Sad story out of Oregon, but a familiar story to anyone who has followed health care issues during any part of the past 40 years: A woman gets cancer, her physician recommends a pharmaceutical or surgical procedure, but the insurance company denies coverage.
In this case, the story is being pushed by opponents to health care reform as a scare tactic. ‘Health care reform means cancer-fighting drugs won’t be covered.’ The tenuous link to reality this argument has is this: The woman is insured by Oregon’s public insurance alternative, a one-state effort to do what private insurance failed to do. So, the critics reason, if she can’t get coverage under Oregon’s public plan, no one will get coverage under any government plan.
The pharmaceutical is a recently-developed cancer fighter, Tarceva.
It’s a crude bluff. Reality is different.
- Medicare may pay for coverage of the drug in question, Tarceva. The Oregon public program has a rather high standard for coverage — 5% chance of survival for 5 months or more, established in clinical trials — but Medicare supplemental insurance plans, a federal program, will pay for Tarceva for non-small cell lung cancer treatments. Oregon’s program may not be equivalent to the federal program proposed.
- Private insurance companies often deny coverage for cancer treatments. The story from Oregon shows the disparities in care, and it demonstrates well that rationing of health care is a key feature of the current system, a key reason to work for reform. But denial of coverage occurs across the nation, and, I think statistics would show, more often from private insurance companies, often for less judicious reasons. In Kansas, Mary Casey got the rejection from her private insurance company: “But when Casey went to fill her Tarceva prescription at the pharmacy, her insurer, Coventry Health Care of Kansas, denied her coverage for the drug, saying it considered Tarceva experimental in her case, even though Tarceva is FDA approved for other lung and pancreatic cancers.” There is no significant difference between private coverage and the Oregon public plan.
- Private insurance failed: This woman is on the Oregon plan because private insurance didn’t provide any coverage for her.
Barabara Wagner’s story troubles anyone with a heart. It’s not an argument against reforming health care and health care insurance, however, because Wagner wouldn’t be alive to this point without a government plan in Oregon, analogous to the public option proposed in the House bill; because private insurance does not differ significantly in its coverage of cancer victims; and because this woman is on a public program in the first place because private insurance simply failed to cover her at all. Under private insurance, this woman would have been dead months ago, if not longer.
Other notes:
- Genentech is the inventor of the this drug. Genentech offers assistance to people who cannot otherwise afford it. (Therapy with Tarceva generally runs in the thousands of dollars per month.) (One more pharmaceutical brought to you couresy of applied evolution theory. Do creationists refuse the therapy because it’s Darwinian?)
Millard Fillmore's Bathtub 
Government offered health programs work much better than private programs, across the board. I suppose that if one wishes to claim the world is upside down, one needs to distort all facts to make that claim appear more nearly accurate.
Government offered health programs serve more people, better, at less cost, than private programs. Sure, there are problems. Multiply any of those problems by 4 times, and that’s the mess in the private health care system now. For example, refer to the recent book, Best Care Anywhere: Why VA Health Care is Better than Yours.
The only reason Medicare and Medicare are “in trouble” are because they work so well and cover so many people — see this report from the National Library of Medicine which indicates Medicaid does its job well. Fact remains that it is less than 1/3 the cost of private insurance in the U.S., and that it works well in the delivery of care — using private suppliers, by the way, avoiding any reason for anyone to call it “socialized” or “nationalized” medicine.
Rocket, have you ever studied health care in America? It’s much different than whatever it is you’re talking about.
LikeLike
The depth of refusal to deal with fact is strong in this one.
Incarcerated people have coverage. They are not among the uninsured. That’s 3 million people (1% of our population, the highest rate in the world. This is a particularly wasteful way to provide insurance coverage.)
Drug addicted Americans number from 16 million to 23 million; tobacco users are 66 million; alcohol users are 109 million. If we assume 100% overlap on tobacco and alcohol use, that’s still about 125 million people — more than double the number of uninsured.
