[quote]DrSkeptix wrote:
Who is this “we” you keep talking about?
I know I make decisions, and I am responsible for them. But who is this “we” that stands over me, or in my way, and takes no responsibility for the outcome?
[/quote]
We as in society in general. Specifically it’s the bureaucrats who form policy.
james
My biggest pet peeve in life are “words not actions” types of people. They really get my ire up!
I can relate to all of this very well see I was born with a very rare type of congenital defects to parents with no Health Insurance at the time ( my Dad was working previously laid off waiting for insurance to kick in). Basically my parents were told to take me home after 3 days in the hospital due to no insurance, it was very touch and go they tell me for about 3 weeks concerning my breathing.
Long story short I am a very productive member of society I give back a lot to my community.
I really hope that Atypical and Csulli never have to go through something like this because when you put value on human life it becomes a very slippery slope of bad decisions after another.
The people on the panel should be ones that take “Hippocratic Oath” would be good for starters.
Ps: In my log in the O35 forum on the first page you can read the list of defects I have, thread is called Twiceborn.
[quote]atypical1 wrote:
[quote]DrSkeptix wrote:
Who is this “we” you keep talking about?
I know I make decisions, and I am responsible for them. But who is this “we” that stands over me, or in my way, and takes no responsibility for the outcome?
[/quote]
We as in society in general. Specifically it’s the bureaucrats who form policy.
james[/quote]
Yes but why should they get to decide this particular way? Why should we give them more power and specifically this one? It’d better be a daaaaaamn good reason because we’ve just curtailed our inalienable rights by allowing that.
And in addition to those two questions, why should we simultaneously give them more power AND make sure that they are removed as far as possible from the negative repercussions of their actions (public outcry, appeal, criminal charges, market forces)?
That is the best recipe for disaster that I know of.
[quote]FISCHER613 wrote:
My biggest pet peeve in life are “words not actions” types of people. They really get my ire up!
I can relate to all of this very well see I was born with a very rare type of congenital defects to parents with no Health Insurance at the time ( my Dad was working previously laid off waiting for insurance to kick in). Basically my parents were told to take me home after 3 days in the hospital due to no insurance, it was very touch and go they tell me for about 3 weeks concerning my breathing.[/quote]
I think you missed my point. I wasn’t saying that life isn’t valuable and that we shouldn’t help people. Just the opposite. In fact you’re kinda a perfect case for universal health care. What I am saying is that insurance companies now decide who lives and who dies based on what’s covered by the plans. The ACA isn’t going to make that any better or any worse. In fact it’s made some of it better through not denying people insurance based on previous conditions.
And what do you mean by “words not actions”? This is a forum, isn’t it all about words?
james
[quote]Aragorn wrote:
Yes but why should they get to decide this particular way? Why should we give them more power and specifically this one? It’d better be a daaaaaamn good reason because we’ve just curtailed our inalienable rights by allowing that.
And in addition to those two questions, why should we simultaneously give them more power AND make sure that they are removed as far as possible from the negative repercussions of their actions (public outcry, appeal, criminal charges, market forces)?
That is the best recipe for disaster that I know of.[/quote]
I’m not saying it’s right or wrong. But it’s the way that it is currently. If the ACA never passed we would still have covered conditions and treatments and conditions and treatments that aren’t covered.
Besides insurance companies we also have economics at play. How many people stay sick and even die just because they don’t have health insurance? In this case there’s no regulation, contract, or “death panel” at work. It’s simply a matter of economics.
james
For example and I am not singling anyone out here on the “words not actions”.
when I start hearing “we” as in Society about making decisions all I hear is a copout or a distancing of oneself to the problem(s) at hand. The Govt’ is not some nameless entity . I know where my Mayor lives I have the phone number/emails of my State Rep etc.
Next phrase is : “I don’t make the rules” or this one really fires me up " I am just following orders…"
I do and would rather hear this : " there was a problem and this is how I overcame or fixed it"
Hope this makes sense.
I am now off to see my Cardiologist and the “Board” about trying to change the testing parameters on Pacemakers on athletes for insurance reasons. It is ironic that this discussion came up this week when I am dealing with this mess.
Check back in tomorrow.
Dispersion of responsibility when it comes to my or a loved ones life?
