Oral candida in dental patients

Dental Oral Candida

Oral Candida

Oral Candida is a yeast infection of the mouth, and is also commonly called 'thrush.' It is generally characterized by white patches in the mouth, but there are other symptoms as well. It can occur in anyone, but it is more likely in babies and young children, and in people that have compromised immune systems, such as HIV / AIDS patients. While not an extremely serious problem, oral Candida is something that should be further examined. This is especially true of drug companies, as some of them may be interested in getting into the market to provide medications for these patients. Whether this is a significant market is debatable, however, and will be examined and discussed here.

Generally, antifungal medications are given for oral Candida. The yeast fungus Candida albicans is responsible for this infection, and there are other bacteria in the mouth that generally keep this fungus under control. The fungus is also associated with vaginal yeast infections. When the bacteria in the mouth cannot control this fungus, however, oral Candida can occur. While HIV / AIDS infection can cause oral Candida, so can illness, long-term use of some types of steroids or medications, and stress. When this type of infection does occur, the type of antifungal medication that is given is generally an oral liquid that is 'swished' around the mouth, usually for 5 to 10 days. Another medication called Diflucan, which is oral and single-dose, can be given if the liquid antifungal medication does not work to control the infection and restore the mouth to normal.

One of the main reasons why it does not appear that drug companies should get more involved in the treatment of this disease, however, is that they have a great deal of competition, and this problem is not one of epidemic proportions that new drugs are generally needed for. In order to better understand this, it is important to look at drug companies in general and the competition that they face from other sources, such as drug companies in Canada that can often get drugs to people much cheaper than U.S. companies can. While the discussion of oral Candida is important, there is not that much available literature on the subject.

What is available, however, are other areas that relate to the issue, such as the health of older Americans who are more likely to have problems with their teeth and mouths, the high cost of prescription medication in this country, and the plight of many individuals that cannot afford medications for themselves and their children, even if it is for a relatively simply problem. Since this is the bulk of the information that is available, it will be the largest part of the discussion, as it can be seen how something simple and simply treated such as oral Candida is actually part of a much larger problem of prescription prices and other issues that is seen within the United States today.

In Canada, prescription drugs cost significantly less than they do in the United States. There is no one specific reason why this is so, and many factors contribute to it, but many United States citizens are taking advantage of it all the same. Those people that live near the Canadian border, and even some that live in other parts of the country, are getting their prescriptions filled in Canada, or over the Internet by Canadian companies. The advantage, obviously, is the cost of the merchandise.

Many of these people are elderly people who live on fixed incomes and need all of the money that they can get. By filling their prescriptions at a much cheaper rate, they are able to afford better food, keep a roof over their heads, and make sure that they have money to pay their heating and cooling bills. Some do it to save money, and others do it because they don't have enough money to fill their prescriptions in the United States even if they wanted to. The cost of the drugs is simply too high, and for people with no insurance, buying from Canadian companies is the only way many of them are able to take any of the medications that could potentially save their lives.

In a recent study about prescription drugs and Canada, the Committee on Government Reform and Oversight found that, when analyzing the costs of the 10 most common prescription drugs taken by senior citizens in the state of Vermont, seniors were paying prices that were on the average of 81% higher than Canadian prices. The prescription drug Zocor, which is used to treat high cholesterol, and in some cases blood pressure, was an average of 149% higher in Vermont than it was in Canada (Committee, 1998).

The Committee appeared to be startled and upset by these findings, as are many American consumers. Not only elderly people need medication. Many younger adults, and even children, sometimes need lifesaving medication, or medication to clear up a problem such as a childhood ear infection. Some of the basic antibiotics for ear infections can cost over $100. Many young parents have no insurance and not a lot of money. There is no way they can afford that, so they suffer and their child suffers with them, all because drugs cost so much in the United States.

While the people who need the medication think that buying from Canada is a wonderful way to obtain their drugs for a cheaper price and still have money for other things that they may want and need, the drug industry in the United States is very unhappy with the arrangement. They state that getting prescriptions filled in Canada is not only illegal, but potentially dangerous.

There are allegations that the prescription drug market in Canada is not as highly regulated as it is in the United States, and therefore the quality of the drugs is not the same, making it dangerous for consumers. Evidence, however, does not really support the fact that buying and taking prescription drugs from Canada is any more dangerous than buying them in the United States. The large drug manufacturers sell to all different countries, and the antibiotic, or blood pressure medication, or cholesterol medication, or anything else that someone buys in Canada is made from the same ingredients that the one in the United States is made from. There is little danger.

