At what point does dependence on insurance become a liability for medical approval? I would have thought we passed that threshold decades ago but the industry appears to have the full throated endorsement of the state for some reason.
I need to order supplemental nutrition for my son. I usually just pay out of pocket, but I contacted a company that can deliver the product and have it billed though my insurance. It would end up costing me about the same but would at least count towards my deductible. They delivered monthly. After the second delivery I got the first bill. It was much higher than they said the per unit cost was.
After a lot of Byzantine exploration of billing codes, I discovered they were billing a daily charge for infusion. A lot of angry phone calls just reached the conclusion that they add this charge because they are allowed to by the insurance.
I'm guessing this is a similar thing. They can keep charging a daily charge so long as they are able to control that the device is active.
Prescriptions are tied to billing. The main party with the incentive to withhold treatment is the party expecting a direct payment from the patient.
I might see some concern if there's concern about abuse of the treatment, but that seems like a fundamental mischaracterization of the concept of prescription.
I assume you meant "expecting a direct payment TO the patient"?
My understanding is that prescriptions are required for medications that carry risk, so a doctor needs to evaluate if it is appropriate for the patient, and at what dose.
This avoids people self diagnosing and taking random doses of various medications.
Pharmacies are happy to sell you medications that aren't covered by insurance at full price.
> This avoids people self diagnosing and taking random doses of various medications.
This is such a non-issue it's impossible to take seriously. People do this regardless of prescriptions and the danger of the substances they're intaking (think: alcohol). What is the risk entailed by the device described in the original post that a prescription guardrail might prevent?
> iTEAR®100 does not run out during its 30 day prescription so you do not have to conserve therapy or worry about wasted practice drops or sprays.
> Q: How long does this last?
> A: The iTEAR®100 device prescription lasts 30 days at which time it turns off and you will need a new prescription from your doctor for further treatment. After 30 days, the device will be inactive.
The iTEAR 100 is not generally reimbursed by insurance. If you have an HSA or FSA, you might be able to get it through that. This whole medical device lifetime thing is because it’s regulated for its medical claims by FDA. Given some of the side effects noted here https://itear100.com/clinical-data.html, and how it changes the kind of tears that the user produces, I think it’s reasonable on its face to require a medical professional to review whether it’s working and needs more time with you every month.
Maybe, but it's also a bigger philosophical debate between positive and negative freedoms. Do you want the freedom for businesses to operate how they want, or do you want the freedom from unfair business practices? You can't really have both.
Do you want freedom from extortion and racketeering?
If you do, are you not against free market?
Do you want collusion and cartels to be legal? If you do, are you not against free market?
It seems the entire distinction of negative vs positive freedom is fictitious.a negative freedom can be a positive freedom when looked at from another perspective
If businesses operated the way they want, they would take 100% of everyone's money and provide nothing of value. Everything else they do is just an inconvenient step on the way to the goal.
If businesses operated the way they want...they would nit be businesses, they would be cartels....or governments!
Businesses operate like the customers want unless the govt tells them to do otherwise. In this case the paying customer is an insurance company who could care less if the medical device was deprecated, or not, after its expected value was delivered
Capitalism looks like game theory, where instead of universal cooperation you have every actor working to restrict or steal information from other actors and generally finding ways to insulate yourself to a point where you can just keep hitting the defect button.
> If your device stopped working, it could be because your prescription has expired, and the device has been deactivated. Talk to your doctor about getting another refill prescription for iTEAR®100. Or you can request a telehealth appointment and the company will assign a doctor to you.
What is the device for? Genuine ignorance and curiosity. Are there folks who cannot produce tears, and do the tears serve an important health function that makes it important to stimulate tears in this way?
What about a prescription though? If someone invented a device that could synthesize opiates and dispense them on demand, surely that should require a prescription?
I don’t think it’s unrelated. The title of this post is “prescription required,” not “subscription required.” Whether or not the device should be so regulated as to require a prescription is one question. But if the FDA has determined that it’s required (and thus you must get a prescription from your doctor), then why should you be able to use it after your prescription has expired? If your doctor prescribes you 1000mg of opiates, you don’t get more opiates when you run out of them unless you renew your prescription with your doctor.
The problem in this case seems to be that the device requires a prescription in the first place. But since it does, I don’t see an issue with enforcing it.
There are far better analogies than opiates though.
There's no reason why a treatment that is working and is expected to continue to be effective indefinitely should be withheld because a doctor's appointment didn't happen during the scheduled window one month, any more than my glasses should stop working because I didn't see my opthalmologist this year.
Freedom to choose suboptimal outcomes is not a bad thing.
If the use of the device genuinely needs continued supervision of a doctor, that's fine. But that's no reason for the device maker to demand eternal payment, which I'm guessing is the case here? If that indeed is the case, then "prescription" is just some corporate lawyer word game.
Revolution is what the would-be proletariat persistently, but perhaps delusionally, assumes it will win (despite the 1% being able to afford more than enough bullets)… end-stage is when the cancer has gone past the point of fighting and you just have to resolve yourself to (in this case human-societal) death. A good sign it’s too late to seize the means of production is when the workers have medical devices that require an active and paid up subscription.
> Revolution is what the would-be proletariat persistently, but perhaps delusionally, assumes it will win
Occasionally, it does win. I think Marx tends to have a point about the inevitability of this given persistent class conflict, but this could play out over centuries rather than something we'll ever see.
Dunno, Elon and Bezos seem to be doing their damndest to push past the red line. A pacemaker with an LLM you can chat with would also be a good sign we’ve passed the point of no return.
In the same way there is Rule 34, I think there applies a similar rule for capitalism: At least it's not a pacemaker, yet, but I'm sure someone is working on it.
