A question about medication

[mr blur]

I'm curious about how this works in the US (and elsewhere). In the UK, any medication I need for my MS I get through the Health Service. A prescription here costs about £6 - any prescription. Because I receive certain benefits because of my condition, I'm exempt from those charges so my prescriptions are free. This means that, however poor I might be, I could get treatment for the MS (and anything else).

It also means that my neurologist is far more careful about the things I take. For example, I could take Beta-Interferon (which would cost the government about £10,000 per patient per year) and she has told me that she will prescribe it for me if I want it but that she advises against it because she doesn't think that enough tests have been made as to possible side effects and that my condition isn't so severe that I should take that risk. I'm happy with that.

People in the US that I "talk" to seem to take an incredible amount of drugs and at one point I remember thinking that this is something to do with the "litigation" aspect - that specialists give out all sorts of things because they're always worried about being sued if they don't offer the latest "big thing".

What happens over there if you don't have medical insurance? Having grown up with a public health service, I can't imagine what it must be like to be suddenly rushed to hospital and then be asked if you can pay for it.

(Of course, it's the drug companies who are the real greedy bastards in all this)

(edited for spelling)

[Liberal Veteran]

1. If you don't have insurance...

Then you are basically screwed.

Unless you can get some kind of public assistance in the US and don't have insurance, you find yourself in a morass of bureaucracy trying to get a little help from already strapped programs.

Many people without insurance use the emergency rooms in hospitals as their primary care, which is a very poor substitute for having a regular physician (and it's very expensive).

That whole business about litigation is a bit overblown. Yes there are issues with lawsuits, but mostly that is just an anti-consumer, pro-insurance company talking point to try to limit the legal recourses people have when a health care professional really screws up.

Quite honestly, we have the most expensive health care in the industrialized world and spend more of our GDP on health care yet have 43 million people who don't have access to basic health care and that doesn't include the number of people who have very inadequate health coverage (high co-pays and uncovered services in the policy that make basic health care just out of reach).

It's a fucking mess all around. Our government cares more about the big health care corporation's and insurance companies bottom line than the well-being of the people and they make it damn near impossible for anyone to do anything to change things. We have no ability to negotiate prices or put limits on how much can be charged for pharmaceuticals. Big insurance companies general have rate schedules they pay for various services that they make doctors/hospitals/labs agree to before they will let them take the insurance, but the uninsured generally end up being charged the highest possible price for anything.

I could spend all day talking about it, but the bottom line is our government is in bed with people who are more interested in profit than health care and the people pay the price for it.

Anyone who tells you we have the best health care in the world is full of shit. We have decent to excellent health care depending on a lot of variables and the largest being: IF YOU CAN AFFORD IT.

The right wing talking heads yammer on and on about how horrible universal health care is because they have stock in companies that are gouging the public for health care and they blow the problems of universal health care all out of proportion such as saying that people have to wait for services, but they never bother to tell you that in the US, we ALSO have to wait for services. I could call my doctor today and it might be a 1-2 months to get an appointment.

[REP]

2. That I Don't Get

I think we're in the same boat, immunosystem-wise, with different etiologies (I have multiple kidney diseases and renal failure + daibetes + a few other things). If I were to call my doctor today, I'd be seen *today*. I'm flagged as a high priority patient and get booked with same day or next day appointments, even if I just think I have a cold (by the way, I never make an appointment for a cold unless it's been going on for more than three weeks). It takes a lot of resisting on my part not to get redirected to the emergency room (no thanks, I'm already sick). If I need to see a specialist, like a urologist, I get an appointment within a week, even if it's for something like the recurrent renal calculi I've had for a decade now.

I think it really depends on the insurance and the doctor. I know I'm lucky to have so many doctors who actually want me (as opposed to my symptoms) to do well.

As for Rxs, I'm currently taking 10; nine routinely and one for an acute infection. I don't take anything to counter a side-effect of another drug and most of the drugs I take are old and generic. There are a couple I take that are available only as name-brand, and I was started on them after being failing others in their categories.

