If a shot prevented a heart attack, would you take it?

[Scott Shepherd]

In the interesting thread about modified foods being sold to the public, a number of people seem dead set against genetically modified foods. This article popped up in the news the other day and it made me wonder how people would react to it.

If you get get a shot of this medicine and it would help prevent heart attacks, would you get the shot? Keeping in mind, it's modifying your genetic make up.

http://news.harvard.edu/gazette/story/2014/06/a-shot-against-heart-attacks/

I wondered if people that are against genetically modifying food would support or reject modifying their own body.

[Myk Rian]

I'm not sure genetic treatments/engineering is a very cool thing. Ever read "Access to the Genome. The challenge to equality"
It discusses genetic engineering, and access by certain classes of people. Possibly creating "Class wars".

[Leigh Betsch]

I'm for it. But I'm willing to change my mind based on further info.

[Scott Shepherd]

A secondary question, would you change your mind relative to before having children or after having children, meaning you might not be for it before you have kids, but once your kids are grown, would you be more for it, knowing that your genetic modification isn't passed to anyone else?

[ray hampton]

I would be more incline to made use of the shot AFTER mine children are grown
next question ?

[Greg Peterson]

This is a relatively easy question to answer. Like many medical procedures or treatments, it is an individual decision.

I am not against medical science that is capable of reprogramming the human body to treat conditions or disease, at the individual level. Each person should be able to decide what treatments align with their value system.

This is not the same as fundamentally altering the DNA most of the world's food supply and denying the consumer the ability to make an informed decision.

[Scott Shepherd]

This is a relatively easy question to answer. Like many medical procedures or treatments, it is an individual decision.

I am not against medical science that is capable of reprogramming the human body to treat conditions or disease, at the individual level. Each person should be able to decide what treatments align with their value system.

This is not the same as fundamentally altering the DNA most of the world's food supply and denying the consumer the ability to make an informed decision.

Quite the contrary, altering your genetic makeup before you have kids, passes those genes to your kids, and everyone else until the end of time. You're making decisions that affect people that won't be born for 100 years from now and more. What if 50 years after you make the decision, they determine it's something they wish they wouldn't have invented because it caused some other serious issues for people that got the shot?

[Greg Peterson]

This is a 'whose life is it' philosophical question with no right or wrong answer.

The individual is allowed to decide what is best for them. We all make decisions daily based on what is best for us, the individual, with no regard for how our action will affect future generations.

Perhaps with quantum computing we will have the type of computational power required to determine the long term affects of DNA manipulation. But it's in our DNA (pun not intended :) mostly) to worry about paying the band later while we dance now.

But to answer your question, yes, I would under go such treatment so long as it was a 'best available option' and I would not pass my genes on down to future generations. but this would also have to take into account several other factors, such as how likely am I to have a heart attack?

One of the unintended consequences of modern medicine is that seemingly enough people think there is a silver bullet sitting on the pharmacy shelf that will cure them of a certain ailment, disease or unhealthy habit, thus they need not take any responsibility for their own health. Many fail to take proper care of their bodies. Proper diet and exercise can go a long way towards preventing many conditions and diseases, thus limiting medical technology interventions.

[Moses Yoder]

I would just say that since this is a personal decision I will answer it personally. It seems to me that it is fairly easy to maintain a safe cholesterol level currently without any genetic aid simply by partaking of a healthy diet. To take a shot that reduces my cholesterol level genetically means I have a license to eat unhealthy foods; in other words, there are no longer bad consequences for partaking of unhealthy food. Just doesn't seem right to me. I always figure if I forget and touch a hot pan, I am going to get burnt.

[David Weaver]

I wouldn't. That simple. You could probably get a similar reduction just by lifestyle changes. That would leave us to ask ourselves a question, is it laziness that keeps us from making lifestyle changes, and if the shot seems like such a wonderful thing, why wouldn't we consider the same thing from lifestyle changes?

The devil will be in the details, too. They should be able to gauge your risk and reduction from the shot otherwise. What would really improve my life and others is decreasing the number of hours it takes for us to work to meet our minimum needs and then also the number it would take for us to be satisfied. I personally wish people would figure that out instead of expensive things (medical treatments, large houses, high taxes, etc) that increase the need for us to work longer and longer.

[Rich Engelhardt]

No way/no how.

I trust modern medicine about as much as I trust our legal system....

