Stealing a long bit from Forbes interviewing Amitabh Chandra on his research in how high deductible health plans change behaviors:
The switch caused a spending reduction of 12%— so HDHPs certainly save money. A 12% saving is really large. If the result is general, it implies that moving everyone to such plans would save about $300 billion annually!
But once we peeked under the hood, what we saw really troubled us. First, we found no evidence of consumers learning to price shop after two years in high-deductible coverage. None. So strike one. We also found that consumers reduce quantities across the spectrum of health care services, including potentially valuable care (e.g. preventive services) and potentially wasteful care (e.g. imaging services). So they don’t know what care is valuable and what isn’t. Strike two. We then leverage the unique data environment to study how consumers respond to the complex structure of the high-deductible contract. We find that half of all reductions come for the sickest consumers, while they are under the deductible, despite the fact that these consumers have quite low end of year prices as a result of their sickness. In other words, consumers respond to prices but they’re responding to the wrong prices— they’re don’t fully understand the complicated structure of the HDHP. Strike three.
What this teaches me is that simply calling a patient a consumer doesn’t make buying healthcare like buying cars. In healthcare, the consumer (i.e. the patient) is sick, tired, confused, distracted— they want their doctor or their insurer to help them manage the health-care that they need. Making them deal with a high-deductible plan is double jeopardy: first, they get hit with an illness. And then we hit them financially and cognitively. It’s not fair. And it doesn’t work.
Late last week, I posted a Twitter link on how healthcare is fundamentally a Pareto industry. Most people barely touch the healthcare system in any given year. More importantly, even more people who are visibly effected by all the insurance market reforms of PPACA are minimally connected to the healthcare system. Medicare and Medicaid both eat up a significant proportion of the most expensive high utilizing 20% of the population. Medicare gets old people who have the expensive chronic condition of being old while Medicaid is a significant payer for certain high cost conditions plus long term care. So in the non-Medicare, non-Medicaid population, an even higher proportion of people just don’t touch the system more than three times a year or more than $1,000 in spending per year.
The shock doctrine of HDHP does not produce better shoppers and instead leads to indiscriminate volume reductions. That leads to all sorts of other payment reform methodologies. Reference pricing on bundles makes clear choices between providers and rewards marginal cost awareness. Bundle pricing reduces decision complexity so instead of trying to price seventeen services for a simple surgery, the bundle collapses all pricing into a single price that can be compared. And on the back-end, it leads to group risk pooling at the provider group level with shared savings and ACO arrangements.
HDHP were an interesting experiment that we need to get away from. It does not meet its objective to better care at lower prices because we are information limited and make horrendous decisions under stress and uncertainty.
dr. bloor
I’m pretty sure the substantial majority of folks with HDHP who have been getting smacked financially or deferring care might describe them a bit differently.
Up next: ACO’s begin to crumble when doctors begin to realize they are much better at being doctors than they are at being actuaries.
MomSense
Wow, this post is the answer to the questions I had last week about these non/under utilizing people.
In semi related news, I finished signing up for my policy for next year. Working with a human being on the phone, I have a better plan for $214 less per month and a better dental plan. It also includes vision screening for adults. Yay me.
Thanks, Obama.
ETA: Not sure if this is because of the GOP risk corridor fuckery, but Maine Community Health (Co-op) is not accepting new patients.
gelfling545
I get enraged whenever I read this “health care consumer” BS. How in HELL is a person supposed to know which treatments, including imaging, are useful without going to med school? The whole concept assumes levels of education, emotional stability and access to information that really cannot and should not BE assumed. This is a concept designed to make nice computer models, not to actually function in real life and it can only be detrimental to the health of the population in general.
Betty Cracker
We have a category for this on the blog; I believe it’s spelled “hoocoodanode.”
Fixed it for him.
RSA
Thanks for the link.
It’s good to see this written down in black and white. It makes me wonder whether relieving or even just reducing financial and cognitive stress might improve outcomes, medical issues aside.
Redshift
But if I’m reading this correctly, it saves money for the insurer, allowing then to offer lower costs to employers, so what incentive is there to move away from it?
Does the fact that it reduces the effectiveness of health care long term mean that it will bite them in the ass eventually, or is that likely to be someone else’s problem (like preventive care pre-ACA)?
Central Planning
We’ve been in the HDHP plan for the past 3 years. Every year so far we have maxed out the out-of-pocket, so it’s not really a big deal for us. I’m fortunate enough to have an employer that lets me put money into a HSA which minimizes the tax burden too.
