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(Washington Post)   Effective eye drug can either be $2000 or $50, doctors choose the more expensive option. $urely there mu$t be a rea$on   (washingtonpost.com) divider line 214
    More: Sick, Genentech, Avastin, return on capital, American health care, eye doctor  
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13517 clicks; posted to Main » on 09 Dec 2013 at 2:58 AM (19 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-12-09 12:43:37 AM
Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.
 
2013-12-09 12:57:58 AM
ObamaCares strikes again.
 
2013-12-09 02:34:02 AM
Doctors, meanwhile, may benefit when they choose the more expensive drug. Under Medicare repayment rules for drugs given by physicians, they are reimbursed for the average price of the drug plus 6 percent.

WTF? Why would they do this?
 
2013-12-09 02:53:10 AM
I am serious and don't call me Shirley.
 
2013-12-09 02:56:28 AM

log_jammin: Doctors, meanwhile, may benefit when they choose the more expensive drug. Under Medicare repayment rules for drugs given by physicians, they are reimbursed for the average price of the drug plus 6 percent.

WTF? Why would they do this?


Because the USA has a for-profit healthcare industry. The end game is not the best or most affordable care, it is the most profitable care.

I feel like you wanted a sarcastic or outrageous answer, but sorry, that's the answer.
 
2013-12-09 03:13:05 AM
The reason isn't that the medical system in the US is for-profit, it's that somebody other than the consumer of care is picking up the tab. Your morning bagel could be $55 if medicare or insurance was paying for it, but you wouldn't care since it's not coming (directly) out of your pocket. Almost all other businesses in the for-profit sector can't get away with overcharging, because their customers would go elsewhere.
 
2013-12-09 03:15:46 AM

Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.


People work for incentives. Remove incentives, and the good ones move to where the incentives are. Maybe just remove their stranglehold on medical choice, maybe. Nah, that'll never work!
 
2013-12-09 03:21:44 AM
The topical I use for my skin costs radically different depending on what pharmacy. Always the same medicine and brand, sixty bucks at Kroegers, 140 bucks at Rite-Aid. Given it's not quite on the scale of this article but yeah weird crap happens with medicine in this country.
 
2013-12-09 03:21:45 AM

foo monkey: log_jammin: Doctors, meanwhile, may benefit when they choose the more expensive drug. Under Medicare repayment rules for drugs given by physicians, they are reimbursed for the average price of the drug plus 6 percent.

WTF? Why would they do this?

Because the USA has a for-profit healthcare industry. The end game is not the best or most affordable care, it is the most profitable care.

I feel like you wanted a sarcastic or outrageous answer, but sorry, that's the answer.


Well, according to TFA the FDA hasn't approved the cheaper drug for use in the eye.  So even if a doctor wants to use the cheaper drug, it is an off-label use, which could open the doctor up to liability should their be a bad reaction.  And they might not even be aware of the cheaper drug since the maker doesn't market it to eye doctors.
 
2013-12-09 03:22:25 AM
"Under Medicare repayment rules for drugs given by physicians, they are reimbursed for the average price of the drug plus 6 percent. That means a drug with a higher price may be easier to sell to doctors than a cheaper one. In addition, Genentech offers rebates to doctors who use large volumes of the more expensive drug."

That looks like a perfect storm of conflict of interest.
 
2013-12-09 03:23:12 AM
Obviously take random statements by Internet strangers with a grain of salt, but over on reddit: http://www.reddit.com/r/politics/comments/1sdxz6/an_effective_eye_dru g _is_available_for_50_but/cdwoh5j a supposed Ophthalmologist weighed in on the article noting that the cost difference between the drugs and why they're not proscribed equally doesn't have to do with efficacy or profit, but more to do with the fact that the expensive one is measured in a provably sterile environment at the manufacturer, while the cheap one is done at a compounding pharmacy, and if the drug is not properly sterilized, it could result in blindness.
 
2013-12-09 03:23:33 AM
That's some pretty ridiculous conflict of interest there.
 
2013-12-09 03:29:11 AM

foo monkey: log_jammin: Doctors, meanwhile, may benefit when they choose the more expensive drug. Under Medicare repayment rules for drugs given by physicians, they are reimbursed for the average price of the drug plus 6 percent.

WTF? Why would they do this?

Because the USA has a for-profit healthcare industry. The end game is not the best or most affordable care, it is the most profitable care.

