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How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those

How can it be acceptable that you would declare people too expensive to save, rather than challenge the prices of a profit-making company that is bringing those costs in the first place? Shouldn't you be able to detect the sheer amount of corporate worship in such a statement before it leaves your mouth? It breaks my heart to keep reading about this epidemic, with such a consistent reaction of hatred from so many people. This state of vulnerability should be met with support, but because opiates are nominally pleasurable, everything surrounding them must be a failure of personal responsibility - of people getting in over their heads.

creaghpatr 9y ago
This is what happens in the UK right now. The government decides when the life support machine gets turned off- they pay for it so it's their choice. Not a common or planned outcome, but an unfortunate byproduct of nationalized healthcare. http://www.bbc.com/news/uk-england-40423371 http://www.bbc.com/news/uk-england-40423371
- extra88 9y ago
  Not really comparable, that's a rare situation with no chance of recovery.
- songshu 9y ago
  Commercial private medicine and commercial private medical insurance are legal in the UK and do exist although the markets are fairly small. If anything private medicine is less regulated in the UK than it is in the US (for example it's easier to call a doctor and get a price list, on enroll at any time in a plan). The legal basis of not allowing Charlie Gard's parents to take him to the US is not related to the existence of nationalized healthcare.
- ivanbakel 9y ago
  The Charlie case is not comparable - the question discussed by the court is not whether it should pay to keep him alive, but whether it's ethical to, given that he's constantly incurring brain damage and few people in the medical community believe he has any chance of survival at all. The justification used is that of "continued suffering", not cost.
- norikki 9y ago
  >Not a planned outcome. Sure, but the people responsible clearly don't care, as evidenced by the tone of the article. Drug addiction is the result of the weak border [1], and a depressing job market [2], which is also the result of the weak border [3]. [1] http://www.businessinsider.com/us-heroin-coming-from-mexican-cartels http://www.businessinsider.com/us-heroin-coming-from-mexican... [2] http://www.gallup.com/opinion/chairman/181469/big-lie-unemployment.aspx http://www.gallup.com/opinion/chairman/181469/big-lie-unempl... [3] https://www.judiciary.senate.gov/imo/media/doc/03-16-16%20Borjas%20Testimony.pdf https://www.judiciary.senate.gov/imo/media/doc/03-16-16%20Bo...
  - DanBC 9y ago
    The US prescribes far more opioids than any other country. It's likely that some of the addiction problem in the US comes from this irresponsible prescribing. https://www.dea.gov/divisions/hq/2015/hq110415.shtml https://www.dea.gov/divisions/hq/2015/hq110415.shtml > Since 2002, prescription drug deaths have outpaced those of cocaine and heroin combined. Abuse of controlled prescription drugs is higher than that of cocaine, methamphetamine, heroin, MDMA, and PCP combined.
- DanBC 9y ago
  This is completely untrue. "The government" has no say in life support. The government has given Charlie Gard world class medical treatment. The government has also paid for Charlie Gard to have his own legal representation - independent of his parents - to protect his legal rights. You might want to learn more about the case because nothing in your comment is true. Here's the GOSH statement which lays out the facts: http://www.gosh.nhs.uk/news/latest-press-releases/latest-statement-charlie-gard http://www.gosh.nhs.uk/news/latest-press-releases/latest-sta... > 7. Charlie’s parents fundamentally believe that they alone have the right to decide what treatment Charlie has and does not have. They do not believe that Great Ormond Street should have had the right to apply to the Court for an independent, objective decision to be made. They do not believe that there is any role for a Judge or a court. They believe that only they can and should speak for Charlie and they have said many times that they feel they have been stripped of their rights as parents. > 8. GOSH holds and is bound by