A second modest proposal
Question:
> After the excellent example of Jonathon Swift, and continuing in > the vein of my earlier proposal (that MD s not be allowed to > treat thyroid disorders until at least 6 months after drinking > a nice thyroid-killing RAI) I would like to make a new modest > proposal. > I propose we all write to our congresscritters (here in the > US of A, people elsewhere will need to make the appropriate > substitutions as to targets for these missives) and demand > that the FDA outlaw TSH testing. TSH testing clearly fails > the two critical FDA mandates — 1) it must be effective, > and 2) it must be safe.
imho, we, in the USA, need these things: we need to put the brakes on skyrocketing health care costs in the USA, whether it’s for docs or meds or whatever we need to get the media (especially TV news) out of the "health care" loop we need the FDA to change drastically, mainly to be more of a provider of information and to be *less* of a watchdog. there are *no* meds that are perfectly safe, and it is the patient (primarily) who should be made aware of that coz the docs and FDA already know it we need to have patients play a bigger part in their own health care, and especially to be a bigger part of their own medical team > TSH testing has lead to systematic under-diagnosing and > under-treatment of thyroid disorders, to the point where > people have ended up in emergency rooms in myxedemic > coma before diagnosis (rare, but it has happened). Such > examples clearly demonstrate that TSH testing is not effective, > and depending upon it puts patients at risk. > (Only half tongue in cheek…)
i’ve no tongue in cheek on the above. :) as far as i’ve been able to figure out, the only way it’s gonna happen is if we have everyone in the USA pay out of pocket but for that to happen, we’ll also need some draconian changes in the political arena. for one we’d need to outlaw health insurance from work. for another we’d need to mandate that insurers could not exclude anyone nor charge different rates/coverage for those who’ve pre-existing conditions. not to mention that the employers would be obliged to pay that saved health care cost money to the employees, and maybe even that it be ID’d as "health" income and not be taxed which is why it won’t happen and will contine to get worse for as far as i can see into the future bill – Hide quoted text — Show quoted text -> Sincerely > Kevin
Response:
> we need to put the brakes on skyrocketing > health care costs in the USA, whether it’s > for docs or meds or whatever
ITA with everything you said, but for me it’s particularly aggravating to have to pay for health insurance which is supposed to cover my health care, but then have to go OUT of the system to pay out of pocket for my thyroid treatment (doctor’s visits, lab tests, pills) because no doctor in the HMO in this area would even treat me, with a tsh of 3.5. I feel like I’m being gouged…when I pay for a lab test, for example, I have to pay whatever the lab asks, but when my dh needs a lab test, he pays a small copay and it’s just astounding how much the ins. co. lowers the bill. For example, he had over $300 in tests recently, and the ins. co. lowered it to 1/10th of that…that’s all they paid – $30 – and the lab had to eat the rest, because of their agreement with the ins. co. But the private patient (or uninsured patient) would have to pay the entire $300. Same thing with the doctor. My dh paid $15 copay (we do pay for ins. for both of us) to an HMO doctor for his medical problem, but because I have to go to a private doctor to get thyroid treatment, I have to pay $75 for each visit, whereas if a HMO doctor saw me and actually believed I needed thyroid treatment, my copay would have been $15 too. I pay all this because I need to and it’s worth it to get my health back, so I don’t usually complain, but since you brought up the skyrocketing costs, I thought I’d mention this, because I’m sure it’s a problem for alot of people.
Response:
<snip> > Today our hodge podge system sees a man I know with many > assets getting free care where he never qualified by > any personal action is getting free care and supplies. > But a person that has paid for insurance since 1947 > taking an economic beating in old age is a bit peeved.. > It seem like I pay about the same out of pocket costs as > long ago, before insurance coverage,but the prices have > risen until all of the supposed gains are soaked up.
