Does it make sense to provide health insurance to smokers and drug users?

[SilverStone05]

great idea. i'd be interested in learning which specific online pharmacy you buy your life-saving prescriptions from.

I'm sensing some sarcasm here. I understand, i'm an easy target, i'm too young to know anything and I'm not as rich as Steve. :wink:

*However*

You DO know...that you CAN ask your Dr. or your pharmacy for the generic version of your prescription, didn't you?

If they refuse, you DO know that you can go to a pharmacy where they will fill generics, don't you?

In addition, there are hundreds of reputable pharmacies online. I'd recommend an escrow service in Canada.....pharmacyescrow.com.

Get a look when you get a chance.

My generation may be a bit more more savvy with navigating the internet than you older folks, so I understand your apprehensions.

But seriously, the victim mentality stinks. It used to be that nobody liked a sore loser....now days no one likes a winner of any sort.

Cheers.

 

[queenlives]

Cheers.

your response to my serious question speaks volumes - thx for clarifying a couple of questions i've had.

i take your answer as "no, i've never bought any life-saving prescriptions that i (or my family members) depend on from an online pharmacy. but - theoretically - the quality of their prescriptions are as good as those i buy from the local, certified pharmacy."

when i read your initial post, i thought, "hmm, i wonder what google will show for buying prescriptions online.". wouldn't ya know, the first listing (for what appears to be a major site) has under their contact info a PO Box. ah... that doesn't give me a lot of confidence about a supplier of the life-saving drug i depend on.

there are a number of primers / family members who rely on prescription drugs to save their lives or prevent disabling medical events from occurring. . heck, i'd even bet that some of them are <100 years of age. but i'll go out on a limb and say that i would be surprised if *any* of these primers rely on an online pharmacy for their life-saving medications. (of course, i'd love to hear from them if they do!)

hal

 

[Tom239]

there are a number of primers / family members who rely on prescription drugs to save their lives or prevent disabling medical events from occurring. . heck, i'd even bet that some of them are <100 years of age. but i'll go out on a limb and say that i would be surprised if *any* of these primers rely on an online pharmacy for their life-saving medications. (of course, i'd love to hear from them if they do!)

For a time, I was taking life-saving medications that I bought online from India. It was a tough call for me to make. On the one hand were doubts that the medicine was legit; on the other hand was the price difference--a factor of about 12 to 1, in this case roughly $1000/month savings. The difference in price reflects differences in US and Indian patent law, which India has been pressured to change.

Such retail drug shipments get through US customs (usually but not always) but I think they are tolerated because the practice isn't too widespread. If enough people bypassed US channels, I suspect authorities would crack down.

 

[Cragar]

You would be surprised what you can get online.

I have a friend who is allergic to bee venom. His last EpiPen ( Epinephrine ) was expired for over 3 years. He did not have the money for the required doctor visit to obtain a recent prescription so he could by one. I looked online and found many places that would sell them without the prescription.

He ended up getting one from a domestic supplier . Not what he did was legal , but he needed it . There was a lot of websites out of the country that sold it even cheaper , but he went the route with a domestic supplier for the sake of knowing he would get the real McCoy and less hassles with customs.

The internet is still fairly unregulated for prescription drugs. I am quite sure the powerful , greedy drug companies will lobby for more control.

Control of your money , that is ......

 

[SilverStone05]

i take your answer as "no, i've never bought any life-saving prescriptions that i (or my family members) depend on from an online pharmacy. but - theoretically - the quality of their prescriptions are as good as those i buy from the local, certified pharmacy."

To clarify, yes I've purchased...as have family members, as have several folks I know, from an online pharmacy. Yes, you get
legitimate product. You can even pick what brand you'd like or what country you'd like to get it from.

This of course, doesn't mean that scammers and fraudsters don't exist in the world of online pharmacies. But you already know that.

Fortunately, I, nor anyone I know of, rely on prescriptions in order to save their lives on a daily basis. I wouldn't guess you know too many either...unless of course you've switched from bee-keeping to med school. :wink:

 

[queenlives]

For a time, I was taking life-saving medications that I bought online from India. It was a tough call for me to make. On the one hand were doubts that the medicine was legit; on the other hand was the price difference--a factor of about 12 to 1, in this case roughly $1000/month savings. The difference in price reflects differences in US and Indian patent law, which India has been pressured to change.

