Socialist Commie Health Care Thread

[LFC]

Eli Lilly cut the price of insulin from soulless murder to just price gouging. Whoop-dee-f***in'-doo.

Eli Lilly & Co. played the altruism card like a champ on March 1, when it announced steep price cuts on its insulin products of as much as 70%.

The big drug company said its action was all about helping diabetes patients, its goal being to “help Americans who may have difficulty navigating a complex healthcare system that may keep them from getting affordable insulin.”

According to Lilly Chairman and Chief Executive David Ricks, America’s healthcare system “still does not provide affordable insulin for everyone, and that needs to change.”

Lilly basked in public praise after the announcement. President Biden observed that Lilly’s cuts would force its two principal competitors, Novo Nordisk and Sanofi, to follow suit.

If you’re inclined to think better of Lilly for taking this dramatic step, here’s our advice: Hold your applause.

The truth is that Lilly’s price cuts won’t cost it a thin dime in profits; it may even collect higher profits. Wall Street recognized that instantaneously: The price of Lilly shares rose on the day of the announcement and has continued to move higher ever since, gaining nearly 6% through Thursday’s trading.

Moreover, the price rollback still doesn’t bring Lilly insulin back to where it should be on an inflation-adjusted basis compared with the price of its key product, Humalog, upon its launch in 1996.

Back then, Humalog cost $21 per vial, which would be about $40 in today’s money; the rollback will reduce the price of a vial from $274.70 to $66.40, according to calculations by the Washington consulting firm Veda Partners. So it’s still higher by two-thirds than it should be, accounting for inflation.

“Lilly is going to bank a lot of goodwill for this, without taking necessarily a big hit to their bottom line,” says Andrew Mulcahy, senior researcher at Rand Corp. and lead author of a 2020 Rand comparison of insulin prices in the U.S. and other countries.

That analysis showed that U.S. insulin prices were way out of line with the rest of the world: For example, a benchmark unit cost (in U.S. dollars) $6.94 in Australia, $12 in Canada and $7.52 in Britain — but nearly $100 in the U.S. Even if Lilly’s price cuts are followed by its competitors, “U.S. prices are still higher than prices in the other countries,” Mulcahy told me, though by two to three times rather than by 10 times.

Insulin’s high list price has fueled efforts to create alternative sources. California Gov. Gavin Newsom last year announced a $100-million program to manufacture a state-branded low-cost insulin, possibly by contracting with a generics firm; an announcement of details could come within days. A similar effort is underway in Michigan.

[LFC]

I wonder how many people were hurt by North Carolina Republicans who decided they needed to throw a political hissy fit rather than actually help out their residents. Finally they're doing the right thing.

The North Carolina state House of Representatives on Thursday morning overwhelmingly approved an expansion of the state’s Medicaid program that would make health insurance available to roughly 600,000 additional low-income residents.

The 87-to-24 vote by the Republican-majority chamber comes a week after the state Senate, also under GOP control, voted for the bill by an even wider margin. Now it heads to Gov. Roy Cooper, a Democrat who has championed Medicaid expansion since first running for office in 2016.

North Carolina would be the 40th state, in addition to the District of Columbia, to expand Medicaid using authority and financing available through the Affordable Care Act.

That law’s architects had once hoped all states would take that step, pushing income eligibility limits to above the poverty line so that millions more nationally would qualify for the program. But a 2012 Supreme Court decision made it easier for states to refuse, and most states where Republican officials had sway over state government did just that, citing their opposition to so-called Obamacare.

In the years since, Medicaid expansion has come to more of those states, either through ballot initiatives or a change of heart by some of those Republican officials. That’s what happened in North Carolina, where key GOP leaders eventually endorsed the idea as good for the state economy and struggling rural hospitals, as well as helpful to working people without access to affordable coverage.

[LFC]

AI can be used for good or it can be used for evil. I suspect in the area of health insurance it will be used for evil more and more. Health insurance companies are already well versed in gatekeeping operations that put their profits before care. Now they're using unregulated and unpublished algorithms to deny coverage. Original link and paywall bypass link.

An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home.

On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help.

It would take more than a year for a federal judge to conclude the insurer’s decision was “at best, speculative” and that Walter was owed thousands of dollars for more than three weeks of treatment. While she fought the denial, she had to spend down her life savings and enroll in Medicaid just to progress to the point of putting on her shoes, her arm still in a sling.

Health insurance companies have rejected medical claims for as long as they’ve been around. But a STAT investigation found artificial intelligence is now driving their denials to new heights in Medicare Advantage, the taxpayer-funded alternative to traditional Medicare that covers more than 31 million people.

