# Terminal Oregon Patient refused costly Drug, however



## R y a n (Apr 4, 2005)

... she was offered a lower cost physician-assisted suicide drug if she wanted to go with that option. 

Ok... I think it is high time our obscene, for-profit "health care" system, which is profitable only so long as it successfully denies care to the sick, gets a swift kick in the a$$.

This just in *from Oregon:*



> The news from Barbara Wagner's doctor was bad, but the rejection letter from her insurance company was crushing.
> 
> The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her *last hope was a $4,000-a-month drug* that her doctor prescribed for her,* but the insurance company refused to pay*.
> 
> ...


I can see both sides to this...

On the one hand if her doctor prescribes the drug, her health coverage should provide it, as it is last ditch end-of-the-line effort.

On the other hand, perhaps this women shouldn't have smoked her whole damn life and then expected every other insurance policy holder to subsidize her feeble attempt at recovery.

But I DON'T think we should allow that insurance companies see dying as a cost-saving measure, and use it as a quid pro quo justification for a denial of benefits.

:******:


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## Chuck Smith (Feb 22, 2005)

Here is the one thing before anyone goes off on the insurance company and health care system.....we don't know the whole story.

Is the drug experimental? 
What does her policy cover? (Different policies cover different things.)
Is the drug on the list of drugs covered in her policy?
What is the amount of coverage she has on medication? (again different policies....co-pay, etc)

I could go on and on.

Health is insurance is like an auto policy....you have liability, full coverage, comp coverage, etc. Now if you are paying for liability and you crash your car.....you should not get a new car. Health care policies are the same.....if you are just a basic coverage (major surgeries)....like many policies out there you should not get everything including medication paid for.

So that is why when articles like this get published it is the media attacking something (health care in this case), or someone.

A lot of the story is not being told.


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## R y a n (Apr 4, 2005)

Chuck Smith said:


> Here is the one thing before anyone goes off on the insurance company and health care system.....we don't know the whole story.
> 
> Is the drug experimental?
> What does her policy cover? (Different policies cover different things.)
> ...


Most of your questions are covered in the story. It is really well written and researched.

Take a moment to go read it.


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## Chuck Smith (Feb 22, 2005)

So her plan did not cover the $4000 a month drug....



> A lifelong smoker, she was diagnosed with lung cancer in 2005 and quit. The state-run Oregon Health Plan generously paid for thousands of dollars worth of chemotherapy, radiation, a special bed and a wheelchair, according to Wagner.
> 
> The cancer went into remission, but in May, Wagner found it had returned. Her oncologist prescribed the drug Tarceva to slow its growth, giving her another four to six months to live.
> 
> But under the insurance plan, she can the only receive "palliative" or comfort care, because the drug does not meet the "five-year, 5 percent rule" -- that is, a 5 percent survival rate after five years.


But the other drug is covered......how is this the health care providers problem. Like I stated early. People want all the coverage in the world just as long as they don't have to pay for it. It is like the auto insurance example I gave.

Yes this is a sad situation, very sad but reality.


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## R y a n (Apr 4, 2005)

Not even sure if she had a "plan" as she was living off the government dole wasn't she? Her doctor simply prescribed it as a last ditch hope.

Let's face it. The health care system is broken. It is a fact. And although that's a bad letter, being poorly written and untimely, however I believe that "death with dignity" statute in Oregon is still a good law.

The Oregonian editorial, "Fix this medical Ethics Glitch" covers it well.

http://www.oregonlive.com/editorials/oregonian/index.ssf?/base/editorial/1217289319150190.xml&coll=7

From that article:



> "Predictably, critics of Oregon's unique-in-the-nation law are aflame over Wagner's story, some claiming it covers killing but not cancer. That's not exactly true, of course. The program that rations subsidized health care for low-income Oregonians has paid thousands of dollars over the years for Wagner's cancer care, and it will continue to do so.
> 
> *It stopped short, however, of paying for a cancer drug that failed to meet the state's long-standing "five-year, 5 percent rule." It won't approve payment for treatment that doesn't provide at least a 5 percent chance of survival after five years.*
> 
> ...


On a personal level I feel for her, but if we ever move to *any* type of a nation health care system we're going to end up having to do *more* of this type of triage. We as a society better start addressing these morality issues now, that is before we see the floodgates really open.

Where do you draw the line? What is fair?