Such retail drug shipments get through US customs (usually but not always) but I think they are tolerated because the practice isn't too widespread. If enough people bypassed US channels, I suspect authorities would crack down.

thx for your feedback on this. my take has been there are likely a number of back-channel / internet-based means of obtaining quality pharmaceuticals (as there are so many medical-tourism facilities around the world these days). my take is much the same as yours, until there is a major health-scare related to the distribution of pharms *or* the volume gets too high, it's probably viewed as let sleeping dogs lie.

good for you, glad you found a quality source

 

[queenlives]

You would be surprised what you can get online.

I have a friend who is allergic to bee venom. His last EpiPen ( Epinephrine ) was expired for over 3 years. He did not have the money for the required doctor visit to obtain a recent prescription so he could by one. I looked online and found many places that would sell them without the prescription.

He ended up getting one from a domestic supplier . Not what he did was legal , but he needed it . There was a lot of websites out of the country that sold it even cheaper , but he went the route with a domestic supplier for the sake of knowing he would get the real McCoy and less hassles with customs.

The internet is still fairly unregulated for prescription drugs. I am quite sure the powerful , greedy drug companies will lobby for more control.

Control of your money , that is ......

buahahahaha - no, i'm not at all surprised at what can be obtained online... i hear there are vast sources of pr0n, too as i said to tom, above, i'm glad your friend found a quality source for the epipen. (let's hope when he needs it, it's good and works as advertised! - said w/sincerity

 

[Dtrigg]

How do you know that the medication(s) you get over the Internet from some foreign country are what you need? I would think that the vast majority of people that order medications over the Internet just receive something that looks like a pill and they put their faith into it being real.

It's not that hard to make something that looks like a pill.

How does that guy know that his "Epi Pen" will work when he needs it?

How can someone order a "life saving" drug over the Internet from some foreign country? What if you get something that isn't life saving? Is it really worth the risk? How do you know what you're getting?

 

[Cragar]

My friend's EpiPen came from a pharmacy in Alabama. The pharmacy looks legit.

The EpiPen looks very legit. It was manufactured in the USA by a major pharmaceutical firm. If it is a fake , they went to a lot of trouble to make it look as real as possible. This is why he decided to pay a little bit more to get it from a USA supplier VS overseas.


I understand what you are saying , Dtrigg.

If he had not gone this route it would have cost him several hundred for the doctor's visit and the prescription which he did not have and would still have an outdated EpiPen.

It comes down to choosing to use an outdated ( but legit ) EpiPen or one that has a potential of being fake.

Given the odds that the outdated one would be useless in a life or death situation or one that may save his life , I would choose the new , untested one before the old one.

The real problem lies with the medical profession making you pay lots of money for a prescription to be renewed for a lifelong aliment that IMO you should be able to renew for a much longer period of time than just a couple of years without needing to see a doctor to get a piece of paper that proves you need it.

 

[Dtrigg]

The real problem lies with the medical profession making you pay lots of money for a prescription to be renewed for a lifelong aliment that IMO you should be able to renew for a much longer period of time than just a couple of years without needing to see a doctor to get a piece of paper that proves you need it.

Keep in mind, I worked in health care for many years. The medical profession has nothing to do with a patient paying lots of money for a prescription. They don't set prices. They also have nothing to do with the shelf life of a drug or device. It's a simple fact that drugs have a shelf life. After a while they lose their effectiveness. Why do you have to see a doctor to get a piece of paper? Very simple - malpractice.

 

[steveny]

How do you know that the medication(s) you get over the Internet from some foreign country are what you need? I would think that the vast majority of people that order medications over the Internet just receive something that looks like a pill and they put their faith into it being real.

It's not that hard to make something that looks like a pill.

How does that guy know that his "Epi Pen" will work when he needs it?

How can someone order a "life saving" drug over the Internet from some foreign country? What if you get something that isn't life saving? Is it really worth the risk? How do you know what you're getting?

I agree BIG TIME!!! Who is to say if the stuff you get wouldn't harm you. I would NOT order prescriptions on line. My perscriptions are ten bucks but keep in mind I pay 15k a year for my health insurance.