[Von Bickley]

Before you say you wouldn't do it, you may want to think about it. A lot of people do not survive the first heart attack. Do you want to leave your spouse and children without you and your income to help support and take care of them. Who will be there to help your wife with a lot of the problems she may face.
I had a heart attack in 1996 that left my heart working about 25%. Is that the way you want to spend the rest of your life. Before you say no, you may want to think it over. It's a lot to consider.

[Moses Yoder]

The earth spun before I was here, it will keep spinning after I am gone. I'll admit I am having fun today. enjoying life to the brim, but I don't think I will miss it. My wife will be fine; I am more worried about what I would do if something happened to her.

[Rich Engelhardt]

Before you say you wouldn't do it, you may want to think about it. A lot of people do not survive the first heart attack. Do you want to leave your spouse and children without you and your income to help support and take care of them. Who will be there to help your wife with a lot of the problems she may face.Von my friend, that's not at all how it works these days.
"they" ( the pill pushers and the medical profession as a whole) - bleed you of everything you've worked your whole life for.
My ongoing medication costs exceed what I can pay. As a result, my only recourse is to - suffer.
I see something like a "heart attack pill" as simply another way the pill pushers have of wringing every last penny out of you.

I have no doubt the ongoing maintenance fees of this treatment are geared towards extracting every last penny of everything a person has.

FWIW - I made "exit plans" to provide for my loved ones some 30 years ago. Matter of fact, the longer I live, the less secure their future is since every month I cut into what they will get when I'm gone.

[Jim Matthews]

The irony of this is that the two concerns are motivated by opposite poles
of the food supply distribution;

Obesity and the secondary diseases that go along for the ride isn't a problem
for people who have unreliable food supplies. Maybe the solution to each set
of problems is to ship the excess to them what isn't fat, already.


I don't see the two questions as ethically equivalent.

One is hypothetical, the other is a reality.
One affects the well-being of the poorest, the other is available only to the wealthiest.

The fuss about GMOs seems manipulated, and I can't see to what end.
If you have to pay for seed every year, that seems designed for a long tail of sales.

That opposes self-reliance. That is conflated with grains that have been modified
to handle harsh climates, limited fertilizer, little rain and skant arable acres.

Programs like "Golden Rice" promote self-reliance and tend to reduce population burdens
as the poorest families realize that their children survive to thrive.

http://www.theglobalmail.org/feature/what-happens-when-half-the-world-stops-making-babies/573/
http://www.goldenrice.org/


I wouldn't take a shot to prevent heart attacks.
I would sign up for a regular injection to allow me to eat more than
1800 calories a day, without weight gain.

[Marvin Hasenak]

I have 2 main Doctors, a private family Doctor and a Veterans Administration Doctor that I see every 6 months. After all I have been through in the last 14 years, if either one recommended the shot I would roll up my sleeve. As far as my other Doctors, I don't see them often enough that they would ever come onto play on something like this.

[Chris Parks]

FWIW - I made "exit plans" to provide for my loved ones some 30 years ago. Matter of fact, the longer I live, the less secure their future is since every month I cut into what they will get when I'm gone.

That I don't get, we as a couple earned it so we are going to spend it. Going poor and suffering is not going to happen to me or my wife and the kids are already better off than we were when we got married.

[Scott Shepherd]

I would just say that since this is a personal decision I will answer it personally. It seems to me that it is fairly easy to maintain a safe cholesterol level currently without any genetic aid simply by partaking of a healthy diet. To take a shot that reduces my cholesterol level genetically means I have a license to eat unhealthy foods; in other words, there are no longer bad consequences for partaking of unhealthy food. Just doesn't seem right to me. I always figure if I forget and touch a hot pan, I am going to get burnt.

I don't think that's a medically accurate statement. Many people eat very healthy and exercise, yet they have health issues. One of my healthiest friends I've ever ate all the right things, worked out all the time, wasn't overweight died at 42 years old. He used to kid him all the time about eating so well and staying in great shape.

You don't have to be eating unhealthy or be overweight to have high cholesterol. I know people who eat horrible and have low cholesterol. I don't think the purpose of the shot is to allow people to eat unhealthy things, but rather to take those that are predispositioned to it from their genetic make up and "fix" that issue for them.

[Chuck Wintle]

In the interesting thread about modified foods being sold to the public, a number of people seem dead set against genetically modified foods. This article popped up in the news the other day and it made me wonder how people would react to it.

