Tuesday, May 15, 2018

U.S. Healthcare Isn't Broken--It's Fixed

Healthcare/sickcare will bankrupt the nation by itself.
If you want to understand why the U.S. healthcare system is bankrupt, financially, morally and politically, then start with this representative anecdote from a U.S. physician. I received this report from correspondent J.F. on the topic of direct advertising of pharmaceutical products to the public (patients).
As background information, pharmaceutical companies were not allowed to advertise directly to consumers (patients) in the good old days. Now, as we all know, half the adverts on TV are for pharmaceutical products, and many of the remaining half are advertising lawsuits relating to pharmaceutical products that harmed or injured the patients who received them (or clamored for them as a result of endless direct-to-consumer adverts).
Here is J.F.'s report:
This morning, I read a report on augmentation of antidepressants. It seems folks who get a little better, but not a lot better on an antidepressant may improve if a drug in the class of second generation antipsychotics is added. Three of these drugs have been tested, with pretty much equivalent benefit - quetiapine, aripiprazole, and brexpiprazole. As the names suggest, the last two are very similar in chemical structure.
- quetianpine and aripiprazole are available in cheap generic for. Brexpiprazole is not, it's sold only as branded Rexulti.
- shortly after reading the piece, I walked past the waiting room TV which was playing an ad urging folks to "ask your doctor about Rexulti".
- lowest costs for a month's supply in my neighborhood, courtesy of goodrx.com:
quetiapine - $6.80
aripiprazole - $22.60
Rexulti - $1,120.20 (!)
- so the ad is urging folks to "ask their doctor" about a drug that is 16,473% more expensive than a similar drug that may work just as well.
Thank you, J.F. There you have it in a nutshell: U.S. Sickcare is organized to maximize profits by any means available, including adverts aimed at patients, adverts aimed at physicians, lobbying to include costly medications in the list of what Medicare pays for, and so on, in an endless profusion of crony-capitalist skims and scams, starting with research that's funded to reach the conclusion the funding pharmaceutical company desires, all the way through masking the real-world consequences of medications.
U.S. healthcare isn't broken, it's fixed--fixed to exploit the many to benefit the few, fixed to maximize profits in a we-win, you-lose system of perverse incentives.
AS I have long held, healthcare/sickcare will bankrupt the nation by itself.Endless wars of choice, unaffordable pensions and rising costs of soaring debt will only speed the arrival of insolvency and systemic collapse.



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