4 ms·

I would assume because they live in a third world country such as the United States.

sbuttgereit 9y ago
Or perhaps a country with a national medical program? https://www.gofundme.com/StephenSykes https://www.gofundme.com/StephenSykes "Unfortunatey, the cost of the drug is above the NHS funding threshold. It is not therefore available on prescription and the Consultants have told us that we will need to raise the funds required to purchase the treatment that Stephen needs to give him the real prospect of becoming well again."
- azernik 9y ago
  Insulin is a much cheaper intervention than that.
- deleted 9y ago
  [deleted]
- deleted 9y ago
  [deleted]
- kalleboo 9y ago
  Every healthcare system rationalizes spending. The US system lets low income people die because they can't afford something as basic as insulin. The NHS rationalizes on £90,000 recently-out-of-trial cancer treatments.
- stordoff 9y ago
  If I'm reading the papers correctly, PD-1 inhibition for Hodgkin's Lymphoma appears to be a particularly early treatment[0]. I doubt "the cost of the drug is above the NHS funding threshold" is a wholly accurate statement, as factors beyond just cost of treatment are involved (the NHS/NICE will approved costly treatments if they are effective and the only available treatment). I'm struggling to find the NICE report (assuming there is one), as the drug in question is not named. [0] See, e.g., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210230/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210230/ from January 2017: "[M]ajor issues such as timing and sequencing, treatment duration and synergistic combinatory approaches remain to be resolved. Furthermore, long-term efficacy outcomes and potential development of late toxicities in lymphoma patients are still poorly defined."
- mehwoot 9y ago
  He has undergone six different chemo therapies since then but none have been successful. His Consultants have concluded that he is now in a position where his only hope of reducing the cancer enough to be able to receive a life saving stem cell transplant is to treat him with a new type of drug called a PD1 blocker. Kind of different to needing insulin, isn't it
noitsnot 9y ago
The emergency room will provide insulin 100% of the time whether you can pay or not.
- Dangeranger 9y ago
  If you don’t have insulin at home it’s easy to go into an acute diabetic shock and die without anyone knowing. A diabetic without insulin quickly loses their higher brain functions, including decision making like “Is this an emergency? Should I call 911?”
  - asimilator 9y ago
    This isn’t accurate. A friend of mine was diagnosed with T1D freshman year of college and was still passing exams when he went to hospital with the initial diagnosis. He told me his blood sugar was so high those standard portable glucose measuring devices couldn’t even measure it.
    - deleted 9y ago
      [deleted]
    - bigiain 9y ago
      I'm type 2 ("adult onset") diabetic. I'm controlled with metformin and insulin. I got gastro a few years back, spend two days throwing up and pooping out all my medication, and then literally spent three days delirious. I should have called an ambulance, but wasn't thinking clearly enough to know it at the time. Eventually a friend dropped in, took me to my local GP, who immediately sent me off to hospital. In bad cases, it _does_ get that bad. Dehydration on top of losing control of my medication and a not particularly serious gastric bug ended up being a very serious thing for me.
      - asimilator 9y ago
        “Bad cases” is a lot different than “really easy”. My friend has a pump which occasionally fails (that wireless pump, forgot the name). It’s possible (in a pinch) go without it for hours. I don’t think most diabetics are that brittle that “without insulin quickly loses their higher brain functions”. One of the above posters explains it better than I have.
katastic 9y ago
Except most hospitals charge _after_ they've administered life saving medicine. (Which is why illegal immigrants and the uninsured have burdened the medical system. This isn't a 'clever jab'--like yours--the way the legal and medical system is setup, hospitals are the ones that are screwed the most and have to fit the bill for non-payers.) https://www.quora.com/What-do-doctors-do-when-a-patient-cant-pay-for-life-saving-surgery-A-person-is-in-need-of-immediate-surgery-which-costs-250-000-He-she-only-has-150-000-Will-the-surgeon-let-the-patient-die-or-perform-the-surgery-at-his-her-own-expense https://www.quora.com/What-do-doctors-do-when-a-patient-cant... >When a patient comes into the hospital and there is a limb threatening emergency, there is no consideration to the patients financial status to provide emergency surgical management, PERIOD. https://insight.kellogg.northwestern.edu/article/who-bears-the-cost-of-the-uninsured-nonprofit-hospitals https://insight.kellogg.northwestern.edu/article/who-bears-t... >That means hospitals are effectively serving as “insurers of last resort” within the American healthcare sector by providing care to uninsured patients who cannot afford to pay their medical bills. “People are still going to the emergency room,” Garthwaite says, “and they are still receiving treatment—so the cost is still there. When governments do not provide health insurance, hospitals must effectively provide it instead.” And before some brilliant downvoter comes along, I'd call attention to the fact I've provided sources for all of my claims. Doctors in the USA don't go through 8+ years of school and residence to simply let people die in front of them. [edit] Per the child poster's date, I've got one more source: >According to the Centers for Medicare & Medicaid Services, 55% of U.S. emergency care now goes uncompensated.[13] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act#Effects https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... That reaffirms my point. And my God, 55% is a staggering amount and it highlights many sides of the issue. That many people know and use "free" emergency care when they have to, without paying insurance. And that hospitals are the ones stuck with the burden of our medical system.
