Text 17530, 146 rader
Skriven 2014-09-30 19:28:00 av NANCY BACKUS (1:123/140)
     Kommentar till en text av MICHAEL LOO
Ärende: Re: health 1
====================
-=> Quoting Michael Loo to Nancy Backus on 09-26-14  01:02 <=-

 ML>> Problem is that the doctor (I agree, it's his or her call,
 ML>> with informed patient consent) has other concerns than
 ML>> patient necessity. It may be appeasing the malpractice
 ML>> lawyers or making numbers for a new piece of equipment.
 NB>> So, you figure that the insurance companies are trying to rein in
 NB>> that sort of thing...?
 ML> It's a tension thing, one part of the insurance industry
 ML> playing against another part. Probably the same companies,
 ML> too (see below for coincidental weirdness), selling health
 ML> insurance to the consumer even as they sell malpractice
 ML> insurance to the medical community.

Possibly...  At one time I might have argued the point, but I see too
many mega-corps now, combining all sorts under one umbrella company... I
wouldn't be surprised to have them disavow any interconnection between
the segments, either...

 NB>> rather than simply the actual needs of the patient.... although I
 NB>> do understand to some extent the concept behind it...
 ML> But with costs no object, test away is what I say. The
 ML> problem is that costs are an object, as is apportionment
 ML> of medical resources.

Agreed... all round... If cost/resources was no object, just think of
what might be learned from testing... presuming the testing itself
wasn't harmful, of course... ;)

 NB>> so while there might not be complete justification for 100 uses,
 NB>> there probably would at least be that for maybe half of them....
 NB>> once it's bought, besides, you then have it for when you do need
 NB>> it... and don't have to ship a critically ill patient to some
 NB>> farther place that does happen to have the tool... 
 ML> By that reasoning, though, every place should have every
 ML> possible kind of equipment. There has to be a cutoff.

One can always extend reasoning to absurdity, granted... But there
remains a case for having a certain amount of coverage at at least one
hospital in a reasonably contained region... presuming, of course, that
there will be some interaction and cooperation between all the hospitals
of the region...

 ML>> Not all that jaundiced. See the NYT article on the guy who
 ML>> got billed something like 117K for the services of a doc
 ML>> he didn't meet? To be fair, the doc may have performed a
 ML>> useful function at some point, but over 100K, doubtful.
 NB>> Didn't see the article... that does have a bogus/fraud feel about
 NB>> it... particularly the amount being billed...
 ML> It's been sitting on the front page of Google News for weeks
 ML> now.

Considering I never see Google News... and I was referring to the action
as fraud/dubious/bogus, not the article... sadly, I know that such does
happen... 
 
 NB>> I do understand your special-case dilemma... (Hmmm... how close IS
 NB>> Wegmans to hitting the states/locations you might need them...?  Maybe
 NB>> someday...)
 ML> Not in my lifetime. No Weggies in most of my places.
 ML> This year on prescription day, I've been in Montreal,
 ML> Washington, Washington, Williamsport, Boston, Washington,
 ML> Juneau, Newark, Washington, Boston, San Fran, Williamsport.
 ML> Exceptional the 4 Washingtons. 

If you had someone to transport you (dunno if there would be viable
public transport, but maybe even that), there are a few Wegmans stores
in the Washington area, the one you know about in Williamsport, and at
least a couple in the Boston area.  Montreal, Juneau, San Fran, and
probably Newark are admittedly unlikely even for down-the-road...  But,
actually, yes, I understand your point...  

 ML> Recently, though, the insurance has agreed to let me get 3
 ML> months' worth at once, which should ease my travails quite a bit.
 
Cuts down on how many fills one needs to worry about... :)

 NB>> As long as the generic works for you just like (or at least as well
 NB>> as) the brand, that works...  and at least the insurance should be

 ML> I've always thought myself fairly hardy, and aside from the
 ML> problem of lactose as filler (commoner than it should be)

Lactose is a filler in lots of meds, true..  brand as well as generic...

 ML> generics usually work okay for me.

That's a good thing going for you.  The only class of meds so far that
I've had no issues with, brand or generic, has been antibiotics...  At
worst, they can sap my energy and send me to bed to actually stop long
enough to heal... (G)

 ML> Diovan was a Novartis product, but the new generic (new
 ML> because only approved for sale this year, even though the
 ML> patent ran out in 2012) is from Sandoz, also a reputable
 ML> company. The new stuff is in the same size/shape/color pill
 ML> and comes in the same size/shape/color bottle ... and I just
 ML> got a bottle to do a direct comparison, and the pill has the
 ML> same markings - o|o on one side and NVR on the other, h'm ...
 ML> Checking the fine print. The bottle says
 ML> Product of Ireland and Switzerland and UK
 ML> Manufactured by Novartis Pharmaceuticals
 ML> Corp. for Sandoz Inc.

Hmmm, indeed...   :)

 ML> So the original manufacturing company, which held the patent,
 ML> is making the product for resale as a generic by a competitor
 ML> - in essence undercutting its own product. How weird is that?

It still gets at least some cut from it, selling to the competitor...
and you, the consumer, can figure that it, being made by the old
company, should be indeed equivalent.  And with the identical markings,
you really could be getting a deal...  :)   A generic like that for my
Prilosec might actually work properly for me.... instead of having
long-term nasty side effects...  Still haven't a clue whether it's
something in the generic that bothers me, or something NOT in the
generic that made the other not bother me... obviously something in the
"non-active" ingredients...

 ML> LYCHEE-CRANBERRY SALSA
 ML> Categories: Asian fusion, celebrity, fruit, sauce, ingredient, dessert
 ML> Yield: 1 quart
 ML> 2 cn lychees, strained
 ML> 1 bag cranberries
 ML> 1/2 c sugar
 ML> 1 orange, zest of, finely chopped
 ML> 1 orange, juice of
 ML> 2 ts vanilla extract
 ML> Combine all ingredients in a food processor
 ML> and blend until medium-coarse in texture.
 ML> Tip: In addition to using this master in some
 ML> delicious desserts, the Lychee-Cranberry
 ML> Salsa is great as an accompaniment to pork
 ML> or poultry dishes.
 ML> source: Ming Tsai

That doesn't look half bad... :)

ttyl          neb

... If you wait, all that happens is that you get older.

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