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peterbecich

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In my opinion this is an unfair risk to the doctor's career in assuming responsibility for the quality of the compounded drug.

In the absence of any other evidence, I assume the 30-fold increase is the cost to the manufacturer of preparing the drug for eye injection "according to Hoyle."

Sure, it is logical that opening a previously restricted or infeasible product space is an easy way to produce business opportunities. Like the legalization of gambling in Nevada.

Chemistry question: is there any advantage to preempting the possible spontaneous explosion with a controlled explosion? This controlled explosion would happen when the MMA is in a less volatile state, perhaps.

Second question: would it be futile to lift a containment vessel over the tank? Would a containment vessel of sufficient strength be too heavy to lift? For starters I'm thinking of a shipping container...

I'm going to guess if net energy use goes up, due to a glut of renewable energy, the gaps on cloudy, windless days will result in greater fossil fuel use than before.

There need to be assurances renewables are replacing fossil fuels rather than just adding capacity.

That is why I said "artificially low." As there is a water shortage, the current price should justifiably be higher. Instead we will simply run out or damage the acquifer by saltwater intrusion.

If wages do not rise sufficiently to cover increased costs, that does not imply that the generational contract was unfulfilled; the taxes were paid.

That's an interesting alternative view I had not considered. I think it is debatable. I believed the generational contract to be "healthcare for 65+ with 20% copay, etc., no gov. expense spared" whereas you argue the generational contract to be "Medicare payroll tax of X% is constant over all time; spend it wisely." I would argue the first option was the original intent of the Medicare law.

Fundamentally, children are an investment. They produce cash flow (taxes) from increased public health. The end-of-life are not

You could argue the same for the end-of-life, in at least two ways: * the end-of-life patient has already produced cash flow to the government, just in reverse order from the student * Good education produces a higher taxpaying adult, the investment you refer to. I would argue the assurance of end-of-life healthcare also produces a higher taxpaying adult.

I acknowledge the costs have gone up faster than wages+population.

Speaking only of the financial aspect, not any other ethical issues:

Those end-of-life patients paid into the system, earlier in their lives, financing the cost of earlier generations of end-of-life patients. It would be unfair to change the social contract now.

In my opinion, it is no different from how adult taxpayers finance public education for children. It is a rolling responsibility from generation to generation.

You may be able to alleviate this financial issue (and not any other ethical issues) by phasing-in this policy change with the youngest generation of Medicare taxpayers, somehow.

I did not claim it would save from unexpected costs. The full premium is an unexpected cost. I claimed COBRA is more affordable than out-of-pocket healthcare if you are in the middle of an expensive treatment at the moment you lose employer coverage.

Jumping onto ACA via unemployment exemption or Medicaid could require a transfer to a different doctor, etc. in the middle of treatment.

Well stated, and I agree completely.

happen much more frequently within the population

I assume the high premium reflects this frequency -- a higher frequency than many people realize. I do not assume the insurance companies are price gouging, but rather pricing their plans to break even/slightly profit.

Compare health insurer profit margin to FAANG.

I realize COBRA is the full premium. My claim is that, if company coverage is lost in the middle of an expensive treatment, COBRA is more affordable than the out-of-pocket cost.

COBRA is older than ACA. Special enrollment in ACA under the job loss enrollment period exemption may be a better option than COBRA.