[Liberal Veteran]

3. I could get in to see a nurse practitioner on short notice, but even so...

...getting a regular old appointment would be difficult.

My doctor is fantastic and I am VERY happy with our doctor-patient relationship and his skills, but he is very much in demand (and is one of the three docs in town who has experience with HIV).

[Warpy]

4. I finally lost my insurance for good in 1987

and worked for another 16 years without it (irony trumpet) as an RN who couldn't get hired on staff because chronic illness drives insurance costs up.

I am not shy in telling people I enjoy the same standard of healthcare as the citizens of Botswana.

When I was a kid growing up in the 50s and 60s, the New Deal protections were in place and the US was just about the best country to live in on earth.

Now it's one of the worst for anyone who isn't in the top 5% of wealth holders. I don't recognize the country I grew up in any longer, and I loathe what greed has turned it into.

[Joe Chi Minh]

5. And can you believe

so many putative DUers are belly-aching for someone other than Kerry for the next Democratic presidential candidate! As if Dem leaders offering the country a New Deal came along with every shower of rain!

[nashville_brook]

7. or the top 5% health-wise

just had to throw that in -- don't get sick in america! especially tennessee, unless you have insurance!

[fudge stripe cookays]

6. Well, between you and me...

I just started Betaseron last month, and have seen wonders with it already.

They treated my first attack with the IV steroid, but since I've started the Betaseron, nothing seems to be bothering me. At least not like it was.

My MS came on like a thundering herd of illness, and scared the living you-know-what out of me. Lots of major numbness (could barely use my left hand), terrible Lhermitte's, utter exhaustion, seriously blurred vision, fucked up depth perception...

Now, the only problem I really have is my legs tingling a lot if I do quite a bit of walking. I'm still averse to the heat. And sometimes if I'm tired, the Lhermitte's signs come back to my neck.

But this stuff is supposed to limit the number of attacks, and make the ones you have less severe. I'd be calling my doc right away to get on the stuff if you don't get a lot of side effects.

Yeah, I wonder about eventual problems they may find with it, but if it increases my quality of life in the meantime, THAT's what I'm concerned about, really.

FSC

[NorthernSpy]

8. what happens in America if you don't have medical insurance, you ask?

You read home medical guides, and pick the disease that sounds the closest to your symptoms.

You buy over the counter medication at the drugstore, and hope it works.

You try some of the medicine that a sympathetic friend has kindly offered to share with you -- in spite of the "Federal Law Prohibits blah blah blah" notice on the bottle.

You try one of those dubious and exotic "supplements" from the health food store. No guarantees are made for these untested quasi-natural substances, but no prescriptions are required, either.

You consider going to the doctor as a self-pay, but once again decide against it: after all the tests and things, who knows how much it might cost?

You remember how long it took to pay off your previous batch of medical bills.

You order medicine from overseas, and hope that it makes it through customs. And that it's not counterfeit, contaminated, or past its expiration date.

You say, "just haven't had the time, I've been so busy!" when people ask you why you don't see the doctor about that cough.

You cut out activities that might aggravate your untreated condition.

You know you can't afford to get injured, so you swear off anything the least bit adventurous and stick close to home.

You try not to worry.

You do without.

[ncrainbowgrrl]

10. Wow. This is such a powerful post.

I wish it was a lone thread so that I could recommend it.

You expressed this SO well.

Thank you.

[Warpy]

9. I haven't been able to get insurance since 1987

because I have a serious illness. I have been able to do the bare minimum to treat this illness and my condition is fairly stable, although worsening slightly every year. I have had no preventive health care since 1987. If something happens, like a pneumonia or broken bone, I suffer through it until an urgent care facility opens up. I don't go to an emergency room unless it is life threatening.

This is what people without insurance do in the US.

The supreme irony in all this is that I'm a registered nurse. I have been refused all but per diem positions because hospitals are terrified I'd cost their for profit insurance plans a few bucks.

To say I despise the medical system in the US is a study in extreme understatement. It is beyond belief in its expense, its inefficiency and its cruelty.