6 ms·

Who dies for want of basic medicines?

by someguydave 2y ago

djbusby 2y ago
Americans w/diabetes is one group.
- 0xBDB 2y ago
  We (I am one, though fortunate to have excellent insurance) really are not one such group. https://www.healthline.com/health/diabetes/16-tips-to-help-you-afford-your-diabetes-medication-and-supplies#where-to-start https://www.healthline.com/health/diabetes/16-tips-to-help-y... I am not a fan of the American healthcare system. Navigating it takes brains and effort that shouldn't be required. But if you have them it is essentially not possible to die here from lack of healthcare, and it's possible but surprisingly difficult to go bankrupt (except from lost wages, which is also a leading cause of bankruptcy in the UK).
  - zrn900 2y ago
    > But if you have them it is essentially not possible to die here from lack of healthcare, and it's possible but surprisingly difficult to go bankrupt That's a false myth. https://www.quora.com/Were-there-any-American-citizens-living-on-US-soil-who-died-because-they-couldnt-afford-healthcare https://www.quora.com/Were-there-any-American-citizens-livin... https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt https://www.theguardian.com/us-news/2019/nov/14/health-insur...
    - 0xBDB 2y ago
      Yes, so this is where the brains and effort (and time, forgot time) come in. The anecdotes in your links (that I read - can't get through all of them right now) have a common theme, which is that people died because they either needed very expensive and/or experimental treatment that probably would not be affordably provided to them under any plausible healthcare system, or else they got a bill, decided they couldn't pay it, and did without or tried to self-ration their healthcare. The correct course of action in that case is to call the healthcare provider and negotiate A) a 90+% discount and B) a payment plan, both of which are pretty readily available in the American system. You have to know that's possible, and you shouldn't have to, but it is possible. Then you reach out to the charities, government programs, and/or nonprofits from my original link to cover what you still can't afford. Same deal if you get screwed by an insurance company as in the Guardian article. This is, again, not something I'm trying to defend. It's not the way a sane healthcare system would run. But it is a system that works, more or less, for those who know how to work within it.
      - zrn900 2y ago
        > The anecdotes The anecdotes show that this is not an 'occasional' or 'edge case' thing but a systemic thing. The statistics show that at least 40,000 people die a year for not having enough money for healthcare and these are the people we know. The statistics don't include those who never go to the hospital to avoid risking medical bankruptcy for their families even if they die themselves. Just being in a hospital bed for one night without anything being done costs $3000/night, whereas waiting in the ER without anything being done can cost $100/hour. https://www.marketwatch.com/story/woman-gets-688-35-er-bill-for-spending-7-hours-in-the-waiting-room-without-being-treated-11635794483 https://www.marketwatch.com/story/woman-gets-688-35-er-bill-... This is a systemic thing. Its not 'not a sane healthcare system'. Its literally a machine that kills people to maximize profit. And it became like this only because people let it and justified this or that other thing in the system.
        0xBDB 2y ago
        > Just being in a hospital bed for one night without anything being done costs $3000/night No, it doesn't. It costs whatever you can negotiate it to cost. I've been without insurance; one experience isn't data, but in my experience just telling the hospital you haven't got insurance is, again, good for 90+% off by itself. https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medical-bills-heres-how-to-lower-your-costs.html https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medic... Hospitals (ed: non-profit ones, but I'm pretty sure similar rules apply elsewhere) in particular are required by federal law to have 'well-publicized' financial assistance policies. https://www.irs.gov/charities-non-profits/financial-assistance-policies-faps https://www.irs.gov/charities-non-profits/financial-assistan... > Its literally a machine that kills people to maximize profit. If that were true it would do a good job of maximizing profit. It's not even that good. Healthcare margins in the U.S. are 0.7%, which sucks. If you're the proverbial evil billionaire or whatever you'd rather own almost anything else. https://www.nadapayments.com/blog/what-is-the-average-profit-margin-in-the-healthcare-industry https://www.nadapayments.com/blog/what-is-the-average-profit... The whole reason I started this thread is because it bugs me when we attribute to malice what is obviously stupidity.
  - joquarky 2y ago
    > But if you have them What if your problem is with your mental health? It's not like mental health problems are fringe lately. It feels to me like you're speaking as though you are in the middle of the bell curve, but from my perspective people who can navigate this system are an exception.
Intermernet 2y ago
That whole EpiPen debacle springs to mind... I'm sure if you looked into it you'd find other examples of basic medicines being unavailable to large sectors of the population purely due to the cost.
mhuffman 2y ago
There are many people that don't qualify for free health care (and some that do!) but can't afford co-pays and co-insurance, and must go without that medicine.
- someguydave 2y ago
  Can you tell me what portion of the population is covered by Medicaid? Give me a guess?
r00fus 2y ago
68k a year die in the US due to lack of medical. Poor people simply don’t visit the doctor.
acaloiar 2y ago
The uninsured. The underinsured. People on the "wrong" insurance plan. People without the budget slack for $100s or $1000s per month for the medication they need. Poor people who don't bother going to the doctor to get needed prescriptions because they can't afford the initial visit. Rich people whose doctors fail to mention the drug that costs $250k because no past patients cleared for it could afford it. People going to the doctor who gets financial kickbacks from the inferior drug's drugmaker. People prescribed drugs that kill them. If your question was actually serious, this is a non-exhaustive list.
- gottorf 2y ago
  When the GP said "basic medicines", they probably meant all the generic stuff that can be had without insurance for a few dollars; all the stuff that is on the WHO list of essential medicines[0], that is. I'd venture that drugs that cost hundreds of dollars or more per month in the US are all cutting-edge stuff. I mean, sure, you have stories of people getting charged $10 for a pill of acetaminophen at a hospital, but that's a separate matter unrelated to the fact that you can get a bottle of 500 pills for single-digit dollars at your local Walmart. > The uninsured. The underinsured. People on the "wrong" insurance plan. Plenty to criticize about the US healthcare system, but let's remember that countries with nationalized medical care also suffer from their own ills, mainly in the form of long wait times. Ultimately, no place has enough doctors per capita that every sick person can be treated promptly and cheaply; so care must be gated one way or another. In America, you pay with money; in most other countries, you pay with time. [0]: https://iris.who.int/bitstream/handle/10665/371090/WHO-MHP-HPS-EML-2023.02-eng.pdf?sequence=1 https://iris.who.int/bitstream/handle/10665/371090/WHO-MHP-H...
  - jackpirate 2y ago
    The WHO list of essential medicines is not just over-the-counter drugs. It includes things like the chemotherapy drug cisplatin. I happened to need that for testicular cancer ~10 years ago, and the treatment cost was $50k (as "payed" by insurance). That overall seems pretty reasonable to me for the treatment I received, but definitely not something I'd expect the median American to be able to pay out of pocket.

