For those in the U.S. how do you think this administrations proposed health care reform would effect us?

Will it be free Imitrex and O2 for everyone for the asking or do you think our choices and our doctors choices become more limited?

I'm on Triwest which is the government's healthcare provider which I earned through serving a career in the military. They basically ration my Imitrex already, although to be fair I don't think its because of the cost (yet) I think its just that its considered dangerous - so unless I pull strings and jump through hoops, I can only get what works out to be about one dose per three days. Not fun when I'm getting three attacks a day.

I used to be able to see a Neurologist at the Army Medical Facility where most of the specialists are. No more. Too many patients, not enough neurologists. Back when I could, the wait time was a few weeks or more. The point is, access to this care is not determined by demand, it is determined by budget.

There are some medications and treatments others have available to them that are not available to me because they have simply made the decision that "we don't do that."

BTW, don't get me wrong, while my health care that I earned through my service may not be perfect, its darned good and I appreciate those who provide it. The problems are mostly due to fixed budgets rather than supply/demand, this would be compounded on a larger scale.

What I'm getting at is, for us, with the nature of CH being a rare and somewhat lightly researched disease already, where most docs the average CH sufferer runs into are well behind the curve - I'm deeply concerned about the eventuality where a lot of the decision making moves from the doctor's office to some windowless room in D.C. where a bureaucrat decides how CH is going to be treated based on cost effectiveness. And I know how the government thinks - I wouldn't be surprised if they refused to give us O2 out of some kind of safety concern or something.

Anyway, I want to see what you all think. The whole deal sounds good on the face of it - "free" health "insurance" for the everyone. But for people who actually have something like we do.... would it be such a good thing?

I seem to remeber posting something similar some months back. If the drug companies launch a cure for CH they would do a lot of business in a short period of time and then it would slow down to a trickle as only newly diagnosed sufferers would be potential customers. How much more profitable for them to sell something that offers only temporary relieve  -  as a consequence they will have an ever growing population of customers. I'm not being cynical, honest  -  if I wanted to be cynical I would suggest that they deliberately market something that perpetuates the problem by irritating the basic causes or causes rebounds, but nobody would do that, would they?  -  I wonder  -  no surely not  -  capitalism puts profit above all else except human suffering surely?  -  we all know and believe that don't we?
And CH is not the only illness that this might apply to  -  think about it, I don't want to !! 

I guess my biggest concern is the fact it will be a huge government program. There is not a single huge government program I have seen that works. (And I work for the government!) Whether you're talking social security, medicare, the IRS, the horror stories abound.

For CH'ers, my fear is the government will decide the "best and most effective" treatment for us, and that's what we'll get. If we don't like it, we'll have to do what our Canadian neighbors have been doing for years when their socialist medical system fails them, travel to a country that still provides normal medical care.

Hoping I'm wrong, maybe someone can show me a huge government program that has worked, and I'll feel a little better about them taking care of me!

Joe

I think cluster suffers will be studied and treated better as decades press on regardless of the reform~ simply out of efforts I see suffers make. Talking, suggesting, even laying our selves out as test rats for possible cures and safer abortives. I see it picking up in manuals and diagnosis charts more now than I did just ten  years ago. That gives me hope it will be treatable like high blood pressure at the free clinic. Thats being optimistic I know.
I worry more that we have two big issues and the reform is trying to address one. Example~ red tape for me was convincing my doctors I would follow through with treatment. They didn't want to waste their time, meds or investigation if I wasn't going to take self responsibility. We have a health issue with our people, and a health bill issue on top. Thats a big problem.

Its a needed outlook to have, but this also a huge country. I can see it more in mico elements, small sectors working together for a whole. We have so many abusers of systems, at the moment I fear a really good idea will be dissolved before it has a chance to prove itself.

Monty,

Compare apples with apples.  I'm not talking about prescriptions, but about the health care itself.  6 months wait for breast cancer treatment is not unusual in Canada as opposed to days here in the States.  (Just one example)

Jerry

1968eric wrote on Jul 27^th, 2009 at 11:24am:


No, Canada has never threatened to ignore patents, as far as I know. What they do is negotiate for price - if there are 15 different medicines that can be used to treat blood pressure, they may decline to carry one of those if the manufacturer won't offer a bulk discount.  At the end of the day, Canada has plenty of medicines for controlling blood pressure, and it costs less.