If you get get a shot of this medicine and it would help prevent heart attacks, would you get the shot? Keeping in mind, it's modifying your genetic make up.

http://news.harvard.edu/gazette/story/2014/06/a-shot-against-heart-attacks/

I wondered if people that are against genetically modifying food would support or reject modifying their own body.

I doubt that such a miracle drug or medicine could ever exist as there are side effects to all medicines. Why should I become a guinea pig for drug companies that potentially will make billions.

[Curt Harms]

I don't think that's a medically accurate statement. Many people eat very healthy and exercise, yet they have health issues. One of my healthiest friends I've ever ate all the right things, worked out all the time, wasn't overweight died at 42 years old. He used to kid him all the time about eating so well and staying in great shape.

You don't have to be eating unhealthy or be overweight to have high cholesterol. I know people who eat horrible and have low cholesterol. I don't think the purpose of the shot is to allow people to eat unhealthy things, but rather to take those that are predispositioned to it from their genetic make up and "fix" that issue for them.

And that seems a legitimate use. But delaying it until after likely reproductive years so as not to pass on any 'unintended consequences' seems like a good idea.

[Scott Shepherd]

I doubt that such a miracle drug or medicine could ever exist as there are side effects to all medicines. Why should I become a guinea pig for drug companies that potentially will make billions.

Oh, I don't know, maybe so you don't die of heart disease?

[Steve Rozmiarek]

Like most of us, I make decisions rationally, after carefully weighing all the variables that I can. It's hard to say definitively yes or no, because the circumstances today could be different when the shot is available, but probably yes.

I get the financial side of this though, and everything has a dollar amount attached to it, including my life, and there is a limit to what I'd pay. Like buying a life insurance policy, it's a financial question, not emotional. There is an emotional component to though, I'd rather stay alive for a while more, so the financial threshold is higher right now. Time would change that. I'd also be more inclined to do it after kids were born, but if I'm genetically predisposed to heart disease, it may be the right decision to take it before they were born.

Interesting questions Scott, and I admire your courage to dive back into this sort of thread. :)

[Chuck Wintle]

Oh, I don't know, maybe so you don't die of heart disease?

so what would be the side affects of a such a drug? I doubt very much you would know this and likely the doctors/researchers have all the answers either. Drugs like this, or any drug for that matter should be approached with caution. JMHO.

[Scott Shepherd]

Interesting questions Scott, and I admire your courage to dive back into this sort of thread. :)

I do think it's an interesting discussion. I also find it interesting that some that don't want their food messed with would be willing to have their own genes modified, which would impact generations of the their children. Spray my food, "no way", change my genetic make up, "sure, why not" :) Very interesting to me. Just like the people who are poor and don't get to decide if their food was modified, neither do 3 generations down your blood line, that have to live with what you did to your genetic make up.

I wouldn't do it pre-kids, but I'd certainly do it post kids, where my actions would have no impact on future generations.

[Rich Engelhardt]

That I don't get, we as a couple earned it so we are going to spend it. Going poor and suffering is not going to happen to me or my wifeI don't know what the health care situation is down under. Here in the States though, unless you're very wealthy or poor - - you're at the (nonexistent) mercy of the medical profession/insurance companies/pharmaceutical companies. That unholy trio of ghouls exist only to bleed people dry of any savings they might have.

[Greg Peterson]

I do think it's an interesting discussion. I also find it interesting that some that don't want their food messed with would be willing to have their own genes modified, which would impact generations of the their children. Spray my food, "no way", change my genetic make up, "sure, why not" :) Very interesting to me. Just like the people who are poor and don't get to decide if their food was modified, neither do 3 generations down your blood line, that have to live with what you did to your genetic make up.


Having not actually counted the yea's and nay's, but my impression is most folks are against the shot, or have qualified it to some degree so as to quarantine any genetic affects.

I don't believe I read more than one, if that, post that was comfortable with taking the shot and then procreating. I may be wrong and I'm sure someone will provide a rebuttal.

Calories are cheap. Nutrient rich calories are expensive and inconvenient. The majority of the US population lives in urban areas. The logistics of shopping for nutrient rich calories in urban/suburban areas is that you have to have a car. Without a car, you're limited to what you can carry on mass transit or from the local corner convenience market. Out here, in densely populated urban and suburban areas, the Safeways and Krogers stores are miles apart and mass transit is not a realistic means of grocery shopping. If you have to spend an hour every day or every other day, walking to and from the nearest Safeway, rain or shine, it's likely convenience will likely win out. That local convenience mart selling a can of soup for $3 suddenly looks like a bargain.

