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View Diary: US Health Care Unmasked: A true story (122 comments)

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  •  There is a generic Lovenox available (1+ / 0-)
    Recommended by:
    the dogs sockpuppet

    There is a generic (substitutable) form of enoxaparin available - the drug is still expensive though because there are only two generics available (it was a very, very hard drug to copy).

    The doctor most decidedly was not getting any kickback in any form for prescribing this drug. It is quite conceivable to me that the doctor thought it was a reasonable drug to use, but not worth making the patient pay $1k for. There is a middle ground between "absolutely essential" and "not needed" and it seems to me this fell into that middle ground.

    •  Gimme a break! (1+ / 0-)
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      zaka1

      Middle ground in medicine! No! It's either needed or it isn't needed? Cost should have no bearing!

      What about the valve replacement? Is there middle ground there as well? Or does it just depend whether the patient can afford it?

      You can chock it up to whatever you want. The US health care system is flawed, and we are all paying for it.

      The future is just a concept we use to avoid living today

      by MetalMD on Mon Dec 10, 2012 at 10:55:57 AM PST

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      •  We wish medicine was that cut and dry. (1+ / 0-)
        Recommended by:
        dogdad

        There is a reason it is referred to as "The Art of Medicine".

        Corporations are driven by the bottom line, not by concerns for health, safety or the environment. This is why we need government regulations.

        by the dogs sockpuppet on Mon Dec 10, 2012 at 11:32:13 AM PST

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        •  And doctors practice medicine (1+ / 0-)
          Recommended by:
          Chi

          You are correct, but that isn't what I'm referring to here. The problem here is, if the medication is not needed now, why was it needed earlier?

          That has nothing to do with the fact medicine is an art, and doctors practice medicine.

          The future is just a concept we use to avoid living today

          by MetalMD on Mon Dec 10, 2012 at 12:23:27 PM PST

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          •  Because more clinical information becomes (0+ / 0-)

            available, because things change, because there are relative priorities... so if the doc finds out the med is going to cost the patient that much, they may prioritize it less... because patient status changes, because a different doc comes on and has a different take on things...

            Unless you are there and part of the doc-patient relationship you just can't know.  HIPPA and all!

            Corporations are driven by the bottom line, not by concerns for health, safety or the environment. This is why we need government regulations.

            by the dogs sockpuppet on Mon Dec 10, 2012 at 12:49:25 PM PST

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            •  If that was so (1+ / 0-)
              Recommended by:
              Chi

              Then the doctor should have cancelled the medication. He didn't do that.

              It wasn't until the patient said he couldn't afford it, did the doctor change his mind. It had nothing do with with changes to the patients condition.

              The future is just a concept we use to avoid living today

              by MetalMD on Mon Dec 10, 2012 at 01:34:33 PM PST

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              •  Oh my goodness. You just can't see the other (0+ / 0-)

                side can you?  What don't you understand about a hierarchy of priorities?!

                Corporations are driven by the bottom line, not by concerns for health, safety or the environment. This is why we need government regulations.

                by the dogs sockpuppet on Mon Dec 10, 2012 at 01:59:20 PM PST

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                •  I'm glad you see only the good in people (0+ / 0-)

                  Unfortunately that isn't the real world.

                  How would you feel if every year you were asked to work for less and less money? Pretty soon you'd get just a little pissed off, maybe even do some things your conscience might tell you not to do. Especially when it is difficult, if not impossible for others to detect.

                  Well that is what doctors and health care providers are asked to do, every time the government and/or health insurance companies lower reimbursements to physicians and hospitals, trying to save money and (in the case of the health insurers) increase profits.

                  Believe what you want. The US health care system is flawed. It encourages over treating, over testing. To believe otherwise is just simply naivete.

                  The future is just a concept we use to avoid living today

                  by MetalMD on Mon Dec 10, 2012 at 02:31:36 PM PST

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                  •  Hmmm. I get a raise almost every year and yeah (0+ / 0-)

                    I work really really hard.  And I stay true to my conscience because that's how I am and how most of my colleagues are...

                    And sometimes mistakes are made and sometimes communication sucks, but never blame malice for things that can easily be explained by stupidity.

                    We don't have a conspiracy against our patients to make more money.

                    I am not talking about the system (which is flawed).  I'm talking about physicians.

                    Corporations are driven by the bottom line, not by concerns for health, safety or the environment. This is why we need government regulations.

                    by the dogs sockpuppet on Mon Dec 10, 2012 at 06:51:23 PM PST

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      •  Of course there's middle ground! (0+ / 0-)

        What, do you think that human bodies are identical make and model machines with interchangeable parts turned out by an assembly-line in Taiwan?  And cost may have no bearing for you, but it obviously did for your friend with the thousand-dollar prescription.  It certainly does for me.

        Every human body is different.  The interaction of millions of genetic variations with environmental factors leads to idiosyncratic reactions to every drug and treatment ever devised.  Yes, the US healthcare system is flawed, yes fee-for-service on a "free market" is a stupid way to run an essential social service with major informational disparities, but one thing you cannot fix is the fact that medicine will always involve uncertainties.  That's why it's so important for medical personnel to provide honest disclosure to patients and respect patient decisions.

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