How many Americans are ill?

London-Virginia

Below you wil find a brief history cancer  research in Britain, and of the drug Tamoxifen. 

In 1896, George Beatson, a Glasgow surgeon, published details of three patients whose advanced breast cancer had responded favourably to oophorectomy (removal of the ovaries). This was the first hint that the hormone system was involved in cancer growth. Beatson's work led scientists to look for ways to block oestrogen's tumour-promoting activity.

By 1937, Dodds & Robinson had invented a chemical called diethylstilboestrol, which showed anti-tumour activity in an MRC trial in 1939. However, the high doses required produced severe side effects. Despite this, the drug became the drug of choice for prostate cancer a few years later.

In 1969, the synthetic oestrogen-blocker tamoxifen was first used to treat breast cancer at the Christie Hospital in Manchester. Tamoxifen is now widely used in breast cancer treatment, and Cancer Research UK has been at the forefront of research into the drug's effectiveness.

In 2002, a Cancer Research UK study, IBIS I, showed that tamoxifen could also be used to prevent breast cancer in high-risk post-menopausal women. However, tamoxifen is not without side effects, so Cancer Research UK is now looking at another anti-oestrogen drug, arimidex, in a study called IBIS II. Arimidex seems to be as effective as tamoxifen, but causes fewer side effects.

But let us not have a health contest, but continue to swap ideas !

London-Virginia

I meant to add, that somewhat sadly, 1969 was the year my lovely mother died of breast cancer, whilst under treatment at the above named hospital, Christie's.  Tamoxifen came too late for her.

But not for me.

Anonymous

I believe we can find sad stories about health care in all countries.  Some come south because the wait for certain tests are too long.  Many times it's a life vs death situation. And the people who come south are the ones who can afford to pay for that medical expense.

There definitely needs to be some kind of health care reform.  However, it cannot be RUSHED through.  This is a very big problem with no easy answers.  And, in this economy we just can't take on anymore deb.  While the CBO is estimating that it will cost OVER one trillion dollars in the next 10 years and still only 1/3 of the uninusred will be inusured, Pelosi and Dodd are poo-pooing this bipartrisan office and saying they will GET THROUGH health care no matter what!  Well, we need to fire the CBO.  And, there is NOT a plan.  We need a plan and Americans need to WANT the plan.

Rahm Emanuel said, "Never let a serious crisis go to waste.  What I mean by that is an opportunity to do things you think you could not do before."

Think about those words.

Anonymous

London-Virginia, I'm so sorry to hear about your mom.  Wasn't it 1969 when we put the first man on the moon?  I was pregnant with my first dd..so yes, it must have been.  We can do all kinds of extraordinary things, and we sit back wondering why.......................

mke

Yes it was 1969, the year I married.  One of the most exciting years of my life.  My husband was part of the lab that got the first moon rocks and my jewelery box holds a grain of sand from the moon.  I've joked that many women have been promised the moon, but I actually got a part of it.

I don't wonder why we can put people on the moon but not cure cancer.  Getting to the moon was just engineering, although great engineering.  The universe inside us is more mysterious than that outside our atmosphere.

Anonymous

Another reason I don't want government run health care.  I can't believe what I read.  Geez!

At V.A. Hospital, a Rogue Cancer Unit

http://www.nytimes.com/2009/06/21/health/21radiation.html?pagewanted=1&em

pip57

Of  course this is a tragic story.  But I question whether it is just a problem in state hospitals.  I would think that private hospitals are better able and financially encouraged to cover up problems.  And since we are dealing with human professionals and human patients, mistakes are bound to occur.

pip57

"In a two-tiered health-care system, one may expect the private system to provide better care. Many people who pay for private health insurance expect there to be fewer mistakes in private hospitals. Yet adverse incidents occur in both private and public hospitals. We just hear more about mistakes in the public system.

While public hospitals report adverse incidents, private hospitals are not forthcoming with such data. As a result, there are no official figures comparing adverse incidents in private and public hospitals. However, there is anecdotal evidence that patients with complex medical and nursing needs may be safer in a public hospital."

The entire article is at http://www.theage.com.au/articles/2003/08/21/1061434983449.html

Anonymous

prettyinpink, I understand what you are saying.  But our VA system is HORRIBLE.  My dh never signed up for it, and I wouldn't want him to go to a VA hospital.

A friend of mine's, who belongs to this board, husband is a retired officer from the Navy.  They have an insurance called Tri-Care.  It is almost impossible to try to find a doctor that participates in that government insurance.  Why?  Because they don't pay enough.  And, she has to get approval every six months or, perhaps, it's once a year from her primary to see a specialist..her oncologist.  How dumb is that.  It's a bunch of bureaucratic crap.