I'm not making excuses for anyone whose diet lacks proper nutrients, but as they say, the devil is in the details. It is easy enough for any of us to tell people they need to make healthier choices in their diets, and maintain that habit longer term. But there are many variables and forces at play that factor into consumers diets, not the least of which is cost. Even for low income families, time is money.

I feel fortunate that I am able to spend as much time as I do keeping my body maintained. I try to consume a healthy diet, but it isn't always convenient. I've made many good choices, but I've made bad choices too, as we all have. I will decide if I want or need to alter my genetics. I also want to be able to make informed decisions when it comes to the fuel I provide body.

[Bruce Pratt]

To interject a clarification into this discussion. All current gene therapies under development are designed and tested to only be active in somatic cells, that is the cells of the body which are not germ cells (eggs and sperm). As such, the effects of any such genetic correction are limited to the individual treated and are not passed to subsequent generations.

--- before the negativists jump all over this, please do a little background reading on tissue specific promoters...

[Greg Peterson]

To interject a clarification into this discussion. All current gene therapies under development are designed and tested to only be active in somatic cells, that is the cells of the body which are not germ cells (eggs and sperm). As such, the effects of any such genetic correction are limited to the individual treated and are not passed to subsequent generations.



IOW, the OP is a moot point? Dammit. I was just getting ready to work Saw Stop into this thread.

[Scott Shepherd]

To interject a clarification into this discussion. All current gene therapies under development are designed and tested to only be active in somatic cells, that is the cells of the body which are not germ cells (eggs and sperm). As such, the effects of any such genetic correction are limited to the individual treated and are not passed to subsequent generations.

--- before the negativists jump all over this, please do a little background reading on tissue specific promoters...

That's Bruce! That's interesting to know.

[Ole Anderson]

If you get get a shot of this medicine and it would help prevent heart attacks, would you get the shot?



I bet that if such a shot were to exist, one of the warnings is that it may cause heart attacks. But to answer the OP's question requires knowing whether or not the side effects are significant. Minimal side effects, heck yes. Ok, everyone taking satins for cholesterol management or even aspirin, raise your hands. You are already on the bandwagon toward the magic pill. And as far as diet and exercise, those are proven tactics to reduce your chance of a heart attack. But they are hard to do for many people. Just because someone isn't motivated to diet and exercise, should we condemn them to die from a heart attack just because they are "lazy"? Same can be said for stopping smoking. Many have seriously tried but just can't break the habit. How about this one as a corollary: Would you have your 12 year old daughter get a shot if it virtually prevented her getting certain types of cervical cancer? Ok, it is not gene therapy, but are the long term side effects any less? I have no idea.

[Bruce Pratt]

OP still poses a valid question, however it can be nuanced by the following considerations. Most gene therapies are designed to correct a known and deleterious mutation in the DNA, for example, a mutation in the gene for adenosine deaminase which causes severe combined immunodeficiency, or a mutation in RPE65 which causes a form of congenital blindness, Leber's congenital amaurosis. In these circumstances, the prima facie risk/benefit is relatively straightforward, i.e, the potential risk of the gene therapy vs. the benefit of survival or greatly improved quality of life for a disease for which there is no other effective therapy. In the case of the potential gene therapy noted in the OP, it would be making a change of an otherwise "normal" gene to form which is even more effective in reducing LDL. The risk/benefit in this circumstance is somewhat different in that: 1) other interventions, e.g. life style, statins are usually somewhat effective in lower LDL, and 2) it would be a change to an otherwise normal gene. As such, IMO, this type of gene therapy would likely be subject to an even higher level of regulatory scrutiny by FDA and other health agencies.

[Jim Matthews]

OIn these circumstances, the prima facie risk/benefit is relatively straightforward, i.e, the potential risk of the gene therapy vs. the benefit of survival or greatly improved quality of life for a disease for which there is no other effective therapy. As such, IMO, this type of gene therapy would likely be subject to an even higher level of regulatory scrutiny by FDA and other health agencies.

