I feel like we are rapidly reaching jump ship level. My own sister (in her 40s with 4 kids and natural born Texas/US citizen) is actively migrating her family to Canada next year. Her daughter with a clef pallet cost her family 90K last year WITH insurance. Her husband makes $150K a year, so they managed...but Christ! My sister is so serious that she already submitted all her immigration papers and is waiting to hear back.
I work in a clinic. The ER at the hospital I work for has sent critical patients to our clinic because they 1) apparently have no staff that know how to evaluate for a emergency (I say this having 8 years ER experience under my belt). I had a patient go to the ER twice in 24 hours for urinary pain, bleeding 1 week post op. They sent him to the clinic pale AF, orthostatic blood pressure 80/40, bladder scan showed 330 after voiding (ended up being a giant number of clots that I got to try to hand irrigate in the OFFICE!). The ER did a UA at both visits and NOTHING ELSE.
You might want to say this is my institution in particular...however I haven't held a job at 1 institution for more than 3 years. I've traveled. So, yes, there are better and worse.....but they are ALL getting worse. Process improvement usually involve trying to make up care gaps with unlicensed, under educated, unqualified people OR have one qualified person do the work of 3-4 people (both of which create gross care gaps).
I wish I could go with my sister. This has only gotten worse in the 15 years I've been a nurse. I'm not proud of my field.
I never mentioned 30 year old equipment, but the very newest advertised in the US aren't used. If a wheelchair is needed, a basic wheelchair is given. I have multiple patients who think that they're going to get a motorized scooter with the horsepower of a racecar
I agree. I am a little torn on what the best policy is to control drug prices in the United States. In the UK the government regulates profits to be a max of just under 30% for a drug. This is problematic in controlling since most of the drug companies are multinationals, making auditing challenging. Like Australia, they also mandate prices be decreased over a period of time so that the older the drug the cheaper it becomes. The thing I think I like the best is that there is an assessment and negotiation regarding the clinical benefit of a medication. The more clinically beneficial the higher the price can be.
Currently in the U.S. there is no federal regulation on the price of medications. The primary pushback to regulating prices is that the less profitable a drug becomes, the less incentive there is to develop something new. Personally I think there should be a balance between incentivizing drug development and regulating prices.
Specializes in NICU, PICU, Transport, L&D, Hospice.
subee said:
How many psoriasis drugs do we need?:)
That depends upon your pov. If you are a pharmaceutical executive there's always room for another new and expensive maintenance drug for a chronic disease. There's always a desire to increase the profit of ongoing treatment in a capitalist health business.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
subee said:
How many psoriasis drugs do we need?:)
Necessity is the mother of invention. So the answer is as many as it takes for everyone to be happy taking the medication to correct their problem?
I guess I just don't get why 'old drugs' are being revalued at exorbitant prices. Like once the research is paid off and infrastructure to make the drug is established, it shouldn't cost so much, therefore more people should be able to buy it and increase the profit for the drug companies once again?
Specializes in NICU, PICU, Transport, L&D, Hospice.
KalipsoRed21 said:
Necessity is the mother of invention. So the answer is as many as it takes for everyone to be happy taking the medication to correct their problem?
I guess I just don't get why 'old drugs' are being revalued at exorbitant prices. Like once the research is paid off and infrastructure to make the drug is established, it shouldn't cost so much, therefore more people should be able to buy it and increase the profit for the drug companies once again?
No. They want to transition you to the new drug. If they could get away with it they would stop producing the old cheap drugs and force people to the new expensive drugs.
A chemotherapy manufacturer turned a standard effective IV treatment into a novel oral med that had more side effects but didn't require a clinic visit. They let their warehouse stock of the cheaper IV med drop and it reached a point where some oncologists couldn't access drugs that patients were already receiving. Lots of people had their chemo courses interrupted. Some insurers would not pay for the new drugs taken in the home setting.
This was in the NY Times this morning. I agree with a lot of his takes, while recognizing there is no perfect system anywhere and overhauling the U.S. system in particular would be monumental, if not impossible:
Indeed, around 150 million Americans rely on private employer-provided insurance. Yet they risk losing that insurance if they lose or change their job. Those with public health insurance, like Medicaid, face nearly the opposite problem. If a family member earns enough money to lift a household above the poverty line, they can lose eligibility. The net result: About one in four Americans under the age of 65 will be uninsured at some point in the next two years.
Many of them will actually be eligible for free or heavily discounted coverage. About 18 million Americans who are eligible for public health insurance remain unenrolled due to a lack of information and complicated signup procedures. And even Medicare, the workhorse public insurance program for many seniors, has out-of-pocket expenses with no cap. A quarter of people on Medicare spend a quarter of their income on health care.
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To Finkelstein and Einav, then, the solution is to provide free, basic health care for everyone. No sign-up woes; enrollment would be automatic. No charges for basic care. No losing insurance if you leave your job. No falling off the public-insurance ranks if you climb above the poverty line.
At the same time, they envision, the U.S. would have another layer of private health insurance, covering health care amenities -; private hospital rooms, say, or other elective elements of medical care. "You can pay to upgrade," Finkelstein says.
Will people be afraid to support these type of recommendations because they are concerned that they will lose something or be asked to pay more for the healthcare of the poor?
Will people be afraid to support these type of recommendations because they are concerned that they will lose something or be asked to pay more for the healthcare of the poor?
Thus far those do seem to be the main arguments against a system like that, spurred on by an excellent system of fear-mongering propaganda from the right wing.
Will people be afraid to support these type of recommendations because they are concerned that they will lose something or be asked to pay more for the healthcare of the poor?
Are you talking about something that compares to the British system?
BeatsPerMinute, BSN, RN
398 Posts
I giggled at this - thanks! I needed the laugh.