you’re focusing on details and not fundamentals <snip> > It will go on for now, but without an answer. It is like a rubber > band tightening. Finally snap.,
it’s not unlike price controls vs. free markets iow, it takes a lot of time for truth to show up. it took the falacy of the USSR system 74 years to "snap" what bothers me about our current direction on health care in the USA is that we continue to put more and more of the money into the pocket of the system which means that there is less money in our own pockets coz that money has to come from somewhere. it also means that others get overly involved in making the health care decisions that we should be making ourselves (with their secondary assistance) it’s no surprise to me that the current democrat proposals are all going in the direction of putting more money into the pocket of the system. i doubt very much that it will be a good long term solution. :( bill
Response:
>> imho, we, in the USA, need these things: > we need to put the brakes on skyrocketing > health care costs in the USA, whether it’s > for docs or meds or whatever > Why are the costs skyrocketing? Reasons – > 1.) Older population increases insurance rates > 2.) The hypothyroid and what he costs, all the problems below originated with > low thyroid -
hi skipper, thank you for a thoughtful response. :) imo, the costs wouldn’t be skyrocketing if we all paid out of pocket coz paying out of pocket is the one best thing that provides real restraint. when it’s the other guy’s dollar, there’s NO restraint > Son- > I paid for ear infections, opthamology when my son lost vision in one eye for > about a year, doctor visits for anorexia for an 8 year old boy, glasses to > protect one good eye, psychiatrist to prescribe Toffranil because it can…
<snip> > Wife – > The pain of watching a happy, active person have a baby and as is common with > hypos, go into severe postpartum depression for a number of years. Several > pregnancy tests when periods were five months apart. At least six different > doctors ran thyroid labs. The pain of listening to her stories about how she…
<snip> – Hide quoted text — Show quoted text -> As for me, I have amblyopia, a lazy eye which one gets when nerve pathways > don’t develop properly. Unlike my brother, I never looked crosseyed in my life > so there were no signs except when I got older, very poor vision in that eye. > It started at a young age. I was incredibly slow physically, slow reflexes, I got… <snip> > I went on 3 grains of Armour, much got better. My painful "plantar fascitis" > went away, and the podiatrist said that meant it had been a nerve problem, > which thyroid is well known for causing. I got a reasonable amount of energy. > Everything would have been great had I not listened to my doctor at one point > in treatment and reduced my dosage, but that’s another story and why I know > food getting stuck in your throat and choking awake at night are signs of > goiter. > Thousands upon thousands upon thousands of wasted dollars. > Yep, that’s why costs are skyrocketing all right. Doctors don’t know how to > treat the sick. This greatly raises the cost of health insurance.
imo, paying out of pocket is the best way to solve this coz the *patient* would STRESS/focus-on costs and alternatives with the doc(s), and would go elsewhere the moment they felt that the doc wasn’t doing that for them – Hide quoted text — Show quoted text -> we need to get the media (especially TV news) > out of the "health care" loop > we need the FDA to change drastically, mainly > to be more of a provider of information and to > be *less* of a watchdog. there are *no* > meds that are perfectly safe, and it is the > patient (primarily) who should be made aware > of that coz the docs and FDA already know it > Give the health care profession a choice between Claritin (or the newest > patented drug that replaced it) and Armour Thyroid and the medical profession > will go for the Claritin. If they changed that behaviour there would be a huge > and drastic recession in the health care industry. Knowing that drug companies > are more willing to go for potent chemicals to control symptoms, and that drugs > are already quite dangerous enough I’m not sure it would achieve your goal.
imo, paying out of pocket would solve this too. :) > we need to have patients play a bigger part > in their own health care, and especially to be > a bigger part of their own medical team > Yes, I think Nora said in her country the doctor will give you what you need > but you might have to sign a medical waiver to get it. That would be fine. > The doctors shouldn’t have the power to decide life or death based on what > treatment they are willing to offer.
agreed. :) <snip skipper’s comment to rhoades> – Hide quoted text — Show quoted text -> as far as i’ve been able to figure out, the only > way it’s gonna happen is if we have everyone in > the USA pay out of pocket > Had there been no health insurance, the costs would have stayed down. If it > followed the course of a story by one person who understood total capitalism > and its price, Jack London, a poor guy would have had a job, but he would get > sick and go to the doctor and if he had gotten an antibiotic from the doctor he > would have made it to work, to keep from starving and being thrown out of the > house. But, since this is Jack London (ever read "A Piece of Steak), he gets > no antibiotic, he can’t go to work because he can’t get out of bed until the > owner of his apartment throws him out into the street. (I never knew when I > read his stories he was a communist, I’m not but he got pure capitalism right. > Ever hear of "Compassionate Conservatism"? Rush Limbaugh coined that phrase I > believe, I would consider that to be a program like ‘Habitat for Humanit" where > you get a house at a discount but you put sweat equity in it, and then you pay > an interest free cost for the cost of the materials put into the home. The > Democrats, like Jimmy Carter are involved in that program that to me fits the > perfect ideal of elevating people while making them responsible. As for the > Republicans, I think their take on "Compassionate Conservatism" was to cut the > welfare rolls just when the economy was booming in the USA, take credit for all > the people that were working and no longer unemployed, and then without all > those huge welfare cuts in the budget anymore, go broke at the first sign of > recession. Small welfare roll, shouldn’t that have meant a bigger bank account > for hard times? Or how about the idea of being taxed at a flat tax of 15.3% > (the Fica employer / employee match on wages) in addition to regular income tax > rates for working hard to make a living while other people can sit back and > collect dividends at special rates so they can save moe money? > That all meant the rich get richer and the poor get poorer these days and the > middle class shrinks as though some enemies within our own country thought many > years ahead to devise a way to make us eventually shrink to the power and > importance of a third world nation.
i get worried when part of the response includes "the rich get richer" coz there’s a real chance that you’re not seeing the fundamentals. btw, i’m not always the best on details, at least in what goes on in the health care biz, but i’m a decent system analyst and tend to see fundaments ok iow, i’m not worried about the rich getting richer so long as they help in getting better health care that is less expensive and available to everyone. that’s a win/win in my book also see my reponse to guy williams (which i x-posted into the thyroid n/g) > but for that to happen, we’ll also need some > draconian changes in the political arena.
