THANK GOD for PRIVATE HEALTH INSURANCE

[Sbane]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

Ok but at the same time, you were proving why some of us have very serious issues with a government system.

But while he has personal evidence to go by, you have only "could" and "might" and "maybe" tossed in with a bunch of "LONG WAITS AND SOCIALISM"

Oh, ok, so until I prove that the system would be a complete failure, we ought to jump at every proposal. Brilliant.

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

[Sbane]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

Except they would care. They may not have a profit motive like private insurers do, but they do have the same problem that private insurers face, that being limited resources and virtually endless demand. Their solution pretty much ends up being the same as private insurers as well - they ration. This happens in both public and private systems, though what type of care is rationed and how may vary.

Yes common sense measures should be taken like using the cheaper drug when possible. If the doctor had prescribed him the more expensive drug to begin with, I can see why the insurance company would have a problem with it and why they would recommend a cheaper option. In this case the cheaper option was explored and when it was proven to be ineffective, the doctor decided to go with the other option. At this point I do not feel the insurance company has a right to deny him the drugs. They can try and present other options to the doctor, but they shouldn't be pulling dick moves like saying his asthma doesn't even exist. This is extremely shoddy service and would not be acceptable in almost any other field except for health insurance.

[Sbane]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

Except they would care. They may not have a profit motive like private insurers do, but they do have the same problem that private insurers face, that being limited resources and virtually endless demand. Their solution pretty much ends up being the same as private insurers as well - they ration. This happens in both public and private systems, though what type of care is rationed and how may vary.

Yes common sense measures should be taken like using the cheaper drug when possible. If the doctor had prescribed him the more expensive drug to begin with, I can see why the insurance company would have a problem with it and why they would recommend a cheaper option. In this case the cheaper option was explored and when it was proven to be ineffective, the doctor decided to go with the other option. At this point I do not feel the insurance company has a right to deny him the drugs. They can try and present other options to the doctor, but they shouldn't be pulling dick moves like saying his asthma doesn't even exist. This is extremely shoddy service and would not be acceptable in almost any other field except for health insurance.

Well, I don't know why they said he didn't have asthma anymore - the problem could have been caused a simple bureaucratic snafu, which again can happen in both kinds of systems. You should hear about the hoops that my Canadian co-worker has had to go through just to get his green card renewed after a small snafu in the paperwork. His driver's license also expired, which means he hasn't been able to drive for the last seven to eight weeks since he needs a valid green card to get that renewed. Just this week they finally said his case is good, but they won't be able to send him his card for up to another sixty days since they have a problem with the machine that prints them. Point is that in either system's bureaucracy, if one person puts one bad piece of information on a piece of paper or into a computer it can completely screw things up. Of course companies shouldn't be allowed to outright lie, but we can't show with any degree of certainty that they did in this case.

None of this is relevant to my previous point though, which is that both systems will care about how much they are spending on you and they will ration care accordingly.

I agree that both options have bureaucracies which are at times inefficient and make mistakes. That said a lot of these "mistakes" by insurance companies seem to be intentional.

[Sbane]

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

I don't care that the insurance companies have competition. I love competition and I'm certainly not some insurance company hack but we're talking about a program that would cost so much money that it's just not feasible. Pointing to "every other developed nation" only goes so far, by the way. There are reasons why we can't implement such a system even though "every other developed nation" has done so.

Why can't America do it when every other developed nation can?  

[Sbane]

My point with the second sentence is that I don't think the government insurance would give a damn about whether or not my asthma med cost $289 or $45.  They'd pay for whatever the doctor prescribed me.

What BC/BS obviously tried to do was keep me on the cheaper Proventil, despite it being ineffective, just because it was cheaper.

Plus there is the fact that you changed from one class of asthma drugs to another.  You went from using a β₂-agonist to a combination β₂-agonist / glucocorticoid, so it wasn't as simple as simply trying a different medication to produce the same effects.

But it was producing the same effects. The budesonide (glucocorticoid) reduces inflammation which helps alleviate the symptoms of asthma and it works in conjunction with the sympathomimetic formoterol, which is a bronchiodilator. This combination of drugs has the same effect as albuterol (proventil) so I don't see anything wrong with the doctor prescribing it. It's not as if he was being switched to a BP drug or anything like that. The doctor was just seeing if reducing inflammation in conjunction with stimulating the SNS would produce a more desired effect than the sympathomimetic alone.

[Sbane]

Well the current system isn't working so shouldn't we try something else, something we have a model for from every other developed nation. I don't see what's the harm in giving the insurance companies more competition with the option of a public plan. The level of service provided by them is horsesh**t as proven by the OP's example and countless others. Perhaps private insurance itself will improve as a result of competition.

I don't care that the insurance companies have competition. I love competition and I'm certainly not some insurance company hack but we're talking about a program that would cost so much money that it's just not feasible. Pointing to "every other developed nation" only goes so far, by the way. There are reasons why we can't implement such a system even though "every other developed nation" has done so.

Why can't America do it when every other developed nation can?  

These other developed nations are much, much smaller countries. We have enough problems with other enormous entitlement programs in this country so it's best to avoid another.

I like Snowguy's idea of making states provide universal care. A smaller system will certainly be better than one huge national one, although a national healthcare system could probably push down costs more effectively.