Quote:
Originally Posted by aaggoswami My family has many doctors, but I am never aware of it. But here is the case with my mother.
My mother was once on insulin injections thrice a day. The doctor has recommended these for good health. That doctor is very famous in Vadodara for keeping the patients in hospital for too long, i.e. admitting the patients and keeping them for too long.
Then we started visiting another doctor who was once a head in IPCL ( when it was IPCL and not reliance ). He clearly mentioned that considering the fact that a lot of medicines are available for diabetes, its not good to jump to insulin injections that too thrice a day.
We started taking his treatment and now mom is currently on tablets and not insulins. This is the effect from doctor to doctor.
One had inscribed three injections of insulin and my mom started taking the injections herself. Even after this mom was not comfortable and low sugar was regular. Right now with the tablets, all parameters are in control. |
Injected Insulin is actually the best treatment for Diabetes, both Type-1 & Type-2. It's better than most other oral medications. However, doctors in general prefer to go the oral medication route because of various reasons.
- Patients in general prefer to swallow a medication than inject it. So compliance goes down with home injections as compared to oral medications
- Insulin treatment ends up being expensive & requires a lot of discipline from the patient. Ideally, you should measure your blood sugar before a meal, calculate the amount of carbs you are going to eat, calculate the insulin needed for that much carbs & then inject yourself the right dosage. Also you should again measure your blood sugar repeatedly during the day to avoid low sugars. This may end up needing making you measuring your blood sugar 5-6 times a day. A blood sugar measuring strip costs upto Rs.25 per strip. So overall it ends up being very expensive. Plus as I said it requires a lot of patient discipline in the absense of which, you may end up with low blood sugar.
- Medications like sulfonylureas for diabetes essentially force your pancreas to increase it's insulin output tremendously - that's how they work. Now in the long term, this eventually causes pancreas burnout leading to increased dosage or adding more medication over the long term. Most people who are on oral medication get to the point where they need to add injected insulin at some point.
- No of times insulin is taken in a day is not meaningful unless you also know what is the quantity injected each time. Plus depending on your stage of diabetes, your dosage may differ. For some people 20 units may be more than enough per day, for others 50 units may be less.
- Dr. Bernstein's
book recommends splitting the dosage into many small units a day as compared to 2 big units.
Quote:
Originally Posted by ntomer Dear Sir,
I know the owners - Junejas pretty well. And although I can't really substantiate it but it is a fact that no well-known hospital prescribes Mankind medicines.
The core market for Mankind is small towns, and micro-interiors. And they'll give doctors anything - from tooth-brushes, razors, shirts to ACs, LCD TVs to foreign trips - to prescribe their medicines.
Other companies might not be much different, but the established names have much better QC, and will not go to such extent to get business.
Nitin |
Considering other companies have bigger margins than Mankind, they can afford to bribe the docs even more!
Mankind has been single handedly responsible for making a lot of other major manufacturers reduce their prices. Many tablets which used to cost Rs. 50 per tablet 10 years back, now cost Rs. 20 from the same major manufacturer because Mankind sells at Rs. 5.
I read an article where a researcher tested various different generics in India & found that all of them are within the mark.
Quote:
Originally Posted by ntomer This incident made me realize that there is a nexus between hospital, TPA and insurance company personnel, which is bleeding the insurer dry.
Nitin |
Personally, I don't like the concept of insurance(all kinds) except in a few cases.
Medical insurance, in the end increases the cost of treatment because of various reasons
- there is another entity in the equation who is making profits
- Doctors have to hire an extra person to take care of billing & following up with insurance companies.
- Doctors/Hospitals try ripping off insurance companies. In the end, the cost is going to be passed on to the customer.
- In the US, people have sued insurance companies for rejecting cosmetic surgery as part of coverage - the argument being - my self esteem is low because of my cosmetic problems, this causes depression, depression is a medical condition, so the insurance has to pay for my nose-shaping. In the end, again, cost is going to be passed on to the customer.
Medical Insurance Industry in India is in very nascent stages, hence we don't see too many problems. However, give it 10 years time, I predict that most people will not be able to visit a doctor for even minor treatments without having insurance coverage.
For people without employer provided medical insurance, I would recommend having a kind of catastrophe insurance if such a thing is available - something like I will take care of all bills under Rs. 2 Lakhs per ailment . The insurance company comes into the picture only for bills above. 2 Lakhs is a random figure - actual figure is what you can afford.
This is something like the deductible you chose in the US for your car insurance. I always used to chose a huge deductible because it lowers my premiums. If I am having accidents frequently enough to make my huge deductible to cause a big hole in my pocket, I probably shouldn't be
driving.
Insurance should be for unforseen circumstances which can screw you up financially & wreck your life. Routine stuff shouldn't be insured.
People even go for life insurance without thinking. Life insurance is a good thing. But not everybody needs it at their current age, situation etc. In life insurance, you & and the insurance company are betting against each other. You win if you die early. The company wins if you live long. In other words, you never win. Insurance your life only if your death today will screw up your family's life economically rather badly. Otherwise, you may not need life insurance - you can probably put the premiums into a recurring deposit & provide for your family that way. Even if you want to insure your life, it should always be term insurance - never ULIPs or Whole-Life insurance.