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Running Up Behind the Wheel

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Re: Running Up Behind the Wheel

Postby bcs89 » Tue Sep 13, 2011 8:00 pm

snoqueen wrote:That's how HMOs make money.



I'm no HMO fan-boy, but please explain how the HMO makes money off of prescriptions? Are you saying they get a "kick back" from the drug company?

It would seem that HMO's do enough to complain about, without having to make shit up.
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Re: Running Up Behind the Wheel

Postby indycoyote » Tue Sep 13, 2011 8:40 pm

Confusing Oxycontin with Oxycodone???
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Re: Running Up Behind the Wheel

Postby jman111 » Wed Sep 14, 2011 8:05 am

indycoyote wrote:Confusing Oxycontin with Oxycodone???

Oxycontin is time-release Oxycodone HCl. It doesn't make sense to prescribe it in the way described. Based on the scenario, I would guess oxycodone (probably Percocet) was prescribed to the 70 year old. Still doesn't fully explain the refills, though. In my experience, opioid analgesics generally aren't refillable.
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Re: Running Up Behind the Wheel

Postby eriedasch » Wed Sep 14, 2011 2:36 pm

bcs89 wrote:Absofuckin'lutly Bullshit. Every fucking word.

Before flying off the handle you might want to find out exactly when bluerose's story supposedly took place (i.e. last month, two years ago, ten years ago?).

I knew of a couple acquaintances maybe 7 or more years ago that were hooked on oxy's and back then did not seem too hard to get.

I would hope after all the problems this drug has caused and continues to cause, there have been increased safegards put in place to reduce abuse.

But the fact remains, kids and younger adults seem to be first getting hooked on oxy's (not sure where they get them), then find out they can get heroin to feed the same addiction easy and cheap in bigger cities.
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Re: Running Up Behind the Wheel

Postby eriedasch » Wed Sep 14, 2011 2:46 pm

bcs89 wrote:
snoqueen wrote:That's how HMOs make money.



I'm no HMO fan-boy, but please explain how the HMO makes money off of prescriptions? Are you saying they get a "kick back" from the drug company?

It would seem that HMO's do enough to complain about, without having to make shit up.

According to this, the doctors get "gifts" from big Pharma.
http://atheism.about.com/library/FAQs/p ... script.htm

I'll admit I'm no expert, but there is a lot of info about this available.

Please educate me, bcs89, with facts, links, and why I should believe you.

I would like to think the HMO doctors have my best interests, but my personal experience with HMOs over the past 15 years have been quite the opposite. Here try this pill. Oh it does not work, try this one. Here is another version to try. Here are some free samples to try. Etc. and so on...
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Re: Running Up Behind the Wheel

Postby bleurose » Thu Sep 15, 2011 12:07 pm

thanks, Indy, it was oxycodone, my mistake. And yes, it did happen several years ago. And for bcs - don't give a good goddamn about your theory that this is all BS, "every fuckin' word". I was there, I am quite fluent in English and Arabic numerals and it was written FOR 3 MORE REFILLS OF A MONTH EACH!

Go blow yourself, ya dick!
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Re: Running Up Behind the Wheel

Postby bcs89 » Thu Sep 15, 2011 1:08 pm

bleurose wrote:thanks, Indy, it was oxycodone, my mistake. And yes, it did happen several years ago. And for bcs - don't give a good goddamn about your theory that this is all BS, "every fuckin' word". I was there, I am quite fluent in English and Arabic numerals and it was written FOR 3 MORE REFILLS OF A MONTH EACH!

Go blow yourself, ya dick!



erie - your link, while as disgusting to me when it was written as the practice is now, does not show how HMO's "make money" off off scripts - do MD's, across the board (not just HMO Docs) get incentives to prescribe one drug over another? Yes, though again, this practice is on its way out, and good riddance. So far as me "proving" your statement that MD's hand scripts for Oxycontin out like it was "candy" is wrong - don't have the time or the inclination. YOU made the accusation. You defend it.

And then there is bluerose. Your right, why let ONE little detail (the actual drug prescribed no less, the crux of my post, and your "story") get in the way of a good MD bashing, Right? I mean Oxycodone, Oxycontin, same diff right? (here's a clue, NO) And then of course, just because you got that detail wrong does not mean your recollection about the rest should be in question.. I mean it was just a few years ago, and it WAS written for someone you know - of course you remember all the details. Well, most of the details.. the ones that count, ya know? Like "Docs are Bad". And as long as you would like to discuss this further, what exactly was your "first choice" as a way to dispose of the unused portion of this medication that was not prescribed for you? You said he flushed them - what were your plans for them? The main problem with Oxycontin is that it gets into the hands of people for whom it was not prescribed. So, again - what were your plans for it?

And as to your final point - :shock:
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Re: Running Up Behind the Wheel

Postby Prof. Wagstaff » Thu Sep 15, 2011 1:31 pm

There is another possibility here, which is that the prescription was simply in error. Prescription mistakes happen frighteningly often, so it's quite possible that bleurose's memory is correct and also that bcs is correct that had an attempt been made to refill it, the pharmacist would have balked.
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Re: Running Up Behind the Wheel

Postby bcs89 » Thu Sep 15, 2011 1:42 pm

Prof. Wagstaff wrote:There is another possibility here, which is that the prescription was simply in error. Prescription mistakes happen frighteningly often, so it's quite possible that bleurose's memory is correct and also that bcs is correct that had an attempt been made to refill it, the pharmacist would have balked.


