Monday, July 27, 2009

The Nexavar / Medicaid challenge

Medicaide turned down the doctor's request for Nexavar ( Amiee. Too expensive. That's a blog post for another day. Anyway, last Friday we went to the hospital to filll out the paperwork to request Naxavar from Bayer for "compassionate use".

Her oncologist at North Broward Cancer Center has been amazing. We have been incredibly fortunate to have an aggressive, young doctor with no ego and tremendous passion. He has treated Amiee as he would his own daughter and that continues to give us comfort through all of this. He mentioned the 'chemo pill' a week or so ago, then seemed to try to brush it off. Her tumor is enormous and the pill is used for liver cancer, but aparently is showing some success in shrinking sarcomas, so we are holding our breaths. First, to be granted compassionate use to get the pills due to their outrageous expense, and next, that they work.

These are the issues being addressed by President Obama today:

  • Young adults 18 - 28 are the most under-insured population in the US today
  • Uninsurable due to "preexisting condition"
  • Exhorbatant pharmacutical costs to the consumer


• The United States is the only industrialized country in the world without a universal
health insurance system.
• In 2006, the U.S. census reported that 46 million Americans (recently revised downward
to 45 million) have no health insurance.
• “Over a third (36%) of families living below the poverty line are uninsured. Hispanic
Americans (34%) are more than twice as likely to be uninsured as white Americans,
(13%) while 21% of black Americans have no health insurance.”
• More than 9 million children lack health insurance in America.
• Eighteen thousand people die each year because they are uninsured.
• According to the UN Human Development Report, “The uninsured are less likely to have
regular outpatient care, so they are more likely to be hospitalized for avoidable health
problems. Once in hospital, they receive fewer services and are more likely to die in the
hospital than are insured patients. They also receive less preventive care. Over 40% of
the uninsured do not have a regular place to go when they are sick and over a third of the
uninsured say that they or someone in their family went without needed care, including
recommended treatments or prescription drugs in the last year, because of cost.”
• Half of all bankruptcies are caused by medical bills. Three-quarters of those filings are
people with health insurance.
• U.S. health care spending is approximately $2 trillion per year, or $6,697 per person.
The United States continues to spend significantly more on health care than other
countries in the world.
• Administrative costs account for 31 percent of all health care expenditures in the United
States. The average overhead for U.S. private health insurers is 11.7 percent; for
Medicare, it is 3.6 percent; for Canada’s national health insurance program, it is 1.3
• According to the UN Human Development Report, while the United States leads the
world in spending on health care, “countries spending substantially less than the US have
healthier populations.… The infant mortality rate for the U.S. is now higher than for
many other industrial countries.”
• A baby born in El Salvador has a better chance of surviving than a baby in Detroit.
The infant mortality rate in Detroit is 15.5, compared to El Salvador's rate of 9.7.
• Canadians live three years longer on average than we do.
• A study in the Journal of the American Medical Association found that older
Americans are significantly less healthy than their British counterparts - we have
more diabetes, heart attacks, strokes, lung disease and cancer. Even the poorest Brits
can expect to live longer than the richest Americans.
• Cubans have a lower infant mortality rate than the United States and according to the
U.N. Human Development Report, a longer average lifespan.
• Over the next decade, the federal government will give the drug and health care
industries an estimated $822 billion as a result of the 2003 enactment of Medicare Part D
(the Medicare prescription drug plan).
• There are four times as many health care lobbyists in Washington as there are members
of Congress.
• Ninety percent of Americans believe the American health care system needs fundamental
changes or needs to be completely rebuilt. Two-thirds of Americans believe the federal
government should guarantee universal health care for all citizens.


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