More on Kent Pankow & Ridiculous Right Wing Statements

Kent Pankow’s story is really drawing a lot of attention in the US, and I found what seems to be the source of it, on popular right wing blog HotAir.com. Here’s their posting on the story.

http://hotair.com/archives/2010/03/10/another-tale-of-government-run-health-care-success/

Again, this post erects a strawman comparison of the current reform proposals in the United States, which bear no resemblance to Canada’s system, and throws around the “government takeover” lie that opponents of reform are using in their typical strategy of lying and fearmongering to block any sort of meaningful change.

Again, this blog cherrypicks the story and has no interest in looking at comparative experiences in the United States.

But that’s not the real gem. Oh no, it gets better than the tired rhetoric.

Here’s the killer:

“Some will say that the runaround happens in America, too, with private insurers. And they’d be right. [warriorbanker’s note: that’s probably the most honest thing I’ve heard a right winger say about healthcare] However, people in America have the ability to move to different insurers when they get lousy service, and still get treatment in their own country. They don’t have to flee across an international border to get medical attention.”

Really?

Really? You actually believe that?

Let me get this straight. Let’s assume I’m suffering from a pernicious cancer like glioblastoma multiforme, which has a tragically low five year survival rate and requires either surgical intervention or extremely expensive chemotherapy to treat. The usual chemo treatment is Temodar, which is not a cheap drug (though I think comparatively it’s cheaper than Avastin). Googling Temodar brought up a few sites with American cancer patients and their families discussing struggling with the cost of copayments for the drug. So it’s not as though it’s a rosy picture even without Avastin, which as I mentioned in a previous post, is a sort of “silver bullet” against cancer, it was described by one doctor as the penicillin-level discovery of our time.

Anyhow, back to this insurance claim made by hot air. Suppose I was the theoretical patient I described. My insurer goes to battle with me about the treatment options. Before they would be likely to approve Avastin I’d likely have to go on Temodar and show no progress. The FDA’s approval of Avastin to treat GBM (it’s here: http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm149364.htm ) seems to suggest that it has to be used after other treatment is not effective. I may not be reading that right, though. I’m not a doctor. I’ll get to another point about the FDA in a moment though. So suppose I conclude I’m getting “lousy service”. Hot Air’s Ed Morrissey suggests that I have the ability to move to a different insurer. If you believe that, we need to talk about some real estate opportunities I have to share with you.

Private insurance companies are in the business of making money. That’s what they do. That is their single crucial interest. They do so by trying to take on as little risk as possible, matching premiums to expected payouts, and trying to get as much information as possible about a person before they take them on. That’s why they have pre-existing condition exclusions, which me in this hypothetical state would face. No insurer would EVER take on someone who’s already got GBM or probably any cancer – at least not without excluding coverage for the treatment of that cancer – or anything that could be considered linked to it or its treatment. Like, well, just about anything. Cancer drugs have a lot of really, really nasty side effects – and even minor ones like diminished immune system resistance to simple conditions. Some cancer treatments can actually be essentially carcinogenic. A cynic I know described her chemotherapy radiation therapy as “poison that will hopefully kill my cancer before it kills me”. It’s not hard for an insurer to assess just about anything a cancer patient could claim as being related to pre-existing conditions.

So, the idea that one can shop their insurance is rather ludicrous. By the time one comes to the conclusion that their insurance is “lousy”, it’s probably far too late to shop around. Never mind that if you’re in a group plan, which is tax advantageous and helps get around eligibility rules in the United States, you’re not going to get a choice of who your insurer is – your employer will determine that. This idea of being able to shop insurance around that HotAir is suggesting is what some might call “horsefeathers”. I’m blunt, I’ll just call it bullshit.

What about fleeing across international borders? Americans don’t have to do that? Actually, that’s also not necessarily true. Medical tourism in the US is big business already, and it’s growing. Here’s some great stories:

http://www.businessweek.com/globalbiz/content/mar2008/gb20080312_835774.htm

http://www.aishealth.com/ManagedCare/BluesNews/BLU_WellPoint_Medical_Tourism.html

And there’s probably hundreds more sites – these are insurers trying to get people to use overseas services. As costs soar, people will try to keep their premiums down by electing progressively less coverage with higher deductibles/copayments, and that’s likely to push more of them to look at going to Thailand, to India, to other countries to use lower cost services. That’s what the right thinks is an okay system (while they seem to deny it actually even happens? So much for that claim, I don’t think I need to go any further.

Back to the FDA to close out my post. Remember Mr. Pankow, and how the problem is that his treatment for his GBM isn’t being covered by his provincial health insurance because it’s not an approved treatment in Canada yet? Well, it’s not like it’s a huge disparity. Avastin was only approved for treatment of gliomas in the US in May 2009. Not exactly ages ago. While I’d like to see Health Canada have a better process to use research data from the USA to expedite its own processes, there’s processes and they exist for a reason. The sad part of them is that they trap people waiting for the approvals like Mr. Pankow. That’s why I hope that there’s some retroactive coverage for him. Again, I wish him much strength and success in his challenges.

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