As for cost here is a little story. A friend of mine had heart surgery in his 70's. He had to take some medication after wards. The cost of the prescription was 1500.00 dollars. It was not covered on his insurance. He tok the pills and they made him worse. The doctor wrote the wrong prescription. My friend had to buy ANOTHER prescription another 1500, no refund for the first prescription, not even a sorry.

 

[Cragar]

Same friend also has another life long aliment. I believe it is called Tinea versicolor. This causes him to get these funny looking patches or discoloration in his skin mostly , his back. He needs a prescription for Nizoral cream ( Ketoconazole).

He cannot afford a doctor's visit for this as well. The prescription is a bit pricey too. He was able by way of a girlfriend/nurse to find out that there is other anti-fungals out there that could help him like Clotrimazole which is available over the counter in some athletes foot products. He decided to give it a try because he could not afford the doctor's visit.

Guess what , it worked. Not only did it work , he found these products in a dollar store !

He will never go back to paying big bucks for the Nizoral product unless he has to or Obama decides he can have it for free and everyone else can pay for it.


This is just an anti-fungal cream. I don't understand why you need a prescription for something like this that can be refilled for say 10 years instead of just 1 or 2 years except for the fact that some company that makes it wants it to stay on a restricted drug list so you need to see a doctor and pay the phamacy big bucks which in turn goes back to the drug manufacturer.


This is a drug that has little to no side affects , costs big bucks and he found a replacement for 1 dollar.

Sounds like to me that there is more concern over this prescription making money for some people than the fear of a lawsuit.

Ironically , Nizoral shampoo for dandruff IS available over the counter without a prescription.



Again , Dtrigg , I hear what you are saying about malpractice and lawsuits. But some of it is just not right. People suffer because they cannot get some basic medicines that would help them.

This is all of part of why our medical costs have gone through the roof in this country.

 

[Dtrigg]

Same friend also has another life long aliment. I believe it is called Tinea versicolor. This causes him to get these funny looking patches or discoloration in his skin mostly , his back. He needs a prescription for Nizoral cream ( Ketoconazole).

He cannot afford a doctor's visit for this as well. The prescription is a bit pricey too. He was able by way of a girlfriend/nurse to find out that there is other anti-fungals out there that could help him like Clotrimazole which is available over the counter in some athletes foot products. He decided to give it a try because he could not afford the doctor's visit.

Guess what , it worked. Not only did it work , he found these products in a dollar store !

He will never go back to paying big bucks for the Nizoral product unless he has to or Obama decides he can have it for free and everyone else can pay for it.


This is just an anti-fungal cream. I don't understand why you need a prescription for something like this that can be refilled for say 10 years instead of just 1 or 2 years except for the fact that some company that makes it wants it to stay on a restricted drug list so you need to see a doctor and pay the phamacy big bucks which in turn goes back to the drug manufacturer.

This is a drug that has little to no side affects , costs big bucks and he found a replacement for 1 dollar.

Sounds like to me that there is more concern over this prescription making money for some people than the fear of a lawsuit.

Ironically , Nizoral shampoo for dandruff IS available over the counter without a prescription.



Again , Dtrigg , I hear what you are saying about malpractice and lawsuits. But some of it is just not right. People suffer because they cannot get some basic medicines that would help them.

This is all of part of why our medical costs have gone through the roof in this country.

I hear what you're saying Craig. I ran a hospital in Europe so malpractice wasn't really a problem. Prior to that I ran a 250 multispecialty physician clinic in California. It is a premier clinic. Our patients came from every state in the Union and over 20 foreign countries every year. We go sued all the time. Some 60 year old lady would come in for a face lift. She would look 40 after the procedure. She wanted to look 20. We got sued. We would get sued for everything you can imagine. If it cost less than $50,000 we would just pay them. It cost us that much to go to court. Want to think about our malpractice premiums? Don't. We were even self funded for our malpractice. Guess who pays for this. You. It's also why you've been hearing those arguments for over testing because doctors don't want to get sued. California has caps on malpractice awards and it still costs a fortune.

My physician friend was going on a vacation to Machu Picchu in Peru sponsored by the University of California - Santa Barbara. He was in Miami airport when a lady in the group came up and gave him a piece of paper. She told him that her husband was taking that list of medications and wondered if he would have any problems. He said he didn't know and he didn't know her husband. On the trip the lady's husband died. They sued my friend for malpractice. It was in the court system for two years. He won but it was at a terrible cost.

