and said it was cancer.

-Monday I was seen by a ear nose throat doctor. Yes, cancer indeed.

-Tuesday I saw a oncologist.

-At this point I decided to move to Portland since my sister lives up here. So the oncologist referred me to another ENT doctor in Portland.

-About a week later I saw a dentist and radiologist on the same day. Everyone agreed that due to the bad shape my teeth are/were in and the location of the cancer my teeth need to come out.

-A few days later another oncologist

-All my teeth removed (this has been rough)

-Tomorrow a "simulation" and PET scan to see if the cancer has spread

-Tuesday is something called a swallowing test

-Wednesday is a check up with the oral surgeon

-Friday is some intake thing for the feeding tube and a meeting with the nutritionist.

-Next Monday feeding tube installed.

-Next Tuesday another check-up with the G.I doctor.

-Next Wednesday radiation and chemo start.

So yeah.. I have no clue how much this shit is costing and I don't really care since I have Medicare. I just wish everyone had the same luxury.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by mvleming on Sunday October 21, 2018 @07:58PM (#18271118)
Godspeed brother, I wish you the best. You'll be in my thoughts
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by monocularvision on Monday October 22, 2018 @01:21AM (#18272371)
I hope you don’t mind, but praying for you and your treatment going forward.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by chrisweekly on Sunday October 21, 2018 @09:04PM (#18271401)
Welcome to the [Cancer] club noone wants to join. Good luck w/ your treatment.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by dimator on Tuesday October 23, 2018 @03:58AM (#18281566)
Fight the good fight, internet stranger. Don't give up. Good luck.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by 1123581321 on Sunday October 21, 2018 @11:20PM (#18271964)
Calling for quotes is how buyers (patients) force prices down in the long run.

For example, I got a quote this summer for an outpatient MRI that was 20% the cost of a hospital MRI, faster, and would accomplish the same thing. Now I tell everyone I know about this. If enough people do this, the hospital will not be as free to increase the cost and might even lower it (or at least start providing quotes!)

This price-shopping process is slowed by all the shenanigans that keep prices and services provided confusing, and demand to improve this is hampered by insistence that patients are never in a state of mind to shop for the best healthcare provider. It’s simply untrue—and there are workarounds in the worst cases like healthcare POAs and family members donating time.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by archagon on Sunday October 21, 2018 @07:09PM (#18270906)
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by tehwebguy on Sunday October 21, 2018 @05:25PM (#18270365)
If you think you're angry now you should try actually calling around for quotes. My experience is that most places you call won't even try to give you a straight answer!
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by bko on Sunday October 21, 2018 @05:13PM (#18270288)
What's the alternative? Everyone charges the same price? Who sets this price?

Calling around and shopping is what people do on practically every other service or good they buy now.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by refurb on Sunday October 21, 2018 @10:38PM (#18271762)
My guess is that this is where healthcare is headed in the US. If things stay on the current trajectory, the govt is simply going to step in set prices.

In terms of how they would be set, Medicare already spends a ton of time created a system of DRG codes for every condition along with a set payment (adjusted by COL and other things).

Of course Medicare rates are sometimes less than the cost to provide the care. But I see us just getting to the point that the govt will just say “tough shit”.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by jacobush on Sunday October 21, 2018 @06:12PM (#18270650)
And on every other service you will get something that at least resembles a straight answer.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by lexs on Monday October 22, 2018 @06:42AM (#18273541)
Do you call around and shop for different fire departments? Seems weird that such a basic need would be treated this way.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by 1123581321 on Monday October 22, 2018 @12:45PM (#18276175)
Fire departments are analogous to ambulance response — these services are entirely based on geographic location and, similarly to insurance, need to be arranged in advance by a municipality or county, or an out-of-district annual payment. Most healthcare is not summoned this way although there are an increasing number of medical practices that charge a subscription in exchange for quick access to the office and remote consultations.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by robertAngst on Sunday October 21, 2018 @05:26PM (#18270374)
>It is just insane to me that you have a medical issue and you're calling around for quotes.

You dont call around for quotes of $100+ services?

Why?