> for one we’d need to outlaw health insurance
> from work. for another we’d need to mandate > that insurers could not exclude anyone
> nor charge different rates/coverage for those
> who’ve pre-existing conditions. not to mention > that the employers would be obliged > to pay that saved health care cost money to the
> employees, and maybe even that it be ID’d > as "health" income and not be taxed
– Hide quoted text — Show quoted text -> Let me see, in the USA, they started talking about the health crises around the > same time as they raised the floor beneath which you got no itemized deduction > from 5% to 7.5% of adjusted gross income. So, if you were unlucky enough to be > sick, the government raised your deductible when they knew about the crises. > They talked about implementing prescription coverage for medicare and I went to > the local lab and they had a petition to prevent those same patients from > having to pay an increased deductible for lab costs. Our government does a lot > of things that look good, but then go in both directions where they give > someone a break and then find a way to also sneakily add to the tax burden of > that person. > You know, the health care system has knowingly killed and caused to suffer more > people than terrorrists ever will. Maybe our soldiers should be parked on the > steps of the International Corporations that are permitting this, as well as > the International Corporations that wanted our peaceful country to be at war. > Unfortunately, unless we all find a way to unite in mass numbers we can’t hope > to change things. When you hear celebrities on the radio talking about how > great this country is and the importance of "diversity" do you think maybe the > "diversity" is good because the more diverse a population is, the less likely > it is to agree to the extent our founding fathers did? Maybe that’s why > blacks leaders agitate blacks against whites and tell them how unfairly we’ve > treated them? It’s likely our President was elected because he seemed to have > high moral values, which is why most of the people not on the East or West > Coast voted for him.
i’m leary of making comments on details, important as they may be i can say that it’s not clear to me exactly what political changes (of which i suggested a few above, which i underlined) we’d need to make in order for us to move to paying out of pocket bill
Response:
> imo, the costs wouldn’t be skyrocketing if we > all paid out of pocket coz paying out of pocket > is the one best thing that provides real restraint. > when it’s the other guy’s dollar, there’s NO restraint
The only problem I have with your solution is that if you are one of those who cannot possibly pay catastrophic or even regular costs because of their income, should you just go off somewhere and die? If you have no extra discretionary income to pay even the "restrained" costs, what are you, just chopped liver? I am being serious. I was born with a pre-existing condition that caused kidney failure. Treatment choices consist of either dialysis, an organ transplant for as long as it lasts, or death. Both of the first two treatments are going to be incredibly expenses no matter how much costs are restrained, and beyond my ability to earn a matching income. I guess I just should go somewhere and die to make you it cheaper for everybody else to live. What happens when the healthy (for now) community says that even your disease is not worth society paying for? I do not have any answers either, but I know that my ability to pay will never match my needs. Dennis (Type 2, Kidney Transplant 1995, Glaucoma) — The temperature has already climbed over 70 fahrenheit on its way to another sweltering day. The brutal cancerous glare of the sun continues to beat down mercilessly. Pollen will soon be choking the air along with the smog. The West Nile laden mosquitos drone on incessantly, lying in wait for a chance to pounce. In other words, it is the start of just another typical day in the Hell on this Earth that every body else lovingly calls summer.
Response:
> I guess > I just should go somewhere and die to make you it cheaper for everybody > else to live.
But if your health costs make it so that I cannot afford insurance and so my child dies? > What happens when the healthy (for now) community says > that even your disease is not worth society paying for?
The thing is, society never pays for anything. People do. If you don’t pay for your health costs, someone else must. If I can no longer afford your health costs and mine, whose should I neglect? I am sorry that you are sick, but it’s not my fault. — 382/370/200 Concerned about Atkins’? July 25, 2003 http://tinyurl.com/hgcx — Outgoing mail is certified Virus Free. Checked by AVG anti-virus system (http://www.grisoft.com).
Response:
- Hide quoted text — Show quoted text -> I guess > I just should go somewhere and die to make you it cheaper for everybody > else to live. > But if your health costs make it so that I cannot afford insurance and > so my child dies? > What happens when the healthy (for now) community says > that even your disease is not worth society paying for? > The thing is, society never pays for anything. People do. If you don’t > pay for your health costs, someone else must. If I can no longer afford your > health costs and mine, whose should I neglect? > I am sorry that you are sick, but it’s not my fault. > —
It is also not my fault if your house catches fire, your car is hit by somebody else, or else you are robbed or assaulted and need police services. We all pay for everybody else for something, be it through insurance or taxes. The debate becomes what services do we pool our money for, and what do we pay for completely by ourselves. Again, I do not have any hard answers, I am just asking questions. Dennis (Type 2) — The temperature has already climbed over 70 fahrenheit on its way to another sweltering day. The brutal cancerous glare of the sun continues to beat down mercilessly. Pollen will soon be choking the air along with the smog. The West Nile laden mosquitos drone on incessantly, lying in wait for a chance to pounce. In other words, it is the start of just another typical day in the Hell on this Earth that every body else lovingly calls summer.
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