The government is too good at running anything.  The government has it's hands in too much now. 

pip57

From what I have heard from my American friends, it is going to be a huge overhaul needed to incorporate the 'health care for all' approach that we have in most other countries.  I just can't see the huge insurance companies giving up a big chunk of their profit without a war.  I do hope that someone will come up with a solution soon though as it seems that the ideas have been bandied about for decades now.  As far as I can see, the situation just gets more complicated as time rolls on.  I will have to check my Canadian history and see how the transition was made here.

crazy4carrots

I watched an interview on CNN about a Texas woman whose BCBS insurance coverage was cut off just before she was to have bc surgery.  Apparently she had overlooked notifying them of a "pre-existing condition -- warts".  She got in touch with her congressman and took her case to the highest levels of gov't. It's an abominable insurance practice called recission (sp?) and 3 insurance CEO's say their companies will likely continue the practice, even in cases that are not fraudulent.

So, I guess for folks like Shirley who have excellent coverage, this sort of thing isn't worrisome.  But think of being in this Texas woman's place, and having to fight so hard for the right to treat her disease.  This sort of behaviour shouldn't happen in a non-profit environment.

cp418 has posted the CNN video in another forum, BTW.

mke

I just talked to my MIL, an army officer's widow, about Tri-care.  She loves it.  She's about 88, says she sees her eye doctor yearly - no charge and no approval that she has heard of.  She's pretty healthy so she has no other specialist that I know of.   She co-pays $3 per month for a generic drug and would pay $9 for a brand if she took one.

She has difficulty walking so got this chair called a "hover-round".  It is a motorized wheelchair that turns on a dime (so to speak).  It's a pretty slick gadget that has allowed her to remain in her house and independent.  Her upper body is strong so she hover-rounds from one place to another and then hoists herself from chair to bed/toilet/easy chair, etc.   Medicare picked up part of the cost, Tri-care paid the rest.

According to her getting Tri-care was like getting a $100 raise per month because she could drop the medicare supplement that was a pain to deal with.

crazy4carrots

Starla, you might want to read a recent article in Forbes Magazine (you can read it on-line) about drugs being used in the U.S. that are incredibly expensive but not effective in the tx of various cancers.  Also, what may be happening in the U.K. is NOT what's happening in other countries that have universal healthcare.  So try not to worry too much....

revkat

I get my health care through a huge non-profit HMO where the doctors are salaried. I can see any doctor in their multi-state network -- and we have had no problems with getting referrals to specialists our of our area. I never recieve a bill for any services, just pay a small co-pay for some of them. The doctor never orders something that they will refuse to pay for. The emotional benefit of avoiding fighting with insurance companies has been huge for me. The downside is that they won't pay for non-approved treatments. But what does non-approved mean? It means that they only pay for treatments that have been shown to actually benefit the patient. I'm ok with that. If a public plan for universal health care in the US looked like my HMO I would be very happy with it.

OTOH, one of my husband's collegues who chose the premium POS type insurance, has had nothing but headaches as his wife went through breast cancer treatment this year. Lots of phone calls to straighten out clerical errors, lots of having to send in forms justifying treatments, just lots of hassle. Insurance companies reward employees who find ways to avoid paying for claims. Why should there be this middle-man who is out to make a profit standing between doctors and patients?

crazy4carrots

Revkat, it's great to hear good stories like yours with your HMO, and MKE's MIL with Tri-Care.  It almost seems as though it's the luck of the draw, though, and I think that's what bothers those of us living in other countries the most -- health coverage shouldn't be a crapshoot.  We have enough of that in other areas, don't we?!

revkat

lindasa -- I totally agree with you! I would be happy with the trade-offs to have a system like Canada's or the European countries here! (don't tell otter and shirley).

Anonymous

This should make everyone feel better.  A very insenstive answer.  I still don't get why he answered like this.

Obama to Jane Sturm: Hey, take a pill

http://www.youtube.com/watch?v=U-dQfb8WQvo&eurl=http%3A%2F%2Fwww%2Ebreastcanswers%2Ecom%2Fbcforum%2Fviewtopic%2Ephp%3Ff%3D48%26t%3D247%26start%3D25&feature=player_embedded  

iodine

Oh, I'm going to be so sorry I did this.  I'm sure to be flamed.

there are millions of dollars wasted, yes, wasted, on end of life treatment for many, many Americans.

My own MIL was 78 and very ill.  She had liver disease and there was nothing left to offer her, except !  the brilliant transplant surgeons in Dallas discovered that she passed the "long green test" ie: she had some money.  Since Medicare would not pay for liver transplants at that time (many years ago), my MIL could give them $150,000 to cover a transplant--ALTHO !, she was in no condition to undergo the surgery and they had no real confidence that she would either survive or improve her quality of life.