- mikeash 9y ago
  This has been a legal requirement since 1986. It’s one of the odd things about the debate over socialized medicine: the US has had socialized medicine for 30 years now. The debate is merely over how it’s provided and who pays for it. But it’s never actually mentioned that this is the case.
Morizero 9y ago
Third world country by definition cannot be the United States. The term refers to countries unaligned with a cold war superpower. It's outdated and has better alternatives.
- amake 9y ago
  Do you really think this correction is relevant or helpful in this context?
- Daishiman 9y ago
  You kind of missed the entire point of the statement.
- phire 9y ago
  That definition also makes Ireland, Sweden, Finland and Switzerland 3rd world countries.
  - Morizero 9y ago
    Correct. The term they should have used is "developing country".
    - int_19h 9y ago
      Language evolves over time. The definition based on Cold War alignment hasn't been relevant for a very long time, and it's not what people have in mind when they say or hear the term "third world".
- Trill-I-Am 9y ago
  In the 21st century, the “world” distinction refers to level of economic development
snowpanda 9y ago
You know I wasn't going to respond to your comment, but as someone who has seen people used as a mere piece of flesh to defuse landmines, I have to say you have no idea how lucky you are to live in a country where you were even able to write your comment from your computer, in your house, with electricity and hospitals nearby. Seriously one of the least productive comments I've seen on HackerNews.
- amake 9y ago
  People shouldn't complain about the sorry state of the US health care system because... other people have it worse? > I wasn't going to respond to your comment Maybe you should have trusted your gut on that one.
- Daishiman 9y ago
  Oh come on, I've been around the block to countries that are substantially poorer than the US where people don't have to give up their life's savings for a medical intervention.
  - kamaal 9y ago
    Actually the parent poster to your comment is right. Most Americans go to other countries as tourists and largely have no idea how hard everyday life there is.
    - jacquesm 9y ago
      Quite a few Americans go to other countries to use their cheap/free healthcare: https://en.wikipedia.org/wiki/Medical_tourism https://en.wikipedia.org/wiki/Medical_tourism Note that America is hardly unique in this respect and is both a destination and a source of such traffic.
      - toomanybeersies 9y ago
        Cheap is relative.
      - 9y ago
forgotpassagan 9y ago
Out of compassion (and possibly not wanting to get sued), doctors and pharmacies will provide you will lifesaving medicine in the US, no matter your ability to pay. I have seen this happen in pharmacies and have firsthand experience with this happening in emergency medicine. Typically you'll be given the insulin and asked to pay later or it will be quietly written off as lost, expired, or just the cost of doing business. The pharmacists I knew we're more than willing to give a free vial if it was crucial and deal with payment later(or in many cases never). Repeat offenders are directed towards programs where they can get insulin at discount or for free. Despite the healthcare system being fucked, letting someone die without insulin is a bad PR move so the giant companies that make it will give it away if necessary (but you have to sign up and pass income checks). Still, this is mostly just human compassion I've seen. Doctors and pharmacists I've known are generally very helpful and nurturing people. You make a lot of money but there's easier ways to make the same if human compassion isn't your thing. If this wasn't the case I assume many would die, because it doesn't seem that the government provides any protection against this. The US medical system is corrupt and FUBAR but this is not a good example. I've worked low level jobs around retail pharmacy and emergency medicine and seen this happen firsthand many times. Healthcare providers in the US are of fairly high quality and generally will not let you die. Most of the insane costs and profiteering are focused around drug pricing, countless layers of nonsense surrounding insurance and pricing structures, and the need for hospitals to charge some people a lot to make up for the huge fraction that don't or can't pay.
dang 9y ago
You can't post nationalistic swipes here, regardless of the target. Snark is not good either. Please read https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and do a better job of taking the spirit of this place to heart. That means thoughtful conversation, or simply not posting. We detached this subthread from https://news.ycombinator.com/item?id=15957446 https://news.ycombinator.com/item?id=15957446 and marked it off-topic.