Behind the scenes, insurers are using unregulated predictive algorithms, under the guise of scientific rigor, to pinpoint the precise moment when they can plausibly cut off payment for an older patient’s treatment. The denials that follow are setting off heated disputes between doctors and insurers, often delaying treatment of seriously ill patients who are neither aware of the algorithms, nor able to question their calculations.

Older people who spent their lives paying into Medicare, and are now facing amputation, fast-spreading cancers, and other devastating diagnoses, are left to either pay for their care themselves or get by without it. If they disagree, they can file an appeal, and spend months trying to recover their costs, even if they don’t recover from their illnesses.
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“We take patients who are going to die of their diseases within a three-month period of time, and we force them into a denial and appeals process that lasts up to 2.5 years,” Chris Comfort, chief operating officer of Calvary Hospital, a palliative and hospice facility in the Bronx, N.Y., said of Medicare Advantage. “So what happens is the appeal outlasts the beneficiary.”

The algorithms sit at the beginning of the process, promising to deliver personalized care and better outcomes. But patient advocates said in many cases they do the exact opposite — spitting out recommendations that fail to adjust for a patient’s individual circumstances and conflict with basic rules on what Medicare plans must cover.

[LFC]

Cigna is another health insurer that simply denies, denies, and denies. This saves them millions of dollars. The doctors who are complicit in this should be opened up to malpractice suits since they are clearly practicing medicine ... very badly.

When a stubborn pain in Nick van Terheyden’s bones would not subside, his doctor had a hunch what was wrong.

Without enough vitamin D in the blood, the body will pull that vital nutrient from the bones. Left untreated, a vitamin D deficiency can lead to osteoporosis.

A blood test in the fall of 2021 confirmed the doctor’s diagnosis, and van Terheyden expected his company’s insurance plan, managed by Cigna, to cover the cost of the bloodwork. Instead, Cigna sent van Terheyden a letter explaining that it would not pay for the $350 test because it was not “medically necessary.”

The letter was signed by one of Cigna’s medical directors, a doctor employed by the company to review insurance claims.

Something about the denial letter did not sit well with van Terheyden, a 58-year-old Maryland resident. “This was a clinical decision being second-guessed by someone with no knowledge of me,” said van Terheyden, a physician himself and a specialist who had worked in emergency care in the United Kingdom.

The vague wording made van Terheyden suspect that Dr. Cheryl Dopke, the medical director who signed it, had not taken much care with his case.

Van Terheyden was right to be suspicious. His claim was just one of roughly 60,000 that Dopke denied in a single month last year, according to internal Cigna records reviewed by ProPublica and The Capitol Forum.

The rejection of van Terheyden’s claim was typical for Cigna, one of the country’s largest insurers. The company has built a system that allows its doctors to instantly reject a claim on medical grounds without opening the patient file, leaving people with unexpected bills, according to corporate documents and interviews with former Cigna officials. Over a period of two months last year, Cigna doctors denied over 300,000 requests for payments using this method, spending an average of 1.2 seconds on each case, the documents show. The company has reported it covers or administers health care plans for 18 million people.

[andydp]

This is too good not to pass on.

They didn't see that coming.

In a stunning turn of events, a judge has temporarily blocked a new Wyoming law that would have classified almost all abortions in the state as felonies. But what makes this decision particularly noteworthy is that the judge used a rule established by Republicans themselves to do it.

This rule, which was added to the state's constitution in 2012 as a reaction to then-President Barack Obama, was intended to prevent the government from meddling in healthcare matters - an effort primarily aimed at blocking the Affordable Care Act.

So, in a strange twist of fate, the rule meant to thwart Obama's healthcare agenda has now been used to stop an abortion law in its tracks.

[LFC]

They really are out to destroy the federal government and weaken our nation into a pile of little nation-states. Putin and Xi must be laughing their asses off at how cheaply they were able to buy one of the major U.S. political parties. Religious rights being supreme over anything and everything else is their new judicial tool.

🚨Judge Reed O'Connor STRIKES DOWN a major provision of the Affordable Care Act requiring insurers to cover a vast amount of preventive care cost-free (contraception, cancer screening, PrEP, a ton of pregnancy-related care). The ruling applies nationwide. storage.courtlistener.com/recap/gov.usco…

Here is a list of the many, many preventive care treatments that insurers must cover cost-free under the ACA. Reed O'Connor just struck down the entire section of the law mandating this coverage. This is a gigantic blow to the ACA and U.S. health care.

www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

O'Connor rules that the U.S. Preventive Services Task Force—the federal agency that decides which medical care all insurers must cover—is unconstitutional because it violates the Appointments Clause, and invalidates its power to enforce anything against anyone nationwide.