That's why a doctor isn't going to tell your friend to use a foot power for his medical problem on his back. Ever notice that physicians won't use e-mail for communicating with patients? Too many malpractice implications in how something may be misconstrued.

I agree with you, I don't like it either. My physician friends would agree with you as well. That's just where we are in terms of how they have to practice.

You may also be correct in terms of the new health care bill. Perhaps your friend may get his medication for free and we'll all pay for it.:wink:

 

[Tom239]

How do you know that the medication(s) you get over the Internet from some foreign country are what you need? I would think that the vast majority of people that order medications over the Internet just receive something that looks like a pill and they put their faith into it being real.

It's not that hard to make something that looks like a pill.

How does that guy know that his "Epi Pen" will work when he needs it?

How can someone order a "life saving" drug over the Internet from some foreign country? What if you get something that isn't life saving? Is it really worth the risk? How do you know what you're getting?

Having done it, I can say that I got drugs in sealed packages from a well-known large manufacturer, and I could tell whether they worked from my own lab results.

Yes of course the peace of mind of a known source is worth a lot. It's one thing to just pay the higher price when you are well enough to work full time and make good money. If not, and if the price difference is substantial, the choice is not so simple.

 

[Dtrigg]

Having done it, I can say that I got drugs in sealed packages from a well-known large manufacturer, and I could tell whether they worked from my own lab results.

Yes of course the peace of mind of a known source is worth a lot. It's one thing to just pay the higher price when you are well enough to work full time and make good money. If not, and if the price difference is substantial, the choice is not so simple.

I hear what you say Tom. Good luck and best wishes.

 

[NSXGMS]

Should it not be:
"Does it make sense to provide health insurance to smokers, drug users and too fast-car owners"!?

I live in Sweden and we are NOT a socialist country, as the americans tend to think - we are as americanized country as we ever can be - what ever you do we do "better".... or "worse", only some years later!!

Our system is widely admired by many countries but it comes with some bad sides too as your system does.

Looking on your system from abroad, having our, I'd choose our!
-AND, we ARE discussing to force people stop smoking before they get an operation they need if the smoking will make the halthcare harder (excuse my bad english-hope you understand what I mean)!

Perhaps we could find something in the middle of these two systems??

You're actually correct in the definitive sense. In the study of Economics Sweden would be considered a "hampered market" system. Economic scholars consider "socialism" to be primarily relegated to communism and fascism. True "socialism" is a very extreme policy.

The US has also become an ostensibly "hampered market" system. The curious advantage Sweden in particular has is that its "Third Way" system began with a "big government" approach and has never been able to produce enormous wealth for the government to gain any more momentum by taking. It appears that throughout history the less powerful a state begins the faster and greater it grows and vice versa.

The problem you end up with in a scenario like Sweden is that the standard of living never rises and always slowly declines as long as the free market remains hampered. Sweden's standard of living and personal wealth has been significantly (25%-50%) lower than the US's since about 1970 and constantly getting worse. Unemployment is massive, particularly among under 30-year olds. The Swedish govt has never been honest with unemployment figures and I have seen several independent sources that suggest under-30 unemployment is around 40%. Take public-sector jobs out of the equation and I'm afraid you'd find that private-sector employment in Sweden is very, very low.

You see the Swedish govt has begun to admit defeat and has been privatizing several of its largest nationalized industries because they simply can't turn the economic ship around with the state running the show.

The US is really in trouble because what we have now is a economic system like Sweden's but we are in denial of it. This nickel-and-diming of state intervention creeps and grows and we can't bring ourselves to either stop it or accept it and we accept it by doing nothing. Publicly we say the US should not be socialist but we allow it to take hold and it's packaged in a bow and we're lied to so we can just believe the lie and not worry about it. At least in Sweden the people get a more honest dose and an effort is made to at least see it for what it is and make it actually work.

 

[NSXGMS]

Keep in mind, I worked in health care for many years. The medical profession has nothing to do with a patient paying lots of money for a prescription. They don't set prices. They also have nothing to do with the shelf life of a drug or device. It's a simple fact that drugs have a shelf life. After a while they lose their effectiveness. Why do you have to see a doctor to get a piece of paper? Very simple - malpractice.

True, the medical profession doesn't control the cost of medication at all.

It's a little complicated but the medical profession does influence the overall cost of insurance, among other things.

