Wednesday, February 08, 2017

Unusual AIDS-like syndrome without HIV; more analysis of "moral hazard" or anti-selection in today's Obamacare

There are a couple of interesting health care stories to cover.

One (“Doctor, Cure Thyself ) is in Sunday Business in the New York Times, by Katie Thomas, about a 25-year-old physician and former football player who developed multicentric Castleman’s disease.

The history illustrates the health insurance problems and treatment problems of rare diseases, often genetic, and often requiring unusual drugs.

Castleman’s is often associated with HH8, the same virus that causes Kaposi’s Sarcoma in HIV-infected gay men.  It is similar to lymph-node KS, but can occur without HIV infection.  The onset can be sudden.  It seems to be a mix of infectious disease, lymphoma, and immune disease.  Susceptibility to HH8 or some similar virus has to be genetic, something that compromises the immune system (helper cells) in a way perhaps analogous to HIV.  Other similar diseases were known before AIDS, like HTLV-1 leukemia in Japan.  They may result from unusual herpes viruses or retro viruses that can affect only genetically susceptible individuals and cannot be spread person-to-person (except maybe to someone with the same genetics).  Normally HH8 will not cause disease, without HIV or some unusual genetic susceptibility.

The Epoch Times has a long article, the “breaking apart of Obamacare” showing that Obamacare now has repercussions over moral hazard and anti-selection.  It makes the young and healthy pay for the old and sick, and it makes single men pay for other people’s pregnancies.  (But, then again, it makes straight people pay for gay men’s HIV.)

When I had health insurance through my employer, my own premiums were usually about 30% of a family plan premium.  I think I probably did not have to pay for women's pregnancies when getting cherry-picked insurance through an employer, who got the tax break.

I thought there was some staging of premiums with age.

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