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by yodsanklai on Sunday October 21, 2018 @05:56PM (#18270563)
Because you should be able to show up, get your treatment and go home without paying a dime, like in most developed countries.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by robertAngst on Sunday October 21, 2018 @08:56PM (#18271366)
That sounds unsustainable and bad capitalism.

Free services mean a few people will overuse and abuse.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by cmyr on Sunday October 21, 2018 @09:18PM (#18271437)
Indeed, ever since I realized I could get medical care without paying for it I've been going out and getting cancer a couple times a week.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by woah on Monday October 22, 2018 @08:39AM (#18274115)
Countries with universal health care spend less on health care. It’s empirically proven to be cheaper.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by monotone666 on Monday October 22, 2018 @02:04AM (#18272521)
Eventually seeking out excessive medical care will be considered a mental illness and it’s practioners hospitalized
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by xkcd-sucks on Monday October 22, 2018 @05:52AM (#18273360)
"Drug seeking behavior" extended to antibiotics and chemotherapy lol
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by Latteland on Sunday October 21, 2018 @09:17PM (#18271432)
So you are saying poor people should just die I guess. Them and their kids.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by ionised on Monday October 22, 2018 @04:43AM (#18273091)
> That sounds unsustainable

It is perfectly sustainable if you have a population that isn't ideologically opposed to taxes. You can fix that with education.

> and bad capitalism.

Good capitalism or bad capitalism, who cares? This sounds like a pointless ideological concern, again.

> Free services mean a few people will overuse and abuse.

It seems spiteful to me to deny universal healthcare to the majority because a minority might abuse it.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by nostromo on Sunday October 21, 2018 @05:11PM (#18270279)
Why?

The most efficient provider should get his or her business. That way we can treat more people for strep and increase human welfare.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by beatgammit on Sunday October 21, 2018 @05:19PM (#18270318)
You shouldn't even need to call around, prices for routine procedures like checking for strep should be clearly posted. The bill shouldn't change if you're insured or uninsured, just the payer changes.

There's obviously some variation here, and for that an hourly rate makes sense.

Health care should be more like car repair: go in for a quote, then pay when you decide on a provider. Obviously emergencies are different, but things like strep or broken bones are pretty common, so they should have a set price.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by HarryHirsch on Sunday October 21, 2018 @05:19PM (#18270322)
The most efficient provider should get his or her business.

That's an assertion, not an argument supported by observations. In the European countries the government sets prices for procedures, and it works well, life expectancy there isn't lower than it is in the US.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by WoodenChair on Sunday October 21, 2018 @05:23PM (#18270342)
Life expectancy is not a simple proxy for quality of health care. Exercise, diet, happiness, genetics, disaster propensity, and many cultural factors have an impact on life expectancy.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by twic on Sunday October 21, 2018 @06:45PM (#18270799)
Compare specifically to the UK then - we get no exercise, have awful diets, are miserable, have a more inbred version of US genetics, fucking love self-inflicted disasters apparently, and are culturally mostly indistinguishable from the US. And yet, despite the fact that we spend a fraction of what you spend on healthcare, have a couple more years' life expectancy.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by Latteland on Sunday October 21, 2018 @09:22PM (#18271452)
And by almost any measure we are no better than and frequently behind other western democracies in healthcare.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by nostromo on Sunday October 21, 2018 @05:25PM (#18270360)
European countries are free riders on the American healthcare system.

Americans pay out the nose for drug prescriptions, which fund the vast majority of research and development budgets, which then benefit all people, worldwide.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by HarryHirsch on Sunday October 21, 2018 @05:33PM (#18270425)
Come on, the big companies are multinationals, and not all of them do all research stateside. Novartis are Swiss, GSK are British, Merck KGA are German, Novo Nordisk are Danish, Takeda are Japanese &c pp. The Yanks overpay terribly for healthcare, that's true.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by nostromo on Sunday October 21, 2018 @05:37PM (#18270445)
It doesn't matter where they do research, it matters where they sell their drugs.