I feel like you wanted a sarcastic or outrageous answer, but sorry, that's the answer.


How dare you be rational in a Fark thread!
 
2013-12-09 03:29:19 AM

foo monkey: Because the USA has a for-profit healthcare industry. The end game is not the best or most affordable care, it is the most profitable care.


but we're not talking about the "for profit healthcare industry". we're talking about "Medicare repayment rules", as written by congress.

foo monkey: I feel like you wanted a sarcastic or outrageous answer


ok?
 
2013-12-09 03:32:58 AM
"Lucentis is Avastin - it's the same damn molecule with a few cosmetic changes," said J. Gregory Rosenthal

This is like a case-study in why healthcare is ludicrous.
 
2013-12-09 03:33:41 AM

Jragghen: Obviously take random statements by Internet strangers with a grain of salt, but over on reddit: http://www.reddit.com/r/politics/comments/1sdxz6/an_effective_eye_dru g _is_available_for_50_but/cdwoh5j a supposed Ophthalmologist weighed in on the article noting that the cost difference between the drugs and why they're not proscribed equally doesn't have to do with efficacy or profit, but more to do with the fact that the expensive one is measured in a provably sterile environment at the manufacturer, while the cheap one is done at a compounding pharmacy, and if the drug is not properly sterilized, it could result in blindness.


Outrage meter: returning to equilibrium.

/ DOO Doo doo  doo
// Wish we had a fact checker system for online articles since that's all we read now
 
2013-12-09 03:36:34 AM
It's a long article, here's the summary of the issue

Lucentis is a very expensive drug used to treat macular degeneration, a leading cause of blindness.  Avastin is a cheaper, similar drug which is used to treat cancer and has not been approved to treat eye disease.  When used to treat eye disease, Avastin has a slightly higher rate of bad side effects (due to risks of contamination) than the more expensive Lucentis.

So doctors have to make a choice.  On the one hand, no one wants to use a more expensive drug when a cheaper one will do (docs don't get paid more/less based on the drug they choose, though the drug vendors/big Pharma certainly do).  But on the other hand, docs don't want to get sued for using a cheaper drug off-label when a patient has a side effect.

Genetech, which makes both Avastin and Lucentis, has really pushed the idea that Avastin isn't as safe for the eye and Lucentis.  They also haven't worked to get Avastin approved for the eye, since it would undercut their more profitable Lucentis.

The 2 ways to fix this:
1) tort reform, so doctors aren't running scared from malpractice attorneys advertising for anyone who has used Avastin
2) allowing Medicare to negotiate drug rates directly
 
2013-12-09 03:39:55 AM
shanghaid:

The 2 ways to fix this:
1) tort reform, so doctors aren't running scared from malpractice attorneys advertising for anyone who has used Avastin
2) allowing Medicare to negotiate drug rates directly


So we're stuck with the bill for the foreseeable future then?
 
2013-12-09 03:43:11 AM
the headline is misleading--it's not doctors who are the bad guys in this story, it's Genentech.  It's ophthalmologists who figured out that Avastin could replace Lucentis, and their organization has been lobbying to get Avantis accepted for use in the eye.  Genentech naturally resists this since it undercuts their profit.
 
2013-12-09 03:46:53 AM

log_jammin: WTF? Why would they do this?


An Audi and a wife who doesn't get "headaches"
 
2013-12-09 03:47:38 AM

shanghaid: Lucentis is a very expensive drug used to treat macular degeneration, a leading cause of blindness.  Avastin is a cheaper, similar drug which is used to treat cancer and has not been approved to treat eye disease.  When used to treat eye disease, Avastin has a slightly higher rate of bad side effects (due to risks of contamination) than the more expensive Lucentis.


Hmmm, here I am wondering "If they're so close, wouldn't Lucentis be the better anti-cancer drug?" What if some of the side effects of Avastin are those differences? Not saying we should be looking for 50 times more expensive cancer drugs, but maybe the higher purity product should be the only one on the market. Since it would be vying for the cancer market they'd have to rethink the pricing structure.
 
2013-12-09 03:50:24 AM

Jragghen: Obviously take random statements by Internet strangers with a grain of salt, but over on reddit: http://www.reddit.com/r/politics/comments/1sdxz6/an_effective_eye_dru g _is_available_for_50_but/cdwoh5j a supposed Ophthalmologist weighed in on the article noting that the cost difference between the drugs and why they're not proscribed equally doesn't have to do with efficacy or profit, but more to do with the fact that the expensive one is measured in a provably sterile environment at the manufacturer, while the cheap one is done at a compounding pharmacy, and if the drug is not properly sterilized, it could result in blindness.


