Also when you say focus on health outcomes those can be manipulated. For example. the insurance industry may measure outcomes by how little insurance is used and how much they can deny therefore cutting the patient off from care prior to actual best outcomes. Also if measures are based on outcomes what is the expected outcome? For example, something that puts a person in complete remission verus something that helps someone function but will not put them in remission would be different categories. There may be people who cannot reach remission but that doesnāt mean they donāt need help or have a positive outcome for their invidual function. This is very difficult to effectively measure. It could cause patients to be cut off when they need something or a drug trial to end when it was actually helping. It would have to be very clear to avoid those issues.
This is also tricky. Isnāt that what they claimed to be doing for COVID? But is that what really happened? I guess it depends who you ask. But I think you are probably in the same thought process since you mentioned FLCCC Alliance.
I see what you mean. The language has to be VERY concise and explicitly defined. Which ties in with the logic espoused by @EthanHowardMfrr in his post The Governmentās Legal Right to Lie in Legislation: USC Title 1āGENERAL PROVISIONS Ch. 1: RULES OF CONSTRUCTION, so it would be important to include a list of definitions and to clarify the meaning in every section and to address all the ways in which capture is possible in contravening the law and establish sound fail safes in light of this. (Hence, oneās inclusion of the Policy to Establish the Separation of the Corporatocracy and the State (Addressing Corporate Personhood), as that works in concert with addressing the abuses of the P(Harm)aceutical industry as it stands today).
Unfortunately, a lot of policy proposals would fall through and be abused without a redefinition of the construction of legislation.
Thanks for the plug.
Even with very clear and concise language there will be shortcomings. The bill is geared toward Pharm. But this is what happens with the insurance industry in writing policies, writing contracts for participating providers, and denying claims. Sometimes putting too much can also be a detriment. The providers need the freedom to case manage and treat the individual rather than a regulation.
It would depend on the end result if I could agree just because there are times when legislation is written but then exploited by those who use it. Insurance Corporations claim they are ensuring best outcomes but they are not. So Iām not a fan of using that as a measure. A person who has a chronic illness or disability is going to have different best outcomes than a 20 year old healthy athlete in college (which are usually the research participants). This is also seen in Disability rating systems where they cut people off from treating based on measures they made on healthy young individuals rather than a 50 year old injured person that was actually getting benefit from treatment but needed longer care due to their age etc. Comobidities are not considered in the guidelines.
Also research is only done for a short period of time due to costs so we donāt always know the impact long term. In addition, success for 80 percent doesnāt mean 20 percent donāt matter. Or success for 20 percent doesnāt mean the 20 percent donāt matter. Itās just a very difficult thing to define as a measure. It can cause people with hard to treat chronic conditions to suffer more because they get cut off. For example, a person who is sensitive to methotrexate may be getting benefit from an alternative therapy of prolotherapy. They get cut off by the insurance industry because it is not the standard or what the majority use successfully. All other drugs are experimental at the time and cost $600 to $800 per month which the person cannot afford because they are now disabled. They put the patient on prednisone for 8 years which is very damaging causing compression fractures, Cushings Syndrome etc. The person ends up dying from all the illness created from having to take prednisone for 8 years. They should have let the patient use the prolotherapy. The patient is at the mercy of what is approved since they are disabled and struggling to make ends meet. These types of decisions were taken away from the healthcare provider and given to the insurance under the guise of it being best practices. Healthcare providers need to be able to maintain control of what is best for the individual. That includes repurposed drugs and off label prescribing.
Thank you for this important perspective @DRSE
Given this additional flagrant perversion of our health system, it seems important to have another policy proposal addressing the abuses of the Insurance Industry as well. I touch upon this with the insurance incentivization program which is a clear collusion for pestilence profiteering, so Iād be open to collaborating with you on a policy that addresses all the failings and remedies in this other very necessary area of reform. In that respect, I then can agree that the proposal could be bifurcated. Feel free to write me a DM to work on a draft proposal.
First I would highly suggest moving to HSAs to provide freedom to the patient to select the care they want to use. However, I do think they need to have more funding in them and I believer there are times when these are invested and they do not have access to the money right away.
Otherwise, traditional Insurance should only be for emergencies or chronic health conditions such as cancer or long term disability.
Insurance should not be making any medical decisions. They are not the providers and have no patient physician relationship to make decisions on an individual.
Insurance Corporations are for profit. They use to be non-profit. They are one of the only entities permitted to use the premiums they collect to invest in the stock market. In order to keep those investments in the stock market and keep investors happy they need to cut spending. They know they will have to pay out large amounts on conditions like cancer or paralysis. So they need the premiums from a number of healthy people or to be able to deny claims on a number of people to be able to both maintain investments and make those large payouts that are inevitable.
I did put a couple policies up on these matters. They could use your outlining skills for sure but they are posted. I will try to get them for you.
These are not all directly related but have some similarities. A lot more raw than your nicely designed outlines. I plan to edit them. Feel free to collaborate or merge.
Excellent, thanks for collating these for me @DRSE
Iāve made a policy proposal outline that merges these concepts and topics cohesively, as well as refers to legal precedents and other resources to address this issue. You can provide more insights for refinements in the comments of that proposal here:
and
I would say this is a well thought out start with some possible overlooking of the underlying issues. In these kinds of proposals, which do need specific language, we need to have a larger bullet point of āwhat do we intend to accomplishā- and this would be used in courts later, the intent of the law. I think it needs to spell out front a couple of things 1) Decreasing the power of big pharm over Doctors treatments 2) Decreasing the power of insurance to dictate Doctors treatments- and really important, maybe not popular opinion here- doctors need massive raises in Medicare/Medicaid billing. We need to tax big pharma to cover this raise. We are giving millions to folks like that murdered executive while paying the doctors very, very little for the service, if at all.
Sure @ManagmentDon
If you review the comment thread here, youāll see I was inspired by anotherās comments to produce the sister policy The Insurance Accountability and Transparency Act (IATA).
Also, from the discussions, I simplified the comprehensive act and then produced 8 sub acts (each linked to their own proposal pages) to allow for more specificity, and detail per subject.
They are:
- Pharmaceutical Mandates Ban Act (PATA-Subsection 01)
- Pharmaceutical Legislative Reform Act (PATA-Subsection 02)
- Pharmaceutical Regulatory Oversight Enhancement Act (PATA - Subsection 03)
- Pharmaceutical Transparency Act (PATA-Subsection 04)
- Pharmaceutical Research Funding Reform Act (PATA-Subsection 05)
- Pharmaceutical Media and Education Integrity Act (PATA-Subsection 06)
- Pharmaceutical Industry Reform Act (PATA-Subsection 07)
- Pharmaceutical Ethical Practices Act (PATA-Subsection 08)
Feel free to review each and provide feedback on them to build upon the outlines with more specific details. Perhaps your concerns about the pharma doctor relationship can be addressed in industry reform.