No thanks. I’d like to be able to look someone straight in the eyes and see them looking back when they are making a decision on whether or not I or a loved one lives or dies. It’s way too easy for someone to make a glib, rubber stamp type of decision when the human element has been removed from a situation, or many thousands of situations per day.
[quote]Chushin wrote:
[quote]atypical1 wrote:
In Austria I would imagine that there’s a list of things that are approved for treatment and things that aren’t. Then if you want something that’s not on the approved list then you appeal it and a committee or individual approves or denies it. It works exactly the same way in the insurance companies.
And it’s not just over things that are life or death. Every treatment you get is on that list. I would invite everyone who has private insurance to review their documents and see the things that are and aren’t covered and what the appeal process looks like. You would be surprised at what’s not covered.
[/quote]
Did I misread, or did Doc not say that the trxt WAS approved by the man’s insurance in this case? [/quote]
No, you got the story correctly. The medication is FDA-approved for his diagnosis. The approval does not specify where it has to be given, or where it cannot be given. MediCare does not pre-authorize medications; but they claim the right to claw back the money if it was paid out for unapproved purposes.
That is not he case here. MediCare pays for a hospitalization for a diagnosis, not for specific medications. So the hospital works to minimize expenses. In this case I was suspicious of the proffered reason for denial of treatment, and…
[quote]DrSkeptix wrote:
No, you got the story correctly. The medication is FDA-approved for his diagnosis. The approval does not specify where it has to be given, or where it cannot be given. MediCare does not pre-authorize medications; but they claim the right to claw back the money if it was paid out for unapproved purposes.
That is not he case here. MediCare pays for a hospitalization for a diagnosis, not for specific medications. So the hospital works to minimize expenses. In this case I was suspicious of the proffered reason for denial of treatment, and…[/quote]
FDA approval is not the same as MediCare approving the drug for use. So in this case it wasn’t the government who denied it first but the hospital and they did it to minimize their costs because they have to maximize their profit. I’m still struggling to understand how you took your hospital policies and extrapolated them to the ACA. You made my point for me that in the case of insurance someone is going to make that decision of what to cover and what not to cover. And that decision is going to be made in order to minimize loss.
james
[quote]SkyzykS wrote:
Dispersion of responsibility when it comes to my or a loved ones life?
No thanks. I’d like to be able to look someone straight in the eyes and see them looking back when they are making a decision on whether or not I or a loved one lives or dies. It’s way too easy for someone to make a glib, rubber stamp type of decision when the human element has been removed from a situation, or many thousands of situations per day.[/quote]
That decision is always going to be yours just like it always has been. No hospital is going to refuse treatment if you can pay for it somehow. That’s always been the case and always will be the case.
james
[quote]atypical1 wrote:
[quote]SkyzykS wrote:
Dispersion of responsibility when it comes to my or a loved ones life?
No thanks. I’d like to be able to look someone straight in the eyes and see them looking back when they are making a decision on whether or not I or a loved one lives or dies. It’s way too easy for someone to make a glib, rubber stamp type of decision when the human element has been removed from a situation, or many thousands of situations per day.[/quote]
That decision is always going to be yours just like it always has been. No hospital is going to refuse treatment if you can pay for it somehow. That’s always been the case and always will be the case.
james
[/quote]
In the Uk that is no longer necessarily true.
[quote]Chushin wrote:
Here in Japan it is definitely not true.
I’ve offered to pay myself a couple of times, and was told it was not allowed.[/quote]
Really? I would certainly be opposed to any system that didn’t allow you to pay for things yourself if need be. How do they handle treatments that aren’t covered?
james
[quote]atypical1 wrote:
[quote]DrSkeptix wrote:
No, you got the story correctly. The medication is FDA-approved for his diagnosis. The approval does not specify where it has to be given, or where it cannot be given. MediCare does not pre-authorize medications; but they claim the right to claw back the money if it was paid out for unapproved purposes.
That is not he case here. MediCare pays for a hospitalization for a diagnosis, not for specific medications. So the hospital works to minimize expenses. In this case I was suspicious of the proffered reason for denial of treatment, and…[/quote]
FDA approval is not the same as MediCare approving the drug for use.[/quote]
And your source for this declaration is…? If a drug is FDA-approved for an indication, MediCare (Parts A and B) can still deny it to patients? Show me an example.