The issue is really that Avastin is packaged by Genentech in large doses for colon cancer, they package Lucentis in small doses for the eye.  So ophthalmologists can get Avastin and cut it into smaller doses in a compounding pharmacy, but that increases the risk for contamination (remember the meningitis outbreak from contaminated steroids a few months ago).  If Genentech wanted, they could just put Avastin into smaller bottles.  But that would cut their profit, so they don't.

And super_grass, I think you're right.
 
2013-12-09 04:01:17 AM
As a guy whose wife is a neuro-ophthalmologist, I'm getting a kick.

/I'd ask her about it, but she's snoring
//doctor money isn't as great as people like to believe
///it's pretty good, though
 
2013-12-09 04:06:03 AM

super_grass: Jragghen: Obviously take random statements by Internet strangers with a grain of salt, but over on reddit: http://www.reddit.com/r/politics/comments/1sdxz6/an_effective_eye_dru g _is_available_for_50_but/cdwoh5j a supposed Ophthalmologist weighed in on the article noting that the cost difference between the drugs and why they're not proscribed equally doesn't have to do with efficacy or profit, but more to do with the fact that the expensive one is measured in a provably sterile environment at the manufacturer, while the cheap one is done at a compounding pharmacy, and if the drug is not properly sterilized, it could result in blindness.

Outrage meter: returning to equilibrium.

/ DOO Doo doo  doo
// Wish we had a fact checker system for online articles since that's all we read now


This was addressed on pages 4-6 of the article.  They pointed out that this concern has been shown this "contamination problem" to be statistically insignificant in 6 clinical trials of the two drugs.

RTFA
 
2013-12-09 04:06:34 AM

shanghaid: It's a long article, here's the summary of the issue

Lucentis is a very expensive drug used to treat macular degeneration, a leading cause of blindness.  Avastin is a cheaper, similar drug which is used to treat cancer and has not been approved to treat eye disease.  When used to treat eye disease, Avastin has a slightly higher rate of bad side effects (due to risks of contamination) than the more expensive Lucentis.

So doctors have to make a choice.  On the one hand, no one wants to use a more expensive drug when a cheaper one will do (docs don't get paid more/less based on the drug they choose, though the drug vendors/big Pharma certainly do).  But on the other hand, docs don't want to get sued for using a cheaper drug off-label when a patient has a side effect.

Genetech, which makes both Avastin and Lucentis, has really pushed the idea that Avastin isn't as safe for the eye and Lucentis.  They also haven't worked to get Avastin approved for the eye, since it would undercut their more profitable Lucentis.

The 2 ways to fix this:
1) tort reform, so doctors aren't running scared from malpractice attorneys advertising for anyone who has used Avastin
2) allowing Medicare to negotiate drug rates directly


3) really farkin' bring the hammer down the current drug company/FDA model.


NASA went to the farkin' MOOOOOOOOOOOOON! At no point in that time did it turn a profit. But, their research basically gave us the modern age be it directly or through inspiration to junior scientists. The people who make the drugs want to cure the cancer, not make the money. It's only the capitalists who want their slice of every pie running the business end who keep drug prices higher than cost plus pharamacy wages.

Not quite sure HOW to reform the system, but making human testing happen sooner and be less expensive and more transparent is a good start.

Also, let people by unlicensed drugs. If I want to take vitamin C instead of retrovirals for a bad case of influenza, and I die, Sunny D doesn't see a courtroom. Why shouldn't the same be true for a lab that tells you they don't know if it will work. Put a big exclamation point on the box. Call them SUs for Sideeffects Unknown, And sell them cheap. People will be their own human test subjects.
 
2013-12-09 04:08:30 AM

doglover: Also, let people by unlicensed drugs. If I want to take vitamin C instead of retrovirals for a bad case of influenza, and I die, Sunny D doesn't see a courtroom. Why shouldn't the same be true for a lab that tells you they don't know if it will work. Put a big exclamation point on the box. Call them SUs for Sideeffects Unknown, And sell them cheap. People will be their own human test subjects.


I have some snake oil I'd like to sell you.
 