There is no indication that being uninsured correlates with any of these conditions. If one pays attention to the health insurance debates over the past 50 years, one observes that smokers, for example, tend to have a higher than average employment rate, and a higher than average rate of health insurance. This is why many insurance plans have, finally, gotten serious about stop-smoking programs. Substance abuse costs everyone, but there is no credence to the claim that the uninsured are disproportionately among the uninsured.
Rocket’s claim is completely fatuous.
Probably because your claim is wrong, stupid and cruel.
Why should any of these populations do without health care, to help them kick abuse if nothing else? Rocket’s solution here is both cruel and costly. Keeping any substance abuser out of health care systems, or even discouraging them from seeking health care, increases costs to the rest of us exponentially.
Look instead at reality. Fully a quarter of Texans are without health insurance. So, of 24.3 million Americans in Texas, at least 6 million lack health insurance. That’s 12% of the 50 million doing without — in one screwed-up state.
Good news this week is that we actually reduced slightly the percentage of uninsured children in Texas, but it remains a huge problem. The bad news is that the count was done before the current recession. So, as the Fort Worth Star-Telegram notes, things are likely to get worse:
Repeated studies show about 1.5 million Texas children uninsured, a number that has proven incredibly stubborn to reduce. Because of the way statistics on substance abuse are gathered, we can be certain none of those 1.5 million kids fall into the 50 million people Rocket is willing to sacrifice.
That CDF site notes these facts:
Working parents who can’t afford insurance, whose employers don’t offer it, or who are knocked out of the system for some other reason. The uninsured are not slacker, substance-abusing good for nothings whose death would go unmourned.
These people deserve health insurance. Their kids do. I’m tired of paying a 15% to 20% premium for the privilege of depriving these people of healh insurance.
For the cost of the private bureacracy we have to deny treatment to these people, we could provide each of them with a gold-plated insurance policy, and reduce costs for everyone.
Even were the uninsured addicts, as Rocket claims, that’s a poor reason to raise the prices for everyone else, just to keep them out of health care.
Remember, we are already paying high amounts of money to health insurers for the people without insurance. That money goes to a bureaucracy to keep them out of health care.
We’d be much better off to give them coverage, reduce costs across the board, and save a few million lives.
LikeLike
Nick, thats the kind of comments I would naturally expect from a pedantic fool such as yourself and Ed.
I have had family members die from smoking, alcohol and drugs, ALL of which is totally beside the point and as usual for you and Ed, have NOTHING to do with B.O. proposing to fix something that doesn’t need fixing.
First of all, my point was that out of 300 million citizens of the U.S. very EASILY 50 million are incarcerated or drug addicts, smokers, alcohol abusers, drug abusers, or thieves. EASILY 7% of our population are these people. This IS the 50 million that is being used to coerce people into thinking we have 50 million people that don’t have insurance and should have it, but pedantic liberals wont grasp this as some have proven.
Second, as I have stated before, B.O. is calling for us to fix a problem that doesn’t need fixing (taking control of a private industry) and offering his solution of “reforming” (which implies its corrupt or broken) an industry by establishing “competition” to the industry with a government created company or entity to compete against it to drive down the price of the industry. The government has failed time and time again doing this. Again, I will give this example to the thick headed liberals on both sides (republican and democrat). The US post office was the first and for a long time the only form of mail service. It was cheap it worked. As it started to get expensive and more costly, other mail services came into existence (FedEx, UPS, DHL, etc) known as the competition, and this did not drive down the price of the US postal service. In fact the USPS got even more costly and as a result are now shutting down post offices nation wide, removing the familiar blue mailboxes, and have downsized while FedEx and the others enjoy the rewards of free market and profitability.
Third, government Health “services” offered currently to just military, ex-military and their families IS failing and has been for years not to mention incredibly corrupted and required a major investigation and clean up. Still they are backlogged with hundreds of thousands of cases and growing. And you want health services to be expanded to everyone in the country?
Fourth, Medicare and Medicaid is government health insurance. It is already offered and has been failing and now facing bankruptcy, because our government cant balance the budget. Our tax dollars are supposed to pay for this and VA services.