If bleurose's second post is correct (i.e. it was Oxycodone as opposed to Oxycontin) there is no problem with refills, though four months worth of Percocet for an elderly patient with short term pain does strain ones credulity.
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Re: Running Up Behind the Wheel

Postby jman111 » Thu Sep 15, 2011 3:40 pm

bcs89 wrote:If bleurose's second post is correct (i.e. it was Oxycodone as opposed to Oxycontin) there is no problem with refills....

Yep. I think I was wrong earlier (it has been a few years since I was prescribed Percs). I don't believe there generally is a problem with refill prescriptions for opioid analgesics, as long as the refills are prescribed initially. But you cannot get refills phoned in to a pharmacy. I recall trying to get a refill one time when my back went out. Doc couldn't phone it in- I had to make the trip to his office to get the paper script.

So, it appears that a few years' time can affect recollection of details....
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Re: Running Up Behind the Wheel

Postby eriedasch » Thu Sep 15, 2011 4:15 pm

bcs89 wrote:erie - your link, while as disgusting to me when it was written as the practice is now, does not show how HMO's "make money" off off scripts - do MD's, across the board (not just HMO Docs) get incentives to prescribe one drug over another? Yes, though again, this practice is on its way out, and good riddance. So far as me "proving" your statement that MD's hand scripts for Oxycontin out like it was "candy" is wrong - don't have the time or the inclination. YOU made the accusation. You defend it.

That was snoqueen that claimed HMO's make money off drug prescriptions.

I simply posted the link attempting to prove MD's are rewarded with gifts for prescribing certain drugs over others.

Either way, I still feel it compromises their ability to be completely neutral, objective and have the patient's best interests in mind.

Furthermore I was not asking you to prove anything I claimed. But I do feel if YOU backed up YOUR own claims with something they might be viewed as more than just your opinion.
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Re: Running Up Behind the Wheel

Postby snoqueen » Thu Sep 15, 2011 6:09 pm

That was snoqueen that claimed HMO's make money off drug prescriptions.

I simply posted the link attempting to prove MD's are rewarded with gifts for prescribing certain drugs over others.

Either way, I still feel it compromises their ability to be completely neutral, objective and have the patient's best interests in mind.


And I haven't replied further because I agree with what was said here. There's no question MDs get premiums from drug companies.

I really didn't want to post a rant, but since this one won't die, I will. This entire system is riddled with problems that definitely affect people's well-being. I was not surprised to read the pain-killer-scrip story upthread. I'll add another one, in fact.

A major part of the business model of HMOs is to minimize MDs' contact time with patients (scheduling four or more appointments per hour) and send as many people as possible away with a prescription so they don't come back and waste more appointment time. These are not necessarily in the best interest of the patient, especially when things get complex, more than one prescriber is involved, and/or the person is not knowledgeable or able to advocate for him or herself.

I have seen prescriptions written (for a family member I was responsible for) that, once I got home and researched the drug, were either irrelevant to the problem or specifically counterindicated.

A pain prescription was written for my elderly mother (now deceased) that just about killed her. Later, when we checked the specifics, we learned that drug was specifically listed as not to be prescribed for patients over 75. She was 90. Fortunately, we elected to stop using it and sought other medical advice, and in time (over several months) she started eating again on her own and regained her independence. That one was written for back pain!

She got a lot more than she bargained for -- the stuff was so strong she was hardly able to move and her respiration rate dropped way down. Very poor prescribing but no surprise -- with back pain they mostly want you to go away, because it's rarely life-threatening.

After that crisis I took over, and I got very, very thorough about reading every detail on the drug handout and asking lots of questions. We had several other instances, before mom died, where after some discussion, prescriptions were reduced or even not written. And at the end we learned she was still being sold inappropriate drugs.

When my mother eventually qualified for hospice care (at a ripe old age) the first thing the hospice doctor did was go through her list of prescriptions. He informed us over half of what remained were left over from conditions that had long since been resolved, and should be dropped. One I remember in particular was to preserve my mother's eyesight, which actually had been entirely gone for more than a year. Even with my own vigilance, Medicare was paying for several irrelevant (or potentially harmful) prescriptions each month.

I became very cynical about the business model of HMOs and even of the Medicare system, which is necessary but definitely ready for a tune-up. HMOs are only tangentially in the patient care business. They are first of all one-stop prescription dealers especially with regard to elderly people and others with insurance.

That's how they make their money, just as I said.
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Re: Running Up Behind the Wheel

Postby indycoyote » Fri Sep 16, 2011 5:09 pm

To be more accurate, SOME MD's get benefits from Big Pharma, but the vast majority do not. In fact, it's becoming more and more common for hospitals to ban physician exposure to drug reps. Things are slowly changing...
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Re: Running Up Behind the Wheel

Postby david cohen » Tue Oct 04, 2011 8:12 am

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Re: Running Up Behind the Wheel

Postby cloudy » Tue Oct 04, 2011 4:09 pm

Snoqueen, your anecdotes really have nothing to do with the "business model" of HMOs. There are several models they use, the original premise being to control costs by assigning a primary care doc who controlled referrals. A good PCP would organize overall care and notice when inappropriate meds were prescribed - your story is exactly what "managed care" is designed to avoid.
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