RCL
2013-12-09 04:09:34 AM
Jragghen: Obviously take random statements by Internet strangers with a grain of salt, but over on reddit: http://www.reddit.com/r/politics/comments/1sdxz6/an_effective_eye_dru g _is_available_for_50_but/cdwoh5j a supposed Ophthalmologist Genentech employee  weighed in on the article noting that the cost difference between the drugs and why they're not proscribed equally doesn't have to do with efficacy or profit, but more to do with the fact that the expensive one is measured in a provably sterile environment at the manufacturer, while the cheap one is done at a compounding pharmacy, and if the drug is not properly sterilized, it could result in blindness.

/FTFA
 
2013-12-09 04:15:14 AM

Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.


Awesome. Now, what's my motivation for being a doctor?
 
2013-12-09 04:17:09 AM

Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?


Helping people?
 
2013-12-09 04:19:10 AM

Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?


Seriously! Spending 15 years in school only to be told by others how much you should make...Why wouldn't people jump at the chance?

/Few years back, a local radio dj was whining on his show about how docs should be capped at 200K...all the while he makes more than that. Wife called in and farking tore him a new asshole.
 
2013-12-09 04:19:43 AM

Danger Avoid Death: doglover: Also, let people by unlicensed drugs. If I want to take vitamin C instead of retrovirals for a bad case of influenza, and I die, Sunny D doesn't see a courtroom. Why shouldn't the same be true for a lab that tells you they don't know if it will work. Put a big exclamation point on the box. Call them SUs for Sideeffects Unknown, And sell them cheap. People will be their own human test subjects.

I have some snake oil I'd like to sell you.


The other problem with this idea is that all of the toxic drugs would then be dirt cheap and the safe ones would be crazy expensive. Kill the poor and milk the rich!

A better idea - all drugs retail prices are set by the FDA and can't be more than double the cost of manufacture. Sure you'd have to make sure the drug companies don't pad their R&D expenses but other than it seems viable.

/ gimme a break - it's 3am - everything seems viable
 
2013-12-09 04:22:16 AM

foo monkey: Because the USA has a for-profit healthcare industry. The end game is not the best or most affordable care, it is the most profitable care.


What follows is simple business, no one went broke by getting his customers to spend more money.
 
2013-12-09 04:23:29 AM

Danger Avoid Death: doglover: Also, let people by unlicensed drugs. If I want to take vitamin C instead of retrovirals for a bad case of influenza, and I die, Sunny D doesn't see a courtroom. Why shouldn't the same be true for a lab that tells you they don't know if it will work. Put a big exclamation point on the box. Call them SUs for Sideeffects Unknown, And sell them cheap. People will be their own human test subjects.

I have some snake oil I'd like to sell you.


Yes, but you'd have to disclose EVERYTHING about the snake oil and sell it at cost. No profit. No advertising.

So it would be the opposite of the old snake oil scam.

You'd have to buy a house in town before you sold anything, then you'd actually sell the oil at a loss after the cost of your time was considered, and you'd pull it if it was unsafe.

And still, someone would take it.
 
2013-12-09 04:24:18 AM

jjorsett: The reason isn't that the medical system in the US is for-profit, it's that somebody other than the consumer of care is picking up the tab. Your morning bagel could be $55 if medicare or insurance was paying for it, but you wouldn't care since it's not coming (directly) out of your pocket. Almost all other businesses in the for-profit sector can't get away with overcharging, because their customers would go elsewhere.


Talk to the cable companies.
 
2013-12-09 04:24:50 AM

robohobo: Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?

Seriously! Spending 15 years in school only to be told by others how much you should make...Why wouldn't people jump at the chance?

/Few years back, a local radio dj was whining on his show about how docs should be capped at 200K...all the while he makes more than that. Wife called in and farking tore him a new asshole.


If you were guaranteed $200k per year then I think everyone would jump at it. However just because you go to school a long time does not mean you deserve to get paid massive amounts of cash.
 
2013-12-09 04:27:11 AM
I'd say it's something to do with the patient's poor eyesight
 
2013-12-09 04:30:29 AM

Mr. Tweedy: robohobo: Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?

Seriously! Spending 15 years in school only to be told by others how much you should make...Why wouldn't people jump at the chance?

/Few years back, a local radio dj was whining on his show about how docs should be capped at 200K...all the while he makes more than that. Wife called in and farking tore him a new asshole.

If you were guaranteed $200k per year then I think everyone would jump at it. However just because you go to school a long time does not mean you deserve to get paid massive amounts of cash.