If insurance were brought down to the cost that it should be one would see that the prescription portion of insurance would amount to a disproportionate amount of that premium and that would open a lot of people's eyes to the gouging going on by the pharmaceutical industry via the state.

For example if an insurance premium is $200/month and $50 of that covers drugs it's not that glaring. But if the premium was $100/month and $50 of that was drugs people would be up in arms.

The inflated overall cost of insurance combined with employer coverage which can mask much of the actual cost keeps people from realizing how much we are paying for drugs.

In a perfect economic scenario this ridiculous profit would be a signal (as all profits are) that there is an opportunity of entry into the health care market in other ways. You'd see capital pouring in to technologies that might replace drugs and move some of that profit from drugs to actual cures since if a drug is no longer needed all the money people had been paying for a drug would now be paid to a more effective treatment.

In a nutshell, outrageous profits are a market signal that consumers are desperate for something better and cheaper to come along. But right now the capital is pouring in to drug companies because they are essentially a protected cartel. It's easy money for investors and it's inflated profits prohibit capital from going elsewhere. Who's going to risk a whole lot of money on new technology when the profit is all but guaranteed in the pharma industry?

The saddest part is indeed all the money that pours into drug research that could be put towards amazing new medical technologies that actually cure problems unlike most drugs.

 

[Jimbo]

Where are these outrageous profits?

The profitability of drug companies is in line with other major industries.

The average profit margin of the pharmaceutical companies in the Fortune 1000 list is 16% (profits as a percent of revenue). This is in line with the profit margins of the banking (13%), diversified financial (11%), tobacco (11%), and real estate (10%) industries. Drug industry returns have remained steady since 1981 at only 2 to 3% above the cost of capital.

The pharmaceutical industry's risk-adjusted return is actually lower than other R&D-intensive industries, such as computer network, equipment, and software services.

And the pharmaceutical companies pay more taxes than most other companies. The pharmaceutical industry's total tax liability (as a percent of income subject to U.S. tax) is 33.8%, which is slightly higher than for all manufacturing (33.7%) and for all industries (33.5%).

 

[NSXGMS]

Where are these outrageous profits?

The profitability of drug companies is in line with other major industries.

The average profit margin of the pharmaceutical companies in the Fortune 1000 list is 16% (profits as a percent of revenue). This is in line with the profit margins of the banking (13%), diversified financial (11%), tobacco (11%), and real estate (10%) industries. Drug industry returns have remained steady since 1981 at only 2 to 3% above the cost of capital.

The pharmaceutical industry's risk-adjusted return is actually lower than other R&D-intensive industries, such as computer network, equipment, and software services.

And the pharmaceutical companies pay more taxes than most other companies. The pharmaceutical industry's total tax liability (as a percent of income subject to U.S. tax) is 33.8%, which is slightly higher than for all manufacturing (33.7%) and for all industries (33.5%).

Your stats above are from 2002...with that being said:

Pharma is the single most profitable sector of the US economy.

Banking's profitability can also be distorted (and can be very unprofitable as we've seen lately) and would be nowhere near 13% in a system with sound money.

Don't know enough about tobacco offhand to comment on that one;

Real estate is in the same category as banking these days.

I would have to say that long-term profit margins of 13-17%, based on what I understand about the history of business and economics are quite abnormal. Typical business profit margins are well below 10% and usually below 5%. In fully saturated and developed markets it's typical to find profit margins of around 1% or less.

Anyway, the relationship between the state and the pharma industry (and banking) is so incestous it's impossible to know exactly how much or little these companies are making or should be making. Drug patent law and the FDA are so arbitrary and illogical it's beyond any reasonable analysis.

As a side note big pharma is probably the leading proponent and will be a huge beneficiary of any proposed health care legislation since when quality of care goes down drug sales go up. They'll make even more of a killing and after 15 or 20 years be forced to submit to nationalization due to "excessive profits."

The drug industry exploded in the 70s due solely to strong patent law. Sure, some great drugs have been discovered but I can't think of many drugs in the last 40 years that cured anything. In addition, most of the best drugs created during this time came in large part from taxpayer-funded, academic or outside research. Maybe only the final 5% of development came from big pharma.

It's just hard to imagine tens of billions of dollars poured into the drug industry not finding an actual cure for something if directed towards other medical technologies.