And it’s true – we have never “price shopped” any treatment because we’re in the HDHP plan. Son needs surgery for tonsils, deviated septum, and andenoids? We didn’t price shop that; we scheduled it and had it done. I had testicular cancer this year. I’m not price shopping, I went to the best doctor in the area (2 follow-ups so far, all clear!). My wife gets migraine medicine that is about $1000/month (yay Frova!).
Finally, the choice from my employer was a HDHP or some HMO. The cost/benefit analysis was always better for the HDHP except for a small window where if you had something like $2000-$2500 of healthcare expenses, the HMO plan was cheaper. For that narrow range it’s not worth the risk.
We signed up for the HDHP again this year. I don’t hear anything internally at work that makes it sound like HDHP is going away. The per-paycheck price has been stable but they have been raising the co-insurance. I bet that trend is here to stay.
gene108
Unlike cars medical services do not have a price sticker on the window.
How do you expect consumers to make informed decisions, when there is no info readily available.
Anyway, the problem with medical spending has never been with consumers. The problem is with providers from medical professionals to administrators for having a convoluted non- transparent pricing and cost structure.
OzarkHillbilly
I have a slightly different recurring problem. It is impossible for me to figure out how much I might owe for any given procedure because I have no idea what is in the billing pipeline. For instance, I just finally received a bill for a stomach scan I had more than a year ago. ($545)
I had forgotten all about it until about 8 mos after I had it when I went in to the hospital to make my 2nd to last payment on a different procedure. I had the bill in my hand and opened it at the girl’s desk and looked at $s I had never seen before. She looked it up on her computer and the bill I had been paying was gone, the bill I now had was a new one (legitimate), and she found the stomach scan was still pending because the insurance still hadn’t paid for it. Is that $545 a legitimate post deductible # for 2014? I’ll never know.
I do know that when I dragged my broken ankle into the ER last week, that # was first and foremost in my brain, and the absolute impossibility of figuring out what this latest calamity might cost me or when the bills might come to me. I also knew I had little choice in the matter. I had watched the 6×6 land on my ankle and there was no doubt in my mind that it was broken.
All of which leaves me saying I will never get another stomach scan or colonoscopy as part of preventive care.
gene108
@Redshift:
Sometimes all employers can afford are high deductible plans. When a major cost has double or tripled for an employer, even with slashing benefits, there’s not a lot of options left.
Anyway, the crux of the problem are the healthcare providers, who are sucking up more of our money and not providing markedly better service. They need to be held to account for why they need to keep charging us more and more every year at rates much faster than inflation.
Ohio Mom
I doubt the geniuses who are behind high deductible plans ever said, “Doc, the thing I care most about is my wallet. What’s the cheapest option? It’s only my kid after all.”
They asked about the same things the rest of us do, things like side effects and overall effectiveness, they asked who had the best reputation. If they turned down a medication or procedure it was for reasons other than cost.
The whole idea of high deductible plans inspiring patients to comparison shop on price is so stupid it doesn’t deserve commenting on, really.
Dupe70
Maybe HDHP could be better structured to target certain non-productive costs to lower cost and improve healthcare? But it is clear that consumers were never going to be data scientists and doctors to better understand what they need and don’t need.
PurpleGirl
MRIs are expensive, X-rays are a lot cheaper. But when you are talking about lower back pain and nerves and muscles you can’t compare the two images. X-rays are better for things involving solid structures like bone, they can’t image soft tissue unless you use a contrast dye (which have their own problems and risks). MRIs can image soft tissues like muscles and nerves.
I have friends who have had multiple X-rays of their lower back, which show nothing is wrong. The doctor doesn’t even suggest an MRI. I keep telling these friends they need to have MRIs done. When I had the herniated disks, the MRIs showed exactly where the problem was. As a result I had surgery on one disk, haven’t had a problem since at that disk.
beltane
I wonder if the people who promote “consumer driven health care” live in some other world, one where providers list the fees for their services in a clear and concise way that is easily obtainable by “consumers”. In my experience, health care is the one area where costs are completely unknown and unknowable to the consumer until after the service has been used. Unless they are medical professionals themselves, most people are also not in a terribly good position to know whether or not a particular procedure or treatment provides good value or not.
beltane
@PurpleGirl: I had an MRI in 2002 that cost $1,000. Two years later, the same exact scan on the same exact imaging machine was billed at $2,300. WTF. Maybe it is not the MRIs themselves that are the problem, but their use as a cash cow by hospitals and imaging centers.
