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General discussion

What a surprise (NOT!) -- many insured quitting expensive drugs

Dec 3, 2003 9:33PM PST

Hi, All.

Most folks use the increasing %age of uninsured to demark the affordability crisis of health care in this country -- a crisis that is doubtless killing tens of thousands annually. But, surprise -- even many of the insured are going off life-saving prescription meds as insurance covers an ever smaller part of the cost, while drug company and insurance company profits soar. But hey -- we have a "free market," and that's all that matters, right?
For the gory details, see Study says many quit pills in 3-tier prescription plan.
The copays on our Rx drugs this year will be well over $2,000 -- when we started working in 1980, there were no copays. Is it any wonder the WHO ranked the U.S. health-care system 71st in the world in their last survey (and we've doubtless dropped a few slots since...)
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

Discussion is locked

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I spend ...
Dec 3, 2003 9:43PM PST

... well over that to maintain my car. Point being that when I start to see a decrease in the blue hair factor at the casinos, and $40K+ cars parked in the driveways in lower income neighborhoods, etc., then the issue of affordability can be addressed. How about you? You can clearly afford the $2K, so quitcherbitchin! As it seems now, you want others to defer even your costs.

Evie Happy

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Re:I spend ...
Dec 3, 2003 10:37PM PST

Hi, Evie.

Maybe those cars are part of the reason for the staggering consumer debt in this country, now at an all-time high? The problem with many of these conditions (blood pressure, cholesterol) is that their effects are not seen immediately, so many people make an ill-advised choice to drop the expensive medication in favor of the expensive car. OTOH, I doubt many janitors are driving those cars you mention -- if they haven't already been "outsourced" to a third-party that doesn't include benefits.

But please ecplain to me -- how is it not a disgrace for the medical care system of the richest country in the world, that ostensibly spends the most per capita on health care, to be ranked in the second quartile of nations?
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Bias in the rankings?
Dec 3, 2003 11:54PM PST

I dunno Dave, perhaps if life expectancy and quality of life were considered more important, Costa Rica might not rank so high? Americans are certainly free to leave and move to these countries with such wonderful health care so you tell me why they stay?

Your comments about choices are interesting. Poor financial choices are not the fault of government. If a person values their own health less than materialistic things there's only so much the government can do to impose responsibility in a free society. When's the last time you drove through a poor neighborhood Dave? Or taught people who qualified for financial aid yet wear more expensive clothes than you do and drive more expensive cars? I'm not saying all do, but I am saying that I hear an awful lot of griping from these kind of "financially strapped" people who seem to have an awful lot of disposable income to use on other things.

It goes along with the trend towards "insurance" being seen as a payment plan. Maybe not gladly, but we pay an awful lot to maintain and operate even a modest vehicle (necessary for all but city dwellers) and don't think much of it. But be expected to pay for one's own medications is somehow unconcionable?

I don't know what all medications you and K take Dave, but to pay less than $100/month for them is really not something you should be complaining about. If more of those who could afford their health care actually paid for it, there would be more funds (preferably at the state level, I see no reason any of these issues have to be addressed at the federal level!) available for those truly in need of assistance.

Evie Happy

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Re:Gee Evie, are you totally oblivious as to how the other half survives ?? (NT)
Dec 4, 2003 2:15AM PST

.

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Are you? What
Dec 4, 2003 2:38AM PST

I happen to know many in that "other half". I've been uninsured and underinsured myself as well. My husband dissolved his business and took a position at considerably lower base pay for the insurance. We pay close to $300/month out of his salary for all of the various insurances Mary Kay, and roughly $75/month in co-pays for his medicines. We pay the lower co-pay for some because we DO get the generic equivalent, which was the big beef of his article -- folks going off meds rather than opting for cheaper generics with tiered coverage.

My FIL is far better off than us financially, as is DK judging from information he has shared, so pardon me if I have little sympathy for their griping about the cost of medications, premiums, etc. I think this new Medicare entitlement is gonna be another huge boondoggle that is largely unnecessary. IF more people actually approached their own health care expenses like they do any other -- e.g. there isn't some magical "insurance" that pays for it -- we would all be a lot better off, and states and private charities would be able to provide care to those truly in need that cannot afford it.