Particularly after what happened at UPenn after the untimely death of an otherwise healthy patient, Jesse Gelsinger.
Fictional accounts aside, this is a very difficult thing to test and trials will likely be approved only on those patients
that have no other options remaining. I worked across the river, in New Jersey when they lost him.

It was a blow to the family, and the research department was banned from any trials for 6 years.
http://www.scientificamerican.com/article/gene-therapy-an-interview/?page=2
http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=4034

Those volunteering are brave beyond measure, as they put their lives on the line when they're most precious.

http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/CellularandGeneTherapy/ucm072587.htm

I haven't heard anything about gene therapies to "prevent heart attack" but I have heard about the serious
and sober approach of the FDA toward human trials and the consequences for researchers playing fast and loose with consent briefings.

Wilson got off easy.

[Raymond Fries]

Interesting idea. I thought that cholesterol built up in the veins because it was protecting the veins from further damage. If this is true then reducing the cholesterol would take away that protective coating. What would happen if the veins kept getting inflamed and damaged? Why not look for what is causing the damage to the veins instead?

To answer the OP question, I would not take this shot.

[Greg Peterson]

Why not look for what is causing the damage to the veins instead?



There is a growing body of work that sugar is an inflammatory agent and is particularly hard on the cardio vascular system.

[Scott Shepherd]

OP still poses a valid question, however it can be nuanced by the following considerations. Most gene therapies are designed to correct a known and deleterious mutation in the DNA, for example, a mutation in the gene for adenosine deaminase which causes severe combined immunodeficiency, or a mutation in RPE65 which causes a form of congenital blindness, Leber's congenital amaurosis. In these circumstances, the prima facie risk/benefit is relatively straightforward, i.e, the potential risk of the gene therapy vs. the benefit of survival or greatly improved quality of life for a disease for which there is no other effective therapy. In the case of the potential gene therapy noted in the OP, it would be making a change of an otherwise "normal" gene to form which is even more effective in reducing LDL. The risk/benefit in this circumstance is somewhat different in that: 1) other interventions, e.g. life style, statins are usually somewhat effective in lower LDL, and 2) it would be a change to an otherwise normal gene. As such, IMO, this type of gene therapy would likely be subject to an even higher level of regulatory scrutiny by FDA and other health agencies.

I was going to say that :p (only kidding).

Here's one to think about, if there are no effects (it's not a medicine you keep taking, it's a 1 shot deal to modify the gene), would you rather take that or end up taking the normal medicines designed to treat various heart disease related issues and deal with all the side effects from those, also knowing you'll be taking them for the rest of your life?

[Roger Feeley]

There is no question I would do it but only after a vasectomy. I would make that decision only for myself.

I assume that the same modification would work for strokes and my family has a long history of strokes. They got my dad at 89 but it took about 5 years of repeated strokes to finish him off. My mother had strokes around the age of 90 that severely impacted her mentally. She is 103 now, in assisted living, and wishing for the end. Were it not for the strokes she would still be living independently.

It's not just about the attacks killing you, it's what they may do to you and leave you alive.

[Dan Hintz]

Interesting idea. I thought that cholesterol built up in the veins because it was protecting the veins from further damage.

Everything you ever wanted to know about the truth of atherosclerosis...

Understanding Cholesterol PlaqueCholesterol plaques start developing in the walls of arteries. Long before they can be called plaques, hints of atherosclerosis can be found in the arteries. Even some adolescents have these "fatty streaks" of cholesterol in their artery walls. These streaks are early precursors of cholesterol plaques. They can't be detected by tests. But researchers have found them during autopsies of young victims of accidents and violence.
Atherosclerosis develops over years. It happens through a complicated process of cholesterol plaque formation that involves:


Damaged endothelium. The smooth, delicate lining of blood vessels is called the endothelium. High cholesterol (http://www.webmd.com/cholesterol-management/default.htm), smoking (http://www.webmd.com/smoking-cessation/default.htm), high blood pressure (http://www.webmd.com/hypertension-high-blood-pressure/default.htm), or diabetes (http://www.webmd.com/diabetes/default.htm) can damage the endothelium, creating a place for cholesterol to enter the artery's wall.
Cholesterol invasion. "Bad" cholesterol (LDL cholesterol) circulating in the blood crosses the damaged endothelium. LDL cholesterol starts to accumulate in the wall of the artery.
Plaque formation. White blood cells stream in to digest the LDL cholesterol. Over years, the toxic mess of cholesterol and cells becomes a cholesterol plaque in the wall of the artery.