So she received a liver transplant that could have gone to a younger, healthier person with a long life in front of them. Post op she remained in ICU at $10,000 a day (and more) for over 5 months. (add that up if you like)   She had no idea who She was, let alone who her son or husband were.  My FIL became so depressed driving back and forth to Dallas that we finally convinced him to quit going except once a week.  We were concerned he would eventually take his life. 

She was finally moved to a nursing home across the street from the hospital and died 6 hours later.  The transplant surgeon called my FIL to advise him of her death, and remarked, well, at least we finally got her out of the hospital.  BS

Now, I certainly understand that not all older folks are debilitated.  My FIL lived to 93, still driving and taking care of himself.  He had bladder cancer and was surgically treated and did well for 12 years till his death.

So I Can see more than one side of the picture.  The bottom line is that Too Many institutions and providers provide treatment, testing, or other---SIMPLY BECAUSE THEY CAN.  Not necessarily because it will improve quality of life.  My own mother was on life support,in ICU,  which she would not have wanted, and all sorts of lab tests and other things were done to her before she passed away, even after they were requested to leave her alone.  But they got a bunch of bucks from Medicare (that was before they had DRGs determining how many hospital days Medicare would pay for.

As a nurse, I have had many discussions with families of  dying patients.  Many, many times the child of these poor patients has a guilt trip and demands that EVERYTHING possible be done for his parent, no matter that all that action can be painful and prolong dying----not extend living.  (my own brother was one of these)  Of course, this child has to pay Nothing for this all possible care.  I do wonder how adamant the child would be if the bill were sent to the family and not Medicare.

 By the way, the Dallas hospital failed to get a signature on the operative permit or on the promise to private pay the bill.  It still cost my FIL a BUNDLE.  Not just in dollars.

We will have to begin to decide how much we as a people are willing to commit to prolong the death of our loved ones.  And ourselves.

abbadoodles

Dotti, I won't flame you on this.  I have also heard that end-of-life treatments and hospitalizations on terminally ill people account for a massive, huge, monumental portion of health-care spending when all the money does is prolong a miserable life, without hope of recovery, for a month or two.  All because either the family won't let go or the docs and hospitals don't want their butts sued.

No, I don't have stats.  This is just what I've heard.  It would be interesting to find out the truth, wouldn't it?  Where would one start?

Anonymous

Dotti, I would never be angry at what you are saying.  You have seen plenty being in the medical profession.  And, I'm sure your dh has also. 

There is a lot of waste and abuse in the system.  Yes, that needs to be fixed.  There are no easy answers.  All I'm saying is we need to take our time on something this big.  We absolutely need to let our families know what we want.

My experience...My dd's step-mil had stage IV bc over 13 years ago.  They sent her to Duke.  They did some kind of "super duper" chemo on her.  I didn't know her at the time.  Also, she had to stay in the hospital for the chemo.  She was NED (as far as we know) for 10 years.  The cancer came back.  They started chemo..did more tests and found it somewhere in her intestines or stomach.  We never really discussed exactly where it was.  However, she wore an ostomy bag.  She had surgery for some tumors blocking something.  He had several tumors, thus the ostomy bag.  The surgeon said there was nothing they could do.  However, she wanted more chemo and her onc agreed to do it.  Carolyn (that's her name) loved life.  She loved her family, friends and adored her gks.  We may have not chosen her path, but she lived at least two years longer.  Her qol was fine for her.  To make a sad story short, she ended up back in the hospital, had more surgery.  Again back in the hospital.  Hospice was called in.  Finally the Hospice nurse asked her if she wanted them to respect her wishes.  She looked at her husband and said, "It's bad, isn't it."  He couldn't answer.  The sweet hospice nurse took her face in her hands, turned her face toward her, and said, "Yes, it's bad."  So, they disconnected the IVs.  Some family members were staying with her and her dd crawed in bed with her and fell asleep.  Carolyn died peacefully beside her dd.

Carolyn did what she COULD do those last couple of years.  However, she was very happy to be alive.  Did it cost money..you betcha.  Should she have denied the "waste" because she only lived a couple of more years and her qol may not have been seen suitable for the professionals or whoever makes decisions?  I say NO.  Carolyn was happy.  I cry as I write this because she was such a lovely human being.

Like I said, there are no easy answers.  I don't want to see a health care bill FLY through the House and Senate like other Bills have been flying through without reading and understanding the consequences.  I believe Carolyn had a right to chose the way she wanted to die.

Just my take on it.