I Need Surgery Because I'm insured

[ElNono]

I heard a day or two the vaccine was available.

Thing is, it's less dangerous than the annual flue. That was it? $5 x 30 or $150 for 30 days. I'd be glad they were willing to give 15. Even though the flue may cost $1,000 if treatment was necessary, I'm pretty sure the chances are well under 1% of needing any medical care. So if we take that $150, x 100, we have a cost of $15,000 per 100 people, at 1% sickness without the preventative care, and $1,000 for the 1%... Look at the math. Under this hypothetical situation, the preventative care is 15 times more expensive. At them giving 15 days without much consideration, it would cost $7,500 to treat 100 people to save a statistical $1,000 in the health care cost. Looks like a $6,500 loss to me.

You can put your calculator away. It costs well over 2K to spend a night at a hospital. And I'm not even begging for a handout here. I simply want my doctor's opinion to be respected, and simply be able to get what the doctor thinks it's best for the two of us, without being overruled by somebody that has no idea about our situation or clinical history for that matter.
They're sure glad to suck up the premium from my wife's paycheck and increase it every year. If anything, give me the pills and then go argue with the doctor. Kick him out of the network. Do whatever you need to do, but stop ing around with your customers that pay on a timely manner every month. , looks like I'm asking for too much.

Before you jump on my example, remember this is to illustrate a point. Not to be accurate costs.I wonder if it really is? This is money in the form of foreign aide for countries to claim this, especially when it was the USA that first became over zealous on the issue. Is it really a problem, or a way for these nations to milk foreign aide?

I'm not asking for ing foreign aid. Stop spinning this thing. I just want my prescription fully filled.

[ElNono]

That's one reason why insurance has become so expensive. People see no need to save on the costs when they expect insurance to pay for it.

It was hilarious for me to watch the liberals cry when they made Prilosec an over the counter drug. It made it so consumers like me could buy it for under $1.00 each when the prescription was running over $3.00 each. Two of my relatives were complaining, because their insurance doesn't pay for over the counter drugs.

Funny how that works.

How much of the drugs costs do you thing go to pay for pharmaceutical regulations, the storage and control and pharmacists pay? If paying less than 30% of the original price is an example of all prescription drugs... The again, I'll bet it's more like a per unit cost.

What reason? That people expect to use the insurance they pay for?
How does the rest of the world manage to do exactly that and the costs are nowhere near what we have to spend?
I'm not claiming the current healthcare proposal will necessarily fix that, but you can't tell me somebody doesn't have a cash cow in the current system.
I mean, you think tort reform will work? Heck, let's do it. But this system is inflated beyond belief. Somebody is cashing in, and it's not any of the patients.

[boutons_deux]

"drugs costs do you thing go to pay for pharmaceutical regulations"

very little.

It was reported that BigPharma spends $60B/year on marketing (because each $ spent on marketing returned nearly $1.50 in sales) but only $30B/year on research.

If you think the FDA is anti-BigPharma, GFY.

The FDA is fully captured by BigPharma, but you want to take drugs that are even less regulated? Be my guest, go for the Darwin Award 2010.

[DarrinS]

"drugs costs do you thing go to pay for pharmaceutical regulations"

very little.

It was reported that BigPharma spends $60B/year on marketing (because each $ spent on marketing returned nearly $1.50 in sales) but only $30B/year on research.

If you think the FDA is anti-BigPharma, GFY.

The FDA is fully captured by BigPharma, but you want to take drugs that are even less regulated? Be my guest, go for the Darwin Award 2010.

I love how you s always say Big Oil, Big Insurance, Big Tobacco, Big Pharmaceutical -- but I never hear anyone say Big Education, etc.

[clambake]

uh oh, mr. birther dropped the word again.

getting pissy?

[Rodriguez]

I love how you s always say Big Oil, Big Insurance, Big Tobacco, Big Pharmaceutical -- but I never hear anyone say Big Education, etc.

Education is too lame to deserve "big" and has long been overlooked, so it's no wonder we have got so many dumb asses even when filtering the immigrants. Like medical system, Education is also an ideal cradle for corruption to lush. It sounds sad but actually exists that, some god-given rights like health care and education, may bankrupt our citizens sometimes.

