Why desperate Americans are driving to Canada in caravans for insulin | CBC News

From the article:

Nystrom, who has Type 1 diabetes, requires insulin to stay alive. She is on a type of fast-acting insulin called NovoLog, which costs about $300 US a vial. The Canadian equivalent, NovoRapid, is about $30 per vial. She was shocked to learn about the price difference.

Source: Why desperate Americans are driving to Canada in caravans for insulin | CBC News

How long a vial lasts is dependent on your needs. Sometimes a vial of insulin only lasts a week.

The very notion that diabetics have to caravan to Canada to buy insulin to literally stay fucking alive is so wrong.

Here’s another instance from the article:

Lija Greenseid, who organized the Caravan to Canada, lives in St. Paul, Minn. Her 13-year-old daughter has Type 1 diabetes and she and her husband buy insurance through the Affordable Care Act.

Last year, she said they spent $13,000 US just to obtain health insurance — and then $14,000 US out of pocket before her daughter’s insulin was covered.

“It’s a huge amount of money for us. Because of that, we didn’t put any money into our kids’ college savings accounts or put anything into retirement for the year. We really just had to pay our health-care bills,” Greenseid said.

“So now you can see why we do crazy things like go across the border and buy insulin.”

This should not be happening. People should not being going through extraordinary measures just to keep their kids alive. It should not bankrupt people to life.

I used to be a nurse. In my first career I have seen what happens to people that ration their insulin. Nothing good.

This is just wrong.


Paula Radcliffe: Caster Semenya ruling could bring ‘death of women’s sport’ · PinkNews

From the article:

Under the regulations Semenya, who has naturally high testosterone levels, would be required to undergo hormone therapy for at least six months before any competition.

The UN has condemned such treatment as an “unnecessary, humiliating and harmful medical procedure.”

Source: Paula Radcliffe: Caster Semenya ruling could bring ‘death of women’s sport’ · PinkNews

This ruling was asinine from the beginning. There is no exact level for testosterone for cisgender women. High level athletes produce more testosterone. There is also a racist element to this targeting.

Semenya is challenging this ruling to force her to undergo HRT therapy to lite4rally change her hormonal makeup in order to compete.

They have already put her through unscientific gender verification where they had some quack literally inspect her genitals.

This is bullshit.

Is Dentistry a Science? – The Atlantic

From the article:

The Cochrane organization, a highly respected arbiter of evidence-based medicine, has conducted systematic reviews of oral-health studies since 1999. In these reviews, researchers analyze the scientific literature on a particular dental intervention, focusing on the most rigorous and well-designed studies. In some cases, the findings clearly justify a given procedure. For example, dental sealants—liquid plastics painted onto the pits and grooves of teeth like nail polish—reduce tooth decay in children and have no known risks. (Despite this, they are not widely used, possibly because they are too simple and inexpensive to earn dentists much money.) But most of the Cochrane reviews reach one of two disheartening conclusions: Either the available evidence fails to confirm the purported benefits of a given dental intervention, or there is simply not enough research to say anything substantive one way or another.

Source: Is Dentistry a Science? – The Atlantic

I started looking into this years ago with this article on the fact that there is no scientific evidence that flossing is necessary. (It’s a great website if you don’t read Harriet Hall’s anti-trans articles. . . )

This article inspired me. I decided to do my own unscientific trial. My dental hygienist at a questionable one dentist shop kept telling me I had to floss and that my gums depended on it. So I did. I flossed morning and night for 365 days in a row.

Then the next year’s cleaning, when she asked, I told her I wanted her to look at my teeth and tell me if I had flossed, and if she saw any improvement. She was caught off guard, and uncertain, and told me that I hadn’t, and gave me the exact same prognosis on my gums that I had heard for two previous years. Then I told her I had been flossing twice a day, and she didn’t believe me.

After that, I started to consider that this dental shop, which kept trying to balance bill us, was doing procedures that were unnecessary. My wife needs a lot of work, and I felt the work was questionable in skill and necessity.

