"Obamacare found Constitutional"

[SR4]

im inclined to believe it will ultimately hurt not the existing middle class, but the supposed next generation of middle class working people. School debts+ doubling interest in a horrible job market, add healthcare costs on top of that.

 

Im really , really interested to see how the economy fairs in twenty years.

[Rubin Farr]

Leaked plot for National Treasure 3: find the hidden map in John Roberts adult diaper!

[goDel]

im inclined to believe it will ultimately hurt not the existing middle class, but the supposed next generation of middle class working people. School debts+ doubling interest in a horrible job market, add healthcare costs on top of that.

 

Im really , really interested to see how the economy fairs in twenty years.

 

This bill will hurt the next generation middle class in what way? I'm inclined to think that without this bill there won't be a next generation middle class. OK, that's a bit blunt. But the point is, this bill will more than likely lessen the hurt the next generation will going to suffer. And that holds for the entire Western society, regardless of which healthcare system.

[sergeantk]

im inclined to believe it will ultimately hurt not the existing middle class, but the supposed next generation of middle class working people. School debts+ doubling interest in a horrible job market, add healthcare costs on top of that.

 

Im really , really interested to see how the economy fairs in twenty years.

 

I am half interested and half scared shitless. I've been lucky enough to be healthy my entire life so far and it seems like being sick is more and more of a nightmare. Being dead middle class as it is, it will be quite interesting to be one of the "guinea pigs" of the bill.

[kaen]

*sits in the warm glow of the NHS while it lasts*

[jhonny]

*sits in the warm glow of the NHS while it lasts*

 

That's the sad thing, we're about to get royally fucked.

[Guest theSun]

while i applaud the end effect of having more people covered on health insurance, the money is still all getting funneled to the pharmaceuticals in the US.

 

profit margins for most health insurers are in the 5% range but big pharma is between 15-20%. just watch the ads during a big sports event or any other popular tv event/show.

 

edit - my criticism is that this legislation has done nothing to regulate the cost of healthcare, it has just expanded our already broken system. since there is so much money in big pharma (and subsequently a lot of big pharma money being funneled into various branches of govt), it will be very hard to impose regulations in this industry.

[Guest disparaissant]

yeah big pharma is totally fucked up

no matter the R&D cost, drugs should not cost hundreds upon hundreds (or more!) per month. especially not when walmart turns around and offers the generic for a dollar a month.

the number one prescribed drug class in america is fucking anti-psychotics. specifically, the atypical kind (seroquel, zyprexa, abilify, etc). now, if you have schizophrenia or bipolar disorder these kinds of drugs are a fucking godsend. but if you don't, what the hell are you taking them for? to deal with life every day? christ it pisses me off how out of control those companies are. i keep seeing ads for abilify as an adjunct for depression and it just irks the hell out of me. most of the people i know have been able to make depression manageable with therapy and maybe, you know, anti-depressants.

[BobDobalina]

Just my 2p, but the baby-boomers have sold out future generations to the hilt - economy, environment, education, you name it - in the interest of short-term gains (political, economic), and I don't see any tickytack reshuffling of the deck re healthcare changing anything. Citizens United is also "constitutional," allowing pharmaceuticals and health insurers to throw their oodles of cash behind whichever politicians best serve their interests.

 

If the supreme court can vote something that so blatantly flies in the face of basic equality/justice as constitutional then everything else is meaningless. Fuck em.

 

/rant

[SR4]

just gotta quickly chime in with over the top bias and say I completely agreee with the baby-boomers thing.

 

If I hear one more 50 year old tell me about how easy I have it compared to him I will slap the beluga caviar out of his mouth.