I anticipated this decision in September when O'Connor first telegraphed it. It is nothing short of catastrophic to the U.S. health care system. Millions of Americans, including many pregnant women, will have to forgo basic care if it is upheld.

slate.com/news-and-politics/2022/09/prep-hiv-religious-employer-preventive-care.html

[goldenvalley]

Mar 30, 2023 18:14:40 GMT LFC said:

They really are out to destroy the federal government and weaken our nation into a pile of little nation-states. Putin and Xi must be laughing their asses off at how cheaply they were able to buy one of the major U.S. political parties. Religious rights being supreme over anything and everything else is their new judicial tool.

🚨Judge Reed O'Connor STRIKES DOWN a major provision of the Affordable Care Act requiring insurers to cover a vast amount of preventive care cost-free (contraception, cancer screening, PrEP, a ton of pregnancy-related care). The ruling applies nationwide. storage.courtlistener.com/recap/gov.usco…

Here is a list of the many, many preventive care treatments that insurers must cover cost-free under the ACA. Reed O'Connor just struck down the entire section of the law mandating this coverage. This is a gigantic blow to the ACA and U.S. health care.

www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

O'Connor rules that the U.S. Preventive Services Task Force—the federal agency that decides which medical care all insurers must cover—is unconstitutional because it violates the Appointments Clause, and invalidates its power to enforce anything against anyone nationwide.

I anticipated this decision in September when O'Connor first telegraphed it. It is nothing short of catastrophic to the U.S. health care system. Millions of Americans, including many pregnant women, will have to forgo basic care if it is upheld.

slate.com/news-and-politics/2022/09/prep-hiv-religious-employer-preventive-care.html

I saw this mentioned in other places and wrote it off as a typical sex obsessed dislike of care for female reproduction parts.  But this list is far broader...heart disease, colon cancer...men have those diseases.  This is far broader and is part of the dismantle the regulatory system ethos of uber libertarian right wing nuts.

[LFC]

Mar 30, 2023 19:03:41 GMT goldenvalley said:

I saw this mentioned in other places and wrote it off as a typical sex obsessed dislike of care for female reproduction parts.  But this list is far broader...heart disease, colon cancer...men have those diseases.  This is far broader and is part of the dismantle the regulatory system ethos of uber libertarian right wing nuts.

I really do wonder if this is going to lead to some kind of soft civil schism in America. I could easily picture a Northeast consortium and a West Coast consortium that had representation, collected tax money from states, and ran certain regionally based program for the benefit of those states. Think two mini-EUs made out of blue states. There's nothing illegal about it if the states enter into it willingly and by the normal legislative process.

The result could be wealthy states with their own regional healthcare policies, emergency management, employment regulation, etc. The gulf between the haves and the have nots would widen and states like Alabama, Mississippi, Kansas, Iowa, etc. would continue sinking into the ooze of their own choosing.

[LFC]

Red states are strangling their own rural hospitals. Buy hey, it's what the residents have overwhelmingly voted for decades. I feel sorry for those who didn't vote for it but anybody backing Republicans, only to find themselves bent over and taking it good and hard? Tough shit.

Since its opening in a converted wood-frame mansion 117 years ago, Greenwood Leflore Hospital had become a medical hub for this part of Mississippi’s fertile but impoverished Delta, with 208 beds, an intensive-care unit, a string of walk-in clinics and a modern brick-and-glass building.

But on a recent weekday, it counted just 13 inpatients clustered in a single ward. The I.C.U. and maternity ward were closed for lack of staffing and the rest of the building was eerily silent, all signs of a hospital savaged by too many poor patients.

Greenwood Leflore lost $17 million last year alone and is down to a few million in cash reserves, said Gary Marchand, the hospital’s interim chief executive. “We’re going away,” he said. “It’s happening.”

Rural hospitals are struggling all over the nation because of population declines, soaring labor costs and a long-term shift toward outpatient care. But those problems have been magnified by a political choice in Mississippi and nine other states, all with Republican-controlled legislatures.

They have spurned the federal government’s offer to shoulder almost all the cost of expanding Medicaid coverage for the poor. And that has heaped added costs on hospitals because they cannot legally turn away patients, insured or not.

States that opted against Medicaid expansion, or had just recently adopted it, accounted for nearly three-fourths of rural hospital closures between 2010 and 2021, according to the American Hospital Association.