Point is if people are really honest about the importance of medical care, and prioritize their health appropriately, most CAN afford it. Yes, there will always be those that really can't and require assistance. But when those who can afford it b!tch about having to pay higher co-pays I tend to lose patience. And when I do see spending beyond one's means for things less important than one's own health and then expressing a sense of entitlement to cheap/free unlimited healthcare, I get a bit frustrated.

Evie Happy

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Re:Are you? What
Dec 4, 2003 2:53AM PST

Hi, Evie.

>>My husband dissolved his business and took a position at considerably lower base pay for the insurance.<<
So does that make our "health care system" a plus or a minus for American entrepreneurship? As for my "bitching" about higher co-pays, you don't get it, do you? Much of that money is being transferred from my pocket to the pockets of stockholders in drug companies and insurance companies -- and that's money I don't have available to spend that boosts the economy. Why don't you think about the $5,000+ that we now have to pay on insurance and copays (where in 1980 our total health care outlay was zero) as a $5,000 tax increase on us? It's irrelevant to me and the economy whether that money goes into the hands of the government (which you'd vehemently oppose) or into the pockets of wealthy corporations in the form of profits -- the effect on me is the same.

As for your claim that most folks can afford insurance, the point here isn't just the cost of insurance -- it's that even increasing numbers of the insured can't afford the cost of their medical care above and beyond the insurance premium.
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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The cost for a supplemental insurance plan
Dec 4, 2003 3:27AM PST

that would include prescription coverage for me is nearly $300 per month....more than the prescriptions themselves cost.

TONI

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increasing numbers of the insured can't afford the cost of their medical care. Amen, DK!
Dec 4, 2003 3:45AM PST

.

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But when the ones who can afford it gripe ...
Dec 4, 2003 5:07AM PST

... about their rising costs, it's not going to help those truly in need. DK is complaining about $2K in copays for cholesterol and bp meds (I believe he has mentioned these for himself) which he can clearly afford. These are maintenance meds for a chronic problem, not some unexpected large cost from an accident or hospitalization. IOW, "insurance" shouldn't necessarily cover these at all, and the only reason many do is that some drug therapies can be tied to decreased hospitalizations and thus save the insurer down the line. Where does the $2K come from if DK's copays are brought back down to 1980 levels? EVERYONE!

If the drug companies actually had to deal with a free market, the prices would come down. As it is, there are enough insureds that their sales are sufficient at the high prices they charge to maximize profits. You really want to see prices come down? Two things:

1. Start the patent period upon drug approval so the company doesn't have to make all their profits in a few years and

2. Sell all prescription drugs for "cash"

#1 is easily doable, #2 obviously would not be met initially with much glee by those who are used to their insurers paying $80 of a $100 medicine. The politicians aren't likely to help this ever become a reality as they are moving to provide prescription "insurance" -- better to call it a subsidy because that's what it is -- in exchange for votes. But so long as the manufacturer is getting the $100 from enough people they don't care where they get it. The number of consumers who could actually afford the $100 out of pocket is a whole lot less, so the laws of economics would dictate that the manufacturer lower the price to increase sales volume. Left on its own, the market would stabilize to where drug prices decrease to a point where most can indeed afford them. Then there will always be some segment of the population that cannot afford this. So just like food stamps and food banks, public (preferably at state/municipal level) and private charities could step in to help the truly needy pay.

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Re: And how are you to know they can afford it.
Dec 4, 2003 5:41AM PST

They may have problems that you are not aware of. And some families are strapped because they are helping older family while raising their own children.

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Well ...
Dec 4, 2003 6:36AM PST

... for the cases I am aware of, I happen to know what the premiums and copays for insurance are. Some of my hubby's colleagues own way more expensive cars than we do, have cable with premium packages, lots of extra gadgets we don't own, but opt not to participate in the health plan because they "can't afford it". Well, sorry, no sympathy here.

You missed my point MK. I am NOT saying everyone can afford it. I AM saying that more can afford it if their health truly is more important to them than a new car, eating out once a week, the bigger house, the brand name clothing, an expensive hobby, etc.

If they have $300/month to lease a car, then they have $100/month to spend on medical care and own a less expensive car at $200/month. No, I don't know the financial circumstances of everyone I see driving a Lexus, but I do know basically what they spend to drive it, and that is money that could be partially spent elsewhere with a more economical choice of vehicle.

DK is bitching about $2K/year for maintaining his and his wife's health. All I'm pointing out is that this comes out to less than $100/month/person which is far less than many of us pay for our vehicles or don't think twice about eating out or buying a Starbucks at $3/day!