 

 

 

*because I need food HELP ME*

[jhonny]

yeah big pharma is totally fucked up

no matter the R&D cost, drugs should not cost hundreds upon hundreds (or more!) per month. especially not when walmart turns around and offers the generic for a dollar a month.

the number one prescribed drug class in america is fucking anti-psychotics. specifically, the atypical kind (seroquel, zyprexa, abilify, etc). now, if you have schizophrenia or bipolar disorder these kinds of drugs are a fucking godsend. but if you don't, what the hell are you taking them for? to deal with life every day? christ it pisses me off how out of control those companies are. i keep seeing ads for abilify as an adjunct for depression and it just irks the hell out of me. most of the people i know have been able to make depression manageable with therapy and maybe, you know, anti-depressants.

 

What do you mean 'no matter the R&D costs'. Pharma claims that it costs half a billion in R&D to develop a new product. Even if that is massively overstated, it still costs a huge amount to develop new medicines and bring them to market. Especially due to the fact that you can blow half a billion before you know that it doesn't really work in humans. They only get that price for a maximum of 20 years before their patent and expires, and a generic usually becomes available.

 

The scandal is that pharma spend far more on marketing than on R&D, and the modern pharma company doesn't do R&D, they just buy molecules from academia and research companies, and then market them. There are less big pharma companies as many have merged, and so monopoly situations are starting to occur and big pharma are looking to exploit their influence (see the recent GSK settlement).

 

In the UK there's an organise that weights up the costs and benefits of new drugs, and determines if they're value for money (NICE). In the US any talk of this has been completely destroyed (see Sarah Palin and the 'death panels'). If you have that decision at the end then it's influence runs right back to where pharma decide to spend their R&D money.

 

What's interesting is that the future isn't pharma per se, but it's diagnostics and genetic testing to be able to select appropriate treatments. These will have both health and cost benefits, and will move things out of big pharma.

[Adieu]

for me, it's sad how the lower middle class is essentially getting screwed with this policy (being in that grey area where you're not below the poverty line so you can't qualify for medicaid but you sure as hell don't have the extra $400 a month to put your family on insurance). i feel like politicians are trying to dismantle the middle class at every turn with these shitty economic decisions.

 

If it only cost $400 dollars a month to put a family on healthcare then this wouldn't be an issue. The issue is that it costs $400 dollars a month to put one person on healthcare.

[Guest disparaissant]

words

"no matter the R&D costs" as in "people should not have to pay out the ass for drugs to help them live fulfilling lives." i'm not saying that r&d is irrelevant, i'm just saying that straight laissez-faire capitalism should not apply to health.

this is obviously not only big pharma's fault, and you got into a lot of the critiques i have of them. we should be looking into investing in the health of people and not the financial wellbeing of corporations.

 

those atypical antipsychotics, for instance, have some hideous drawbacks. zyprexa, for instance, causes obesity and diabetes. but that doesn't stop them from being aggressively marketed to people who are not in any way psychotic or in any position to need an antipsychotic. they're used to quell kids in juvenile detention facilities. they're used to get old people to go to sleep. and i will not even lie, they work AMAZING for that. but the risk/benefit is skewed WAY toward risk if you are not actually in need of something to stop psychosis.

 

oh shit xxx readin the topic hrury up with your response WE NEED YOU

[Adieu]

Yeah, you go to the doctor and they prescribe drugs when their are tons of natural remedies that could really help you. Lazy ass shitty doctors are still a problem in this country. I went to a 20 minute doctor visit on Tuesday and they charged me $160.00. When I was checking out supposedly the visit would normally have cost me $667.00. The doctor was nice enough to realize I was just coming in for a checkup and get some minor things looked at and noticed I don't have insurance. Thankfully, this one doctor saved me a shit load of money. This is not the normal encounter though. I had dental coverage and went to the dentist for a cleaning last year. I gave them my insurance information. They said at the front desk after my visit that I didn't owe anything per my insurance. Then I get $100.00 bill in the mail. WTF? If I went to Starbucks and they forgot to charge me correctly do you think they would send me a bill for the extra money? Hell no! When I walk out the door and you haven't got your shit together it should be on you.