Opponents of expansion, who have prevailed in Texas, Florida and much of the Southeast, typically say they want to keep government spending in check. States are required to put up 10 percent of the cost in order for the federal government to release the other 90 percent.

America, the richest nation in the land where many people can't get basic preventative healthcare. Welcome to Mississippi.

“I can tell you I have a number of patients who are on dialysis with renal failure for the rest of their life because they couldn’t afford the medication for their blood pressure, and that caused their kidneys to go bad,” said Dr. John Lucas, a Greenwood Leflore surgeon.

Yes, this is Republican healthcare. It's what they want. It's what Paul Ryan fought to preserve, with an intentionally disappearing fig leaf of catastrophic coverage. Alan Grayson's words were true when he spoke them and they're true now.

"If you get sick in America, this is what the Republicans want you to do. If you get sick America, the Republican health care plan is this: Die quickly. That's right, the Republicans want you to die quickly if you get sick."

[goldenvalley]

Apr 5, 2023 19:57:27 GMT LFC said:

Red states are strangling their own rural hospitals. Buy hey, it's what the residents have overwhelmingly voted for decades. I feel sorry for those who didn't vote for it but anybody backing Republicans, only to find themselves bent over and taking it good and hard? Tough shit.

There's a lot at work here in the closing of rural hospitals.  Medicaid is a huge part of the problem.  But so is depopulation in rural areas.  The hospitals don't see a lot of patients that they are actually staffed and equipped to serve so the hospitals lose money.  It's a downward spiral.  

As I age I will never move to somewhere rural in pursuit of a cheaper cost of living.  I'd rather not spend the rest of my life driving to distant doctors offices and hospitals for adequate care.

[LFC]

I decided that a couple of posts on life expectancy in the U.S. fit here reasonably well. First off, we have how the U.S. has rebounded (not) compared to other countries after COVID.

Just before Christmas, federal health officials confirmed life expectancy in America had dropped for a nearly unprecedented second year in a row – down to 76 years. While countries all over the world saw life expectancy rebound during the second year of the pandemic after the arrival of vaccines, the U.S. did not.

Then, last week, more bad news: Maternal mortality in the U.S. reached a high in 2021. Also, a paper in the Journal of the American Medical Association found rising mortality rates among U.S. children and adolescents.

"This is the first time in my career that I've ever seen [an increase in pediatric mortality] – it's always been declining in the United States for as long as I can remember," says the JAMA paper's lead author Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University. "Now, it's increasing at a magnitude that has not occurred at least for half a century."

Across the lifespan, and across every demographic group, Americans die at younger ages than their counterparts in other wealthy nations.

Distribution of life expectancy, as expected, is hardly uniform. In fact, it's enormous.

America is seeing the greatest gap in life expectancy across regions in the last 40 years. While most people will live to 78, some Americans are likely to die a decade earlier if they happen to be born in a handful of other counties in the US. Average lifespan has generally been increasing over this period as advances in medicine, social factors, and quality of life have helped people live longer, however, many Americans have not seen this benefit. As a result some Americans are actually dying far younger than they used to. While life may be unequal, death should not be.

[LFC]

Wow.

Black people in counties with more Black primary care physicians live longer, according to a new national analysis that provides the strongest evidence yet that increasing the diversity of the medical workforce may be key to ending deeply entrenched racial health disparities.

The study, published Friday in JAMA Network Open, is the first to link a higher prevalence of Black doctors to longer life expectancy and lower mortality in Black populations. Other studies have shown that when Black patients are treated by Black doctors, they are more satisfied with their health care, more likely to have received the preventive care they needed in the past year, and are more likely to agree to recommended preventive care such as blood tests and flu shots. But none of that research has shown an impact on Black life expectancy.

The new study found that Black residents in counties with more Black physicians — whether or not they actually see those doctors — had lower mortality from all causes, and showed that these counties had lower disparities in mortality rates between Black and white residents. The finding of longer life expectancy persisted even in counties with a single Black physician.

“That a single Black physician in a county can have an impact on an entire population’s mortality, it’s stunningly overwhelming,” said Monica Peek, a primary care physician and health equity researcher at UChicago Medicine who wrote an editorial accompanying the new study. “It validates what people in health equity have been saying about all the ways Black physicians are important, but to see the impact at the population level is astonishing.”

[LFC]

[LFC]

This is from two years ago but still, it's a great illustration of what our healthcare system has devolved into and how conditions are even worse in a red state.

