Michael Moore's Latest Target: Your HMO

[Schneed10]

Originally Posted by Southpaw

For the record, the vast majority of drugs are insanely marked up. I understand that the research and development side is expensive, but look at cancer treatments, which have been basically the same for 20+ years. My father has been on aggressive chemo and radiation for several months now. He was getting one of each treatment almost weekly for a while, and racking up around $10,000 in bills per week. It's friggin ridiculous that people are being charged insane amounts of money for drugs that are easily mass produced and haven't changed dramatically for over two decades.

OK here's the lowdown on cancer drugs. Essentially, the federal government is retarded, and incapable of catching unscrupulous practices by the pharmaceutical industry.

You're right, there are cheap cancer drugs like Vincosar, Troposar, and Neosar. They're mass produced and aren't all that expensive. But pharmaceutical companies know that Medicare patients are the most frequent recipient of cancer treatments. And the pharmaceutical companies know that Medicare administrators aren't always on the ball. So, knowing that Medicare will reimburse the pharmaceutical companies at 80% of AWP (the average wholesale price), the pharmaceutical companies jacked up the AWP of cheaply manufactured generic cancer drugs. They'll charge $700 for a 2 mL dose of Vincosar, knowing that Medicare will reimburse them 80% of it ($540 per dose).

So Medicare pays this high price because they're not on the ball, and as Medicare continues to pay that price, it only lends validity to the high price in the marketplace. So... if you don't have Medicare? You better have solid insurance that has an agreement in place with the Pharmaceutical companies to pay a reasonable price for the drug (Aetna at 30% of AWP, etc.). If you don't have insurance? You're on the hook for all $700 per dose. Blame the pharmacuetical company for being unscrupulous with the pricing, blame the federal government and Medicare administration for being too inept to catch the problem, and blame yourself for not getting a job that has good insurance coverage. Plenty of blame to go around.

One of the true horrific examples of our bullshit system.

Does your father have insurance coverage? Is it commercial coverage or is he on Medicare?

[Schneed10]

Originally Posted by Mattyk72

Plenty, where should we start?

Let me answer with a question, what's good about our health care system?

The quality. Outcomes and survival rates are higher here than in any other developed nation. Infection rates in hospital facilities are the lowest here of anywhere in the world. While I'm deeply troubled by the cost physicians incur for malpractice coverage, at least there is a system in place to deter physicians from making mistakes. There are fewer physician errors here than in any other nation.

But from a cost standpoint, and a fairness standpoint as far as different people paying different prices for the same service? Yeah we got plenty of problems.

[MTK]

I'll give you quality... but I think most would agree that doesn't outweigh the negatives.

[Southpaw]

Originally Posted by Schneed10

Does your father have insurance coverage? Is it commercial coverage or is he on Medicare?

I believe he has commercial coverage through his employer, but I know he was basically fighting his insurance company to get them to cover some of the costs. And thanks for the info. I always assumed that federal government was involved, but your example makes them sound completely inept(shocker...) instead of being in on the scam.

[Schneed10]

Originally Posted by Mattyk72

I'll give you quality... but I think most would agree that doesn't outweigh the negatives.

It sounds like you're comparing our healthcare system to those of European nations where healthcare is nationalized.

I'd take the American system any day of the week. There are more positives than just quality...

- Choice. Overseas, you are often designated to a certain facility or healthcare provider. If you don't like them, tough, you're stuck. Here, even if you have a crappy HMO, you still get to choose from a network of providers. If you have a PPO, you can see anyone.

- Fire and rescue services (including the 911 system) here are 1000% better than in Europe.

- Wait times at hospital ERs are way shorter here.

- There is a much greater specialization of surgical services here. In Europe, if you need to have a tumor removed from your spine, you often end up having a general surgeon do it. In the US, you have a spine specialist do it. Explains why survival rates are so much higher here for like procedures.

All this is not to say that we don't have major problems because we do. No matter what, it's total bullshit that someone without insurance pays 10 times what someone with insurance is charged. But I'd take quality over cost any day of the week; especially if it's my wife, daughter, mother or other family member getting taken care of.

[MTK]

I'm really not comparing it to anything, the bottom line is it could and should be a lot better than it is. It's been broken for a long time with no viable solutions in sight.

[Schneed10]

Originally Posted by Mattyk72

I'm really not comparing it to anything, the bottom line is it could and should be a lot better than it is. It's been broken for a long time with no viable solutions in sight.

Yeah true that. Economic inertia is a factor. It would take so much time and money just to change the system to a more fair process regarding reimbursement. And there's no catalyst in place to make hospitals, insurance companies, and pharm companies to make the switch. They'll just keep on keepin on until the government forces the issue. Healthcare providers are too busy just trying to survive as it is; they don't have time to think about industry changes, they just need to think about how they're going to keep the lights on.

[dmek25]

Originally Posted by Schneed10

Ugh. I'd love to go toe to toe with this douchebag in a healthcare debate.

First I gotta say that the American healthcare system is pretty busted up. But you can't blame the HMOs or the drug companies for that as Moore does in his film. The HMOs don't pull mad profits from their business. It's a low-margin business.

I can see an argument against pharmaceutical companies to some extent, because they pull in massive profits. But you can't get all up in arms about one particular drug costing an insane amount of money. People like to say oh well that drug only costs $10 to make and they're charging $100 for it. Well that's because they spent $80 researching other possible drugs and vaccines that were deemed either ineffective or unsafe by the FDA. Pharmeceutical R&D is a huge expense and has to be factored into the equation for the drugs that do actually make it to the market.