[SR4]

I recently found out I was allergic to almost everything save for consumables (thank god for that...i like my seafood/gluten/whatever).

 

I got lucky because the doctor is close friends with my family and was willing to work something out with me, but originally being uninsured, it would cost over 4k a year. Just for allergy shots.

 

I can't even afford rent, if I had 4k added to my credit or loan debt, thats another one to two year setback (and thats assuming I get into a far better financial position within that timeframe). Not to mention doubling interest rates on student loans,physician visits, dentist appts. (i havent seen a dentist in two years now), and a montly scrip. The most infuriating part to me is that I have it relatively easy compared to a lot of other people.

[Adieu]

You could go acquire the things you are allergic to and then synthesize them into liquids and inject them yourself. This would save you a lot of money in the long run. Make sure to check the dosages though or have your Epi-Pen handy. I was on allergy therapy for a little while and then had to cut it off because of losing my insurance. Good times.

 

Also, the $300+ insurance plan I was on recently didn't even cover Aids. So if I were to contract HIV I wouldn't even be covered. My plan was still that expensive and I had huge deductibles too.

[SR4]

You could go acquire the things you are allergic to and then synthesize them into liquids and inject them yourself. This would save you a lot of money in the long run. Make sure to check the dosages though or have your Epi-Pen handy. I was on allergy therapy for a little while and then had to cut it off because of losing my insurance. Good times.

 

Also, the $300+ insurance plan I was on recently didn't even cover Aids. So if I were to contract HIV I wouldn't even be covered. My plan was still that expensive and I had huge deductibles too.

wait, what? are you serious? i need more information.

[Adieu]

On the allergy therapy? Well, the basis for allergy therapy is that they shoot you up with all the shit that you are allergic to in the hopes that constant exposure will cause your body to become accustom to the presence of the things to which you are allergic. I'm sure it is slightly more complicated than that, but that is the general idea. So, if you were to take the sheet where they told you everything you are allergic to and gathered all of those things then extract the essence/oil of them or whatever you could then create a solution filled with all of those things and then inject into yourself like they do. The only real danger is that if you use too much of one thing or if by chance those basic types of natural substances create some kind of chemical reaction. Like i said, have your Epi-Pen ready in case you overdose and start going into anaphylactic shock. That is already a danger from the therapy anyhow which is why you are supposed to carry an Epi-Pen with you when you are on allergy therapy.

 

In theory you could probably soak all the materials in purified water then use that water solution to make your mixture. I'm not a doctor or a scientist though so more research would need to be done.

[Hoodie]

for me, it's sad how the lower middle class is essentially getting screwed with this policy (being in that grey area where you're not below the poverty line so you can't qualify for medicaid but you sure as hell don't have the extra $400 a month to put your family on insurance). i feel like politicians are trying to dismantle the middle class at every turn with these shitty economic decisions.

 

If it only cost $400 dollars a month to put a family on healthcare then this wouldn't be an issue. The issue is that it costs $400 dollars a month to put one person on healthcare.

 

my mom and i haven't had insurance since 1999 so i don't even know the cost :/

[goDel]

the number one prescribed drug class in america is fucking anti-psychotics. specifically, the atypical kind (seroquel, zyprexa, abilify, etc). now, if you have schizophrenia or bipolar disorder these kinds of drugs are a fucking godsend. but if you don't, what the hell are you taking them for? to deal with life every day? christ it pisses me off how out of control those companies are. i keep seeing ads for abilify as an adjunct for depression and it just irks the hell out of me. most of the people i know have been able to make depression manageable with therapy and maybe, you know, anti-depressants.

 

You word it like there's a sharp distinction between anti-psychotics and anti-depressants. And the distinction is mostly in the name and in the chemical working. But different anti-depressants have different chemical workings as well. Both these types of medicines do "something" with the chemicals in the brain. And because there's actually no real evidence that depression/psychotics are chemical related issues, both can and are prescribed under wildly various psychiatric conditions.