How Cholesterol Plaque AttacksOnce established, cholesterol plaques can behave in different ways.


They can stay within the artery wall. The cholesterol plaque may stop growing, or may grow into the wall, out of the path of blood.
Plaques can grow in a slow, controlled way into the path of blood flow. Slow-growing cholesterol plaques may or may not ever cause any symptoms -- even with severely blocked arteries.
Cholesterol plaques can suddenly rupture -- the worst case scenario. This will allow blood to clot inside an artery. In the heart, this causes a heart attack. In the brain, it causes a stroke.

[Dave Sheldrake]

replying to the question Scotty actually asked and based on that alone, yes I would likely opt for it. My kids are grown (and have their own DNA all sorted ;))

I'm already on medication for life that comes with a 15% mortality rate but the flipside is after having 3 PE's I should probably be dead already anyhows so the 15% is better than 99.9% chance of death :)

Genetic modification.......hummmm yes the N*zis tried to do it (umm the *** are because they do not deserve a name) but then again so has nature over several million years.


They were undone, destroyed, after all of man's weapons and devices had failed, by the tiniest creatures that God in his wisdom put upon this earth. By the toll of a billion deaths, man had earned his immunity, his right to survive among this planet's infinite organisms. And that right is ours against all challenges. For neither do men live nor die in vain.

This line from WOTW 2005 springs to mind :)

cheers

Dave

[Mike Cutler]

I would just say that since this is a personal decision I will answer it personally. It seems to me that it is fairly easy to maintain a safe cholesterol level currently without any genetic aid simply by partaking of a healthy diet. To take a shot that reduces my cholesterol level genetically means I have a license to eat unhealthy foods; in other words, there are no longer bad consequences for partaking of unhealthy food. Just doesn't seem right to me. I always figure if I forget and touch a hot pan, I am going to get burnt.

Moses

Not quite correct, but I understand your point.
I have three friends that suffer from high cholesterol. All are fit, well within weight boundaries, and live a healthy lifestyle. Their entire diet is wrapped around their cholesterol issues. I on the other hand can eat double bacon cheeseburgers and fries, donuts and crap, and my cholesterol levels are 115/43. It's primarily how well you pick your parents unfortunately. Genetic programming

Would I take a drug that eliminated the risk of heart attack? I don't actually need one, as I have no genetic predisposition to heart problems in any parts of my families, but if I did, yes I would.
A more pointed question may be that if you knew that you would pass on cancer genes, that predisposed your children to a 70%-80% risk of developing cancer in their lifetimes, would you take some form of gene modification prior to having children. I would.

[Brian Ashton]

In the interesting thread about modified foods being sold to the public, a number of people seem dead set against genetically modified foods. This article popped up in the news the other day and it made me wonder how people would react to it.

If you get get a shot of this medicine and it would help prevent heart attacks, would you get the shot? Keeping in mind, it's modifying your genetic make up.

http://news.harvard.edu/gazette/story/2014/06/a-shot-against-heart-attacks/

I wondered if people that are against genetically modifying food would support or reject modifying their own body.

Probably has a lot to do with whether one is almost certain to suffer a heart attack or not. If they're diagnosed with such odds and had family history and such, what would they have to lose?

[Dave Cullen]

Probably has a lot to do with whether one is almost certain to suffer a heart attack or not. If they're diagnosed with such odds and had family history and such, what would they have to lose?

That'd be me. I'm the oldest male in my family in 3 generations, by 11 years. My destiny is genetically predetermined. Yes, I monitor my health and take appropriate meds but so did my dad before me.

No more kids in my future, if my doctor recommended this shot I'd be first in line. I hope I live long enough to do that.

[Rich Engelhardt]

Ok - here's a question, based on my recent real world experience with the cost of medications (IMHO - if you can't afford the medication, then nothing exists that will help you - it really is as simple as that).

How many people would still get this shot if your out of pocket expense for it was $300,000.00 and the ongoing costs ran $25,000.00 per year?
That's what your bill would be, not what the insurance company charged.

[Bruce Pratt]

There are not enough gene therapies on the market to make a realistic guess at to what the cost might be.