[quote] So in this case it wasn’t the government who denied it first but the hospital and they did it to minimize their costs because they have to maximize their profit.
[/quote]
Yes, now you understand. But is denying a treatment–a legal, FDA-approved treatment, available to anyone–right? or is it legal? Ever heard the term “elder-abuse?” If the patient dies because a legitimate treatment was denied him for pecuniary reasons–is that right? is that legal?
Who decides?
[quote]
I’m still struggling to understand how you took your hospital policies and extrapolated them to the ACA. You made my point for me that in the case of insurance someone is going to make that decision of what to cover and what not to cover. And that decision is going to be made in order to minimize loss.
james[/quote]
Your struggle, at this point, is of your own making. I am describing how a bureaucracy will develop extralegal policies that limit meaningful care to unsuspecting victims. Am I making myself clear?
And I did not make any point for you, insofar as you have a point. Insurance companies enter into contracts with providers and with patients. Lost in the fine print is the right to deny drugs of proven efficacy, almost always where some alternative may be available. But you seem not to understand that the ACO (which is a key part of the ACA), will subvert the contract through extralegal policy, and the most vulnerable people in our society will be victimized, without their knowledge or permission.
Why do I know this? Because I see it every day.
[quote]atypical1 wrote:
[quote]SkyzykS wrote:
Dispersion of responsibility when it comes to my or a loved ones life?
No thanks. I’d like to be able to look someone straight in the eyes and see them looking back when they are making a decision on whether or not I or a loved one lives or dies. It’s way too easy for someone to make a glib, rubber stamp type of decision when the human element has been removed from a situation, or many thousands of situations per day.[/quote]
That decision is always going to be yours just like it always has been. No hospital is going to refuse treatment if you can pay for it somehow. That’s always been the case and always will be the case.
james
[/quote]
You have way too much confidence in govt. bureaucracy if you think that any of them wouldn’t gladly usurp individual autonomy if it meant justifying its own continuing existence and position on a budget ledger.
No one single person means anything to a bureau or department, nor does an entire population, when you get right down to it. Once created, they exist ultimately to continue to exist regardless of their original intention.
Why the hell anybody would forfeit some of lifes biggest and most important decisions to the judgement of nameless faceless strangers is beyond me.
OK people… Shit loads of back and forth… lots of strawmans, lots of name calling. You gotta love T-Nation.
I pose this question to all: What is the answer? Assume you have dictatorship for a week- what would you do to make everything fabulous?
At some point, money runs out. Whether it be yours, “the governments” (read: yours), a charities, etc. The sanctity of human life cannot be quantified, but at some point it has to be, doesnt it?
Consider the OP - say by some act of god he gets the meds he needs at the low-low cost of $100k. What if by some amazing mishap he has another issue and ends up being in the same situation a year or 2 later? Do you take his history into account this time and deny him the drugs? Do you drop another $100k on the treatment that was supposed to keep this second issue from happening and disregard his history?
Is there a lifetime limit or yearly limit like every insurance I have ever had? Is there some level of risk that must be overcome before treatment is considered? Does every person have the right to an endless flow of cash to extend their life, whether morally right or wrong? At what point does the piggy bank get closed?
At what point does the cost outweigh the return? Honest question.
And who the hell gets to make that call?
Up front- I see the ACA as an abomination. it does absolutely nothing to help keep costs down. At best it is a path to a single payer system. At worst it is a blatant power grab (wtf do house sales and student loans have to do with health care?).
To those that say something must be done, I absolutely agree. But ACA is NOT the solution. If your house is burning down, you have to do something. Do you grab a gallon of gas and throw it on the flame and call that the solution? You did something, right? But it sure as hell wasnt the RIGHT something.
[quote]Da Man reloaded wrote:
At what point does the cost outweigh the return? Honest question.
[/quote]
Thats easy. You take their current yearly income and increase it 2.2%/year, then calculate their federal tax debt per year multiplied by the number of years they have left as a viable entity in the workforce.
That is how much we are worth to our gov. When the cost of treatment meets or exceeds their value- Pull the plug.
The average person would last about 3 days in an ICU. Neonatal or cardiac units can just shut their doors right away. Nobody is going to last more than 10 min. in one of those.