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## Chuck Smith (Feb 22, 2005)

I agree that the system is flawed. But the system also needs rules or everyone would be going in for the sniffles.

In this article the lady wanted something for nothing and the paper went with it.

Here is an example of one of the best health care systems in the world and how they had to revamp what coverages they gave employees...

The Mayo Clinic.

It used to be everyone was covered in your family for everything 100%. At a very low cost. They have cut that back because too many employees were taking advantage. Yep going in for anything and everything. Take up doctors time when it could have been spent on more pressing issues or patients.

Now they still provide great benifits but you choose the plan and pay extra for the amount of coverage.


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## hunter9494 (Jan 21, 2007)

R y a n said:


> ... she was offered a lower cost physician-assisted suicide drug if she wanted to go with that option.
> 
> Ok... I think it is high time our obscene, for-profit "health care" system, which is profitable only so long as it successfully denies care to the sick, gets a swift kick in the a$$.
> 
> ...


*by golly ryan, i agree, i don't think we should allow insurance companies to make the decision either, but you know what son?........yep, the NO-bama "budget" health care plan will have the GOVERNMENT make the decisions and God only knows, a NO-bama health care plan will cover euthaniasa too! yep, some things will never "change".*


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## R y a n (Apr 4, 2005)

:lol:

We probably agree on much more than you think h94.

Half the time I take a position on a topic just to provide a different perspective for others to consider. It doesn't mean I'm endorsing that position, just that it needs presenting so that others understand it from a different angle.

:thumb:


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## swift (Jun 4, 2004)

I want a new computer program that will make my internet speed faster and help do my bills for me. The one I use now does that but not as quick. With the new program I can probably save 90 seconds a day. BUT Microsoft wont give it to me. I mean cmon they make millions in profits every year so why can't they give it too me.


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## Chuck Smith (Feb 22, 2005)

My question for everyone here....

How is the insurance company in the wrong???

They set up rules and they followed them. This lady knew or should have know what her plan covered.

Now they will pay for one drug and not the other based on the rules they have set for the company.

How are they in the wrong???


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## swift (Jun 4, 2004)

chuck you are right. People don't want to see healthcare as a business. They think they are entitled to it for free. They cry foul when someone that has not followed a healthy lifestyle becomes ill and cant afford treatment. News flash for the bleeding hearts out there. Everyone will die someday. Using a 4000 dollar per dose medicine to extend a life a few months makes no sense.

On the same topic, how many out there have nursing home insurance? I bet there are not many. But when medicaid is footing your bill you will still demand a private room in the best place.


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## Plainsman (Jul 30, 2003)

Good point swift. My wife and I have nursing home insurance. We have friends that laugh at us, spend their money at the casino and tell us they are going to let the government pay for it. If Obama gets in he is going to spend so much on other countries that government will not be able to take care of Americans. I will be looking out my nursing home window at their cardboard box.

My wife's grandfather paid his own way through the nursing home. That ate up an entire farm. He cut corners while those on medicare had all the activities and anything they needed. Now you want to talk unfair??????

Bleeding hearts want what they have earned, what you have earned, and anything else they can get for free. They are not so worried about this woman who couldn't get her expensive medicine, they are pushing so they can live plush in old age at our children's expense. How about their children you say? Well, they are raising their children to be parasites just like them.


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## R y a n (Apr 4, 2005)

Plainsman said:


> Bleeding hearts want what they have earned, what you have earned, and anything else they can get for free. They are not so worried about this woman who couldn't get her expensive medicine, they are pushing so they can live plush in old age at our children's expense. How about their children you say? Well, they are raising their children to be parasites just like them.


Every time I hear arguments like this I immediately think of Social Security. How do you jive that statement with the fact that Social Security is an awesome ponzi scheme that I will never see everything I put into it, and at a lesser ROI than if I invested in an alternative financial vehicle?

Am I not paying for someone older's current retirement (which they are enjoying at an earlier age and living longer than ever), whilst likely never seeing the $$ I put into it?

Who is parasiting who?


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## Chuck Smith (Feb 22, 2005)

Ryan....

Social security is in shambles. But what its original intent was to help the needy, like the handicap, disabled, etc. Not a retirement fund. But now everyone views it as a retirement fund. Because they have changed things so more people could draw from it.