[Wild Cobra]

It was reported that BigPharma spends $60B/year on marketing (because each $ spent on marketing returned nearly $1.50 in sales) but only $30B/year on research.

And at what cost does advertisement add to the product price? Prilosec is advertised, and less that $1 per pill.

[clambake]

gee......less than $1 for an over the counter drug.

what a bargain!

[Wild Cobra]

I'm not asking for ing foreign aid. Stop spinning this thing. I just want my prescription fully filled.

I didn't mean you were spinning things in this regard. I meant that countries that rely on USA aide trump up the real effects of a problem that the USA recognizes. This way, they get more money from us. In this case, the swine flue. This strain has proven to be harmless except for people already in real bad health. I'll bet your insurance company recognized that fact. It wouldn't surprise me if your doctor, like most, will prescribe what the patient wants, even if they really don't need it.

Let me ask this a different way.

What are the known side effects of the medication you want. If they are serious enough, that's another reason an insurance company may have a hard time agreeing to pay for it.

[ElNono]

In this case, the swine flue. This strain has proven to be harmless except for people already in real bad health. I'll bet your insurance company recognized that fact.

It's not a matter of bad health. It's a matter that the doctor, that knows my wife has a immunodeficiency disease, deemed appropriate for her to have access to the drug in case she acquires said flu. And that's all I need to know.
There's a reason I go to the doctor to get his professional opinion instead of visiting the insurance's office. I don't want the insurance to make decisions that the doctor already made.

What are the known side effects of the medication you want. If they are serious enough, that's another reason an insurance company may have a hard time agreeing to pay for it.

They will allow half of the prescription to the be filled, and have no problem filling the other half next month, so obviously that's not the problem.

[Wild Cobra]

They will allow half of the prescription to the be filled, and have no problem filling the other half next month, so obviously that's not the problem.

Side effects please...

[ElNono]

Side effects please...

What that has to do with anything? Look it up yourself: Tamiflu
The doctor wrote the prescription not because he's a nice guy, but because in his professional opinion it was something he deemed we should have.
I don't care what the insurance company thinks. They don't go to Medical school.

[Wild Cobra]

What that has to do with anything? Look it up yourself: Tamiflu
The doctor wrote the prescription not because he's a nice guy, but because in his professional opinion it was something he deemed we should have.
I don't care what the insurance company thinks. They don't go to Medical school.

I just did. Side effects include:

Anaphylaxis

Stevens–Johnson syndrome

Toxic epidermal necrolysis

Cardiac arrhythmia

Is it worth the chance of these side effects for a flue that is less sever than the annual flue outbreaks?

Is it possible your insurance company recognized the costs of treating these side effects if necessary?

[Wild Cobra]

ElNono...

Did you even know there were that many possible serious side effects?

Why would anyone in their right mind take it for a minor flue they are unlikely to come in contact with?

Again, hypochondriac by chance?

[ElNono]

I just did. Side effects include:

Anaphylaxis

Stevens–Johnson syndrome

Toxic epidermal necrolysis

Cardiac arrhythmia

Is it worth the chance of these side effects for a flue that is less sever than the annual flue outbreaks?

Is it possible your insurance company recognized the costs of treating these side effects if necessary?

For crying out loud you're dense. The doctor has the full clinical history, drug interaction with what she's already taking, we talked for over 30 minutes with him about what we were doing, where we were going and how long we were going for.
The pharmacist spent under 3 minutes talking with the insurance drone, who is not a doctor, does not have her clinical history, didn't know until we told him why the doctor wrote a prescription for 30 pills instead of 15, and yet refused to authorize more than half the prescription.
If they had any fears of side effects, they simply don't authorize anything at all.

It's amazing at which levels you try to reach to justify these guys. It's not really complicated. The insurance won't authorize more than half the prescription for this month and we have to deal with it.
And I don't give a what cost conscious reasons they have. If the Doc says I need X prescription, then I don't need to argue with anybody else.
The expert opinion is the one from the guy that went to Medical school and has a license to practice medicine. End of story.

[ElNono]

ElNono...

Did you even know there were that many possible serious side effects?

Why would anyone in their right mind take it for a minor flue they are unlikely to come in contact with?