Or perhaps a country with a national medical program? https://www.gofundme.com/StephenSykes https://www.gofundme.com/StephenSykes "Unfortunatey, the cost of the drug is above the NHS funding threshold. It is not therefore available on prescription and the Consultants have told us that we will need to raise the funds required to purchase the treatment that Stephen needs to give him the real prospect of becoming well again."

azernik 9y ago
Insulin is a much cheaper intervention than that.
deleted 9y ago
[deleted]
deleted 9y ago
[deleted]
kalleboo 9y ago
Every healthcare system rationalizes spending. The US system lets low income people die because they can't afford something as basic as insulin. The NHS rationalizes on £90,000 recently-out-of-trial cancer treatments.
stordoff 9y ago
If I'm reading the papers correctly, PD-1 inhibition for Hodgkin's Lymphoma appears to be a particularly early treatment[0]. I doubt "the cost of the drug is above the NHS funding threshold" is a wholly accurate statement, as factors beyond just cost of treatment are involved (the NHS/NICE will approved costly treatments if they are effective and the only available treatment). I'm struggling to find the NICE report (assuming there is one), as the drug in question is not named. [0] See, e.g., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210230/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210230/ from January 2017: "[M]ajor issues such as timing and sequencing, treatment duration and synergistic combinatory approaches remain to be resolved. Furthermore, long-term efficacy outcomes and potential development of late toxicities in lymphoma patients are still poorly defined."
mehwoot 9y ago
He has undergone six different chemo therapies since then but none have been successful. His Consultants have concluded that he is now in a position where his only hope of reducing the cancer enough to be able to receive a life saving stem cell transplant is to treat him with a new type of drug called a PD1 blocker. Kind of different to needing insulin, isn't it

noitsnot 9y ago

The emergency room will provide insulin 100% of the time whether you can pay or not.

Dangeranger 9y ago
If you don’t have insulin at home it’s easy to go into an acute diabetic shock and die without anyone knowing. A diabetic without insulin quickly loses their higher brain functions, including decision making like “Is this an emergency? Should I call 911?”
- asimilator 9y ago
  This isn’t accurate. A friend of mine was diagnosed with T1D freshman year of college and was still passing exams when he went to hospital with the initial diagnosis. He told me his blood sugar was so high those standard portable glucose measuring devices couldn’t even measure it.
  - deleted 9y ago
    [deleted]
  - bigiain 9y ago
    I'm type 2 ("adult onset") diabetic. I'm controlled with metformin and insulin. I got gastro a few years back, spend two days throwing up and pooping out all my medication, and then literally spent three days delirious. I should have called an ambulance, but wasn't thinking clearly enough to know it at the time. Eventually a friend dropped in, took me to my local GP, who immediately sent me off to hospital. In bad cases, it _does_ get that bad. Dehydration on top of losing control of my medication and a not particularly serious gastric bug ended up being a very serious thing for me.
    - asimilator 9y ago
      “Bad cases” is a lot different than “really easy”. My friend has a pump which occasionally fails (that wireless pump, forgot the name). It’s possible (in a pinch) go without it for hours. I don’t think most diabetics are that brittle that “without insulin quickly loses their higher brain functions”. One of the above posters explains it better than I have.

katastic 9y ago

Except most hospitals charge _after_ they've administered life saving medicine. (Which is why illegal immigrants and the uninsured have burdened the medical system. This isn't a 'clever jab'--like yours--the way the legal and medical system is setup, hospitals are the ones that are screwed the most and have to fit the bill for non-payers.) https://www.quora.com/What-do-doctors-do-when-a-patient-cant-pay-for-life-saving-surgery-A-person-is-in-need-of-immediate-surgery-which-costs-250-000-He-she-only-has-150-000-Will-the-surgeon-let-the-patient-die-or-perform-the-surgery-at-his-her-own-expense https://www.quora.com/What-do-doctors-do-when-a-patient-cant... >When a patient comes into the hospital and there is a limb threatening emergency, there is no consideration to the patients financial status to provide emergency surgical management, PERIOD. https://insight.kellogg.northwestern.edu/article/who-bears-the-cost-of-the-uninsured-nonprofit-hospitals https://insight.kellogg.northwestern.edu/article/who-bears-t... >That means hospitals are effectively serving as “insurers of last resort” within the American healthcare sector by providing care to uninsured patients who cannot afford to pay their medical bills. “People are still going to the emergency room,” Garthwaite says, “and they are still receiving treatment—so the cost is still there. When governments do not provide health insurance, hospitals must effectively provide it instead.” And before some brilliant downvoter comes along, I'd call attention to the fact I've provided sources for all of my claims. Doctors in the USA don't go through 8+ years of school and residence to simply let people die in front of them. [edit] Per the child poster's date, I've got one more source: >According to the Centers for Medicare & Medicaid Services, 55% of U.S. emergency care now goes uncompensated.[13] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act#Effects https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... That reaffirms my point. And my God, 55% is a staggering amount and it highlights many sides of the issue. That many people know and use "free" emergency care when they have to, without paying insurance. And that hospitals are the ones stuck with the burden of our medical system.