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## R y a n (Apr 4, 2005)

Chuck Smith said:


> Ryan....
> 
> Social security is in shambles. But what its original intent was to help the needy, like the handicap, disabled, etc. Not a retirement fund. But now everyone views it as a retirement fund. Because they have changed things so more people could draw from it.


Incorrect.

Social Security is not in total shambles. It is still somewhat functioning, except that its mandate keeps changing as more and more special interest groups and their legislators figure out ways to draw from it. It is a form of Socialism, yet those who stand to benefit from it the most scream the loudest when discussion about wanting to privatize it flare up.

Social security was established in 1935 to "give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age."

It was originally designed to provide a safety net for the average citizen to supplement their pension, so that they could live a comfortable middle class life given current inflation for that year.

Over time, social security has evolved into three programs (and a separate Medicare Program):

Old Age and Survivors Insurance (OASI) 
Disability Insurance (DI) 
Supplemental Social Insurance (SSI)

SSI provides supplemental benefits to workers whose retirement benefits would leave them in (extreme) poverty and is funded from general tax revenues. Having noted it's existence as part of the Social Security system, it is funded from general revenues and not a part of the "problem" Social security is facing.

OASI covers the retiree benefits most people consider "Social Security." But it also provides benefits to the spouses and underage dependents of deceased workers, regardless of their age at time of death.

DI provides, as it's name implies, benefits for disabled workers who have contributed to Social security, but are too young to meet the requirements for retirement benefits.

"Social Security" is and never has a been a "savings program." It has always operated on the premise that we will pay for our parents' benefits and count on our children to pay for ours. As such, its funding is most appropriately thought of as a dedicated "inter-generational tax."

My original point still stands...

Who is parasiting who...


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## Plainsman (Jul 30, 2003)

> Who is parasiting who?


I don't have a dog in that fight. Since I am on the old federal retirement system I can not draw social security. I paid in, but I can never draw. Talk about being shafted huh.

The people paying in and drawing out are not the parasites. At one time or another they all pay in. The money lost is going to manage the system, and the special interest groups (parasites) that you mentioned.[/quote]



> I will never see everything I put into it, and at a lesser ROI than if I invested in an alternative financial vehicle?


Bush tried to change that, but the liberals flipped out. They said it was because it would risk peoples elderly income. It was only two percent. Their real concern was that it would become two percent that they couldn't get their grubby mitts on to buy votes from some fringe group.

I was listening to the Hiedcamp show on KFYR (Bismarck) the other day. They were saying how every woman and child should have health care. What????? How about men? Liberals constantly divide people into groups by race and gender. They are the prejudice while blaming Conservatives, just like they cause the high energy costs while crying it's oil men in the White House. It all may come back to haunt them this fall.


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## barebackjack (Sep 5, 2006)

Ryan is somewhat correct in that social security isnt in shambles. The problem is the dynamic of the country has changed, while the general concept of the program hasnt. The only part of the program thats really changed is it now pays to several different "categories".

People are living longer after retirement, so are drawing more money overall.

The program has been revamped to pay out in more categories, as Ryan stated, still the same people paying in the same amounts, but now we've just increased the number of people eligible to draw from it. (Whoever thought this up was a freakin rocket scientist,....wait, didnt slick willy have something to do with a small piece of it?)

And of course, the "pork", special interest groups, and politicians (man I love these guys :eyeroll: ) have had their way with it as well.

Doesnt Obama want to give SS benefits to the illegals?

But back to the original story. Lung cancer? Im guessing a smoker? And the bleeding heart liberal media is jumping on the insurance company which no doubt is just following the policy. :eyeroll: 
But thats the liberals for ya.


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## Plainsman (Jul 30, 2003)

barebackjack wrote:


> Doesnt Obama want to give SS benefits to the illegals?


Plainsman previously wrote:


> Their real concern was that it would become two percent that they couldn't get their grubby mitts on to buy votes from some fringe group.


Clear to us isn't it bareback?


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## R y a n (Apr 4, 2005)

Plainsman said:


> > Who is parasiting who?
> 
> 
> The people paying in and drawing out are not the parasites. At one time or another they all pay in.
> ...


Some who pay in draw out more than they have paid in... while others who have paid in more don't draw out all that they have put in.

Unless I get to retire at the same age as the original beneficiaries, I am not an equal player in the system.