 

It'd be better if both types of medicins would be brought under a single banner: brain-chemicals. Because both tend to screw peoples brain-chemicals (for better or worse). From my cynical perspective, these medicines make people sick in a number of ways. So sick that the original symptoms which they should treat are pushed to the background. Some would call that cured.

 

What's interesting is that the future isn't pharma per se, but it's diagnostics and genetic testing to be able to select appropriate treatments. These will have both health and cost benefits, and will move things out of big pharma.

 

But wouldn't the next step -after you've been diagnosed/genetically tested- be that people are put on medicins? To prevent whatever may be diagnosed? Yes, I'm a sceptic.

[jhonny]

the number one prescribed drug class in america is fucking anti-psychotics. specifically, the atypical kind (seroquel, zyprexa, abilify, etc). now, if you have schizophrenia or bipolar disorder these kinds of drugs are a fucking godsend. but if you don't, what the hell are you taking them for? to deal with life every day? christ it pisses me off how out of control those companies are. i keep seeing ads for abilify as an adjunct for depression and it just irks the hell out of me. most of the people i know have been able to make depression manageable with therapy and maybe, you know, anti-depressants.

 

You word it like there's a sharp distinction between anti-psychotics and anti-depressants. And the distinction is mostly in the name and in the chemical working. But different anti-depressants have different chemical workings as well. Both these types of medicines do "something" with the chemicals in the brain. And because there's actually no real evidence that depression/psychotics are chemical related issues, both can and are prescribed under wildly various psychiatric conditions.

 

It'd be better if both types of medicins would be brought under a single banner: brain-chemicals. Because both tend to screw peoples brain-chemicals (for better or worse). From my cynical perspective, these medicines make people sick in a number of ways. So sick that the original symptoms which they should treat are pushed to the background. Some would call that cured.

 

What's interesting is that the future isn't pharma per se, but it's diagnostics and genetic testing to be able to select appropriate treatments. These will have both health and cost benefits, and will move things out of big pharma.

 

But wouldn't the next step -after you've been diagnosed/genetically tested- be that people are put on medicins? To prevent whatever may be diagnosed? Yes, I'm a sceptic.

 

That's be one of the steps, but it'd also remove a lot of the uncertainty regarding drug development and drug administration, which is where a lot of the high costs stem from.

 

Just to make it clear, big pharma is rotten to the core. I also agree that drugs aren't the cure for all things.

[goDel]

I'm afraid these new ways of diagnostics tend to create a world where medicins tend to be prepared on a much more specific basis. Currently there's already more and more orphan drugs being developed. In the future it is not unheard of that medicins will be specifically prepared for the patients with a specific genetic map, if you will. So the medicines will be made in smaller and smaller volume, but with the same high costs in development. And because these medicines will be so specific, there will also be less competition between various manufacturers. All I can see is huge price increases.

 

So no, I don't see a smaller impact of big pharma in the future. I hope I'm wrong though.

[Guest disparaissant]

You word it like there's a sharp distinction between anti-psychotics and anti-depressants. And the distinction is mostly in the name and in the chemical working. But different anti-depressants have different chemical workings as well. Both these types of medicines do "something" with the chemicals in the brain. And because there's actually no real evidence that depression/psychotics are chemical related issues, both can and are prescribed under wildly various psychiatric conditions.

 

It'd be better if both types of medicins would be brought under a single banner: brain-chemicals. Because both tend to screw peoples brain-chemicals (for better or worse). From my cynical perspective, these medicines make people sick in a number of ways. So sick that the original symptoms which they should treat are pushed to the background. Some would call that cured.

