I have always suffered from high cholesterol. Despite having high levels of the “good” cholesterol as a result of being very athletic all my life, my “bad cholesterol” is about 100 as a result of my love of fried foods, steak, and cheese.
My new doctor is an absolute firebrand on cholesterol (Damn that Obama- my old doctor was willing to let my 200 total cl level slide). He says I need to get to 160, knocking 40% off my bad cl. And there is a new drug that will do that for me called Prauluent. It is incredible - will knock LDL into the teens.
But here is the catch- it is very expensive, nearly $15,000 a year- and my Obamacare insurer will not pay for it. As they told me Monday, “if you will read page 17 of your policy, you will see that “experimental drugs” are not covered.” And Prauluent is not yet FDA approved for someone like me with high cl but no chest pain or heart attack history.
It seems to me that I have a pre-existing condition and am being denied appropriate treatment, in violation of the Affordable Care Act. They will pay for Type II diabetes which is self- inflicted but not state of the art cl drugs. True, I can afford to pay for it myself but ouch – we don’t do means testing for coverage and that would wipe out my “play” budget.
Shouldn’t my insurer pay for at least some of this? Or should I start eating celery and tofu for all my meals? Or should I go with my old doc and just let it slide?
More fundamentally – should health insurers be required to pay for the best possible treatment, or just some treatment? Poor people will never be able to afford this drug.
Anyone else in my predicament? Over 200 total cl? What would you do
You don't mention if you presently take a statin to achieve your present status. My Doctor is also very aggressive regarding cholesterol. He quit looking a Total cholesterol years ago. Paying attention to the 3 main components individually make much more sense. You did not make note of your HDL. What is it? An LDL of 100 is quite good. only if you are at high risk for an MI etc. would a lower value closer to 75 be suggested. Getting it in the teens or even 20s could be suicidal. At the very least you'd be opening yourself up to possible brain damage. Your brain and nervous system need enough to function. Lastly, what is your Triglyceride level (the 3rd leg of the "Total" number)?
Getting the high reduction offered by this new liver enzyme blocker (which is what statins are also) is suitable for people with super high cholesterol (LDL > 600 to 800) and not controllable with other older means.
My old doctor did not see that as a problem bc my ratio of HDL to LDL is within normal guidelines; not sure what my triglyceride number is.
But my new doc. a young guy, believes the guidelines for total cl are way too high, regardless of your ratio. And, yes I “achieved” 200 or so total cl with the help of statins. That is what makes me eligible for the new drug apparently bc statins will not take me any lower. So my natural number probably is in the danger range.
But the point of the post is – how, once this drug leaves experimental status, should Obamacare treat this new category of cholesterol treatment which probably millions of people need, yet the cost ($15,000) is more than a year’s worth of premiums?
Getting the high reduction offered by this new liver enzyme blocker (which is what statins are also) is suitable for people with super high cholesterol (LDL > 600 to 800) and not controllable with other older means.
to makeup of fats, proteins and carbs.
Total Cholesterol is simply LDL + HDL +0.2 X Triglycerides
BTW, Praluent (yes, both you and BP misspelled it; and I would have not mentioned it except for the fact that it was. . . .well you know. . .BP), was FDA approved 4 days ago, but I think only for people with extremely high cholesterol not controllable in other ways (hypercholesterolemia) so I don't know for sure, but I doubt you qualify, given today's standards, unless of course you've already had an MI (like I did 10 years ago). Again, an LDL of 100 is very good. Unless your HDL is at the superhuman levels enjoyed by St. Croix I'm guessing your Triglycerides are high.
I don't know the numbers but I seriously doubt millions need Praluent. There are lots of approved drugs that cost far more than Praluent. Many are vital to sustain life, others are used to only extend life by a few months. For 15+ years my wife took various expensive drugs with a list price during some years in excess $80,000 per year. It wasn't a matter of decreasing her mortality risks. She would have died without them.
a lot closer than I have. I have zero history of heart disease but my doctor nonetheless wants me to lower total cl. He has long followed this drug and believes it is just a matter of time before it is available to a wider spectrum of patients.