Sure it does, if it's something everyone requires to live. Not many people have the patience, brains, and ability to work hard enough to spend 15 very, very long years in school, which really never ends, since you're constantly having to pick up new things. Also a good number of those who CAN do it are paying a goodly sum. 200k is nothing against all that. Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.
 
2013-12-09 04:34:47 AM

robohobo: Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.


$100 an hour is nothing to sneeze at.

Mostly, your body heals itself while doctors kind of help it along and tell you what to do for yourself. They're not all heart surgeons.

Almost anyone could go to medical school and graduate if it was free, or at least very much cheaper. The main difficulty with medical school isn't the skills, it's the bills.
 
2013-12-09 04:40:34 AM

doglover: robohobo: Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.

$100 an hour is nothing to sneeze at.

Mostly, your body heals itself while doctors kind of help it along and tell you what to do for yourself. They're not all heart surgeons.

Almost anyone could go to medical school and graduate if it was free, or at least very much cheaper. The main difficulty with medical school isn't the skills, it's the bills.


To clarify, I'm not speaking of a GP or something, which are generally the bottom tier of doctors in all ways, where 200k is great. I'm speaking more of specialists, people who cut into and treat your most important parts. The wife deals with eyeballs and brains. A fair amount of her patient load comes from states away. She didn't work her ass off since she was 17 to not make bank appropriate to her skillset. Even before she was studying her specials, in basic medical school, something like 20-30% couldn't cut it. That says something. Most of the bottom of her class ended up as GPs.
 
2013-12-09 04:40:35 AM

untaken_name: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

People work for incentives. Remove incentives, and the good ones move to where the incentives are. Maybe just remove their stranglehold on medical choice, maybe. Nah, that'll never work!


So the solution is to pay doctors less than minimum wage and let them accept tips as an incentive to work better?
 
2013-12-09 04:41:39 AM
A few years ago, the Govt. made major changes in the way compounding pharmacies had to operate per regulation, increasing the safeguards that protected the patient and forcing these pharmacies to update their systems to avoid cross pollination and provide safeguards to the purity of drugs they were compounding.
I know this because my company made a hefty profit targeting our product to help these pharmacies meet the new regulations; we made a sizable profit and the pharmacies were made much safer as a result.
This is a red herring from the pharmaceutical industry to keep profit margins higher.
 
2013-12-09 04:42:22 AM

robohobo: The wife deals with eyeballs and brains


I hope she's a doctor and not a chef.
 
2013-12-09 04:43:41 AM
So because you can hold

robohobo: Mr. Tweedy: robohobo: Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?

Seriously! Spending 15 years in school only to be told by others how much you should make...Why wouldn't people jump at the chance?

/Few years back, a local radio dj was whining on his show about how docs should be capped at 200K...all the while he makes more than that. Wife called in and farking tore him a new asshole.

If you were guaranteed $200k per year then I think everyone would jump at it. However just because you go to school a long time does not mean you deserve to get paid massive amounts of cash.

Sure it does, if it's something everyone requires to live. Not many people have the patience, brains, and ability to work hard enough to spend 15 very, very long years in school, which really never ends, since you're constantly having to pick up new things. Also a good number of those who CAN do it are paying a goodly sum. 200k is nothing against all that. Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.


So because people need it to live then it's okay to charge however much you want?
 
2013-12-09 04:44:17 AM

Danger Avoid Death: robohobo: The wife deals with eyeballs and brains

I hope she's a doctor and not a chef.


Ha, about the only thing she can cook is a steak.

/don't trust a midwestern farmgirl who can't cook a steak
 
2013-12-09 04:46:57 AM

Mr. Tweedy: So because you can holdrobohobo: Mr. Tweedy: robohobo: Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?

Seriously! Spending 15 years in school only to be told by others how much you should make...Why wouldn't people jump at the chance?

/Few years back, a local radio dj was whining on his show about how docs should be capped at 200K...all the while he makes more than that. Wife called in and farking tore him a new asshole.

If you were guaranteed $200k per year then I think everyone would jump at it. However just because you go to school a long time does not mean you deserve to get paid massive amounts of cash.

Sure it does, if it's something everyone requires to live. Not many people have the patience, brains, and ability to work hard enough to spend 15 very, very long years in school, which really never ends, since you're constantly having to pick up new things. Also a good number of those who CAN do it are paying a goodly sum. 200k is nothing against all that. Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.

