Hacker News Reader

Comment by nyx | Hacker News Reader

The scan that indicated the 80% reduction was after just a couple of weeks, if I recall correctly.

Since you're talking about immunotherapy not typically being a first-line treatment, I'll share a morbidly interesting fact that underscores some of the, er... quirks of the US medical system. The oncologist treating my relative initially staged my relative's cancer in the electronic health records as stage IV, despite no evidence of metastasis (the usual criterion)--he explained that he did this specifically in order to pursue first-line Keytruda (which is indicated for stage IV but not stage IIIC) and have it be covered by insurance.

View on HN

I don't understand how medical insurance companies can choose what treatments can be applicable to what patients and yet not be as liable as a doctor for medical malpractice.

It’s not that they choose the treatment, you can get whatever treatment you want. They just say that they won’t pay for treatment other than X. This is unavoidable, really: if you look at countries with public healthcare system, like eg. UK, the (state) insurer there also makes decisions as to which treatments are covered, and which patients are eligible to get them. If anything, they are more conservative than private insurers in US: due to public nature, typically they do not offer higher range of treatments to customers who pay higher premiums. Instead, the coverage is “one size fits all”, and to limit costs, covered treatments options are seriously limited compared to what private insurers offer in US, especially in countries other than the wealthiest ones: in Poland, for example, cancer treatments available to patients on government healthcare are at least a decade or two behind the state of the art. Of course, the flip side is that you then get to see how cheap health care per capita is in Poland, and gripe about outrageous costs in US.

Thanks for the info on the timing. And that's my kind of oncologist. Risk in doing that on multiple levels, of course, but reassuring that some physicians are willing to do what's right vs what fits into into an insurance company's flow chart.

Reply on news.ycombinator.com