Evie Happy

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Yeah, like me for instance.
Dec 4, 2003 11:02AM PST

Mom with diabetes and kidney disease back at our house, one daughter in college this year, next year both daughters in college, and still have one starting kindergarten next year. Stretches things a bit thin.

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Well I can afford it I guess, but since software won't let me post reply in one post, forget it
Dec 4, 2003 6:03AM PST
Sad
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Well, in a perfect world .......
Dec 4, 2003 6:52AM PST

But it's not a perfect world and we have to deal with what we have. I too can afford my meds right now. Just because someone gripes about something don't assume they are griping on their own behalf.

I'm not on Medicare either but I know people who are and I see first hand the problems they encounter. Most have secondary insurance, God help those that don't. God willing and nothing upward happens I too will have that secondary insurance when I become eligible for Medicare but I can see now that will not eliminate sacrificing some normal parts of my life style in order to have medical care. The medical industry is out of control.
.

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Re: But when the ones who can afford it gripe ... -- Dbl standard, Evie?
Dec 4, 2003 12:38PM PST

Hi, Evie.

You complain bitterly about the graduated income tax which discriminates based on wealth. But now you're saying only those who aren't being bankrupted have the right to complain about being gouged for the cost of their medical care? Surely you can see the inconsistency...
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Actually, I think she's saying that only....
Dec 4, 2003 12:44PM PST

those that are being bankrupted after making health their primary priority are allowed to complain.

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And that group is growing.
Dec 4, 2003 5:46PM PST

.
Even with insurance, a major medical problem can clean out your savings.

With the rising cost of medical care, insurance premiums and fraud there is a huge nationwide disaster just waiting to happen.
.

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No ...
Dec 5, 2003 10:17PM PST

... what I'm saying is that most people really can afford the costs if they are prioritized. Am I happy with the costs? No. But I don't expect my neighbor to pay for my meds, or my parents, etc.

Dave has taken two rather expensive vacations in each of the past two years. He is b!tching about his copays for medicines he needs to take to maintain his health/life. Not about being bankrupted by a hospital stay. Why, Keith, should he not be paying out of pocket for his meds entirely? He is employed by the State of TX, therefore whatever his employer's premium on his behalf is paid by the taxpayers of TX. I'm thinking his co-pays went up as TX cut costs, and I see nothing wrong with that except Dave seems to think he is entitled to "insurance" for all his meds at no cost to him.

Evie Happy

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Re:No ...
Dec 6, 2003 12:59AM PST

Hi, Evie.

Yes, we've taken a couple of nice vacations. But you continually comlaim about the excessive income taxe rates on those who make ten times more than you and I combined. WHAT is the difference?

I submit that there is none, except that in one case the money goes to the government, and benefits everyone, while in another it goes to excessive profits by drug companies and insurers (and their primarily wealthy shareholders), and excessive salaries for their upper management.

Why is it ok for Malcom Forbes to gripe about his tax rate, but not for me to gripe about being gouged for "health care" costs? And if you think my vacations have been anything like Malcom Forbes', or that I'll give myself a Faberge egg for Christmas, then you completely misunderstand my financial situation!
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Primarily wealthy shareholders, Dave...
Dec 6, 2003 1:48AM PST

Dave, there is but one Malcom Forbes. How many shareholders do you think there who hold shares of drug companies as a part of their retirement nest egg or hold them because the yield is better than the yield from something like a savings account? Come to think of it, my parents put some of their savings for their retirement years into stock in drug companies. I wonder if my mother knows that she is "wealthy"? You wouldn't call them wealthy by looking at their house, but it has the best advantage that there is, they finally paid it off.

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Re:Primarily wealthy shareholders, Dave...
Dec 6, 2003 4:12AM PST
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Then I would think, Dave...
Dec 6, 2003 4:27AM PST

Dave, then I should think the question is how many total shares do they own vs. how many total shares do non-wealthy stockholders own. And of course, should the mass of non-wealthy holders of stock be hurt in order to hurt those small number of "rich" stockholders?

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Only to a socialist...
Dec 5, 2003 1:18AM PST

would there appear to be any "inconsistency" because complaining about not getting what you are not paying for is not comparable to complaining about paying more for one's own medicines while also paying more for subsidising the medical costs of others.