Why should it be mandated that I cannot retire for an extra 5-9 years compared to my grandfather? Do I not want to enjoy being retired at a younger age so that I may (hopefully be) in better health to enjoy my retired days? Why should I have to agree to a reduced benefit if I want to retire younger?

If I would have put $$ into a Roth IRA, I could have withdrawn it sooner with no penalty, and likely have seen a higher ROI.

My beef is the reverse sliding scale that I am putting in more than I will take out, and/or that I could be enjoying that money now if I (had the ability to ) and chose to "opt out" of Social Security entirely. Being forced to pay in to a system that due to individual circumstances doesn't benefit me has always irked me.

</rant>


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## Chuck Smith (Feb 22, 2005)

This is why in my mind it is in shambles....

Because like Ryan and others have stated.....Many people who are paying in will never see the benefits of SS.

Plus how the US sees it as a sole retirement fund.


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## swift (Jun 4, 2004)

> Unless I get to retire at the same age as the original beneficiaries, I am not an equal player in the system.
> 
> Why should it be mandated that I cannot retire for an extra 5-9 years compared to my grandfather? Do I not want to enjoy being retired at a younger age so that I may (hopefully be) in better health to enjoy my retired days? Why should I have to agree to a reduced benefit if I want to retire younger?


Social security is not a retirement fund. Why is that so hard to figure out? You can retire at 38 if you planned for it. Brett Farve did. Planning to retire on SS is akin to waiting for a bus in the middle of the road. When it finally gets to you you wont like it.



> If I would have put $$ into a Roth IRA, I could have withdrawn it sooner with no penalty, and likely have seen a higher ROI.


It's nice to see some Republican logic come from ole Ryan once in awhile.


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## R y a n (Apr 4, 2005)

swift said:


> > Unless I get to retire at the same age as the original beneficiaries, I am not an equal player in the system.
> >
> > Why should it be mandated that I cannot retire for an extra 5-9 years compared to my grandfather? Do I not want to enjoy being retired at a younger age so that I may (hopefully be) in better health to enjoy my retired days? Why should I have to agree to a reduced benefit if I want to retire younger?
> 
> ...


I will be semi-retiring at 38...possibly 40 depending on several factors.  Wish me luck. fyi.. I have no need for SS.

I'm just making the argument.

Most folks need the safety net of some kind of SS. Approx ~80% of the county has no financial acumen when it comes to understading investing. 50% don't have a retirement strategy other than SS. The remaining 30% have a 401k or maybe a pension, but have no knowledge of how to invest further with any other vehicle.

Very few understand financial accounting in regards to balance sheets, income statements, debt/asset ratios, assets vs liabilities, 1031 Asset exchanges, advantages of corporations to shield income, Roth IRA's vs traditional IRAs etc...

They simply go thru the motions of working their 8-5, contributing to their 401K and crossing their fingers.

I'm truly scared for the future, when these (financial) idiots reach retirement age and all hell breaks loose. Many will be blue collar, have major loans/liabilities and have not saved enough to retire. They will be working until they are in their 70's or 80's, will have major health problems, and will not have insurance or health care to cover their needs. It will be even worse because many will be working labor type jobs that will increase their likelihood in older age of suffering a workplace injury. They will then turn to the government who will turn to me (via taxes) to subsidize their foolishness at not investing earlier, or they will turn and whine to their legislators to give them more bennies. Who do you think will pay for it all? It could run into the millions (the number of people who fit that demographic). That is why your legislators are considering privatizing some aspects of healthcare. It has more to do with them realizing there is a lot of financial idiots out there.



swift said:


> > If I would have put $$ into a Roth IRA, I could have withdrawn it sooner with no penalty, and likely have seen a higher ROI.
> 
> 
> It's nice to see some Republican logic come from ole Ryan once in awhile.


ha :beer: I am a conservative when it comes to many things financial. I'm only liberal on social policies for the most part (except when it conflicts with my financial interests  )


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## swift (Jun 4, 2004)

A fiscally conservative liberal. That is an oxymoron if I've ever heard one.


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## buckseye (Dec 8, 2003)

> On the other hand, perhaps this women shouldn't have smoked her whole damn life and then expected every other insurance policy holder to subsidize her feeble attempt at recovery.