Who dies for want of basic medicines?

djbusby 2y ago

Americans w/diabetes is one group.

0xBDB 2y ago
We (I am one, though fortunate to have excellent insurance) really are not one such group. https://www.healthline.com/health/diabetes/16-tips-to-help-you-afford-your-diabetes-medication-and-supplies#where-to-start https://www.healthline.com/health/diabetes/16-tips-to-help-y... I am not a fan of the American healthcare system. Navigating it takes brains and effort that shouldn't be required. But if you have them it is essentially not possible to die here from lack of healthcare, and it's possible but surprisingly difficult to go bankrupt (except from lost wages, which is also a leading cause of bankruptcy in the UK).
- zrn900 2y ago
  > But if you have them it is essentially not possible to die here from lack of healthcare, and it's possible but surprisingly difficult to go bankrupt That's a false myth. https://www.quora.com/Were-there-any-American-citizens-living-on-US-soil-who-died-because-they-couldnt-afford-healthcare https://www.quora.com/Were-there-any-American-citizens-livin... https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt https://www.theguardian.com/us-news/2019/nov/14/health-insur...
  - 0xBDB 2y ago
    Yes, so this is where the brains and effort (and time, forgot time) come in. The anecdotes in your links (that I read - can't get through all of them right now) have a common theme, which is that people died because they either needed very expensive and/or experimental treatment that probably would not be affordably provided to them under any plausible healthcare system, or else they got a bill, decided they couldn't pay it, and did without or tried to self-ration their healthcare. The correct course of action in that case is to call the healthcare provider and negotiate A) a 90+% discount and B) a payment plan, both of which are pretty readily available in the American system. You have to know that's possible, and you shouldn't have to, but it is possible. Then you reach out to the charities, government programs, and/or nonprofits from my original link to cover what you still can't afford. Same deal if you get screwed by an insurance company as in the Guardian article. This is, again, not something I'm trying to defend. It's not the way a sane healthcare system would run. But it is a system that works, more or less, for those who know how to work within it.
    - zrn900 2y ago
      > The anecdotes The anecdotes show that this is not an 'occasional' or 'edge case' thing but a systemic thing. The statistics show that at least 40,000 people die a year for not having enough money for healthcare and these are the people we know. The statistics don't include those who never go to the hospital to avoid risking medical bankruptcy for their families even if they die themselves. Just being in a hospital bed for one night without anything being done costs $3000/night, whereas waiting in the ER without anything being done can cost $100/hour. https://www.marketwatch.com/story/woman-gets-688-35-er-bill-for-spending-7-hours-in-the-waiting-room-without-being-treated-11635794483 https://www.marketwatch.com/story/woman-gets-688-35-er-bill-... This is a systemic thing. Its not 'not a sane healthcare system'. Its literally a machine that kills people to maximize profit. And it became like this only because people let it and justified this or that other thing in the system.
      - 0xBDB 2y ago
        > Just being in a hospital bed for one night without anything being done costs $3000/night No, it doesn't. It costs whatever you can negotiate it to cost. I've been without insurance; one experience isn't data, but in my experience just telling the hospital you haven't got insurance is, again, good for 90+% off by itself. https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medical-bills-heres-how-to-lower-your-costs.html https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medic... Hospitals (ed: non-profit ones, but I'm pretty sure similar rules apply elsewhere) in particular are required by federal law to have 'well-publicized' financial assistance policies. https://www.irs.gov/charities-non-profits/financial-assistance-policies-faps https://www.irs.gov/charities-non-profits/financial-assistan... > Its literally a machine that kills people to maximize profit. If that were true it would do a good job of maximizing profit. It's not even that good. Healthcare margins in the U.S. are 0.7%, which sucks. If you're the proverbial evil billionaire or whatever you'd rather own almost anything else. https://www.nadapayments.com/blog/what-is-the-average-profit-margin-in-the-healthcare-industry https://www.nadapayments.com/blog/what-is-the-average-profit... The whole reason I started this thread is because it bugs me when we attribute to malice what is obviously stupidity.
- joquarky 2y ago
  > But if you have them What if your problem is with your mental health? It's not like mental health problems are fringe lately. It feels to me like you're speaking as though you are in the middle of the bell curve, but from my perspective people who can navigate this system are an exception.