As a point of clarification, there are two main strategies of gene therapy regarding frequency of dose (and associated recurring costs). The first category are designed to be either a single, once in a lifetime treatment, or possibly, depending on the durability of gene expression, repeat doses many years apart. A second approach is regulated gene expression, which is a single treatment to correct the genetic error with a gene construct whose level of activity is determined by the presence of a small molecule (drug) taken as a pill. This latter approach is not a strategy by "big bad pharma" to lock a patient into recurring costs for the activating drug, but rather is a safety strategy, with the ability to turn on a gene when needed (by taking the pill) and turning it down or off when not needed. With the regulated expression systems under development, many of the activating drugs are low-cost generics, so the ongoing costs would be expected to be minimal.

A summary of this latter approach is given in this recent article http://www.hindawi.com/journals/nri/2012/595410/

BTW - this regulated gene expression approach is being investigated as a means of restoring lost hearing by stimulating the growth of new cochlear hair cells. See http://journals.lww.com/thehearingjournal/Fulltext/2014/06000/Moving_Closer_to_a_Gene_Therapy_for_Hearing_Loss.6 .aspx
for details.

[Pat Barry]

Ok - here's a question, based on my recent real world experience with the cost of medications (IMHO - if you can't afford the medication, then nothing exists that will help you - it really is as simple as that).

How many people would still get this shot if your out of pocket expense for it was $300,000.00 and the ongoing costs ran $25,000.00 per year?
That's what your bill would be, not what the insurance company charged.
Nope - way too expensive for me. Even at 1/10 the price I wouldn't do it. I might do it for $5000 up front and guarantee that my current med's could be done with, also with the promise that I could eat and drink whatever I want.

[Greg Peterson]

How many people would still get this shot if your out of pocket expense for it was $300,000.00 and the ongoing costs ran $25,000.00 per year?
That's what your bill would be, not what the insurance company charged.

I think $300k and annual 'subscription' or 'license' of $25k is unrealistic for 99% of the population. Seriously.

Health care, whether it be services or goods, is a finite system, and as such there are inherent limitations on how much each individual can receive. In the 90's when HMO's were introduced as a means of cost control, the concern voiced was that health care was being rationed. Then, when cost containment/reductions were addressed twenty years later, the same interest's rhetoric took on a more sinister tone, with claims of death panels and such, as if no insurance provider had ever denied a single life saving treatment for fear that the profit margin for the quarter might be lower than the investors expected.

The simple fact is that delivering health care is extraordinarily expensive in the US. By no measure or standard is our system cost effective or moral. We have access to the greatest medical technology, but few can afford the best. Triage care is not denied to anyone, as most everyone pays into the system that provides emergency medicine. But there does exist a line where health care becomes a privilege. And at $300k, you are standing on higher, privileged ground.

[Rich Engelhardt]

I think $300k and annual 'subscription' or 'license' of $25k is unrealistic for 99% of the population. Seriously.

I think you need to take a long hard look at what the cost of medications and hospital procedures is these days.

http://www.aflac.com/individuals/realcost/source/

Feel free to peruse some of the figures there.

The health care industry is no more or less greedy than the oil industry.

The four prescriptions my doctor wants me to take total up to over $2250.00 per month.
W/ my insurance co pay - the cost to me is $270.00 per month.
Either way it comes out to the same thing.
I can't afford either so the medication may as well not even exist.

[Greg Peterson]

I think you need to take a long hard look at what the cost of medications and hospital procedures is these days.


Actually Rich, you and I are in quite significant agreement.

As unfortunate as your plight, it is also not unusual. We are slowly returning to the era where languishing away in some institutionalized facility for the elderly indignant is accepted as part of the social norm. It's the least we can do as a society. I mean, losing the retirement nest egg you spent your entire adult life building, to a medical condition, shouldn't make you homeless.

It should not be alright that in your golden years, that should you have to choose between all the material wealth you amassed over lifetime of a hard work or survival. Are we so shorted sighted to not realize how poorly we are setting ourselves up for OUR golden years.

If you think I am being selfish, you got that right. I don't think there are too many retired folks that don't appreciate a little physical and financial comfort, peace of mind, and I don't mind paying into a system that takes care to ensure some level of compassion and dignity for them. And when I'm retired, I don't expect a hand out or help, but it's nice to know that should something happen there is some kind of safety net.

Been a long tiring day. Rant over.

[Rich Engelhardt]

As unfortunate as your plight, it is also not unusual.
Correct.. @ least according to the pulmonary technician I was talking to the other day.
She told me that every day she sees more and more people like myself - people that come in to her for testing & she asks about what medications have been prescribed to them and they respond that it doesn't matter since they can't afford them.