different principles. A world where only parents speak and decide for children and where children have no separate identity or rights and no court to hear and protect them is far from the world in which GOSH treats its child patients. > 9. Throughout this court process, Charlie has been represented by his Cafcass Guardian who has visited him in hospital, spoken to Charlie’s parents, nurses and doctors and written reports that ensure that as much as is possible for a desperately unwell baby, Charlies own viewpoint is articulated and given weight. When asked what happens to the role of the Guardian if their belief that only they have the right to decide on Charlie’s treatment is correct, Charlie’s parents answer that he does not need a Guardian because they will speak for him. > 10. GOSH believes in its core that every patient is his or her own, unique and special person and that it owes a duty of care to each. The hospital’s mission statement is “The child first and always” and the hospital does not treat any child differently or as less of an individual because of the severity of illness or disability or because of infancy. If anything, special care is given to discover and work out with parents what is best for very vulnerable patients who cannot speak for themselves
maxerickson 9y ago
Resources are finite. For a less dire example, when people stop making progress in physical therapy, insurance stops paying for it. Not because there is no chance they will benefit from further therapy, but to control costs.
- ivanbakel 9y ago
  >Resources are finite. But the important point is what exactly is making this drug scarce for local authorities. Opiod addicts are not rapidly consuming all the reserves of the drug on earth; companies have just set high prices and left the people to take the burden. Accepthing that this resource is scarce for governments means inherently agreeing with the price set by the pharmaceutical company - and I don't think that's what we should do at all.
  - maxerickson 9y ago
    As someone pointed out in a sibling to my comment, the prices aren't high for generics. So if they are spending for the branded version something else is going on.
Alex3917 9y ago
Naloxone is already generic and basically free, government officials just like buying the branded version so they can get kickbacks while complaining about the cost.
- traviscj 9y ago
  Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?
  - Alex3917 9y ago
    > is this antipattern actually codified In regulations, or more of a de-facto/status quo thing? A lot of drug purchasing things are codified. For example, Medicare is banned from negotiating drug pricing with manufactures. So even though they're buying billions of dollars worth of drugs in bulk, they're literally paying the retail price, which is just whatever the Pharma companies ask for. In terms of why they're buying the branded version in the first place, not entirely sure what the exact situation is right now. I'm sure someone will write a great article on it in a few years though after all the money has already been siphoned off.
    - zanny 9y ago
      > why they're buying the branded version in the first place Probably doesn't take a psychic to see its because the brand bought the right politicians at the right time.
    - refurb 9y ago
      Medicare does negotiate on drugs, just not in a direct way. For injected drugs, Medicare pays no more than the average price that private insurers pay. They basically piggy back on the deals. If you look at heavily discounted drugs, Medicare is paying no where close to list price. For peals, Medicare doesn't negotiate because they buy them. Private insurers adjudicate all claims and they certainly do negotiate drug prices. Those lower prices get passed to consumers who purchase their plans. And this doesn't even include the 340B discount which is mandatory. Medicare doesn't negotiate, it creates laws that lower it's drug costs.
tigershark 9y ago
Epidemic: "a widespread occurrence of an infectious disease in a community at a particular time." I can't see how drug addiction can fit in this definition. If one of them sneezes I don't immediately feel the urge to put some shit in my veins. I think that if someone doesn't want to be saved then maybe after a while it doesn't make much sense to try to save him.