Prices for drugs in the US are not much affected by what Canadians pay -  the fact that one person at a market haggles for a good price does nothing to harm or protect the next guy who comes along (especially when the second guy is obviously willing to pay whatever the vendor asks).


1968eric wrote on Jul 27^th, 2009 at 11:24am:


What?  A 3 year difference in lifespan is SIGNIFICANT.

Multiply that times 300 million people, and it is VERY SIGNIFICANT. Would you rather be born as an average person in a country where the lifespan was 65 years, or in one where the average lifespan was 70 years??  

How much of that 3 years is related to the healthcare systems?  That is difficult to say ....  But what is evident is that Canadian society has managed to achieve a very long lifespan, they spend less, and people do not lose their coverage due to pre-existing conditions or unemployment.


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And what do you assume that means?  Kentucky and Louisiana have a cancer mortality rate that is 65% higher than Utah and Hawaii. Even though Blue-Cross Blue Shield offers similar policies in all four states. What you are missing is the fact that the death rate from cancer is primarily driven by how many people get cancer in the first place - some types are treatable, but many types are not.  More people getting cancer = more people dying of it.

What happens when we take cancer data and pool the Canadian provinces with the US states?  The 60 states/provinces blend together with no national differences to comment on.  Ontario and Saskatchewan are right at the average for the large group, British Columbia and Alberta have rather low rates, and the Maritimes are on the high end with Tennessee and Alabama.  Only Nunavut (with a few thousand Innuits) has a remarkably high cancer mortality rate.  

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Looking at that data gives a very different picture from the cherry-picked statistics you presented.

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No - that is a misleading statistic and a dubious conclusion. That '25%' difference cannot be used for comparison ... 12% of Canadian cancer deaths are from colon cancer, while 10% are from colon cancer in the US, which can be rendered as '25% more.'  But those are RELATIVE percents ... if less people die from lung cancer, the percent of deaths from colon cancer would increase, even if the number of people dying from colon cancer remained the same. Comparing across groups in that way is an apples/oranges comparison ... the 10% makes sense only when discussing US numbers, the 12% makes sense only when discussing Canadian numbers ...

Are some doctors in Canada pushing for more colonoscopies? Yes. Do they currently have the infrastructure? No, it would have to be added. Is early screening and treatment a good thing? Only sometimes. Colonoscopies are far more invasive than other cancer screening tests, and have a complication rate that is 10x higher than other routine tests (a friend's father died of a torn membrane from a colonoscopy).  Doubling the rate of colonoscopies will not cut the death rate in half, but it will double the number of serious complications.  We don't have people jump up on the x-ray machine for every cough and cold ... the risks are higher than the benefits.  

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Average wait for radiation therapy in breast cancer is 40 days in the US, 73 days in Canada ... sounds bad, yet Canadian women have a lower death rate from that disease.  I know if it were my wife or daughter, I would want to maximize chances of survival, not minimize wait (even though not doing something can be emotionally excruciating).

Likewise, with prostate cancer (#2 cancer killer of men), 'watchful waiting' often makes more sense than rushing to surgery or radiation. The cancer may be very slow growing, and a long wait (which adds to the average) doesn't change the risk of dying or surviving. In an older person, surgery may pose a greater danger to life than doing nothing.

People that have advanced cancer are probably already gone. People that have early, treatable cancer need prompt treatment, but not immediate treatment.  Is the one month average wait in the US too long?  Is one week too long?  Two weeks too long?  What about 3 or 4 weeks?  Emotionally, yes, that seems like a long time. Medically, it may not be.


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What is health care itself if not Diagnosis and Treatment? Prescription medicine is a big component of Treatment, and it is one that sends many thousands of people over the border into Canada, where that component of treatment is better in several ways.  When millions of US Americans have to choose between food and medicine, that DOES impact health care itself. When hundreds of people post to this board that they can't afford medicine, that is an indication that the health care system has some real shortcomings.