Now you want the government to expand this kind of corrupt mismanagement to affect every single citizen in America?
My solution, stop trying to control free enterprise and the free market and private industry with government control, and FIX the “existing” health services and insurance the gov’t “already” provides.
Fifth, and this is a big one that I will never expect thick headed liberals to grasp, insurance is purchased to pay for things that YOU CAN NOT AFFORD TO PAY FOR YOURSELF. Everyone pays a small portion called a premium to pay for the small percentage of people that file claims. Claims pay for things that can not be paid for by the individual alone. which is what all of the tax payers are doing when medicare and medicaid taxes are taken out of your paychecks before you get your paycheck, and again, this is failing.
IT would also be a totally different story if people were in an accident and injured and need to be healed and paid for by the masses. But this isn’t the case.
We are paying for “SELF-INDUCED” illnesses and injuries. Smoking (lung and mouth and throat cancer), alcoholism (pancreatic, liver and brain cancer), drug abuse (many forms of illnesses and cancers), and the list is endless, not to mention all the injuries from car accidents, killings from people high on drugs going crazy, and other related medical incidents caused by these abuses all born from self induced abuses.
There are situations that should qualify for coverage and those that should not. B.O. is asking you to step in and give the gov’t control (with your approval) of the private companies and force them to lower their rates to cover ALL, whether they qualify or not.
oh, by the way, this health reform will require you to have insurance either through your employer or registered in the “public option” “single payer” bill being proposed and if you don’t, you will be FINED $3800 for NOT carrying insurance.
It will be a crime for you NOT to carry insurance and you can go to jail for it. So, you will pay for it with your tax dollars first, then you will be required to register and be covered by the insurance, and if you “choose” not to, it will be a crime which you will pay the fine for again. The system will still be as corrupt and broken as VA and Medicare/Medicaid which you will STILL be paying for along with the new reformed insurance plan which is still failing, and private industry insurance prices will not go down as a result, and any increases in costs to the private insurance companies incurred by this foolish action will be passed along to YOU and/or your employer who will inevitably pass it along to you anyway.
You don’t have to accept this, but THIS is the reality and is backed by the present and past.
LikeLike
These are the facts, Rocket.
50 million people in this country don’t have health insurance.
10 million people lost their health insurance in the last year.
1 million families went bankrupt paying for health bills.
Percentage that the average insurance premium has risen since 2001: 75 percent
Percentage that the average wage has risen in that same time period: 15%
Rescission rate in California: (Rescission being the insurance industry term for canceling policies) 20-40% With Wellpoint and United Health being at 40%.
No matter what you say, Rocket, the health insurance industry is driving families into bankruptcy, it’s driving businesses into bankruptcy and in the end it is killing people.
By protecting the insurance industry, Rocket, you are guaranteeing that more and more of your money will go to line their pockets. Because every time someone who doesn’t have insurance has to go to the emergency room for treatment IT IS YOU THAT PAYS FOR IT.
It is time you get your head out of your ass and quit protecting an industry that has absolutely no benefit to the people in this country.
LikeLike
Rocket, smoking is what killed my mom just over a year ago.
So congratulations you morally depraved jerk, if you thought I went after you before you haven’t seen anything yet. I’m now going to take personal delight in tearing you apart.
If you had said that to my face, Rocket, you would have woken up in the hospital. So back off little boy and apologize for your moral depravity. Prove that you’re a man, Rocket, apologize for your stupidity. Or are you just a gutless coward?
LikeLike
So my mom, because she smoked and that’s what she did die from, shouldn’t have had health insurance and my family should have gone bankrupt to pay for her care?
mind showing up on my doorstep? I want to break every bone in your body and stick you in a hospital for that particular piece of moral depravity you just engaged in. I’d drive you into the ground.
LikeLike
A sensor made with gold nanoparticles can detect lung cancer in a patient’s breath and may offer a diagnosis before tumors show up on an X-ray. The device, which the Israeli developers say would be cheap enough for daily use by family doctors, detected lung cancer with 86 percent accuracy and may offer a way to screen for a disease not usually diagnosed until it has spread and is no longer curable.