WereBear
Yes, but they did it anyway.
And how are we supposed to comparison shop in a narrow network? They really thought it was the same as getting a toaster from Target and a bath set from Kmart?
Keith
The mantra of the HDHP plan purveyors was “you’ve got Skin in the Game” – which only made sense in one way; when you are sick and seeking medical care it is your physical skin (or something contained within your integument) that is in play.
Seeking the lowest cost physician or specialist to take care of what ails you is not, at the core, a rational response to the patient’s problem. Their rational response is to get help as fast as possible.
Mechanisms which result in delayed or deferred treatment, because of economic rationing, merely make the problems worse and eventual costs higher.
PurpleGirl
@beltane: That could be true and should be addressed by the insurance provider and medical company. I just know that for certain conditions, MRIs are the superior imaging method.
ETA: I also had an MRI on my left knee which showed the tears in the cartiledge. The X-ray did not show anything. Again, the surgeon was helped by having the MRI.
beltane
@Keith: How can one even find the lowest cost physician? They don’t make it easy, or even possible, to find a schedule of the fees they charge. The old saying “If you have to ask you can’t afford it” comes to mind here.
beltane
@PurpleGirl: After years of severe and debilitating neck pain, an MRI found an apricot sized Hurthle cell tumor on my thyroid. It was biopsied and the thyroid removed. I have been pain-free ever since; it is truly amazing. X-rays only showed cervical osteoarthritis.
Keith
@beltane: True, though for specialty services many insurers tout cost comparison “tools” – for which you register and then leave to languish while accepting your PCP’s recommendation for where to go for that MRI or other required service.
Bottom line, people trust that they are being guided toward the best and most appropriate service; cost is decidedly a secondary consideration.
As for the insurance company, which has as a goal the minimization of cost, they need to come up with better means to ensure service delivery at a price which does not break their (and our) budgets. In the end, they hold the purse strings.
Edward G. Talbot
The whole HDHP/HSA thing was never about anything other than the insurance industry and by extension employers saving money. Whatever was said otherwise about skin in the game was – as others have articulated here – a steaming heap of fecal matter. These things are bad as a matter of policy.
That said, my HDHP/HSA has saved me money for two reasons. One is that the requirements for preventative care coverage are more substantial for HDHPs than for other employer-based plans. The second is that by me taking on more “risk”, the insurance company is willing to charge me less. But the reality is that with my family’s healthcare spending, I’m not actually taking on more risk. As Central Planing said, there’s only a narrow band where it’s more expensive so I’m actually taking on LESS risk.
My healthcare behavior is exactly the same as it was with prior plans. But most people don’t have either the financial ability or the mental ability (while under health pressure) to keep their behavior the same and reap the benefits. If they did, HDHPs would disappear.
p.a.
Hell, that’s the exact situation car dealers try to inflict on car buyers.
Just as THERE ARE NO MODERATE REBELS, THERE ARE NO (FEW) RATIONAL SHOPPERS. Theory used to be buyers had ‘perfect information’. That was so ridiculous it’s been emended to ‘adequate info’. Still Wrong. How many people have the time, and honestly, the mental capacity, to check the benefits and run the numbers?
The states that have Shoppers’ Aids do a fine job overall, depending on training. If people are on their own? Pfffttt.
gene108
@Ohio Mom:
Back when Bush, Jr. rolled out the idea of HDHP, he was trying to sell the idea of an “Ownership Society”, where the magic of the free market would solve all the problems, if only it was unleashed.
HDHP was the Republican solution to trying to control health care costs and align it with Bush, Jr.’s vision of an “Ownership Society”.
The flaws were obvious from the start, but I remember arguing with right-wingers about you can’t comparison shop because the prices of medical procedures are not transparent, but they had bought into the whole idea of the “free market solutions solve everything.”
On the bright side, unlike today this was an actual attempt at governance, even if the idea did not work.
Ultimately healthcare providers need to own up to their responsibility in this mess.
Unfortunately too many of us associate healthcare providers, with the our friendly PCP, who we trust with our lives and not the hospital administrator crunching numbers in a windowless office or the medical device manufacturer trying to increase market share.