Hookworm disease flourishes in hot, moist climates where people have limited access to water or have inadequate sewage systems or poor hygiene.

There are ongoing efforts to wipe it out in Africa. Latin America. Asia.

And now, in Alabama.

Dr. Rojelio Mejia, infectious disease specialist at Baylor College of Medicine, says the parasites are no strangers to U.S. soil. In a paper published in 2017, Mejia and his team reported finding more than a third of the people in one Alabama county were infected with hookworm disease.

Mejia has worked to quell hookworm disease in Ecuador, Mozambique, the grassy plains of northern Argentina. Now, he and partners are leading efforts to control the outbreak in rural Alabama. We talked with him by telephone about the disease and the various struggles the U.S. has keeping it under control compared with resource-poor countries. His answers have been lightly edited for space.

[snip]

Are there disadvantages to being diagnosed with hookworm in the U.S. compared to poorer countries?

One disadvantage in the U.S. is the cost of treatment. In Colombia, we treated 400 patients with albendazole for pennies per patient, thanks to a donation from Mark Cuban, owner of the Dallas Mavericks. But in [most places in] the U.S., the cost is astronomically higher — up to $500 a pill. If you don't have insurance, the cost is prohibitive. [In rural Alabama, thanks to a new collaboration between researchers at the National School of Tropical Medicine at Baylor College of Medicine and the Mark Cuban Cost Plus Drug Co., children with hookworm infection will receive the drugs at greatly reduced cost.]

Note that the solution didn't come from the state government which should be first in line in solving a major health issue for its residents.

[LFC]

I only watched the first 4 minutes and wanted to hurl. The vulture capitalists doing this are psychopaths, without a shred of human decency or compassion in their bodies. This hospital is only about an hour from where I live.

[goldenvalley]

May 1, 2023 20:38:42 GMT LFC said:

I only watched the first 4 minutes and wanted to hurl. The vulture capitalists doing this are psychopaths, without a shred of human decency or compassion in their bodies. This hospital is only about an hour from where I live.

I join you in hurling.   The hospital industry is being taken over by people who are inhumane and dollar driven.  I almost wish for the olden days when religious institution created some of the original hospitals in our country but I know that, for example, hospitals established by Catholic institutions will not do abortions, nor probably would right winger Protestant groups.  We are screwed...unless we are pretty well off life will go back to being short, nasty, and brutish.

[andydp]

As you know, I had a fall in Colorado, spent two days in an excellent hospital and came out with a $50K bill +/-. The MRI was billed at over $25K

MEDICARE and TRICARE paid everything except about $54.  One goal during my working life was to make sure I would have health coverage in retirement.  I guess it was worth it.  According to "Rush L", the health care our military gets is Socialism.  To Rush wherever you are:  bite me.

We have incessantly hammered that thought to our kids to make sure they have health coverage.  They have followed our advice.

[pnwguy]

May 3, 2023 12:10:53 GMT andydp said:

  According to "Rush L", the health care our military gets is Socialism.  To Rush wherever you are:  bite me.

Wherever Rush "is", I hope he doesn't have any teeth, because someone kicked them in.  He can endlessly fellate Dumpster when he (hurry karma, hurry) arrives soon.

Two weeks ago I ended up in the ER twice, cardiac ICU, and then pacemaker surgery.  My employer's policy is a BCBS one but I'm expecting to have numerous fights on coverage, especially the infamous "out of network" doctors in ER that private equity firms have been raping the public with.

[goldenvalley]

May 4, 2023 3:15:07 GMT pnwguy said:

May 3, 2023 12:10:53 GMT andydp said:

  According to "Rush L", the health care our military gets is Socialism.  To Rush wherever you are:  bite me.

Wherever Rush "is", I hope he doesn't have any teeth, because someone kicked them in.  He can endlessly fellate Dumpster when he (hurry karma, hurry) arrives soon.

Two weeks ago I ended up in the ER twice, cardiac ICU, and then pacemaker surgery.  My employer's policy is a BCBS one but I'm expecting to have numerous fights on coverage, especially the infamous "out of network" doctors in ER that private equity firms have been raping the public with.

I hope you are doing well.  

Didn't you negotiate your medical costs while in the ER?  Hey doc are you in my network? No? Do you have an ED or cardiac doctor friend who is?  What's the per day cost of cardiac ICU? Let me call around to find out if there is a cheaper version in some other hospital. etc.  That pacemaker, is there a store brand we can use that is cheaper? This is what the anti-socialist medicine supporters seem to expect us to do whilst sitting in the ED waiting to be seen.