Again, hypochondriac by chance?

Jeez... One more time. Let's see if it sinks in this time: I DON'T WRITE PRESCRIPTIONS. A DOCTOR DOES. WE WENT TO HIM FOR HIS OPINION AND HE WROTE THE PRESCRIPTION, BASED ON THE CIR STANCES OF OUR TRIP.

Can you get that into your head? If the doctor deemed that we didn't need anything, then we would be ok too.

[Wild Cobra]

For crying out loud you're dense. The doctor has the full clinical history, drug interaction with what she's already taking, we talked for over 30 minutes with him about what we were doing, where we were going and how long we were going for.
The pharmacist spent under 3 minutes talking with the insurance drone, who is not a doctor, does not have her clinical history, didn't know until we told him why the doctor wrote a prescription for 30 pills instead of 15, and yet refused to authorize more than half the prescription.
If they had any fears of side effects, they simply don't authorize anything at all.

It's amazing at which levels you try to reach to justify these guys. It's not really complicated. The insurance won't authorize more than half the prescription for this month and we have to deal with it.
And I don't give a what cost conscious reasons they have. If the Doc says I need X prescription, then I don't need to argue with anybody else.
The expert opinion is the one from the guy that went to Medical school and has a license to practice medicine. End of story.

A normal dosage is something like six days, 2 pills a day. It is normally not used for longer periods of time because of the side effects.

I didn't make those side effects up, and they are more serious than the flue you are afraid of. Granted, the chance is unlikely, but some of them can be fatal.

Rocheusa writeup on Tamiflu (23 page PDF)

[Wild Cobra]

Jeez... One more time. Let's see if it sinks in this time: I DON'T WRITE PRESCRIPTIONS. A DOCTOR DOES. WE WENT TO HIM FOR HIS OPINION AND HE WROTE THE PRESCRIPTION, BASED ON THE CIR STANCES OF OUR TRIP.

Can you get that into your head? If the doctor deemed that we didn't need anything, then we would be ok too.

I do understand. I think your doctor want you to remain his client, so he give you want you want instead of proper advice.

Please. Do some research on the side effects.

[ElNono]

A normal dosage is something like six days, 2 pills a day. It is normally not used for longer periods of time because of the side effects.

I didn't make those side effects up, and they are more serious than the flue you are afraid of. Granted, the chance is unlikely, but some of them can be fatal.

http:Rocheusa writeup on Tamiflu (23 page PDF)

We're going to be out for 35 days, and we're TWO persons. You do the math.
We have access to a doctor over there, but the doc here wanted to make sure we had access to the drug.

[Wild Cobra]

We're going to be out for 35 days, and we're TWO persons. You do the math.
We have access to a doctor over there, but the doc here wanted to make sure we had access to the drug.

OK, remain ignorant. I just hope your wife doesn't go into Anaphylactic Shock while you're there.

[ElNono]

I do understand. I think your doctor want you to remain his client, so he give you want you want instead of proper advice.

Please. Do some research on the side effects.

This doctor is a 10 year old friend and partner on a medical business. It's nothing but in his best interests that I stay alive and healthy.
And I know of the side effects, and they're no different than most flu prescription medicines out there.

[ElNono]

OK, remain ignorant. I just hope your wife doesn't go into Anaphylactic Shock while you're there.

Please dude. I write medical systems for a living. We work with doctors every ing day. One thing I know is that the doctor knows a lot better than either you or an insurance drone.

[chode_regulator]

I fail to see how your one instance of one doc in teh whole health care system of the entire united states cons utes a problem
Thats like saying because there is one bad judge in teh whole entire united states that the entire justice system if ed up
or because we had one bad president, pick one, the presidency is a dumb idea

and why do people always feel a need to put useless, senseless jabs at mass groups of people?

[baseline bum]

I love how you s always say Big Oil, Big Insurance, Big Tobacco, Big Pharmaceutical -- but I never hear anyone say Big Education, etc.

You must seriously be smoking rock cocaine if you think people here don't complain about the education industry, how college costs are through the roof due to things that have nothing to do with education, how textbook publishers rape the students, etc.

[ElNono]

I seem to recall boutons having a word or two about Ivy League schools...