All those fuckers are responsible and need to get their shit together.
gene108
@beltane:
Medical professionals have no fucking clue what things cost, in order to base a transparent price on.
Mayhew insurance will pay me $250 for an MRI and provide 1,000 possible customers. Gene108 insurance will pay $150 per MRI and provide a possible pool of 2,000 customers. Medical Provider will charge $1,000 for anyone wanting to pay cash and not use insurance.
So what’s the actual break even point for providing MRI’s?
I don’t think you can even figure that out from the above pricing options.
Getting hospital and medical professional accounting to make some damn sense is the first thing government needs to do, in order to get to transparent pricing.
Procopius
@gene108: Yeah, I never understood how people were supposed to choose. Say you’re crossing the street and some speeding maniac runs you down. You’re very lucky, you’ve got broken ribs, maybe a ruptured spleen, a broken leg, and maybe you’re unconscious. The ambulance decides what hospital you’re going to. Even if you’re conscious, they have company rules they have to follow as to which hospital they are going to take you to. Maybe their company says take you to the nearest hospital which is equipped to deal with your injuries. Or maybe their company requires them to take you to a hospital which pays them a small “honorarium.” You have a heart attack, are you gonna call all the hospitals in the area asking for prices? How would you even know how to describe the treatment you need? OK, sometimes you can choose. Last year I had cataract surgery. There’s only one doctor for that in my small city, but I could have gone to Bangkok and asked around. The price I was quoted here was roughly the same as the estimate I was given a couple years earlier at a government hospital in Bangkok, so I didn’t do any further shopping. The whole idea that patients are “consumers” is preposterous.
Procopius
@WereBear: I’ve never seen a satisfactory answer to that, but I swear it’s true that there are economic studies out there that show HDHPs “reduce unnecessary procedures without any degradation of the overall results.” I have a cousin who was in that field and she sent me a link to one such study back in 2009 or 10. Big Insurance and Big Pharma pay for such studies and then take them to the congressmen they’re lobbying. The only answer is single payer for all, and don’t try to tell me “we can’t afford it” when every other industrialized country in the world does it. Cheaper than we do it and with better outcomes.
Roger Moore
Shorter: punishing people for going to the doctor does not encourage them to stay healthy.
WereBear
@Procopius: That’s another absurdity. Who gets a cataract operation for chuckles? Medical treatment is something people avoid.
HinTN
Here we go; mobile has the web page…
Roger Moore
@beltane:
No. They live in the world of Cadillac health plans, and the only time they’ve ever had to worry about prices is when dealing with the kind of expensive elective procedure (e.g. cosmetic surgery) where you actually have some hope of price shopping. IMO, the people who propose new health schemes like HDHP should be required to enroll in them until they come up with something better.
WereBear
@Roger Moore: And you know what happens when people go price shopping for cosmetic surgery? They wind up in a strip-mall office with a jury-rigged operating room, and the lucky ones don’t die, just get hideously disfigured.
Eric U.
very few people shop for the lowest price on anything, really. I find something I want, price seems reasonable, I buy it. With medical care, I push back against the things I don’t think are necessary, but I’m relatively healthy and mostly understand the things that are wrong with me. I squashed my finger once, and the doc was going to send me for x rays. I asked him what the outcome would be if my finger was broken, and we agreed that he would just tape it back together anyway. And that if it didn’t heal, we would reconsider. Turns out it wasn’t broken, just squashed. That’s about the only thing I learned from our high school football coach.
beltane
@Roger Moore: In other words, these people are utterly ignorant of how the US healthcare system operates in a real world setting. They really have no business writing about subjects they no nothing about.
gene108
@Procopius:
Well patients are consumers. What the HDHP proponents refused to acknowledge in public (I doubt they could be this stupid in private) is Price Elasticity of Demand.
Not all services are price sensitive.
If you need ‘x’ to live, you will pay whatever it costs to keep getting ‘x’.
The only people, who will be price sensitive are relatively healthy people, who do not have chronic conditions to treat.
And it seems those folks are putting off care rather than spending money, because if it’s not totally broke, why fix it?
The Other Chuck
@Roger Moore: Said people can afford it. They also need to have their income and assets stripped so they have to decide between doctors bills and rent. Not that even that matters, since voting in one’s own interest hasn’t exactly been a priority the last few elections…
The Other Chuck
@gene108:
Oh ye of far too much faith…
Roger Moore
@WereBear:
That’s what happens if you shop exclusively by price. But real people comparison shop including both price and quality. It’s only the WalMarts of the world who try to push the idea that comparison shopping is exclusively about price.
benw
HDHPs are obviously a way for health insurers to save money by shifting who pays for shit from the insurer to the patient. Anything else is lame ass rationalization. And the people who are getting screwed the hardest by HDHPs are the sickest:
That’s a feature, not a bug.