If, however, some of the allegations are true, and people in Canada really are careless with their dispensation of prescription drugs, this could lead to problems with ensuring that people are getting the right medications, and that the dosage they need is the one that they are getting through the Canadian company. It is somewhat difficult to determine whether this worry over the quality of the drugs coming from Canada is truly legitimate, or whether the accusations are merely an attempt by the drug companies to keep their profit margins high. It does seem likely, however, that the alleged problems are only complaints from drug companies.

Drug companies sell to people and institutions all over the world, but the people of the United States pay a great deal more for their drugs than anyone else. The main reason for this seems to be what the drug companies call 'cost shifting.' Cost shifting is basically price discrimination. In other words, the drug companies charge a lower price to a certain group, and 'shift' the extra cost over to another group so that they can make money.

It works like this: drug companies give huge discounts to institutions in the United States, such as the government and health maintenance organizations (HMOs). These HMOs are a large part of the problem when it comes to getting prescription medication or the tests that are necessary to determine the cause of the problem. While they are designed to keep costs down for the patient, some argue that this comes at the price of good quality care for those same patients, and much more aggravation and helplessness for the doctors. While HMOs may not seem to be directly related to a discussion of oral Candida, it is important to discuss them here, as they do relate to the market for prescription drugs, which relates directly to the drug companies and what they are doing or not doing when it comes to creating newer and better medications to treat common and simple health problems. Many believe that HMOs are contributing greatly to a lack of healthcare and a lack of appropriate medications, and that this practice must be stopped in any way possible.

For quite some time, there have been arguments about whether Health Maintenance Organizations (HMOs) should be able to be sued. There are many that think suing these companies would help people to protect their rights. These people believe that lawsuits against HMOs will eventually help to bring the costs of healthcare down, but many skeptics argue that there is no reason to believe this. Lawsuits, some believe, will just cause the already rising prices of healthcare to go up because these companies will then be required to pay a great deal of money to those that have sued them. This could hardly be seen as a way to lower the healthcare costs of people in this country.

Still, though, it is apparent that something must be done. Healthcare is extremely expensive anymore, and there are more and more people in this country that no longer have health insurance. Because of the lack of insurance that is available to these people, they do not go to the doctor when they really should. As a result, they get sicker until they finally have to go to the emergency room or they end up in the hospital. They certainly cannot pay for these kinds of services any more than they can afford insurance, but hospitalization costs much more than insurance premiums. Since these people cannot pay for the emergency services that they have received, rates for insurance and for procedures must be raised to cover the costs of those that default on medical bills.

From the point-of-view of hospital administration, suing HMOs will likely just bring more paperwork, aggravation, and uncooperative insurance companies that they will then be required to deal with graciously. Also, doctors that sue HMOs will often not be able to work with that HMO anymore, so they will lose patients. This will happen because the HMO will no longer use a particular doctor as a care provider and those that have that HMO will then have to find a new doctor. This happening to a lot of doctors that are affiliated with a hospital could provide disastrous results for the profit margin of that particular hospital. In order to make money, the hospital must then charge more to the patients that it does have, so this will not help work to lower costs in any way.

In Texas, things are moving forward with the idea of suing HMOs. In 1997, it became the first state that allowed a claim against an HMO to go through the court system. This was significant because it will likely lead the way to more of these cases in Texas and also across the country. In one of the cases that was presented in Texas one of the main medical directors for a healthcare organization was forced to be held accountable for the decisions that he made from a medical standpoint (Reece, 2000).

This was significant because it will require others in this field to do the same. This is important for medical directors of HMOs, but it is also important for hospital administrators, as the need for discipline of those acting as medical doctors is clearly necessary. This is not as large of a concern as it relates to lawsuits as is the money that could be lost by hospitals that will lose patients. Since the time that Texas created their law, however, eight other states have also passed laws allowing for HMOs to be sued. The Supreme Court, however, has tried to remain removed from the issue as much as possible. The Court did say, however, that the ERISA guidelines could not be used to sue HMOs. This is not the same thing as saying that HMOs cannot be sued at all (Reece, 2000).