If you think I am being selfish, you got that rightNot at all...
IMHO - you're thinking is in a refreshingly realistic manner.
Unfortunately - this is one of those types of things that people will petty much ignore until it hits home with them.

[Jim Matthews]

I mean, losing the retirement nest egg you spent your entire adult life building, to a medical condition, shouldn't make you homeless.

Vermont has already made a major step to rendering Medical bankruptcy a thing of the past.
There will be limits to this, and they will likely involve a shift to palliative care at a given age.
The flip side of this sort of coverage must be compulsions to manage weight and reduce risk factors to maintain full coverage.

Compare this to the States rejecting provisions of the ACA, thereby rendering an ever larger minority of their citizens
effectively uninsured, and more likely to seek medical attention from Emergency services.

http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/

The compounding effects of job loss, reliance on credit and diminished capacity can lead to bankruptcy.
Roughly 30% of bankruptcies in the US can be attributed to medical bills for catastrophic illness.


Most of those had precursors - the illness was the last straw that brings the finances down.

The problem is that the current approach shifts costs from those that are in the last years
of their lives to those in the first, and it's an inter-generational wealth transfer.
These are the same people being squeezed for higher premiums or are foregoing
insurance, altogether. They're justifiably ticked off, but at the wrong people.

It's not the "elderly indignant" that forced this conflict.
It's the writers of a crap law that has been designed to generate tension
between voting blocks, as a backdoor to gut and dismantle the provisions.

Follow the money back to who benefits from a return to the previous scheme.

It's unfair to demand that with a fixed sum to draw from, more goes to a given demographic.
Universal coverage draws resources from a broader base, and grants all equal access.

I'm way more worked up about the poor state of dental care for young people that could still be productive
than the care and feeding of "elderly indignant" that cost more in their final years than their stake in the game.

If Seniors want to really clean up the mess that is the American medical system, they'll lobby for a Single Party system,
so that there isn't the obvious divide between "cost no object" and "your money or your life" payment plans.

You can bet that if there was only one system available to all Americans, those that can currently afford
any and all options would ensure that it was the best, available to all.

291616

[Scott Shepherd]

Let's not get dragging into a healthcare debate in this thread. The thread was about a shot that modified one's genes and reduced the chance of a heart attack. Let's keep it on topic. Once this turns into a healthcare debate, this thread, which has had some great comments on it, will end up locked or deleted, so let's not go there.

[Rich Engelhardt]

Scott,
I'm sorry if I caused the veer.

As I mentioned above, a recent real world experience hit home with me about this topic.

There's a whole lot more to it than just a simple - yes, I'd take the shot - and/or, no, I wouldn't take the shot.
Just because someone is willing to - or even more than willing to take the shot - doesn't mean they can get it.

Like I said above about my situation.
Medicines do exist that can help, but, since I can't afford them they might as well not exist.

I see "the heart attack shot" the same way.
If it's cheap enough or if the insurance company picks up the tab for it, then people will probably want it.
OTOH - if it's something they have to pay for, out of pocket, that's a whole different set of rules.


In my personal case - would I take "the heart attack shot".
Not only no, but hell no!

Why, because I simply don't trust the medical industry. I believe they are as bad as street drug pushers.
"The shot" would just be an introduction to some ongoing long and expensive set of treatments.
Once they got you hooked, they'd just bleed you dry.

[Scott Shepherd]

Scott,
I'm sorry if I caused the veer.

As I mentioned above, a recent real world experience hit home with me about this topic.


I understand, my recent real life example upsets me greatly too.

[Rich Engelhardt]

"Upsets" me isn't really the correct term.
Even though I guess I am "upset" about the whole thing.

It's more of an eye opener than anything else.

I always though of retirement and the "golden years" as a time when you got to kick back and enjoy the fruits of your years of labor.

Instead, between the medical industry, the oil companies and the taxes, I feel more like a "crop" that's being harvested and/or cultivated for the harvest.

:(

[Scott Shepherd]

Upset was as nice as I could put it on a public forum. Let's just say that someone in an office in Washington that represents my state got about a 45 minute lecture from me. I was asked "please stop yelling at me". I responded with a "Well, you don't seem to listen when I'm talking calmly".

[Rich Engelhardt]

:D

Good on ya!