mikeash 9y ago
This has been a legal requirement since 1986. It’s one of the odd things about the debate over socialized medicine: the US has had socialized medicine for 30 years now. The debate is merely over how it’s provided and who pays for it. But it’s never actually mentioned that this is the case.

Morizero 9y ago

Third world country by definition cannot be the United States. The term refers to countries unaligned with a cold war superpower. It's outdated and has better alternatives.

amake 9y ago
Do you really think this correction is relevant or helpful in this context?
Daishiman 9y ago
You kind of missed the entire point of the statement.
phire 9y ago
That definition also makes Ireland, Sweden, Finland and Switzerland 3rd world countries.
- Morizero 9y ago
  Correct. The term they should have used is "developing country".
  - int_19h 9y ago
    Language evolves over time. The definition based on Cold War alignment hasn't been relevant for a very long time, and it's not what people have in mind when they say or hear the term "third world".
Trill-I-Am 9y ago
In the 21st century, the “world” distinction refers to level of economic development

snowpanda 9y ago

You know I wasn't going to respond to your comment, but as someone who has seen people used as a mere piece of flesh to defuse landmines, I have to say you have no idea how lucky you are to live in a country where you were even able to write your comment from your computer, in your house, with electricity and hospitals nearby. Seriously one of the least productive comments I've seen on HackerNews.

amake 9y ago
People shouldn't complain about the sorry state of the US health care system because... other people have it worse? > I wasn't going to respond to your comment Maybe you should have trusted your gut on that one.
Daishiman 9y ago
Oh come on, I've been around the block to countries that are substantially poorer than the US where people don't have to give up their life's savings for a medical intervention.
- kamaal 9y ago
  Actually the parent poster to your comment is right. Most Americans go to other countries as tourists and largely have no idea how hard everyday life there is.
  - jacquesm 9y ago
    Quite a few Americans go to other countries to use their cheap/free healthcare: https://en.wikipedia.org/wiki/Medical_tourism https://en.wikipedia.org/wiki/Medical_tourism Note that America is hardly unique in this respect and is both a destination and a source of such traffic.
    - toomanybeersies 9y ago
      Cheap is relative.
    - 9y ago

forgotpassagan 9y ago

Out of compassion (and possibly not wanting to get sued), doctors and pharmacies will provide you will lifesaving medicine in the US, no matter your ability to pay. I have seen this happen in pharmacies and have firsthand experience with this happening in emergency medicine. Typically you'll be given the insulin and asked to pay later or it will be quietly written off as lost, expired, or just the cost of doing business. The pharmacists I knew we're more than willing to give a free vial if it was crucial and deal with payment later(or in many cases never). Repeat offenders are directed towards programs where they can get insulin at discount or for free. Despite the healthcare system being fucked, letting someone die without insulin is a bad PR move so the giant companies that make it will give it away if necessary (but you have to sign up and pass income checks). Still, this is mostly just human compassion I've seen. Doctors and pharmacists I've known are generally very helpful and nurturing people. You make a lot of money but there's easier ways to make the same if human compassion isn't your thing. If this wasn't the case I assume many would die, because it doesn't seem that the government provides any protection against this. The US medical system is corrupt and FUBAR but this is not a good example. I've worked low level jobs around retail pharmacy and emergency medicine and seen this happen firsthand many times. Healthcare providers in the US are of fairly high quality and generally will not let you die. Most of the insane costs and profiteering are focused around drug pricing, countless layers of nonsense surrounding insurance and pricing structures, and the need for hospitals to charge some people a lot to make up for the huge fraction that don't or can't pay.

dang 9y ago

You can't post nationalistic swipes here, regardless of the target. Snark is not good either. Please read https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and do a better job of taking the spirit of this place to heart. That means thoughtful conversation, or simply not posting. We detached this subthread from https://news.ycombinator.com/item?id=15957446 https://news.ycombinator.com/item?id=15957446 and marked it off-topic.