I was well aware of the huge profits on genuinely new drugs, which in turn puts pressure on the companies to find marginal improvements that a new drug might make. or to pressure the FDA to approve new drugs of dubious benefits or high risk. But what shocked me about my ear drops was that there didn't seem to be anything remotely new in them. Thus this seems to represent a new and higher level of hucksterism for which some lucky executive presumably received a healthy bonus, if you'll excuse the expression.

Originally Posted by KaiserD2

I was well aware of the huge profits on genuinely new drugs, which in turn puts pressure on the companies to find marginal improvements that a new drug might make. or to pressure the FDA to approve new drugs of dubious benefits or high risk. But what shocked me about my ear drops was that there didn't seem to be anything remotely new in them. Thus this seems to represent a new and higher level of hucksterism for which some lucky executive presumably received a healthy bonus, if you'll excuse the expression.

All they have to do is change one ingredient a miniscule amount and they can sell it as a new drug. They did this to my mom's ear drops. My mom's doctor couldn't even find the changed ingredient.

Originally Posted by Deb C

All they have to do is change one ingredient a miniscule amount and they can sell it as a new drug. They did this to my mom's ear drops. My mom's doctor couldn't even find the changed ingredient.

Well geez, ask the doctor to prescribe something generic or an alternative!!
Come on people, you can be proactive about these things.

Originally Posted by The Rani

Well geez, ask the doctor to prescribe something generic or an alternative!!
Come on people, you can be proactive about these things.

The doctor thought he ordered the generic. That's why I was shocked when they told me the price. I was proactive at the pharmacy, but to reorder the drops without that one tiny ingredient that changed it to a new drug, would have been another 24 hours. To make a long story short, my mom was in such pain that I had to give them to her sooner than later.

Originally Posted by Deb C

The doctor thought he ordered the generic. That's why I was shocked when they told me the price. I was proactive at the pharmacy, but to reorder the drops without that one tiny ingredient that changed it to a new drug, would have been another 24 hours. To make a long story short, my mom was in such pain that I had to give them to her sooner than later.

That is odd. Unless a doctor specifies "do not substitute," pharmacies are allowed to dispense generics at their own discretion.

Originally Posted by The Rani

That is odd. Unless a doctor specifies "do not substitute," pharmacies are allowed to dispense generics at their own discretion.

Maybe the doc didn't want to admit that he wrote the wrong script.

Originally Posted by Deb C

All they have to do is change one ingredient a miniscule amount and they can sell it as a new drug. They did this to my mom's ear drops. My mom's doctor couldn't even find the changed ingredient.

Pretty bizarre that we are both talking about ear drops! Mine haven't really worked after two days, either.

Originally Posted by KaiserD2

Pretty bizarre that we are both talking about ear drops! Mine haven't really worked after two days, either.

I hope your not in too much pain.

Last August I lost my employer-provided heath care (from Kaiser Permanente) and enrolled in this thing called the Healthy San Francisco Program, which could be a model for what government-run health care in the future may very well look like.

Here's a link to their website. I'm sure you'll find it highly informative.

http://www.healthysanfrancisco.org/

Originally Posted by KaiserD2

Pretty bizarre that we are both talking about ear drops! Mine haven't really worked after two days, either.

Perhaps an Ear Drop Revolt is in order!
Alcohol and vinegar works pretty well for swimmer's ear, and it's dirt cheap.

The games pharmaceuticals play. And unfortunately, Obama's backroom deals with this greedy industry, has only given them more clout.

The New York Times
January 1, 2011
Coupons for Patients, but Higher Bills for Insurers
By Andrew Pollack

With drug prices rising and many people out of work, pharmaceutical
companies are increasingly helping patients with their co-payments.

Drug companies say the plans help some patients afford medicines that they
otherwise could not.