And all of those countries make more revenue selling to the US than they do any other country by a long shot.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by wonderwonder on Sunday October 21, 2018 @09:18PM (#18271435)
Of course they do. But that's not the fault of the other countries, its because US politicians allow the pharmaceutical and health care industry to get away with it. The fix is not to force others to pay the same high price for life saving medication; the solution is to bring the costs down for all. But in the US we allow corporations and lobbyists to control the narrative and people actually think its ok to force someone to choose between being able to afford their medication or food.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by zaphar on Monday October 22, 2018 @08:59AM (#18274233)
While I probably agree with your thesis, you have not actually addressed GP's assertion that the US subsidizes Drug Research. There is no question that we pay more for drugs than others. There is also no question that it is better for the consumer if we have cheaper drugs.

What you haven't answered is whether the research can be supported without the American market subsidizing of that research.

It is in fact, expensive to develop new drugs and something has to pay for that development.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by maxxxxx on Sunday October 21, 2018 @05:32PM (#18270418)
I think this is very self-serving propaganda by the American healthcare system. And even if it's true let's fix this by charging less in the US and see what happens to the rest of the world. .
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by FeepingCreature on Sunday October 21, 2018 @06:39PM (#18270768)
As a European, I agree.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by DoreenMichele on Sunday October 21, 2018 @06:42PM (#18270787)
Americans pay out the nose for all medical care, not just drugs. So I doubt your assertion really holds water.

If the world wants and needs better drugs, there are other ways to fund research. If we give a damn, we can find such solutions.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by enraged_camel on Sunday October 21, 2018 @05:35PM (#18270436)
>>European countries are free riders on the American healthcare system.

Citation needed.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMckenny on Sunday October 21, 2018 @05:52PM (#18270543)
>The most efficient provider should get his or her business.

Given that the US has this system and US healthcare is multiples more expensive with worse or similar outcomes in essentially every field, I suggest we can put that theory to rest now.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMarius on Sunday October 21, 2018 @06:32PM (#18270733)
What about Switzerland though?

(definitely not defending the US system)

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMckenny on Monday October 22, 2018 @12:24AM (#18272170)
There must be some additional variable. Be nice to know what it is.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by nostromo on Sunday October 21, 2018 @07:48PM (#18271061)
> Given that the US has this system

The US does not have this system.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMckenny on Monday October 22, 2018 @12:31AM (#18272200)
The grand parent describes this exact process. Why would we think he was lying?
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMarius on Monday October 22, 2018 @08:13AM (#18273984)
No lying is necessary, misinformation is common. People generally don't know how much the healthcare industry is regulated and how exactly.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by charlesdm on Sunday October 21, 2018 @07:26PM (#18270972)
The most efficient provider, however, might not be the best provider. If you have cancer, you want to get the best treatment and survive. But hey, this other guy might be able to do it cheaper!
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by shanusmagnus on Sunday October 21, 2018 @09:35PM (#18271514)
Just as big a problem as the opacity in pricing, is the opacity in figuring out who the best providers even are. There's no Yelp for healthcare because powerful groups won't let it exist.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by mrep on Sunday October 21, 2018 @05:14PM (#18270297)
Probably because if we had universal healthcare, you wouldn't have to call any because you would get the same service for free.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by WoodenChair on Sunday October 21, 2018 @05:26PM (#18270372)
It's true that you wouldn't have to call around, because you wouldn't have to compare the cost of out-of-pocket providers. It's not true that you wouldn't have to pay. You would pay through taxes, or someone else would pay through taxes. And you would pay in terms of the waiting time, which becomes an alternative form of payment in public systems.
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by jimktrains2 on Sunday October 21, 2018 @06:24PM (#18270707)
Interesting that everyone makes this argument for things that aren't already covered by taxes. No one sits and argues that you do have to pay for the interstate system in a discussion about the cost of using it as the turnpike.

No one thinks that no end user cost (what people usually mean when they say free) <> no money spent.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMarius on Sunday October 21, 2018 @06:35PM (#18270747)
Isn't the interstate system frequently blocked and the roads not really good, the speed limit low, construction way too expensive and slow, etc? I wouldn't really want to have that in my healthcare system...

