For those who think National Healthcare is a bad idea...

B B

buckshot

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Baby is born w/ a horrible disease but there is a drug that can save her but it costs more than $2 million. Initially the insurance company denied coverage so the mother tried to go online and ask for donations so her baby won't die but the insurance company relented and agreed to cover the treatment.

Of course they didn't have to do that and they might not the next time. And how could any treatment cost $2 million?

https://www.wgal.com/article/my-bab...nsurance-company-has-change-of-heart/28527973
 
I've a bit of input here which might be of help, as I worked for a company that was involved in drug testing equipment for 20 years

If company A discovered the cure for the common cold, it would have to enter a period of testing to prove that the drug, amongst other tests, was stable for use across the entire world. It is well known that drugs can change their characteristics depending on what temperatures and humidities they are exposed to and therefore may become dangerous. This could mean drugs used in a temperate climate such as ours may be safe, but the same drug stored / used in tropical climates may be dangerous.

I was told that only 10% of drugs in development make it through all of the tests they have to complete before they get to market because the other 90% fail for one reason or another. Therefore the 10% of drugs that make it through to production have to recoup not only their own development costs but also the development costs of the 90% of drugs that failed somewhere along the line.

In addition to this, company A has to state how long its cure for the common cold will last in your medicine cabinet at home. Obviously company A will want it to be as long as possible especially as company B is probably working on the same cure. So a clock starts ticking and it lasts for eight years. Now, assuming you claim that you drug is safe for five years, then you have to provide test results over five years to prove your drug is safe no matter where it is used / stored throughout the world. Until you provide this proof, you will not be given a licence to sell your drug.

So. after five years of testing, you finally have a drug that you can sell and can make you loads of money. Unfortunately, that only means you have three years to 'cash in' before the licence expires. Now your drug becomes GENERIC meaning yo have to release all of the technical data so that anyone can make the drug.

Paracetamol, may have been a clever drug when it was first produced, but now you can get 100 tablets in Tesco for 20p if you see what I mean
 
flyer said:
I've a bit of input here which might be of help, as I worked for a company that was involved in drug testing equipment for 20 years

If company A discovered the cure for the common cold, it would have to enter a period of testing to prove that the drug, amongst other tests, was stable for use across the entire world. It is well known that drugs can change their characteristics depending on what temperatures and humidities they are exposed to and therefore may become dangerous. This could mean drugs used in a temperate climate such as ours may be safe, but the same drug stored / used in tropical climates may be dangerous.

I was told that only 10% of drugs in development make it through all of the tests they have to complete before they get to market because the other 90% fail for one reason or another. Therefore the 10% of drugs that make it through to production have to recoup not only their own development costs but also the development costs of the 90% of drugs that failed somewhere along the line.

In addition to this, company A has to state how long its cure for the common cold will last in your medicine cabinet at home. Obviously company A will want it to be as long as possible especially as company B is probably working on the same cure. So a clock starts ticking and it lasts for eight years. Now, assuming you claim that you drug is safe for five years, then you have to provide test results over five years to prove your drug is safe no matter where it is used / stored throughout the world. Until you provide this proof, you will not be given a licence to sell your drug.

So. after five years of testing, you finally have a drug that you can sell and can make you loads of money. Unfortunately, that only means you have three years to 'cash in' before the licence expires. Now your drug becomes GENERIC meaning yo have to release all of the technical data so that anyone can make the drug.

Paracetamol, may have been a clever drug when it was first produced, but now you can get 100 tablets in Tesco for 20p if you see what I mean
Click to expand...
That still doesn't change the fact that insurance companies make decisions on who lives and who dies. They make these decisions based on profits not people's health. Getting sick or having a sick child shouldn't ruin you financially.
 
buckshot said:
That still doesn't change the fact that insurance companies make decisions on who lives and who dies. They make these decisions based on profits not people's health. Getting sick or having a sick child shouldn't ruin you financially.
Click to expand...
To be fair, there are plenty of examples of the NHS having to refuse a drug because they decided it wasn't an effective use of their budget. I don't think that's unique to private insurance.

But yeah, as someone who's trying to deal with a broken leg on private health insurance at the moment, I can tell you it's an absolute pain in the arse. I had to start my physio before my follow up appointment with the doctor because the doctor had booked my follow up 15 days after my discharge, but the insurance has some arbitrary rule where they'll only fund rehabilitation if it begins within 14 days of discharge from the hospital. They said they may extend this if the doctor could send them a medical reason why he waited 15 days instead of seeing me within 14 days, but they couldn't guarantee it. This is the most annoying thing about it. My recovery from a major operation is being determined by some insurance policy rather than the doctor who actually performed the surgery. And even this is only because I was careful enough to look at the insurance policy. It would have been very easy for me to just assume that of course the insurance company would cover the rehab no matter what. In reality, it's just a constant situation of having to check whether something is covered, make sure you do everything correctly and within the time limit, and working out which treatments can be covered in advance, which you have to pay for and claim the money back and which hospitals have direct billing with which insurer.

I'm sure in countries like the Netherlands, it works better, but I honestly don't believe how anyone could experience going through private insurance and consider it more efficient than the NHS.
 
It helps to have American friends. They can tell you about their wonderful experiences, like having a huge bill for childbirth, or finding that your insurance company will not pay for the drug your doctor prescribes but only for something less effective. And so on. The NHS is far from perfect (largely due to deliberate underfunding) but it actually gets a lot of bang for your buck. If someone can suggest an alternative that will give a better service (to all) at no additional cost, bring it on. However, I suspect they would be liars and charlatans.
 
BrianW said:
It helps to have American friends. They can tell you about their wonderful experiences, like having a huge bill for childbirth, or finding that your insurance company will not pay for the drug your doctor prescribes but only for something less effective. And so on. The NHS is far from perfect (largely due to deliberate underfunding) but it actually gets a lot of bang for your buck. If someone can suggest an alternative that will give a better service (to all) at no additional cost, bring it on. However, I suspect they would be liars and charlatans.
Click to expand...

My American daughter in law can tell you all about the health service in the US and all about her brother who, 6 years after, is still paying off the hospital fees for the birth of his 2 children. She thinks it is amazing over here.

She was absolutely gobs smacked the day she got here with my son with a broken ankle, walked into QMS Nottingham and walked out 4 hours later without paying a penny. She isn’t going back to good old US of A any time soon.
 
buckshot said:
Baby is born w/ a horrible disease but there is a drug that can save her but it costs more than $2 million. Initially the insurance company denied coverage so the mother tried to go online and ask for donations so her baby won't die but the insurance company relented and agreed to cover the treatment.

Of course they didn't have to do that and they might not the next time. And how could any treatment cost $2 million?

https://www.wgal.com/article/my-bab...nsurance-company-has-change-of-heart/28527973
Click to expand...
Yeah, but at least they aren't trying to ban abortion...... Oh, wait.
 
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