But health insurers and some consumer groups say that in many cases, the
coupons are just marketing gimmicks that are leading to an overall increase
in health care costs. That is because they circumvent the system of higher
co-pays on costlier drugs that insurers use to encourage consumers to use
less expensive products.

Any shift to brand-name drugs can have a big impact on health care costs.

At District Council 37, a union representing public employees in New York
City, 59 percent of claims for statins in the year ended in June 2009 were
for brand-name products that cost the plan $17.3 million. The other 41
percent of claims were for generic statins, which cost only $179,000. A year
ago, the health plan eliminated the co-pay on generic statins to encourage
more use of them.

For very expensive drugs, co-pay assistance is almost de rigueur, because in
some cases co-payments can be up to 20 percent of the price of the drug.
Novartis?s new pill for multiple sclerosis, Gilenya, costs $48,000 a year,
compared with $30,000 to $40,000 for rival drugs, which are injected.
Novartis is offering to cover the entire co-pay, up to $800 a month, which
is 20 percent of the drug?s monthly cost.

Jazz Pharmaceuticals has quadrupled the price of its narcolepsy drug Xyrem,
to about $30,000 a year, over the last five years, according to a recent
report from the securities firm Jefferies & Company. To cushion patients,
the company recently increased its co-pay assistance to as much as $1,200 a
month.

Drug companies cannot offer co-payment assistance for patients in federal
programs like Medicare because such offers are considered an inducement to
use a drug and in violation of anti-kickback laws. Some companies have
responded by contributing to, or even helping to set up, charitable
foundations that can provide co-payment assistance legally.

Executives at insurers and pharmacy benefit management companies say they
would like to counter the cards and coupons but are not sure exactly how to
do so. One problem is that the information they receive from pharmacies does
not specify whether the co-pay was made by the patient or by the drug
company.

?The payer doesn?t know, and the P.B.M. doesn?t know,? said F. Everett
Neville, chief trade relations officer at Express Scripts, a pharmacy
benefits manager. ?We have no ability to stop it and no ability to prohibit
it.?

http://www.nytimes.com/2011/01/02/bu...pagewanted=all


Comment: Should a health care system be designed to ensure that patients
receive appropriate medications that they should have to relieve symptoms or
cure disease? Of course. Yet co-payments (a dollar amount) and coinsurance
(a percentage of the cost) impose on the patient financial barriers to the
medications - barriers which frequently are not surmounted, and thereby may
result in impaired health outcomes.

With our fragmented system of financing health care those seeking greater
profits will always find another way to achieve their goals. In this
instance, the pharmaceutical manufacturers have found a way to reduce or
eliminate these financial barriers to their products.

In providing cost-sharing assistance to the patient, the manufacturers are
not specifically removing barriers to the most appropriate products, but
rather are removing barriers to their most profitable products, irrespective
of whether or not they are the best choice. Since these are more expensive
products, that increases the drug costs of the private insurers. Those of us
paying premiums to private insurers that cover drugs are paying for these
excess costs.

These practices do not require collusion with the physicians and pharmacists
since their marketing practices are effective in creating a demand for their
products regardless of the appropriateness.

Note that these pharmaceutical industry subsidies of co-payments and
coinsurance are illegal in federal programs such as Medicare because they
are the equivalent of kickbacks. If we had a Medicare program that covered
everyone and eliminated the private intermediaries such as the insurers and
pharmacy benefit managers, then these kickbacks wouldn't exist. Drugs would
be prescribed based strictly on appropriateness, and would be priced to
provide fair profits for the pharmaceutical firms and fair costs for
Medicare.

My ear is not hurting badly although it's reacting oddly to my piano playing. But I went to the ear doctor today, whom my wife and I really like a lot. He knew all about those drops--he said the company is taking advantage of a loophole in the Medicare prescription plan--they simply added a preservative to an existing drop formula, declared it a new drug, and increased the price tenfold. He told me to put a little non-prescription hydrocortisone on a cue tip and use that to put it in my ear! And wrote a script for a cheap drop. He doesn't think anything is seriously wrong but could do something more if the ringing in my ear (which is intermittent) persists. I suspect it will go away.