It uses sensors based on gold nanoparticles to detect specific compounds – volatile organic compounds – that lung cancer patients have in high levels in exhaled breath.
Breath testing is already recognized as a way of linking specific VOCs in exhaled breath to certain medical conditions. In 2006, researchers found dogs could be trained to smell cancer on the breath of patients with 99 percent accuracy.
ADVERTISEMENT
Lung cancer kills 1.3 million people a year and is the leading cause of cancer death across the world.
Only 15 percent of patients live more than five years after they are diagnosed, in part because the disease is usually detected so late.
香港仔時昌迷你存倉
LikeLike
Say 50 million. The actual total has been bouncing between 46 million and 49 million, but there are many others uncounted. 50 million’s accurate enough, and an easy enough number to work with.
How many are in those categories you describe, the dissipated, self-medicated to ill health, and ex-cons?
An insignificant number.
But why shouldn’t they be covered by insurance, too? Especially since you are already paying more than $1,500 a year to cover their costs (if you have insurance)? Why should you pay for something no one gets?
I believe, Rocket, you enjoy throwing money away.
Some counts say ten million of those people are kids in Texas. More than half of them are below the age of 25, at ages when preventive care prevents enormous costs down the line.
Why should any person do without insurance coverage? That only costs all of us a lot more.
LikeLike
In fact, Discordian, though you may have meant it as a joke, that is exactly what the liberals are trying to hide from you with this smoke and mirrors plan, and scaring you with things like this woman would be dead if…blah blah blah. As Scott said with good research, this woman has been killing herself for years, and is dying, and her current insurance company won’t pay for her to survive a possible 2 more months on the new drug. No matter how sad that is, the woman had a choice, go to a different insurance company (of which there are hundreds) for the coverage, or look to gov insurance.
Obviously this woman was trying to get her choice of insurance company to cover the costs of extending her life for 2 more months while she continues to smoke. The company wouldn’t do it and it’s likely she would have to look for another insurance company to insure her pre-existing condition. Failing that she turned to the government to pay for her final days of killing herself.
Now since these posts by Ed are quoting others who are leaving out facts and details as is typical of a news source trying to make a profit by selling only information that will shock you or make you angry or any way they can get your attention, and using it to posture and support his approval for bigger government and more government control of your lives and the lives of honest hard working business owners, then we don’t really know the facts of this “singled out case”.
Lets ask this question. Of the 40 million uninsured people in America that the government wants covered and given health care by the doctors and nurses and facilities that don’t exist to handle 40 million more people, how many of them are not insured because they have commenced to killing themselves with cigarettes(lung mouth and esophageal cancer), alcohol (pancreatic cancer), and other abuses and addictions?
How many of them are not insured because of their crack careers, drug careers, thieving and robbery, etc? How many of those 40 million are career criminals ?
See..thats the real rub. Manipulating numbers and statistics to support something. There are over 300 million people in the united states. What percentage of them are criminals and illegals? 40 million uninsured people is only 7.5% of the TOTAL population of the entire country.
I’d say that 40 million easily covers the total number of criminals in jails, on the streets and here illegally.
Liberals and politicians from both sides are hoping you will buy into ANYTHING that sounds appalling or inhumane, if they can just manipulate the numbers to make it sound bad enough to support something that will obviously make them look good or make them wealthier and get your vote.
LikeLike
This particular case was cited in Mark Levin’s book Liberty and Tyranny (with footnotes no less) as evidence that government run programs are terrible. Because of the footnotes I did some snooping on the internet and found this woman was a smoker with stage 4 recurrent lung cancer (recurrent is bad and stage 4 means terminal). Of patient’s with her condition, something like 20% of them live more than a year. The drug which cost something like $48,000 over the course of treatment raises that figure to 30% and even then, extends life by something like 2 months. It apparently also has terrible side effects like your skin peeling off.
LikeLike
But, now that she has cancer and knows her insurance won’t cover her meds, she can just use the free market to get insurance with someone else. Problem solved, right? (/sarcasm)
LikeLike