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Biotech / Medical : XOMA. Bull or Bear? -- Ignore unavailable to you. Want to Upgrade?

To: aknahow who wrote (9125)	3/11/1999 4:03:00 PM
From: opalapril	Respond to of 17367

<OT mutterings -- followed by a question about post-meningo life> I have no gripe about doctors or for that matter hospitals in the US. The best of them are the best there are -- but that is as relevant to the lives of most people as saying Yale has a great collection of eggheads teaching a handful of undergraduate honors students. It doesn't say anything relevant about the quality of education their kid is getting. The fundamental problem with the U.S. medical system is the way access is rationed for all but the very wealthy. One unfortunate aspect of the health care system is that individual insurance in the US is highly integrated with employment benefits -- a custom that grew up accidentally but makes as little sense as providing fire or police protection only to those who are insured for it through their jobs. Another is that health care available to the AVERAGE citizen (not the super-rich who fly in, snap their fingers, get treated by world famous doctors, pay cash, and fly out again) now is dominated by insurance companies and their gate-keeping minions who hold a yellow eye firmly on the bottom line. Typically, a sick person is required to see a general practitioner or family physician first. The terms of his/her group contract with the insurance company contains many different incentives which discourage intensive treatment or rapid hospitalization. In the U.S., "Take an aspirin and call me in the morning about those flue symptoms" kills kids with flu-like meningo symptoms, but saves big bucks for the insurance companies. Legislation pending in Congress will help: it would hold insurance companies liable for medical harm caused when they refuse permission/coverage for physicians who recommended necessary treatment or hospitalization. Yet another systemic problem is that once most insurance companies identify a health risk likely to be chronic or expensive, they do everything they can to exclude coverage for that condition in the future -- which, of course, is why the insured needs the policy to begin with. Here is an example known to me: a dear friend lost her husband and after a time went to a grief counselor three times. When she switched jobs, the same Blue Cross carrier (but under a different employer's group policy) insisted on excluding all future treatment for depression!) We have more than 40 million people with no health insurance in this country, more than 70% of them children of the working poor or destitute. Millions more have basic health insurance which they are terrified to use for "lesser" illnesses because (a) the co-pay is too great; (b) the employer will find out about the health problem in the periodic management reports sent to group plan administrators; (c) it's a hassle to be seen by the gate-keeper and wait for him/her to recognize necessary treatment is beyond their capabilities, or to get permission from the insurance carrier, before being referred where you knew you should go to begin with; or (d) they are (rightly) distrustful of insurance companies and fear that to make a claim is to put at risk their coverage for catastrophic health care, should they ever need it. I could go on -- and maybe I will after signing off -- but say what you will, the fact we may have greatest doctors, researchers, and clinics in the world is utterly useless if the political/economic rules that control access to that system exclude most people. So, here's a question for those of you with an intense interest in meningo: what kind of insurance coverage do you suppose victims of meningo will get in their adult life given their loss of limbs or other complications?