All in all, an educational experience--but not as educational as being told you have cancer, and then finding out a few years later that doctors in the know realize that the tumor you had never metastasizes and should not be called cancer at all.

Originally Posted by KaiserD2

My ear is not hurting badly although it's reacting oddly to my piano playing. But I went to the ear doctor today, whom my wife and I really like a lot. He knew all about those drops--he said the company is taking advantage of a loophole in the Medicare prescription plan--they simply added a preservative to an existing drop formula, declared it a new drug, and increased the price tenfold. He told me to put a little non-prescription hydrocortisone on a cue tip and use that to put it in my ear! And wrote a script for a cheap drop. He doesn't think anything is seriously wrong but could do something more if the ringing in my ear (which is intermittent) persists. I suspect it will go away.

All in all, an educational experience--but not as educational as being told you have cancer, and then finding out a few years later that doctors in the know realize that the tumor you had never metastasizes and should not be called cancer at all.

They are all practicing.

James50

Originally Posted by The Rani

It's not only grandma facing a "death panel;" it's anyone without money or health insurance. Nobody wants to think about the cost/benefit ratio of treatment. People just assume that more money means better care.

Sorry, I should have attributed the "death panel" comment to a certain media personality from Alaska. I don't think she had poor people in mind when she used the emotional argument to derail HCR.

My point was more about facing end-of-life issues and planning to deal with them appropriately in advance. Regardless of ability to pay.

Originally Posted by Xer H

Sorry, I should have attributed the "death panel" comment to a certain media personality from Alaska. I don't think she had poor people in mind when she used the emotional argument to derail HCR.

My point was more about facing end-of-life issues and planning to deal with them appropriately in advance. Regardless of ability to pay.

Yeah I know what you meant. MY point is that media personalities on the "other" side use the same emotional argument, applied to poor people instead of old ones.

Originally Posted by The Rani

Yeah I know what you meant. MY point is that media personalities on the "other" side use the same emotional argument, applied to poor people instead of old ones.

Gotcha.............

Almost all pharmaceuticals are dangerous substances. If abused they cause trouble. One might have no choice with some drugs if one wants to survive.

Drug interactions kill. Indeed, some drugs are best described as means of borrowing time by trading off some malady likely to kill earlier for something that will kill later. Patients should leave the prescribing of drugs to physicians.

Yes, I investigate every drug that I ever have prescribed for me. Fortunately they have been entirely antibiotics and painkillers. At age 55 I know that my luck will eventually run out. I want to put off any substances that "can cause liver damage".

I guess it would be very wrong of me to pray that the politicians who take away health care from the poor, may one day be without it themselves. I know, it's not nice to think this way but I get so frustrated with these callous decisions.

The Wall Street Journal
January 4, 2011
Cuomo Targeting Medicaid Spending
By Jacob Gershman

Gov. Andrew Cuomo is aiming to reduce the state's Medicaid spending by
billions of dollars, exceeding the size of cuts to the program proposed in
past years, according to individuals with knowledge of his budget.

The Cuomo administration is considering a cut of about $2.1 billion out of
the state's projected spending on Medicaid in the upcoming fiscal year. With
federal matching funds, the cut comes to more than $4 billion.

http://online.wsj.com/article/SB1000...154691892.html

And...

The Sacramento Bee
January 3, 2011
Brown to propose broad list of budget cuts
By Kevin Yamamura

(Gov. Jerry Brown) will propose Medi-Cal (Medicaid) savings by requiring
patients to provide co-payments for services, limiting doctor visits and
reducing rates paid to health providers. In Healthy Families (CHIP), which
provides subsidized care for low-income children, he wants participants to
pay more in premiums and co-payments while eliminating vision care.