How do you know she smoked? She could of been a ship builder and welded all day. I didn't read it all so maybe this was covered. :wink:


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## g/o (Jul 13, 2004)

> I'm truly scared for the future, when these (financial) idiots reach retirement age and all hell breaks loose. Many will be blue collar, have major loans/liabilities and have not saved enough to retire. They will be working until they are in their 70's or 80's, will have major health problems, and will not have insurance or health care to cover their needs.


Wrong, most of which are referred to as blue collar workers are union factory, and trade workers. You know Ryan the guys who build things.


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## hunter9494 (Jan 21, 2007)

swift said:


> A fiscally conservative liberal. That is an oxymoron if I've ever heard one.


 :lol: :beer: :lol:


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## R y a n (Apr 4, 2005)

g/o said:


> > I'm truly scared for the future, when these (financial) idiots reach retirement age and all hell breaks loose. Many will be blue collar, have major loans/liabilities and have not saved enough to retire. They will be working until they are in their 70's or 80's, will have major health problems, and will not have insurance or health care to cover their needs.
> 
> 
> Wrong, most of which are referred to as blue collar workers are union factory, and trade workers. You know Ryan the guys who build things.


wrong? riiiggghhhtttt.

And we both know that is not the "blue collar" worker I am talking about or worried about. It is everyone else making less than middle income, who is non union. How many of those folks exist? How many of those folks will have the means to have created a nest egg sufficient enough to retire on? How many of those with a "nest egg" will have enough in it to also cover their high medical insurance?

hmmm?


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## g/o (Jul 13, 2004)

Ryan, very few places don't offer 401k's, I unlike you think this country is in much better shape than you.


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## swift (Jun 4, 2004)

Ryan, 
very few will not have the "means" to build a nest egg. The problem is they choose to have the new cars, boats, atv's, beer, cigarettes and every thing else today instead of putting it torward their future retirement. Why should I pay for other peoples poor decision? The folks that don't have the means to put some away truely, are likely already on SSI for a disability. Starting at age 18 it doesn't take much to build alot of money for retirement. IF Obama gets in it will take alot more since 30 percent will go to capital gains tax.


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## R y a n (Apr 4, 2005)

swift said:


> Ryan,
> very few will not have the "means" to build a nest egg. The problem is they choose to have the new cars, boats, atv's, beer, cigarettes and every thing else today instead of putting it torward their future retirement. Why should I pay for other peoples poor decision? The folks that don't have the means to put some away truely, are likely already on SSI for a disability. Starting at age 18 it doesn't take much to build alot of money for retirement. IF Obama gets in it will take alot more since 30 percent will go to capital gains tax.


I agree to a point. Some of those you mention will be so over leveraged, that they will need to work an extra 10 years to pay off their larger debts. I agree we should not be paying for their poor decisions. Most of them don't start until they are in their late 30's to 40's saving for retirement. Losing those first 10-15 years and not getting the benefit of compound interest, they lose out on over $1 million in retirement savings. That leaves them with only $100,000 to retire on for 20 years. Not gonna happen. They will cry and complain, and demand help for their poor choices. They will demand that those of us who've sacrificed earlier, not lived a foolish life and wisely saved, pay for their folly. THAT pi$$es me off to no end.

Secondly, there is still another (large) segment of the population that doesn't fit the beer drink'in "new boat" profile. Consider for a moment all those people who work at some minimum wage job that barely pays for their essentials each month. I know one of those people. She is a relative of mine. She makes around $9.50 an hour. That equates to between $1250 and $1400 a month. She doesn't have any toys, no loans etc. After expenses(rent, utilites, insurance, gas, food) she has $150 a month left. She has no SSI disability, she has a high school education, some college and a (true) lack of mental ability to ever get a bachelor's degree. She is stuck in a perpetual rut, and will be some form of a burden on society forever.

There are millions who fit that description in some way. Those are the ones that eventually figure out a way to come up with a disability to "make it" on their own. For them they have no 401K, no (or poor)medical insurance. Inflation is absolutely killing them.

What do we do about them?


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## swift (Jun 4, 2004)

Maybe their rich relatives that can semi-retire at 38-40 could help them out. Blood is thicker than water afterall.

I agree there is a population out there that doesn't have the means but that population is much smaller than the millions you speak of. Minimum wage will in all states qualify you for medical assistance. Around the world the less affluent societies provide for each other in their family. Somehow in the richest country in the world we have gotten away from that and made it the governments job to support them.


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