creaghpatr 9y ago

This is what happens in the UK right now. The government decides when the life support machine gets turned off- they pay for it so it's their choice. Not a common or planned outcome, but an unfortunate byproduct of nationalized healthcare. http://www.bbc.com/news/uk-england-40423371 http://www.bbc.com/news/uk-england-40423371

extra88 9y ago
Not really comparable, that's a rare situation with no chance of recovery.
songshu 9y ago
Commercial private medicine and commercial private medical insurance are legal in the UK and do exist although the markets are fairly small. If anything private medicine is less regulated in the UK than it is in the US (for example it's easier to call a doctor and get a price list, on enroll at any time in a plan). The legal basis of not allowing Charlie Gard's parents to take him to the US is not related to the existence of nationalized healthcare.
ivanbakel 9y ago
The Charlie case is not comparable - the question discussed by the court is not whether it should pay to keep him alive, but whether it's ethical to, given that he's constantly incurring brain damage and few people in the medical community believe he has any chance of survival at all. The justification used is that of "continued suffering", not cost.
norikki 9y ago
>Not a planned outcome. Sure, but the people responsible clearly don't care, as evidenced by the tone of the article. Drug addiction is the result of the weak border [1], and a depressing job market [2], which is also the result of the weak border [3]. [1] http://www.businessinsider.com/us-heroin-coming-from-mexican-cartels http://www.businessinsider.com/us-heroin-coming-from-mexican... [2] http://www.gallup.com/opinion/chairman/181469/big-lie-unemployment.aspx http://www.gallup.com/opinion/chairman/181469/big-lie-unempl... [3] https://www.judiciary.senate.gov/imo/media/doc/03-16-16%20Borjas%20Testimony.pdf https://www.judiciary.senate.gov/imo/media/doc/03-16-16%20Bo...
- DanBC 9y ago
  The US prescribes far more opioids than any other country. It's likely that some of the addiction problem in the US comes from this irresponsible prescribing. https://www.dea.gov/divisions/hq/2015/hq110415.shtml https://www.dea.gov/divisions/hq/2015/hq110415.shtml > Since 2002, prescription drug deaths have outpaced those of cocaine and heroin combined. Abuse of controlled prescription drugs is higher than that of cocaine, methamphetamine, heroin, MDMA, and PCP combined.
DanBC 9y ago
This is completely untrue. "The government" has no say in life support. The government has given Charlie Gard world class medical treatment. The government has also paid for Charlie Gard to have his own legal representation - independent of his parents - to protect his legal rights. You might want to learn more about the case because nothing in your comment is true. Here's the GOSH statement which lays out the facts: http://www.gosh.nhs.uk/news/latest-press-releases/latest-statement-charlie-gard http://www.gosh.nhs.uk/news/latest-press-releases/latest-sta... > 7. Charlie’s parents fundamentally believe that they alone have the right to decide what treatment Charlie has and does not have. They do not believe that Great Ormond Street should have had the right to apply to the Court for an independent, objective decision to be made. They do not believe that there is any role for a Judge or a court. They believe that only they can and should speak for Charlie and they have said many times that they feel they have been stripped of their rights as parents. > 8. GOSH holds and is bound by different principles. A world where only parents speak and decide for children and where children have no separate identity or rights and no court to hear and protect them is far from the world in which GOSH treats its child patients. > 9. Throughout this court process, Charlie has been represented by his Cafcass Guardian who has visited him in hospital, spoken to Charlie’s parents, nurses and doctors and written reports that ensure that as much as is possible for a desperately unwell baby, Charlies own viewpoint is articulated and given weight. When asked what happens to the role of the Guardian if their belief that only they have the right to decide on Charlie’s treatment is correct, Charlie’s parents answer that he does not need a Guardian because they will speak for him. > 10. GOSH believes in its core that every patient is his or her own, unique and special person and that it owes a duty of care to each. The hospital’s mission statement is “The child first and always” and the hospital does not treat any child differently or as less of an individual because of the severity of illness or disability or because of infancy. If anything, special care is given to discover and work out with parents what is best for very vulnerable patients who cannot speak for themselves

maxerickson 9y ago

Resources are finite. For a less dire example, when people stop making progress in physical therapy, insurance stops paying for it. Not because there is no chance they will benefit from further therapy, but to control costs.

ivanbakel 9y ago
>Resources are finite. But the important point is what exactly is making this drug scarce for local authorities. Opiod addicts are not rapidly consuming all the reserves of the drug on earth; companies have just set high prices and left the people to take the burden. Accepthing that this resource is scarce for governments means inherently agreeing with the price set by the pharmaceutical company - and I don't think that's what we should do at all.
- maxerickson 9y ago
  As someone pointed out in a sibling to my comment, the prices aren't high for generics. So if they are spending for the branded version something else is going on.

Alex3917 9y ago

Naloxone is already generic and basically free, government officials just like buying the branded version so they can get kickbacks while complaining about the cost.

traviscj 9y ago
Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?
- Alex3917 9y ago
  > is this antipattern actually codified In regulations, or more of a de-facto/status quo thing? A lot of drug purchasing things are codified. For example, Medicare is banned from negotiating drug pricing with manufactures. So even though they're buying billions of dollars worth of drugs in bulk, they're literally paying the retail price, which is just whatever the Pharma companies ask for. In terms of why they're buying the branded version in the first place, not entirely sure what the exact situation is right now. I'm sure someone will write a great article on it in a few years though after all the money has already been siphoned off.
  - zanny 9y ago
    > why they're buying the branded version in the first place Probably doesn't take a psychic to see its because the brand bought the right politicians at the right time.
  - refurb 9y ago
    Medicare does negotiate on drugs, just not in a direct way. For injected drugs, Medicare pays no more than the average price that private insurers pay. They basically piggy back on the deals. If you look at heavily discounted drugs, Medicare is paying no where close to list price. For peals, Medicare doesn't negotiate because they buy them. Private insurers adjudicate all claims and they certainly do negotiate drug prices. Those lower prices get passed to consumers who purchase their plans. And this doesn't even include the 340B discount which is mandatory. Medicare doesn't negotiate, it creates laws that lower it's drug costs.

tigershark 9y ago

Epidemic: "a widespread occurrence of an infectious disease in a community at a particular time." I can't see how drug addiction can fit in this definition. If one of them sneezes I don't immediately feel the urge to put some shit in my veins. I think that if someone doesn't want to be saved then maybe after a while it doesn't make much sense to try to save him.