"These would be shocking cuts if we hadn't seen them before, but we have
seen them before," said Anthony Wright, executive director of Health Access
California. "This is what's left to cut outside of the wholesale dismantling
of core programs. These are bad cuts that will impact millions of
Californians."

http://www.sacbee.com/2011/01/03/329...d-list-of.html


Comment: A substantial increase in eligibility qualification for the
Medicaid program is a crucial measure in the Patient Protection and
Affordable Care Act (PPACA), designed to decrease the numbers of Americans
without insurance coverage. Now the newly-elected Democratic governors of
the two most populous states in the nation intend to sharply reduce funding
of their Medicaid programs. What does this say about the wisdom of the PPACA
policy of using Medicaid to expand coverage?

Gov. Brown's proposal to impose financial penalties for accessing care,
placing caps on doctor visits, and further slashing payments in this already
critically underfunded program can only be disastrous for the low-income
patients enrolled.

Once again, this is not change we can believe in. We desperately need an
improved Medicare that covers everyone.

Originally Posted by Deb C

Once again, this is not change we can believe in. We desperately need an
improved Medicare that covers everyone.

Will not exist unless treatment costs come down.
And, as I've said elsewhere, when that happens, the entire system goes through upheaval.
Careful what you wish for.

Originally Posted by Deb C

Once again, this is not change we can believe in. We desperately need an
improved Medicare that covers everyone.

It might interest you to know that price inflation in medical care started to outpace the general price inflation rate in 1966 after Medicare and Medicaid were passed. This effect is easily predictable since you have the combination of government bureaucracy and increasing demand on already scarce resources.

The simple fact of the matter is that there will be rationing of medical care. You can choose to do it by a wait list or by ability to pay. Pick one.

What surprises me is the inability of anyone to consider the possibility that government intervention in the provision of medicine is making things much worse.

Originally Posted by Galen

It might interest you to know that price inflation in medical care started to outpace the general price inflation rate in 1966 after Medicare and Medicaid were passed. This effect is easily predictable since you have the combination of government bureaucracy and increasing demand on already scarce resources.

The simple fact of the matter is that there will be rationing of medical care. You can choose to do it by a wait list or by ability to pay. Pick one.

What surprises me is the inability of anyone to consider the possibility that government intervention in the provision of medicine is making things much worse.

There's already a rationing of care, it's done by the for profit insurance industry. They are continuously denying procedures and life saving diagnostic care. Thousands of people go bankrupt every year for the lack of health insurance, or having been sold junk policies with huge co-pays and out of pocket expenses.

Hospitals, just like people, are held hostage by this industry. If they want an insurance corporation's patients, then that price for their patients are negotiated for the lowest possible payments for care, and that's dictated by the the insurnace giants. Health care is also high in this country because of tons of administrative costs. My husband has a staff person just to deal with the craziness of the paper work and time required trying to get approval for treatments.

It is a fact that an 'improved' Medicare for all would make health care available for everyone and take us from one of the worst countries in regards to mortality rates, to one of the best.

If we continue on this road of private insurers, hospitals and doctors will continue to be burdened with absorbing the non-payments from insurance industry.

Originally Posted by Deb C

There's already a rationing of care, it's done by the for profit insurance industry. They are continuously denying procedures and life saving diagnostic care. Thousands of people go bankrupt every year for the lack of health insurance, or having been sold junk policies with huge co-pays and out of pocket expenses.

Hospitals, just like people, are held hostage by this industry. If they want an insurance corporation's patients, then that price for their patients are negotiated for the lowest possible payments for care, and that's dictated by the the insurnace giants. Health care is also high in this country because of tons of administrative costs. My husband has a staff person just to deal with the craziness of the paper work and time required trying to get approval for treatments.

It is a fact that an 'improved' Medicare for all would make health care available for everyone and take us from one of the worst countries in regards to mortality rates, to one of the best.

If we continue on this road of private insurers, hospitals and doctors will continue to be burdened with absorbing the non-payments from insurance industry.

