Posted on 03/22/2010 8:52:30 AM PDT by Wontsubmit
For nearly a decade, Paula Oertel's brain tumor was kept at bay by a drug that was not approved to treat her condition.
Then Oertel did something she never imagined would jeopardize her good health.
She moved -- less than 30 miles -- from one county in Wisconsin to another.
That move triggered a review of her health insurance from Medicare, which eventually led to a loss of coverage, including the drug.
And the tumor returned within four months.
What happened to Oertel stunned her doctor, Dr. Mark Malkin. Nothing he learned in medical school prepared him for what now is too often a sad and frustrating part of his job as an oncologist: fighting Medicare and private insurance companies over life-or-death decisions.
Doctors aren't supposed to get emotionally involved in the cases of their patients, but tears well up in Malkin's eyes when he talks about Oertel, the 40-year-old Oshkosh woman he has been treating for several years.
"I wish Paula would have a second chance," he said, choking up.
(Excerpt) Read more at abcnews.go.com ...
USSR is a good call. But it can be taken back even further. The Diocletian Reforms (c. 300 A.D.) required that people stay on their land and work in their father's profession. This led right into the Medieval notion of serfdom.
The lords want to live in their castles, and they want us to be serfs laboring in the fields below. It's barely hyperbole.
Most people won’t be able to change their addresses soon if they own a house. You are going to have to pas a federal “energy audit” before you can sell it. That means that in most cases the cost of bringing it up to that code would be so expensive that it won’t be worth selling it. For example in my case I would have to spend about $25,000 to be able to have my house pass the fed’s “energy audit”.
Those of you who live (and own homes) in the bleu states who want to get out better do so quick before you can’t afford to.
Most people won’t be able to change their addresses soon if they own a house. You are going to have to pas a federal “energy audit” before you can sell it. That means that in most cases the cost of bringing it up to that code would be so expensive that it won’t be worth selling it. For example in my case I would have to spend about $25,000 to be able to have my house pass the fed’s “energy audit”.
Those of you who live (and own homes) in the bleu states who want to get out better do so quick before you can’t afford to.
oops, sorry about the double post.
I’d guess she’s on disability...which I believe makes you eligible for medicare at any age...
She’s probably on Social Security Disability. They are entitled to Medicare 2 yrs after they are awarded disability, regardless of age.
Thanks for the clarification.
Cancer.......I know there is a reason the drugs are so expensive but I can’t wrap my mind around that.(the expense)
The media, prompted by their rat bastard masters, are going to start playing up this “in state” stuff to counteract the states’ efforts to legislate against DictatorCare.
I don’t get your comment. Could you please explain. Thank you.
I agree - how do they justify $8000 a month??? Unbelievable!!!
Even so...Medicaid should pick it up....
On the other, are the insurance companies that must use good sense and not rubber-stamp every request for an expensive, unproven drug.
Too bad the doctor didn't call the drug company to help her get her medication for reduced or no cost
Too bad the doctor didn't offer to treat her at his own cost, donate his own time, and his own services for free...
You know, I'm getting all choked up here.
Assuming that the reported drug costs are accurate (this site - http://ms.about.com/gi/o.htm?zi=1/XJ&zTi=1&sdn=ms&cdn=health&tm=12&gps=501_387_1117_628&f=10&su=p284.9.336.ip_p736.8.336.ip_&tt=2&bt=0&bts=0&zu=http%3A//www.destinationrx.com/ - suggests there may be an overstatement of the costs in the story), this is the tough part of paying for health care. This drug is not approved. This drug apparently costs $8000 per month. This poor woman has no means of paying for the drug. The alternative “approved” treatments are likely as or more expensive than the effective treatment.
This story goes to the heart of health cost issues. I think the new health care bill is a catastrophe - but I cannot envisage a bill that would actually resolve this issue. Simplistically one could argue that we, via Medicare, should continue to pay for this treatment for this patient but that hardly addresses the systemic issues this case raises.
Sooner or later someone will have to decide whether to invest $100K in this patient or $100K in these 20 patients. Sooner or later someone has to decide whether to pay for an experimental and unproven treatment. These are the real dilemmas and it is no good blaming decision makers for these dilemmas.
We have created a system where people’s expectations are not in line with what they or others can afford.
IIRC If you get disabilty you qualify for Medicare.
Ever had any experience with treating cancer?
My B/F passed away from colon cancer in June 09
We were finally able to get him Medicaid for his coverage because he was unemployed at the time of his diagnosis.
I can’t begin to tell you what we went through to get coverage, then when we did, the hoops we had to go through to get certain chemo drugs approved. We were told prior to treatments, which drugs medicaid would/would not approve.
Saddest is that at the very end, we had more than a couple thousand dollars worth of Chemo med prescripts already filled when it was decided the last treatment would not be given....I couldn’t give the pharmacy the medicine back, I couldn’t give them to charitable organization nor could I donate it to the Dr’s office to treat another patient who might not be able to afford the chemo meds.
Horrible.
I don’t believe you can get both at once. Medicaid usually denies coverage more than Medicre does and god luck finding a cancer doc that would accept it.
Medicare covers the elderly and the disabled. My husband has had Medicare since he was 31. He was diagnosed with stage IV stomach cancer in 1990. Let me tell you, the rules and the hoops are tremendous. We know that each time medicare does a review, it can limit or stop any and all of my Husband’s medicines... sad but true.
Rationing is a dirty word, but it is and will continue to happen.
I can relate, trust me.
All the best to your husband....and to you...
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