It was at this time I started hearing more anecdotal stories about people being screwed over by dentists. I remember reading of a Native American that went to get a filling, and being told her insurance was already used up fort the year, because the dentist was committing insurance fraud saying they had given her fillings and pocketing the cash. That guy was busted.

There were billing frauds. There were extra work being ordered.

We have a good dentist now, that we travel an hour for, because we trust them with the billing and the work, but we went through quite a few.

I wish they’d loop dentistry into the rest of the medical system, and just be done with it.

Now that there is scant evidence that half this shit is necessary? Wow.

High-Deductible Insurance Linked To Delays In Cancer Diagnosis And Treatment : Shots – Health News : NPR

From the article:

Her employer offered only a high-deductible health plan; that meant she’d have to pay up to $6,000 out of pocket each year. Advocates for patients say this sort of underinsurance is snatching lives.

Source: High-Deductible Insurance Linked To Delays In Cancer Diagnosis And Treatment : Shots – Health News : NPR

I feel like I am constantly breaking down cost benefit analysis for my friends on these high-deductible plans that will literally get you killed if you have health issues.

First, some terminology.

  • Premium: The monthly amount you pay to have insurance.
  • Deductible: The total dollar amount you have to pay before your insurance wills tart covering you.
  • Out of Pocket: This is the dollar amount you pay yourself, like a co-payment, when you go to the doctor, even though you have insurance.
  • FSA/HSA: Flexible Spending Account/Health Savings Account. The are accounts that are taken from your paycheck that can only be used for healthcare. Some can be used in total on day 1, some cannot. It basically skims your paychecks for the money, and are often used in conjunction with higher deductible plans.

People look at these high deductible insurance plans, and it’s attractive. The monthly premium payment is often a lot less.

However, high deductible plans are often filled with higher out of pocket amounts. For instance, you might not be covered 100% of a hospital visit. You might only be covered 50%. Specialist doctors might only be covered 80% for the visit and the testing. This is something you really have to look at. One accident, one set of testing, and you could blow all the money you are saving on the monthly premium’s and more. These high deductible plans always go hand in hand with crappy coverage if you actually need it.

The problem is that most FSA/HSA funds is that they are not big enough to cover these high deductibles, and the out of pocket costs that are usually associated with these plans.

Let’s break it down quick and dirty. This is not a real plan, but kind of what I’ve seen over the years, give or take. This is just to show you how it works.

Low Deductible Plan High Deductible Plan  Cost Per Visit
Monthly Premium 100 50
Deductible 500 5000
Copay 20 20%                   125
Specialist 30 20%                   200
Testing No Copay 20%                   800
Hospital stay 150 a day/maxes at 500 50%              10,000

Okay, now let’s say for the year you see the doctor 3 times, have one specialist visit, and testing procedure like an MRI/CAT etc. Then you have an in-hospital stay for a week.

I super low-balled the costs for each visit. Specialist visits can go up and up. Testing procedures can be in the thousands. Hospital stays for a week are probably never going to be that low in the US.

You pay
Low Deductible Plan High Deductible Plan
Premiums                               1,200                            600
Copay                                    60                              75
Specialist                                    30                              40
Testing                                     –                            160
Hospital                                  500                         5,000
Total                               1,790                         5,875
Add Deductible                                  500                         5,000
Total paid for year                               2,290                       10,875

This super simplistic example shows that you would end up paying $10,875 for the year of costs, versus $2,290 if you had a low deductible plan.

The problem is that people often think it will help them if if it’s catastrophic health care, which these plans don’t really help with because the coverage is usually shit on top of the high deductible.

Even worse, you can get knocked out of access to financial help because you actually have an insurance plan.

I hate these plans. They are a scam that do nothing for anyone.

Mentally Ill New Yorkers Seeking Independence Find Safety Net Has Holes, Report Finds — ProPublica

From the article:

An independent monitor has found that many of the city’s most vulnerable remain stuck in troubled adult homes too long and that the state loses track of them once they move out.