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of course, to an unrestrained capitalist such as yourself
Dec 5, 2003 10:45AM PST

the total social upheaval and revolutions that will result from creating class differences by abolishing social welfare programs is a wonderful thing. You'll get to use all those guns you and J. have saved, shooting the poor who have gone into riot.

The thing you always overlook Ed, is that Capitalism is no more successful than Communism.

Mixed economic and political structures survive.

I am beginning to find your and J.'s 100% attack on DK and any form of SOCIAL rather than political justice: a) very boring and repetitive. Try thinking up a subject for a change, instead of lurking to attack DK. Or is the appearance a fact: neither of you can generate a new idea?

b) Damned irritating. The fact is that YOUR reading of links is no more accurate than your non-sycophants on many an occasion. All studies are subject to interpretation, statistically and factually. You, with J. following 10 minutes later to tell you your the hero, always state that your reading of the evidence is the truth, the whole truth, and nothing but the truth; and anyone who disgarees with your reading of the evidence is a socialist or communist.

It isn't that bloody black and white. Truth is infinite shades of grey. Only this week, one of the fundamental universal physical constants has come under review: Hubble's Constant.

Enough ranting, 'fore I really go berserk at this boring ........

Ian

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Well, now that you got that out of your system...
Dec 6, 2003 9:46AM PST

you should feel better for another week or two.

You like and approve of a welfare state and government spending your earnings for you while I do not.

Capitalism, while definitely not perfect, is a far sight better than communism and history reflects its success. It is only AFTER the people learn that they can vote for reps who will legislate all the benefits one can imagine that civilizations have crumbled because no one had paid the bill or even considered it.

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Taxation and paying your way have no relationship
Dec 5, 2003 10:21PM PST

I would say you are the one with the double standard, because you are always complaining about "reverse Robin Hood" about anything that you perceive as taking money from the poor and middle class to pay for the rich. Well Dave, having the taxpayers of TX subsidize your routine prescription drugs sounds an awful lot similar to that. And I see you are not now gleefully paying "your fair share" but rather b!tching about something you can obviously afford and then some.

Where's the vacation to next year?

Evie Happy

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Re:Taxation and paying your way have no relationship
Dec 6, 2003 12:52AM PST

Hi, Evie.

I don't object to paying my way. I do object to paying my way and another 50%-60% for excess profits by the drug and insurance companies, and that's what's happening today. And the effects on my budget and discretionary spending of a $5000 increase in "medical costs" (which are really profits to the gougers) are every bit the same as if the government had increased my taxes by $5000. It's just your ideology sees one as a problem, the other as a desirable result of capitalism. And, btw, this is just on routine care. If I got appendicitis in 1980, having the surgery would have cost me nothing. Today, even though I'd be in hospital for less than half the time, my total out-of-pocket expenses would be $2-3k. I can afford that, but it means money i can't save for retirement or spend on the new laptop I need to replace the one that died at Thanksgiving. That would be a tax on me, regardless of whether it goes to increase the insurance company's proft (in this case) or to the government. In just about every other country, my tax rate to the government would be less, but the medical care would be free or much less expensive. More importantly, those who can't afford it are covered, where here people are literally dying because of our absurd "health care system." And thinking that's fine is NOT "compassionate."
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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How would you, Dave...
Dec 6, 2003 2:10AM PST

Dave, you said, " In just about every other country, my tax rate to the government would be less, but the medical care would be free or much less expensive."
O.K., let's wave the "what if" wand and imagine a senario in the U.S. where medical care is free and taxes are less. What would be cut to pay for that increase in spending? Oh, wait a minute, you said "my tax rate", I smell something. I've experienced Government health care, it may not be the the "heaven" that you may envision.

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Re:How would you, Dave... Ooops -- miswrote!
Dec 7, 2003 6:41AM PST

I obviously meant "tax rate to the government would be more." Otherwise the "but" makes no sense...
-- Dave K.
Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Very interesting ...
Dec 7, 2003 2:59AM PST

... if you get appendicitis, the $2-$3K you would pay is wrenching funds from your personal retirement account. Yet you fail to see that the money you spend on multi-week vacations to foreign lands could also have gone to the same?

I'm suggesting that if those like yourself who can afford to pay their own way don't, then you are indeed contributing to the factors making medical affordable for all increasingly difficult.

Evie Happy