Intermernet 2y ago

That whole EpiPen debacle springs to mind... I'm sure if you looked into it you'd find other examples of basic medicines being unavailable to large sectors of the population purely due to the cost.

mhuffman 2y ago

There are many people that don't qualify for free health care (and some that do!) but can't afford co-pays and co-insurance, and must go without that medicine.

someguydave 2y ago
Can you tell me what portion of the population is covered by Medicaid? Give me a guess?

r00fus 2y ago

68k a year die in the US due to lack of medical. Poor people simply don’t visit the doctor.

acaloiar 2y ago

The uninsured. The underinsured. People on the "wrong" insurance plan. People without the budget slack for $100s or $1000s per month for the medication they need. Poor people who don't bother going to the doctor to get needed prescriptions because they can't afford the initial visit. Rich people whose doctors fail to mention the drug that costs $250k because no past patients cleared for it could afford it. People going to the doctor who gets financial kickbacks from the inferior drug's drugmaker. People prescribed drugs that kill them. If your question was actually serious, this is a non-exhaustive list.

gottorf 2y ago
When the GP said "basic medicines", they probably meant all the generic stuff that can be had without insurance for a few dollars; all the stuff that is on the WHO list of essential medicines[0], that is. I'd venture that drugs that cost hundreds of dollars or more per month in the US are all cutting-edge stuff. I mean, sure, you have stories of people getting charged $10 for a pill of acetaminophen at a hospital, but that's a separate matter unrelated to the fact that you can get a bottle of 500 pills for single-digit dollars at your local Walmart. > The uninsured. The underinsured. People on the "wrong" insurance plan. Plenty to criticize about the US healthcare system, but let's remember that countries with nationalized medical care also suffer from their own ills, mainly in the form of long wait times. Ultimately, no place has enough doctors per capita that every sick person can be treated promptly and cheaply; so care must be gated one way or another. In America, you pay with money; in most other countries, you pay with time. [0]: https://iris.who.int/bitstream/handle/10665/371090/WHO-MHP-HPS-EML-2023.02-eng.pdf?sequence=1 https://iris.who.int/bitstream/handle/10665/371090/WHO-MHP-H...
- jackpirate 2y ago
  The WHO list of essential medicines is not just over-the-counter drugs. It includes things like the chemotherapy drug cisplatin. I happened to need that for testicular cancer ~10 years ago, and the treatment cost was $50k (as "payed" by insurance). That overall seems pretty reasonable to me for the treatment I received, but definitely not something I'd expect the median American to be able to pay out of pocket.