Villago Delenda Est
This is really, really, simple, and I wish the sociopath vermin that are CEOs would get it:
GETTING HEALTH CARE IS NOT LIKE GETTING A NEW TV AT VIDEO ONLY.
Perhaps they’ll finally get this as they ride the tumbrels to a well earned demise.
LWA
I would like to think- although I am by no means optimistic- that this sort of data will bury once and for all the “everything is a market” stuff from the market fundamentalists.
There are some goods that no one wants, even if it were given away free. Medical care is one of those. No one wants it, everyone struggles to avoid needing it, and when you do need it, the price is irrelevant to your decision making.
Villago Delenda Est
@Procopius: The “studies” are rigged to show the outcome the Ferengi slime that commissioned them want to present to whoever it is they need persuade to do things the way the Ferengi want it to be done, because profit is sacred, fuck the health care “consumer”.
Villago Delenda Est
@LWA: “Market fundamentalists” are like “Christian Fundamentalists”: they ignore everything in the source material (The Wealth of Nations, The Bible, respectively) that gets in the way of their warped selective reading of it. “Market fundamentalists” only know about the Invisible Hand. They didn’t bother to read the rest of the book that shows how the Invisible Hand can be bought by the greedy and unethical, and why Government is needed to prevent that.
Villago Delenda Est
@p.a.: The “Perfect Information” that is needed to make the fantasy free market model work also exists only in fantasy, or in the ivory towers of the University of Chicago.
gene108
@benw:
Until the PPACA made HDHP’s the norm, they were not readily adopted by employers. If it was a sop to insurance, it was a pretty poor way of doing it, as so few companies / people adopted them.
As far as cost shifting goes, insurance companies have had very sophisticated models that predict patient behavior at certain price levels, i.e. the co-pay is $10 per visit there should be ‘x’ number of doctors visits and if the co-pay is $20 per visit there should be ‘y’ number of visits.
The short of it is, if an employer ups the co-pays and less first dollar money comes out of the insurance company, then the 20% rate increase, at renewal, will only be a 15% rate increase.
I think with HDHP there’s not as much of a push to influence consumer behavior, since the first dollar is always coming out of the consumer’s pocket. The insurance is pricing itself on how much risk it is taking on, i.e. a $2000 deductible versus a $4000 deductible.
Roger Moore
@LWA:
Good luck with that. Market fundamentalists didn’t adopt their position based on logic and evidence, so they aren’t going to abandon it based on logic and evidence. They will hold onto their beliefs with as much tenacity as religious fundamentalists, because at its core their belief in the efficacy of the market is a matter of faith.
p.a.
@WereBear:Yes. This. If I were ever at a ‘Meet your Congresscritter’ event and some pol spouted that ‘skin in the game’ stuff I’d end up in jail.
I overuse the medical system because it’s sooo much fucking fun. Now there may be what? 1%, .5% who may. But EVERYONE ELSE must suffer for this!!?
Ella in NM
How we are thinking that by throwing away all support for outpatient evaluation and exams by making those have the highest deductibles and co-pays is a mystery to me.
My 78 year-old mother slipped and fell in her kitchen last October, hitting her head and seriously bruising her arm and hip. She not only didn’t tell me until two weeks after the fall, she refused to go to the Emergency Room to get a CT scan because she has an out of pocket deductible for outpatient procedures and ED visits on her health insurance that would amount to several thousand dollars.
When I noticed the bruising on her arm and queried her, I also found she had the soft, “boggy” area on her head where it hit that as an RN I knew to be indicative of a hairline fracture of the skull. Alarmed, I again tried to get her to go to the hospital, but she refused. She also has had severe pain in her hip and lower back since the fall, and has pretty much taken to her bed even missing Thanksgiving Dinner this year.
