Reply to Universal Healthcare UK - Baby can't have treatment in US

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]So you are comfortable allowing government to make decisions for you even if you can afford to go private?[/quote]

As ok as I am with some administrative insurance employee making decisions for me after I paid the company for coverage.[/quote]

PP here-A child I know has Crohn's disease and is flaring badly, despite using Humira.  She's been admitted to the hospital because she's having bloody diarrhea and is very sick.  Her doctor wants to try her on Entyvio, a relatively new biologic developed specifically for IBD.  She can go home when she's "only" having bloody diarrhea 10-12 times a day, rather than mostly continuously.  The insurance company says they'll cover Entyvio, but not on an inpatient basis.  Without the trying the Entyvio, it'll be hard to stablize her so she can get the Entyvio as an outpatient, but she can't get it covered as an inpatient.  So, the dr. has to try to find some other less theraputic and desirable way to stablize her so she can be released long enough to get the Entyvio as an outpatient.  Nevermind that she's seriously ill and suffering, she's not able to get the most beneficial treatment when she needs it.

WTF kind of sense does that make?[/quote]

Drug companies will bypass insurance companies and give the drug for free in cases like this. Doctor won't ask for it - parents have to. They could also just buy it themselves outside the insurance and bring it to the doctor.  There ARE choices. These parents in the UK have 1.8 million dollars. They aren't asking the government to do anything but release their child to them and the government is saying no, your child will die here and without your say.

By the way? Your friend's child can go home any time her parents sign a release to get her out. The hospital cannot hold her prisoner in this country.  Your friend also had choices of insurance companies, and clearly didn't research this aspect of things, given she has a chronically ill child. They can also appeal it further up in the insurance company, including involving a lawyer.

These parents in the UK have no option but to watch their child die because the government won't release their child. They have NO choice.[/quote]

You have no clue what you're talking about.  None. At. All.

No one's giving Entyvio away.  It's an expensive infusion that has to be administered like chemo under medical supervision.  You don't know anything about the child's mother and her health insurance choices, so just STFU with your judgment.  You also don't know how long the child's had a chronic illness; kids can present with IBD, be diagnosed, and immediately need to have their colons removed to save their lives.  People get sick AFTER they've selected insurance and then have to try to make that coverage work or they don't have any choices about their coverage.  How long should a child be having bloody diarrhea, losing massive amounts of weight to the point of emaciation, and deteriorating while the appeals are done and the lawyers battle it out?  To even suggest that to bolster your own weak and erroneous points and to justify our health care system shows the kind of horrible person you are.[/quote]

I know little about medicine, PO, and appreciate your explanation.   Is there a better treatment for the child with Crohn's disease.

Thank you [/quote]

There are limited options for treating moderate to severe Crohn's disease (there are various options, but not all of those options treat the disease in all places where the disease presents) and some people are resistant or quickly become resistant to the available treatments.  In this child's case, she quickly worked her way through Remicade and Humira, which lost effectiveness.  Steroids can sometimes be used to achieve remission, but they can't be used long-term and don't always work and didn't for her.  Entyvio is the newest drug and costs about $100,000 a year and is generally tried last.  Unfortunately, there are people including kids, with refractory disease and nothing much works or works for long.  It's pretty awful and terrifying.[/quote]

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