Many doctors will no longer take new Medicare patients because of reimbursement rates.

I am in favor of single payer as a business person because the current system gives me rationing decisions. I don't want this responsibility. I do not want to make those decisions. If the people/government want rationed care, let them do it and not me.

James50

Originally Posted by James50

Many doctors will no longer take new Medicare patients because of reimbursement rates.

I am in favor of single payer as a business person because the current system gives me rationing decisions. I don't want this responsibility. I do not want to make those decisions. If the people/government want rationed care, let them do it and not me.

James50

Your correct, this is why single payer advocates are working for an 'improved' Medicare for all. But it's not just Medicare that's underpaying the docs and hospitals.

Single payer would level the playing field for businesses. And, when employees are getting good health care, they make for better employees.

Originally Posted by Galen

It might interest you to know that price inflation in medical care started to outpace the general price inflation rate in 1966 after Medicare and Medicaid were passed. This effect is easily predictable since you have the combination of government bureaucracy and increasing demand on already scarce resources.

The simple fact of the matter is that there will be rationing of medical care. You can choose to do it by a wait list or by ability to pay. Pick one.

What surprises me is the inability of anyone to consider the possibility that government intervention in the provision of medicine is making things much worse.

U.S. far from having finest health system
The Coloradoan, Jan. 3, 2011

I am writing in response to "U.S. has world's best health-care system." It was said that "we have, without a doubt, the finest health-care system in the world."
In the United States, we do have the finest nurses, physicians and technology in the world. The system, however, is far from the finest. Each year in the United States, the system drives 700,000 families to bankruptcy from medical bills (the majority of whom have medical insurance). Every year, the system leaves 50 million people uninsured. Every year, the system allows 45,000 people to die from lack of access to basic medical care. Our system charges nearly twice as much per capita to accomplish these statistics. The system is neither fair nor fiscally sound. The good news is that the solution exists in a uniquely American proposal put forth by an organization endorsed by more than 18,000 medical providers in our country. Learn more about the proposal at Physicians for a National Health Program (www.pnhp.org).

Learn more about other successful health-care systems by reading T.R. Reid's well-considered "The Healing of America." We need to open our minds and hearts to a health-care system that provides access for all and promises our sons and daughters a fiscally sound and sustainable future.
Doug Whitman, M.D., pediatrician
Larimer County

http://www.coloradoan.com/article/20...INION/U.S.+far

Originally Posted by Galen

It might interest you to know that price inflation in medical care started to outpace the general price inflation rate in 1966 after Medicare and Medicaid were passed. This effect is easily predictable since you have the combination of government bureaucracy and increasing demand on already scarce resources.

Oversimplification. A simple example ... what did medical imaging consist of in 1966? A simple x-ray exam. That was about it. What does medical imaging consist of today? Well, let's see ... MRI's, PET's, nuclear medicine studies, CT's, Ultra-sound, oh, yeah, and x-rays.

This increase in technology has had lots of impacts on medical care, many good things, some not so good. It has, without any question, drastically increased the amount of imaging procedures done and the resulting expense of being "examined."

Blaming it on government bureaucracy is just more blah, blah, blah from someone who lives in a two-dimensional world.

Originally Posted by Galen

The simple fact of the matter is that there will be rationing of medical care. You can choose to do it by a wait list or by ability to pay. Pick one.

Perfect. The old "False Dichotomy" argument. Again, a superficial comment that adds nothing to anyone's perspective.

As any sophomore knows, there are lots of excellent ideas around, none of which get any consideration whatsoever to avoid much "rationing" and to provide much better care to virtually all of our citizens.

Originally Posted by Galen

What surprises me is the inability of anyone to consider the possibility that government intervention in the provision of medicine is making things much worse.

I think you'll find that on this forum there are many who will challenge such a bald statement with requests for substantive data that demonstrates your position.

Again, I would suggest that your superficiality runs very deep.