This week, she’s finally getting healthcare she can afford: she was admitted for a seizure and found to have a small blood clot in her brain, as well as a healing hairline fracture of the skull. Her lower back, which is osteoporotic, has a stenosis which is causing pressure on her lumbar nerve, which was causing her pain. She will be treated conservatively for both, but inpatient care for 7 days in an ICU Stepdown unit and all the subsequent lab, imaging and medication costs cannot be cheaper than having diagnosed her earlier in her illness and treated as an outpatient. I believe that had she not been worried about money and had gone in to the ED, they would have seen this earlier the interventions may have prevented the blood clot and her seizure, and she may have had treatment for her back that allowed her to enjoy what may be one of her last few Thanksgivings with her family.
But her co-pay?
$250 dollars.
benw
@gene108: I don’t get it, then. In the study cited in the OP, moving people onto HDHPs saved the insurance companies 12%. Where does that come from?
Raven Onthill
I think the HDHPs do serve as something of a check on the medical tendency to overtreat. But, also, they discourage people from getting care they need.
When people are poor — or feel poor — they don’t spend money they don’t immediately need to spend, because there is always some other expense, poking its nose around the corner, waggling its little tail. It’s hard to assess risks in this area, even for knowledgeable people. Does the remote of finding cancer outweigh the immediate risk of being out of your home because you can’t meet the rent some month in the future? No knowledge puts you in a position to judge that!
@OzarkHillbilly: “I will never get another stomach scan or colonoscopy as part of preventive care.”
The screening tests — what the ACA calls “preventative care” — are free. But these, sensibly, are designed to miss nothing and produce relatively large numbers of false positives. The diagnostic tests that follow on a positive screening test are not free. So the free preventative care works as marketing for the expensive diagnostic tests, many of which will be negative.
That said, if you have a family history of stomach or colon cancer I do suggest you find the money for the diagnostic tests — they may save your life.
J R in WV
When my wife had pneumonia/septic shock, the first thing that happened to her was induced coma and ventilator. How was she supposed to make health care decisions?
Knowing what I knew then about septic shock (30-40% survival rate) how was I supposed to make health care decisions? At least we have a long-term family doctor with experience selecting specialists for his patients, and a good friend who is a MD and willing to talk about anything with me – known each other since 1968.
I took their advice and hoped for the best, which is what happened. At low cost to us!
C.V. Danes
@beltane: The people who promote consumer driven health care most likely have nice cushy traditional plans. Consumer driven is for the rest of us.
Seanly
@gelfling545:
Yes, this is incredibly stupid. BlueCross Idaho (or whatever it’s called) has TV ads touting how their website will help you find the lowest cost for such & such a procedure. It’s not necessarily an HDHP plan, but they seem to think that people in Idaho like the idea of having to research which doctor to set their broken arm.
I’m not a medical professional so I have no ability to evaluate the price structure of various costs.
All HDHP does is scare people into not going to the doctor.
pseudonymous in nc
I’m currently weighing up two silver plans, both with the same premium and network: one is HSA-eligible with a lowish deductible by ACA standards ($3600) and no coinsurance after that’s satisfied; the other has reasonable copays and drug tiers but a higher deductible and coinsurance up to the out-of-pocket limit. Either way I’ll be dealing with Bistromathic pricing for any healthcare I actually “consume”.
I hate hate hate this entire process, because I’m smart enough to know that I’m basically selecting which way I’m going to be fucked next year.
So yes, the fundamental flaw of the ACA is that it’s brought in HDHPs by stealth via the exchanges. And consumer-driven healthcare is mostly bullshit preached by people with very comfy health insurance plans, just as charter school reform is mostly bullshit preached by people who went to fancy schools and send their kids to fancy schools.
J R in WV
And the Big-Pharma advertising !!!
A Chance to Live Longer!! spayed out on skyscrapers, and elderly people looking at the message with a gleam of hope in their eyes!
For patients with small-cell lung cancer who have already tried platinum-based chemotherapy, our miracle drugs may keep you alive, miserable but alive, for 9 more months!!!!
For just all the money your entire family has or will ever have… but they don’t mention that, in their “Your chance to live longer” ads, do they?
The most despicable people in the universe invented those ads. If you don’t trust your doctor to know the latest and greatest about your specific condition… maybe you are doing something wrong.
And then they tell you in the commercial to tell your doctor about all your medical conditions – like your doctor doesn’t know your medical condition, it isn’t in the inch thick chart!?!?
I’m not going to know if I have liver or kidney problems unless my doctor tells me about it. For one example.
The FDA needs to stop those ads yesterday at the latest.
Villago Delenda Est
@J R in WV: All prescription pharmaceutical advertising needs to be banned.