So because people need it to live then it's okay to charge however much you want?


However much the market can bear. Anything else, you're shorting yourself. There is no shortage of patients, while there IS a limited amount of doctors/nurses good at what they do.
 
2013-12-09 04:47:58 AM

doglover: robohobo: Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.

$100 an hour is nothing to sneeze at.

Mostly, your body heals itself while doctors kind of help it along and tell you what to do for yourself. They're not all heart surgeons.

Almost anyone could go to medical school and graduate if it was free, or at least very much cheaper. The main difficulty with medical school isn't the skills, it's the bills.


Lemme know how that works out for you when Dr. Jimbo and his University of Phoenix med degree put you in the hospital for a staph infection.
 
2013-12-09 04:49:49 AM

robohobo: something like 20-30% couldn't cut it.


But that's true in any field. Your wife probably can't announce a hockey game on ESPN worth a damn or make 100 five star dishes in a night. Different strokes for different folks.

Do you know why I didn't go into medical school? Don't you wonder why?


a57.foxnews.com
 
2013-12-09 04:53:03 AM

doglover: robohobo: something like 20-30% couldn't cut it.

But that's true in any field. Your wife probably can't announce a hockey game on ESPN worth a damn or make 100 five star dishes in a night. Different strokes for different folks.

Do you know why I didn't go into medical school? Don't you wonder why?


[a57.foxnews.com image 660x371]


Not every field is needed for basic survival. No one's life is hanging on a 5 star dish or sports announcing, though I get what you're saying. Most of the best doctors don't ever pay much for their schooling, it's generally taken care of. Avoid doctors who are still paying student loans more than few years into their career. Really.
 
2013-12-09 04:58:56 AM

robohobo: Mr. Tweedy: So because you can holdrobohobo: Mr. Tweedy: robohobo: Carousel Beast: Sid_6.7: Probably at least 50% of medical expense inflation could be cured by placing all doctors on salary and forbidding profit from per-service fees.

Source: father who was a medical group manager for about 40 years, including a stint as regional president in the MGMA.

Awesome. Now, what's my motivation for being a doctor?

Seriously! Spending 15 years in school only to be told by others how much you should make...Why wouldn't people jump at the chance?

/Few years back, a local radio dj was whining on his show about how docs should be capped at 200K...all the while he makes more than that. Wife called in and farking tore him a new asshole.

If you were guaranteed $200k per year then I think everyone would jump at it. However just because you go to school a long time does not mean you deserve to get paid massive amounts of cash.

Sure it does, if it's something everyone requires to live. Not many people have the patience, brains, and ability to work hard enough to spend 15 very, very long years in school, which really never ends, since you're constantly having to pick up new things. Also a good number of those who CAN do it are paying a goodly sum. 200k is nothing against all that. Even at 48 weeks a year, that's just over $100 an hour with 40 hour weeks, which is laughable.

So because people need it to live then it's okay to charge however much you want?

However much the market can bear. Anything else, you're shorting yourself. There is no shortage of patients, while there IS a limited amount of doctors/nurses good at what they do.


When you're talking about something like a person's life you can't talk about how much the market can bear - that's only valid reasoning about the new XBox. Otherwise I can say something snarky like: "So your wife became a doctor because she felt she could hold people's lives hostage for a big paycheck?"
 
2013-12-09 05:04:22 AM

ShawnDoc: foo monkey: log_jammin: Doctors, meanwhile, may benefit when they choose the more expensive drug. Under Medicare repayment rules for drugs given by physicians, they are reimbursed for the average price of the drug plus 6 percent.

WTF? Why would they do this?

Because the USA has a for-profit healthcare industry. The end game is not the best or most affordable care, it is the most profitable care.

I feel like you wanted a sarcastic or outrageous answer, but sorry, that's the answer.

Well, according to TFA the FDA hasn't approved the cheaper drug for use in the eye.  So even if a doctor wants to use the cheaper drug, it is an off-label use, which could open the doctor up to liability should their be a bad reaction.  And they might not even be aware of the cheaper drug since the maker doesn't market it to eye doctors.



It's the company preventing the drug being approved for eye use, not the FDA.


FTFA: Avastin was not originally intended for use in the eye, and the company has refused encouragement from the FDA to seek official approval for using it to treat eye ailments, according to unpublished internal FDA documents.


Just clarifying for people who don't read the article.
 
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