 

But there are sharp differences between the two: in what they do, and how they do it.

and as for the idea that there is no real chemical link between chemicals and depression/psychosis/mental illness:

http://bipolar.about.com/cs/menu_science/a/press_umich0210.htm

http://psychcentral.com/news/2006/11/09/depressions-chemical-imbalance-explained/398.html

http://www.cdhb.govt.nz/totara/brain.htm

 

i don't really get where you're going with the other half of that. if masking my symptoms with other symptoms lets me go about my daily life without spending all my money and making all my friends hate me, i'll gladly do it, i guess.

[goDel]

Thanks for the links.

 

The following quote I think to be very typical.

"To put it simply, these patients' brains are wired differently, in a way that we might expect to predispose them to bouts of mania and depression," says Jon-Kar Zubieta, M.D., Ph.D., assistant professor of psychiatry and radiology at the University of Michigan Health System. "Now, we must expand and apply this knowledge to give them a treatment strategy based on solid science, not on the current method of trial and error. We should also work to find an exact genetic origin, and to relate those genetic origins to what is happening in the brain."

 

It talks about wiring and genetic origins. To me that sounds like something rather physical as opposed to chemical. Sure, chemicals are involved. I'm not denying that. But what can chemical drugs do with respect to the wiring?

 

And the next article links to another:

http://psychcentral.com/news/2009/12/09/antidepressants-may-be-missing-the-mark/10075.html

 

A new study suggests most antidepressants do not target a key brain protein believed to be of importance in maintaining mood.

The protein is monoamine oxidase A (MAO-A), a substance that is highly elevated during clinical

depression

. The new study suggests this chemical is unaffected by treatment with commonly used antidepressants.

 

According to experts, the study has important implications for understanding why antidepressants don’t always work.

 

That's a rather cynical understatement, don't you think?

 

So we already have anti-depressants on the market which don't always work because they don't target this key protein. But now we know which chemical should be targeted, the treatment should always work, right? Is there a medicine on the current market which always works?

And why did those anti-depressants which didn't target these key proteins still get to be called anti-depressants? Wasn't there supposed to be research proving their effectiveness? What's the value of that research now we know of this new key protein?

 

I've said it in the past, but I'll repeat myself again: read "The emperor's new drug". It gives a good picture on pharmaceutical research and regulation and how it can be possible drugs are marketed as proven to work even though there's no real (=good) evidence.

 

It's a difficult subject, but the fact is there are and have been drugs on the market for many years even though science is still looking for the actual cause(s) for mental illnesses.

 

And the last point: if the goal of medicines is to make people better able to cope with the symptoms of their conditions, don't you think there couldn't be cheaper alternatives? These new high-tech brain-chemical drugs are pretty expensive. How about running 5 miles ad see what that can do with your brain-chemicals?

 

Sorry for being so inconsiderate for your personal situation. The above is more a general statement. And I understand there's always going to be circumstances which should be treated differently. But if 20% of all people which are currently taking anti-depressants would run 5 miles, 3 days in the week, I wouldn't be surprised these people would be better off. Financially and mentally.

[jhonny]

There are plenty of drugs that are regularly used because they provide clinical (and patient-valued) benefits even though their mechanism of action isn't understood. A well designed trial allows you to identify if a drug has an impact on a certain outcome. Unfortunately, not all trials are well designed, and the ways they can be biased is complex. Especially in depression, the confounders and biases (self-selecting, engagement with health services etc) mean that it's hard to be sure that anti-depressants have helped.

 

Methotrexate is a very commonly used drug for rheumatoid arthritis. It's mechanism of action is complex, somewhere between an anti-inflammatory and an immuno-suppressant. Even so, a great number of patients get better because of it (or more precisely, because of being treated with it). It's the same with anti-depressants. Like RA, depression is a complex condition and it's still not clear why it occurs (a combination of biological, genetic and environmental factors seems likely) and so different people may have depression for different reasons. Targeting a protein or biomarker may be appropriate for some people but not for all. If you can better understand why a person has depression (biological, genetic, environmental) then you can better target drug or psychological therapies to help that person.