 

[steveny]

Anyone making 10% in real estate is doing something horribly wrong. My lowest ROI is 38% and my highest is north of 100%, yearly. Flips, at least 100% or I don't do them.

 

[JonBoy]

Where are these outrageous profits?

The profitability of drug companies is in line with other major industries.

The average profit margin of the pharmaceutical companies in the Fortune 1000 list is 16% (profits as a percent of revenue). This is in line with the profit margins of the banking (13%), diversified financial (11%), tobacco (11%), and real estate (10%) industries. Drug industry returns have remained steady since 1981 at only 2 to 3% above the cost of capital.

You're looking at these numbers as absolute figures. If you look at them COMPARATIVELY, pharmaceuticals are 23% more profitable than the next most profitable sector and they are a whopping 60% more profitable than the least profitable.

That's significant!

 

[NSXLuvr]

If he had not gone this route it would have cost him several hundred for the doctor's visit and the prescription which he did not have and would still have an outdated EpiPen....

The real problem lies with the medical profession making you pay lots of money for a prescription to be renewed for a lifelong aliment that IMO you should be able to renew for a much longer period of time than just a couple of years without needing to see a doctor to get a piece of paper that proves you need it.

I was going to leave this alone but did you just say SEVERAL HUNDRED $ to see a doctor If he had a doctor already it would have only cost him a phone call. Otherwise at the most a simple follow up visit which is usually $35-55. Thats it. I'm pretty sure your friend could afford that.

I'm amazed to read that you really think all we(physicians) do is gouge people of money for a "piece of paper". UNBELIEVABLE.

 

[Cragar]

If he had not gone this route it would have cost him several hundred for the doctor's visit and the prescription which he did not have and would still have an outdated EpiPen.


The real problem lies with the medical profession making you pay lots of money for a prescription to be renewed for a lifelong aliment that IMO you should be able to renew for a much longer period of time than just a couple of years without needing to see a doctor to get a piece of paper that proves you need it.

I was going to leave this alone but did you just say SEVERAL HUNDRED $ to see a doctor If he had a doctor already it would have only cost him a phone call. Otherwise at the most a simple follow up visit which is usually $35-55. Thats it. I'm pretty sure your friend could afford that.

I'm amazed to read that you really think all we(physicians) do is gouge people of money for a "piece of paper". UNBELIEVABLE.

I am not saying doctors are thieves. I am sorry if you took my post the wrong way. That was not the point I was trying to make. But here in the northeast it is difficult to see a doctor for less than a hundred dollars. The prescription is over a hundred dollars for 1 EpiPen. That is a couple hundred for both.

My beef is why the prescription is only good for 1-2 years. If the prescription was good for 5-10 years it would make more sense. Limit the dosage to 1 or 2 EpiPens per year ( they expire in one year )

What this does is take away from my friend with limited funds to have something he needs to very possibly save his life. Yes , maybe this needs to be watched closely and require a visit a year , but the Nizoral cream prescription probably needs very little supervision and he is denied that as well.

It is all about controlling costs to the person in need. Not throwing up roadblocks to someone with limited funds.

 

[SilverStone05]

My beef is why the prescription is only good for 1-2 years. If the prescription was good for 5-10 years it would make more sense. Limit the dosage to 1 or 2 EpiPens per year ( they expire in one year )

In this litiguous society it wouldn't make much sense.

Your body chemistry can change over time and the same medication may not work as well, or it could even harm you.

There's a negligence lawsuit waiting to happen.

Not saying your buddy would do that, but it isn't uncommon.

 

[Cragar]

In this litiguous society it wouldn't make much sense.

Your body chemistry can change over time and the same medication may not work as well, or it could even harm you.

There's a negligence lawsuit waiting to happen.

Not saying your buddy would do that, but it isn't uncommon.

I am not going to argue your point , it is correct. He has tried several times to get his prescription refilled by avoiding an office visit only to be told he needs to see the doctor in person. They ask him the same questions , check his vitals and the usual stuff. I don't know if there is an test to find out if you are allergic other than showing signs of shock after a bee sting. In the 20 or so years he has known about this he has never needed to self inject himself as he as always been able to get to the hospital in time. I have taken him there on two different occasions for a bee sting.

It is sad that in this country were are so concerned about lawsuits ( and rightly so ) that it puts someone's life in danger because they can not afford proper medical care.