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Gizmo

Rabble Rouser
Is anyone here up for a discussion about how health care should be funded? It's not that I want to stir up s*** on here (no really) but every time I see a thread like this - and I seem to see a lot of them lately - I'm reminded that I live in a country where health care for the populace is funded out of general taxation, and that most of us in the UK like it that way.

Most Americans here, on the other hand, seem happy with the status quo in their country too where health care is concerned (or at least they aren't saying anything to the contrary), and that's a divide which puzzles me. Maybe most of us think our country and the way it does things is the best.

In the US it is more complicated than " funded ".

The US Gov't already runs a health care system called the VA ( Veterans Administration ) & it is dysfunctional.

Meficare ? Frought with fraud.

Obama Care - all 2500 ill defined pages ? Without a single word about TORT REFORM ?

The US Gov't has yet to figure out how to do much besides make politicians into millionaires.

Yes, the US needs healthcare somewhat sanely implemented .
 

Cat's Squirrel

Gold Meritorious Patron
In the US it is more complicated than " funded ".

The US Gov't already runs a health care system called the VA ( Veterans Administration ) & it is dysfunctional.

Meficare ? Frought with fraud.

Obama Care - all 2500 ill defined pages ? Without a single word about TORT REFORM ?

The US Gov't has yet to figure out how to do much besides make politicians into millionaires.

Yes, the US needs healthcare somewhat sanely implemented .

In what way?
 

Gizmo

Rabble Rouser
In what way?

Pretty plain I thought ...
In the US it is more complicated than " funded ".

The US Gov't already runs a health care system called the VA ( Veterans Administration ) & it is dysfunctional.
[ Get some competent management instead of political cronies to run it ]

Medicare ? Frought with fraud.
[ Get a gripe on managing it. Get the on-the-gov't-payroll -crooks out of the system. cut the red tape .simplify. Run it like a business not a gov't home boy club.]

Obama Care - all 2500 ill defined pages ? Without a single word about TORT REFORM ?
[ Scrap. rewrite using health care professionals not gov't pencil pushers. Address tort reform. Eliminate lobby fund receiving politicians from writing laws that benefit those who they lobby for.
All politicians limited to 2 terms. No politician accept money from any lobby group]

The US Gov't has yet to figure out how to do much besides make politicians into millionaires.
[ make it illegal for politician to be bought & paid for by lobby groups]

Yes, the US needs healthcare somewhat sanely implemented .
[Outlined above! ]
 

Udarnik

Gold Meritorious Patron
That might possibly be happening. I have taken one or two meds that are available in some asian countries and in Mexico - or somewhere - but not available in USA Brit NZ OZ etc. There could be other reasons than simply using less litigation-conscious and more obedient patients ----the govt regulations may be more relaxed, but I can't help wondering if there is an element of using other populations as the guinea pigs. The meds I am talking about are not totally untested. Actually there was a drug I took for sleep once. It really knocked me out. Checked it on internet and found it is widely thought of as a date rape drug and therefore very very restricted now in USA. And, FWIW, in the country I am in now amphetamines are banned I think, even though there has never been abig problem with them here AFAIK. In Thailand there were a few easy to get meds without prescriptions but now they are tightening up because of abusers.

I have no Internet and cell service is spotty out here (plus no one speaks English), so I'll deviate from my normal MO and keep this short :lol:.

No matter where you do the trials, the Treaty of Helsinki applies. There is a shift to 2nd world countries, due to the fact that any have not had access to "gold standard" drugs in the 1st world, and many trial designers work better in naive patients. You can't do trials in thev3rd world because the shitty healthcare in everything you are not studying confounds he results. I worked on a drug tested in India, and a patient died because they had minor outpatient surgery, the surgeon FORGOT TO TAKE OUT THE GAUZE, that parent aspirated the gauze and choked to death. obviously not drug related, but also obviously, that patent was lost to follow up.

More later when I get back to civilization.
 
I have no Internet and cell service is spotty out here (plus no one speaks English), so I'll deviate from my normal MO and keep this short :lol:.

No matter where you do the trials, the Treaty of Helsinki applies. There is a shift to 2nd world countries, due to the fact that any have not had access to "gold standard" drugs in the 1st world, and many trial designers work better in naive patients. You can't do trials in thev3rd world because the shitty healthcare in everything you are not studying confounds he results. I worked on a drug tested in India, and a patient died because they had minor outpatient surgery, the surgeon FORGOT TO TAKE OUT THE GAUZE, that parent aspirated the gauze and choked to death. obviously not drug related, but also obviously, that patent was lost to follow up.

More later when I get back to civilization.

Thanks. Will forego provocative questions about how patients in 2nd world countries will be naive, but presumably those who are researcher's assistants, and even doctors, are not naive. Will also forego questions about....never mind.
Yes, I can imagine the horrors of having to do serious research in some places, even the purely admin aspects of it would be enough to drive a person loopy!
Good luck to you.
 

Udarnik

Gold Meritorious Patron
Thanks. Will forego provocative questions about how patients in 2nd world countries will be naive, but presumably those who are researcher's assistants, and even doctors, are not naive. Will also forego questions about....never mind.
Yes, I can imagine the horrors of having to do serious research in some places, even the purely admin aspects of it would be enough to drive a person loopy!
Good luck to you.

Are you being deliberately funny, or did you misunderstand what I meant by "naive"?

In medicine, a patient is naive to something if they've never been exposed to it: a drug, a virus, whatever.

In the 2nd world, a lot of patients are not given what's gold standard in the West because it costs too much, but otherwise their healthcare is pretty cromulent - in general their surgeons don't leave their tools in them after an operation. And if they get TB, they get isoniazid and rifampin and get better. But they won't get, for example, Enbrel for their Rheumatoid Arthritis, they'll get methorexate and steroids, and maybe leflunomide on top of that if they fail that regimen.

Those patients will enter an Enbrel trial because their current regimen isn't working all that well, and the trial gives them access to Enbrel, which they otherwise would never get, or get only after a lengthy waiting period in their country. Meanwhile, the drug company gets an Enbrel-naive patient, in fact a fair amount of them. To find such a patient in the US would mean recruiting them right at the exact time their doc decides "enough is enough" on methotrexate. It's really hard to find enough sites with enough of those kind of patients who are switching right during the 18 month time window of a clinical trial recruiting period (and of those eligible, not all will volunteer for the trial...). The 2nd world option is a win-win-win for the 2nd world patient, the Pharma company AND the first world regulators who want to see how the new drug really performs in a naive population.
 
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