ALL insurance companies have big time profit margins. should i start by posting links to the salaries of the ceos? insurance is almost bordering the pyramid schemes, where they want your money, but you play hell getting yours if something happens. if your looking for pity for the mega money insurance giants, your looking the wrong way. and this lies the problem. why should the same procedure have 3 different costs, for 3 different people/ its how they balloon their profits. no one in that business goes hungry. and the lobbyists in Washington are some of the richest, most powerful in the world.

[Sheriff Gonna Getcha]

I have no doubt that our healthcare system has serious problems, but I cannot stomach Michael Moore. Truth be told, I lean left on most issues, but I cannot stand people on either side of the fence that cherrypick evidence. Michael Moore is to the left what Bush is to the right. Moore takes data and facts and manipulates them in such a dishonest way.

Bowling for Columbine was entertaining, but it was incoherent and made no real point other than that America has a gun problem. Farenheit 9/11 was not only incoherent, but it was also filled with B.S. In sum, Michael Moore has as much credibility with me as Dick Cheney does when it comes to WMDs in Iraq (i.e., none). The sad thing is that people on the left idolize Michael Moore because of his "conclusions" despite the fact that his analysis sucks, he's dishonest, and he's a world-class a-hole.

[FRPLG]

Originally Posted by dmek25

ALL insurance companies have big time profit margins. should i start by posting links to the salaries of the ceos? insurance is almost bordering the pyramid schemes, where they want your money, but you play hell getting yours if something happens. if your looking for pity for the mega money insurance giants, your looking the wrong way. and this lies the problem. why should the same procedure have 3 different costs, for 3 different people/ its how they balloon their profits. no one in that business goes hungry. and the lobbyists in Washington are some of the richest, most powerful in the world.

Actually you are wrong. Insurance companies do not make what most people would consider "big time profits" relative to other comparable industries. Compare their profits to pharms and it isn't even close. And CEO salaries are not indicative of huge profits. They are more closely aligned with revenue than with net profits. The cost of doing business as an insurance company is astronomical. What do you think the "managed healthcare" concept was born out of? The need to increase profits to a viable point due to the skyrocketing cost of healthcare. Go ahead and posts the CEOs salaries, they mean nothing.

[MTK]

Originally Posted by Sheriff Gonna Getcha

The sad thing is that people on the left idolize Michael Moore because of his "conclusions" despite the fact that his analysis sucks, he's dishonest, and he's a world-class a-hole.

Funny that the same thing could be said of the right and GW. Only difference is Moore isn't running the country.

[FRPLG]

Originally Posted by Sheriff Gonna Getcha

I have no doubt that our healthcare system has serious problems, but I cannot stomach Michael Moore. Truth be told, I lean left on most issues, but I cannot stand people on either side of the fence that cherrypick evidence. Michael Moore is to the left what Bush is to the right. Moore takes data and facts and manipulates them in such a dishonest way.

Bowling for Columbine was entertaining, but it was incoherent and made no real point other than that America has a gun problem. Farenheit 9/11 was not only incoherent, but it was also filled with B.S. In sum, Michael Moore has as much credibility with me as Dick Cheney does when it comes to WMDs in Iraq (i.e., none). The sad thing is that people on the left idolize Michael Moore because of his "conclusions" despite the fact that his analysis sucks, he's dishonest, and he's a world-class a-hole.

Bingo. I lean right on issues but I try to be reasonable and see all sides to an issue. Moore is what is wrong with the liberal side in America. He is not only ultra-liberal beyond what what regular liberal Aemericans are he also one-tracked. He cannot even fathom agreeing with a conservative view and seeks out ways, both honest and dishonest, to advance his ultra-liberal views. He lies consistently and CREATES discontent where there need not be any. The problem is that for some reason the money in the Democratic party goes more towards this type of idiot rather than towards a reasonable liberal who will to do what really is best for America. The right has increasingly the same problem. Both parties have been or are very close to being totally taken over by the extreme sides and they are the ones who take no prisoners and cause serious problems. This is not a right/left/middle situation. This is a very right/very left/everyone else situation.

[FRPLG]

Originally Posted by Mattyk72

Funny that the same thing could be said of the right and GW. Only difference is Moore isn't running the country.

I think it is funny when leftists think GW is very conservative. GW is inarguably middle of the road for republicans. He has espoused very little in terms of true conservative values. This is the reaason he is so unpopular. Even righties don't much like him.

[MTK]

Originally Posted by FRPLG

I think it is funny when leftists think GW is very conservative. GW is inarguably middle of the road for republicans. He has espoused very little in terms of true conservative values. This is the reaason he is so unpopular. Even righties don't much like him.

'W' is no Reagan that's for sure when it comes to how far to the right he leans.

I think what really rubs people the wrong way with him is that "You're either with me or against me" attitude he has. There's no middle ground with him.

Most of all the guy is just an idiot, but that's a debate for another day.

[dmek25]

Originally Posted by FRPLG

Actually you are wrong. Insurance companies do not make what most people would consider "big time profits" relative to other comparable industries. Compare their profits to pharms and it isn't even close. And CEO salaries are not indicative of huge profits. They are more closely aligned with revenue than with net profits. The cost of doing business as an insurance company is astronomical. What do you think the "managed healthcare" concept was born out of? The need to increase profits to a viable point due to the skyrocketing cost of healthcare. Go ahead and posts the CEOs salaries, they mean nothing.

first off, what exactly is the cost of running an insurance company? it only takes a handful of non trained professionals to deny a claim. managed health care was thought up by a group of insurance companies to control costs, and make sure the profit margin is at its greatest. there should be no way an insurance company can deny someone coverage on a claim that is needed. but it happens all the time. when these companies start dictating to the medical profession what they can do, and what they can charge, thats the problem. i am for national healthcare. it cant possibly be any worse then it is now, and it will be cheaper