My point: Let's stop comparing healthcare to road construction/maintenance. It's human lives. It works differently.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by jimktrains2 on Sunday October 21, 2018 @11:01PM (#18271869)
I wasn't comparing healthcare to roads. I was commenting about how silly people sound when they say "it isn't free, taxes fund it".

Also, speed limits can be comparable to turnpike's, the interstates are rarely "blocked" unless you mean congested, which is a different issue and one that more road at that location would actually make worse. Construction costs are comparable to turnpike construction and maintenance costs and are slow because, unlike a turnpike it's most visible and most delaying in areas like cities where you can't move cars to a shoulder, something that isn't an issue for turnpikes..

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by monotone666 on Monday October 22, 2018 @03:18AM (#18272775)
>interstate frequently blocked

By whom? Traffic is just an argument for mass transit

>roads not really good

That’s an argument for more government not less. They’re fine where I live.

>speed limit low

It’s reasonable in cities and towns

>construction expensive and slow

Also high quality

You already have a beurocracy in “your” health care system. It’s just a private one and not a public one. The difference is cost involved in administrative overhead deciding who gets care and for what.

A nation needs a good health care system and a good road system to afford productive workers.

Both systems when implemented poorly cause human death and disability.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by TomMarius on Monday October 22, 2018 @05:16AM (#18273229)
> By whom? Traffic is just an argument for mass transit

Huh? I don't see any argument at all. The fact is that it is, right now, blocked.

> That’s an argument for more government not less. They’re fine where I live.

Yeah, sure - I live in the Czech Republic, a place where we have more government and the worst roads you will ever see in a first world country.

It's definitely not an argument for "more government" - actually it's not an argument for either because you've provided zero arguments. Why it'd be better than it is now?

> Also high quality

The highways are definitely not high quality, it's just good enough. Visit Germany sometimes. Construction time has almost no relevance to quality, btw (if we don't talk about extremes).

> It’s reasonable in cities and towns

We are talking about interstates.

> You already have a beurocracy in “your” health care system. It’s just a private one and not a public one.

Yeah, I know. Again, what's your point? You stated facts that are well known by everyone interested in this topic. There are very clear advantages to a free market and there are very clear disadvantages of a public solution (and of course the contrary).

Have you ever thought about the fact that only people in the USA actually want a public system? Maybe a private system could work well if implemented correctly (see Switzerland, a country with one of the best healthcare in the world - that is private) - government is not a universal and definitely not always the best solution.

> The difference is cost involved in administrative overhead deciding who gets care and for what.

Is that the only difference, really? How much experience exactly do you have with public systems? Are you sure you have a complete picture? I have lived in several ones over my whole life. I prefer the US system.

BTW is there really a difference? You know the same thing needs to happen in a public system as not everyone is eligible for everything? How does it compare to waiting for 4 months until a doctor is available (in non-urgent cases)? How does it compare to generally substantially lower quality of care (not medical, but care - as in quality of food in hospitals, whether they treat you respectfully, whether you need to sleep on a hallway because all rooms are packed with 5+ people...)?

Do you know that only the most basic (we call it "medically necessary") treatments are paid and everything else needs to be paid out of pocket in full as there is no possibility to insure yourself for upper level of care (actually it's illegal)?

> Both systems when implemented poorly cause human death and disability.

Exactly. So let's stop with "hurr durr we need full government intervention" and let's focus on what's wrong, why it happened and how to fix it ASAP - and you're not going to fix anything ASAP if your way is to rebuild the whole thing and nationalize/bankrupt (or both, as is common with governments doing business) huge companies.

The USA system needs change, however I'm pretty sure that such dramatic change would leave the country in ruins (or more likely in a lot of dead bodies) simply because it's extremely hard to run such system even if you've been doing it and continuously improving it and gaining experience for the last 70 years and your country is 20x smaller - and there is no country in the world where a public system would have substantially better results than the US one.

Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by mitchtbaum on Sunday October 21, 2018 @05:20PM (#18270332)
How would the universe provide healthcare?
Re:A Billionaire Pledges to Fight High Drug Prices, and the ... by mrep on Sunday October 21, 2018 @05:42PM (#18270472)