Heart disease is not always predictable. I ran the NY City Marathon in 1981 in about 4 hours. The winner that year, AS, finished in 2 hours 8 minutes and had not an ounce of body fat. His fitness level was light years ahead of mine. Years later, however, he had a near fatal heart attack. I just have bad knees.
Sorry to hear about your wife’s health problems. Interesting that you are not an Obamacare fan given that awful experience. I would presume that she exceeded the yearly cap for coverage by her health insurer and even approached the lifetime cap.
Under Obamacare, of course, there are no longer such caps. This is why I have always said that, for the individual, it is absolutely crazy to oppose Obamacare bc premiums are higher etc because once you get sick , it’s all covered no matter the cost. The extra premiums you pay are a tiny fraction of what you get
Mari seems to have issues with the realities of how things actually work, and really wants to believe everything he reads with any application of common sense.
How does anyone expect for EVERYONE to be covered for EVERYTHING without costs for insurance to go through the roof? As St C so aptly said below, "insurance is for when bad shit happens" It's not a personal ATM machine for each of us to get Cadillac service while paying Yugo rates.
It amazes me that someone with such low regard for telling the truth himself can forget that "figures don't lie, but liars figure" It's impossible for everybody to put in only a "tiny fraction" of what they get. The system would simply implode. Mari manages to write in complete sentences and at least gives the illusion that he has more than a third grade education, How these simples truths escape him is beyond me.
...concocted by doctors and Big Pharma. High cholesterol used to be considered anything over 300. But when statins were invented, all of a sudden high cholesterol was lowered to 200+ in order to sell more statins.
Same with high blood pressure. HBP used to be 140/90 but when new BP meds came out, doctors started prescribing them for "borderline" HBP, as low as 120/80+.
Diabetes is not self-inflicted. It is an autoimmune disorder that you are born with. Like other autoimmune disorders, in diabetes the body attacks itself, destroying the cells in the pancreas which produce insulin. It is similar to high cholesterol in that the patient can aggravate his/her own condition by poor dietary choices.
Try cholestyramine. It was the drug of choice before statins and is still in use because many doctors today are turning against statins. Cholestyramine causes constipation so it is rarely given to conservatives because those uptight mofos are constipated enough already. That's why you'll find the medicine cabinets of Republicans full of laxatives and Preparation H.
Too many people look to medicine for answers to their own laziness and sloth. We wouldn't need Obamacare if people just took responsibility for their own healthcare
And I hardly think cholesterol drugs are a racket. Nothing like having your doc tell you "you need to lower your cholesterol" to get religion. Type II diabetes I think can fairly be characterized as self inflicted.
Fear of that one has always helped me keep my weight down. Never heard of cholestramine but I 'd guess that statins were more effective and that is why only the righties still use it.
And while it seems like it is not etched in stone scientifically, it does seem most beleive type 2 is caused by a lack of exercise and obesity.
No?
...rather than an autoimmune disorder. But some want to reclassify it as an autoimmune disorder in order to better understand why the body doesn't produce enough insulin or becomes insulin-resistant. Doing this may lead to a cure for Type 2 faster than they're going at the current rate.
Treating Type 2 diabetes as a metabolic disorder involves only managing the condition through diet, lifestyle and medication. Even then, it's a crapshoot at best. I knew a girl in high school who had Type 2 diabetes. She was fat too which didn't help. At the ten-year high school reunion, she had lost a lot of weight and was quite thin; she was trying very hard to control the diabetes. At the 20-year reunion she was still thin but she had gone blind so the diet and medication didn't work. Others lose fingers, toes or limbs despite taking good care of themselves.
Over one-third of Americans are obese so there should be a lot more cases of diabetes if that were the sole cause. I believe certain people have a latent tendency to become diabetic and it can be triggered by obesity. If the same people remained thin and exercised, perhaps the diabetes would remain dormant throughout their lives.