Source: Mentally Ill New Yorkers Seeking Independence Find Safety Net Has Holes, Report Finds — ProPublica

This is a problem in myself state as well. We have too few resources, and people are being left out. I routinely got patients in the facilities I used to nurse at that were struggling from homelessness, abuse, and health issues because they needed mental health care and did not get it until they ended up in the ER in an escalated crisis.

I never hated nursing because of the care I could give to my patients, but because of a system that just failed so many people so badly.

Wish us luck!

Medicare’s Uncapped Drug Costs Hit Elderly Hard : Shots – Health News : NPR

From the article:

Unlike many private health plans, Medicare has no cap on out-of-pocket expenses for prescription drugs in Part D. As the cost of specialty drugs rises, some Medicare patients owe thousands of dollars.

Source: Medicare’s Uncapped Drug Costs Hit Elderly Hard : Shots – Health News : NPR

I saw this first hand when Medicare started up its Part D when I was a nurse in 2003. I literally sat down with elderly patients, and we sorted the medications they could do without and not die, or be so uncomfortable they felt like dying.

It is a travesty built on the unregulated costs the pharmacological industry is able to raise in a predatory manner, and the reluctance of our political representatives to institute legislation to protect our most vulnerable populations.

They did close what is called the “donut hole” which was if you were sick enough, and needed enough meds, there would be a stop in coverage. After a few thousand dollars of medications, it was thought you should pay your own, until you were “really sick” because folks that used more meds should pay more. This belies the reality that folks on more meds are probably too sick to have many resources left.

So now, they just don’t have a cap on drug coverage like any other sane insurance plan. They still pay 25% of their meds, and with the way drug companies price things? Jesus, that can cost.

The article dicsucxcs a man taking Copaxone that costs $75,000 annually. The patient will have to pay $5100 before it drops to $295 a month. I mean, I guess if you have MS and the med helps, but are poor? You just do without.



Wireless vulns in Medtronic’s implanted defibrillators allow remote shocks, shutdown, denial-of-service battery attacks and data theft / Boing Boing

From the article:

Medtronic is the most notorious maker of insecure medical implants in America, with a long history of inserting computers into people’s bodies with insecure wireless interfaces, toolchains and update paths, and nothing has changed.

In a new CERT advisory — scoring 9.3/10 for severity! — we learn that remote attackers can hijack a Medtronic implanted defibrillator and administer potentially lethal shocks, shut down lifesaving features, and put the device into a high power-consumption mode that drains the battery. A separate attack allows attackers to steal sensitive patient data from the device.

Source: Wireless vulns in Medtronic’s implanted defibrillators allow remote shocks, shutdown, denial-of-service battery attacks and data theft / Boing Boing

Just what the ever-loving-fuck is this? You have to have a defibrillator put into your body because your health is so at risk that you need that safeguard, and the damn company is so bad at their job you can get remotely hacked and potentially killed by some random person.

This is criminal negligence.

Trump Reduces Size Of Fines On Nursing Homes For Health Violations : Shots – Health News : NPR

From the article:

Inspectors are citing facilities more often than during the Obama administration. But in response to industry prodding, the average fine is nearly a third lower, and the total assessed is down.

Source: Trump Reduces Size Of Fines On Nursing Homes For Health Violations : Shots – Health News : NPR

This means more is wrong than ever in facilities that care for the vulnerable elderly, but Trump’s administration reduced the fines they will receive. Just fucking wow. Fuck everything about this.

A detailed analysis of American ER bills reveals rampant, impossible-to-avoid price-gouging / Boing Boing

From the article:

For more than a year, Vox’s Sarah Kliff has been investigating hospital price-gouging in America, collecting hospital bills from her readers and comparing them, chasing up anomalies and pulling on threads, producing a stream of outstanding reports on her findings.

In her latest installment, Kliff digs deep into the famously bizarre world of ER bills and points out some of the most egregious ways in which these are rigged.