I'm no expert on diabetes - I know far more about autoimmune disorders.
before a cheese fondue accident, or an overdose of truffle parmesan potato chips. Why? Have you seen Freeport McMoran share price of $12.33 per share, or are you checking for polyps with your head up your ass? You couldn't leave well enough alone. You had to go pull a Bank America again. You even had the audacity to mention that you view FCX as a bond. Didn't they cut their dividend by 80%. Your like Bill Murray in Groundhog Day.
This is the deal with cholesterol. Have you noticed that EVERYBODY is touting the benefits of a statin drug. It's the new wonder drug, and cures everything. They're making it like 80mg aspirin. My HDL is 162 and LDL 89 after a daily dose of 40mg of Simvastatin. All for the low low price of $12.38 for 3 months supply at Costco.
What you need to do is watch your diet, exercise more, assuming you can get out of bed after looking at FCX every morning. Next, there are dozens of generic statin drugs. Have you tried them all? Don't try and get the insurance company to pay for something that is probably not necessary, and which a change of behavior will fix.
Regarding your new doctor. He probably just met his new drug rep from (enter name of the pharma company), and she is a recent college grad, 5-10, blond, nice tits, great body, and your doc wants to help her out with this new experimental drug.
So what have we learned?
Change your diet
Exercise more
Try some of the other generic drugs
Quit buying stocks (you're not good at it)
And start viewing insurance companies and your policy as when "BAD SHIT HAPPENS", not some personal ATM machine, which drives up my premiums.
My new doctor is an absolute firebrand on cholesterol (Damn that Obama- my old doctor was willing to let my 200 total cl level slide). He says I need to get to 160, knocking 40% off my bad cl. And there is a new drug that will do that for me called Prauluent. It is incredible - will knock LDL into the teens.
But here is the catch- it is very expensive, nearly $15,000 a year- and my Obamacare insurer will not pay for it. As they told me Monday, “if you will read page 17 of your policy, you will see that “experimental drugs” are not covered.” And Prauluent is not yet FDA approved for someone like me with high cl but no chest pain or heart attack history.
It seems to me that I have a pre-existing condition and am being denied appropriate treatment, in violation of the Affordable Care Act. They will pay for Type II diabetes which is self- inflicted but not state of the art cl drugs. True, I can afford to pay for it myself but ouch – we don’t do means testing for coverage and that would wipe out my “play” budget.
Shouldn’t my insurer pay for at least some of this? Or should I start eating celery and tofu for all my meals? Or should I go with my old doc and just let it slide?
More fundamentally – should health insurers be required to pay for the best possible treatment, or just some treatment? Poor people will never be able to afford this drug.
Anyone else in my predicament? Over 200 total cl? What would you do?
but a totally new kind of drug. Statins have helped me but apparently the doc thinks I have received the max benefit from them.
Once FCX cut the dividend there was no reason to stay in so I bought a bunch more at $17 and sold when it went back to $23, at still a 3 or 4 k loss. I figure I will recoup that when I sue you for telling me FCX was a “good idea.”
I have bought some Rengeneron which actually went down when the FDA news broke last week. Now, if I can just get the insurers to pay for the drug, the stock price should sky rocket
yet constantly has to "double up to catch up" to save his sorry ass, every time he makes a bad pick. Which seems to be all the time. Buy, hold, and then load up when you stock plummets is NOT an investing strategy, it's an act of desperation and is likely to end up with him needing to be an "employed" male porn star to pay the bills in his old age, but it's unlikely that he will ever get paid for anything other than fluffing or receiving.
As for Obamacare and his Diabetes, I don't want to be accused of taking pleasure in someone else's suffering, but it just drips irony IMO. Today it's Mari not getting "free" health care, tomorrow will be the day for the rest of us. I really don't take any pleasure in Mari finding out the hard way about the limitations of "free health care", but maybe it will serve as a wake up call that Obamacare is not a bottomless money pit for those taking from the system, only for those of us paying in, just like Social Security.
What drugs any insurence is up to the insurence carrier. Nothing in the AFCA directs what specific drugs they will cover or not.