For example, if you are injured and also financially precarious, you might travel to a more distant ER just to be sure that the hospital you’re visiting is in-network for your insurer, but that means nothing. “In-network” ERs often staff “out-of-network” doctors, and there is no way to find out whether the doctor treating you is covered by your insurer until you get the bill: one of Kliff’s readers got bills for $8,000 from an out-of-network surgeon who treated his broken jaw at an in-network hospital.

And much of the care you receive at an ER is subject to bizarre price gouging: one of Kliff’s readers was charged $238 for two drops of the generic eyedrop ofloxacin which retails for $15/vial; the routine pregnancy test that ERs administer to women of childbearing years can cost up to $465, enough to buy 84 pregnancy kits at the pharmacy; and one Seattle hospital charged $76 for a squirt of generic neosporin. Not all hospitals gouge on all drugs, and many of these drugs are not being administered for urgent health problems — a halfway honest hospital could advise a patient, “We charge $238 for this eyedrop, why don’t you pick up a bottle for $15 next door and administer it yourself?”

Source: A detailed analysis of American ER bills reveals rampant, impossible-to-avoid price-gouging / Boing Boing

I worked at an insurance company for a hot minute, while trying to get out of nursing. I couldn’t do it because the disconnect from the price gouging bullshit to how it would impact people’s lives was astounding.

My boss bought a new Jetta with a bonus for “saving the company money”. That was code for denying claims. I’m not even kidding.

It was so bad, when I was literally dying from Grave’s Disease because I had a thyroid storm on my own without medical intervention, I refused to go to the ER. We were destitute with me not working and my husband finishing his last quarter at college, and I knew we could never dig ourselves out of the costs for an uninsured ER visit that ws literally just a fishing expedition to figure out what was wrong with me. In hindsight, this was a terrible choice because people die of heart attacks during thyroid storms. Yah ‘Murica, where a nurse could not get medical insurance and nearly dies because of it.

The most telling part of the article is that after journalists discuss specific bills, the hospitals reverse them. This is an article that should be in everyone’s reading list if they deal with the US medical system.

GoFundMe CEO: ‘Gigantic Gaps’ In Health System Showing Up In Crowdfunding | Kaiser Health News

From the article:

Q: KHN and other news outlets have reported that hospitals often advise patients to crowdfund their transplants. It’s become almost institutionalized to use GoFundMe. How do you feel about that?

It saddens me that this is a reality. Every single day on GoFundMe we see the huge challenges people face. Their stories are heartbreaking.

Some progress has been made here and there with the Affordable Care Act, and it’s under fire, but there’s ever-widening gaps in coverage for treatment, for prescriptions, for everything related to health care costs. Even patients who have insurance and supposedly decent insurance [come up short]. We’ve become an indispensable institution, indispensable technology and indispensable platform for anyone who finds themselves needing help because there just isn’t adequate coverage or assistance.

I would love nothing more than for “medical” to not be a category on GoFundMe. The reality is, though, that access to health care is connected to the ability to pay for it. If you can’t do that, people die. People suffer. We feel good that our platform is there when people need it.

Source: GoFundMe CEO: ‘Gigantic Gaps’ In Health System Showing Up In Crowdfunding | Kaiser Health News

The thing is, that people that argue that they have great healthcare probably have never had an emergency so big that they expended it. There is simply so much that isn’t covered, or is only halfway covered.

I had insurance when my spouse worked at a CPA firm. We paid $50 a month for her insurance, and $450 a month to cover me. Not including dental and vision, which we could not afford on one income.

The diagnostic process to find out why I was literally dying from a thyroid storm due to Graves Disease had procedures that were only covered 80%. So that 20% hit close to $40,000. That was just for a 3 month period of diagnostic tests that were medically necessary to confirm my diagnosis. That 80/20 split will fucking kill you financially.

That doesn’t even go into mental health lifetime coverage caps, meds that are skyrocketing in cost because the companies that make them feel predatory pricing is acceptable.

I don’t care what you call it, universal healthcare or medicare for all, just cover everyone in this country already.