One of the main problems that many have with the HMOs is that they are not required to be nearly as responsible as doctors and others that are involved with the healthcare system. This lack of accountability has much to do with why there is a movement in this country to make HMOs available for litigation. Hospital administrators, however, see that allowing for this kind of litigation would provide many more people with an opportunity to sue people and get wealthy for things that really should not be sued over. There are some reasons that lawsuits should certainly be filed, especially in cases of obvious negligence, but Americans today file an amazingly large amount of lawsuits, and many are truly unnecessary. These kinds of lawsuits are already a problem for the medical community and they will only become more problematic if suing HMOs becomes big business (Alter, 2001).

The main reason that HMOs have not been sued is because of the ERISA law, which protects employee benefit plans. Because it protects these kinds of plans, it also protects HMOs. This is changing, however, as has been mentioned. Another issue about whether HMOs should be sued has to do with whether patients are getting the care that they really need. A case in point is one young woman, the mother or two, who thought that she had appendicitis. She went to her doctor, who said it was a urinary tract infection, gave her some medicine, and sent her back home (Decarlo, 2000).

The lab tests showed that she did not have a UTI after all, and the doctor found a mass in her abdomen, but decided that it was not an emergency. Finally, the scan that she got, eight days after the second doctor visit, showed that her appendix had burst. This caused internal damage and spread infection throughout her abdomen. She almost died. There are many cases like this, and the argument about this is that doctors that work with HMOs and are trying to save money often do not check patients thoroughly or give them the tests and procedures that they might need. This is largely because many of these doctors get paid a specific amount, regardless of how much time they spend with their patients or how many tests that they order. This is the main concern that many have when it comes to whether HMOs are doing everything that they can to help patients get good healthcare at an affordable cost, which is what they were really designed for (Decarlo, 2000).

Healthcare administrators are concerned about this potential for new lawsuits because of what might happen to the costs of healthcare. It would appear, though, that despite the ability to sue HMOs in several states, there have only been a few lawsuits. Those that were worried about getting flooded with lawsuits have not seen this happen, and many lawyers are actually disappointed because they thought that they could make a great deal of money off of many of these high-dollar lawsuits. That does not mean that there will never be a flood of HMO lawsuits, but it has not happened yet (Kilcullen, 1996).

People that work in healthcare administration are breathing a collective sigh of relief that there have not been more lawsuits. The idea of excessive lawsuits has been upsetting to many. Now that it would appear that this will not be an immediate concern, people are taking another look at the entire issue and what it will mean for patients, doctors, HMOs, and hospital administration. More lawsuits coming to light and the Supreme Court potentially getting involved in whether HMOs can be sued and on what grounds that this might be possible in the future will undoubtedly change the scope of things (Kilcullen, 1996).

The limitations that HMOs place on care, however, greatly affect those that need the care the most, and this is realized by hospital administration. Unfortunately, there is not always anything that the hospital administration can do to help these people. The bottom line is that they are around to make money, even though the also try to help people to live longer and enjoy their lives. This interest in money makes them vulnerable to the things that HMOs want to do, because they have to be able to make a profit (Perry, 2001).

The more the rates for things like tests and surgical procedures rise, the more that individuals need insurance and HMOs to pay for these things. If HMOs are forced to raise their rates because they are being sued, more people will be unable to afford the insurance that they need. They will opt for emergency services only when absolutely necessary, and because of their inability to pay for it, healthcare costs and insurance premiums will go up yet again. This has become a vicious circle, and one that hospital administration is watching very carefully, in the hopes that they will find some way to break this cycle. Most of them do not believe that suing HMOs will help this at all (Perry, 2001).

There are others, though, that still maintain that HMO premiums have not gone up even though there have been lawsuits. This may be factual. However, there have been so few lawsuits to this point that it is really impossible for anyone, including healthcare administrators, to determine whether this will really significantly affect the amount that people have to pay for their healthcare (Perry, 2001). Since there are both pros and cons to being able to sue HMOs, it is clearly something that has to be studied very carefully.

Hospital administration, patients and their advocates, doctors, and many others must spend time studying this issue in order to determine whether the right to sue HMOs is really as good of an idea as it would seem. It is skeptical to assume that costs will go down because of lawsuits. These companies will be paying out more money, and they will have to get that money from somewhere. Lowering their premiums to those that need the coverage does not make sense in the face of having to pay out more money. The premiums will eventually go up if the lawsuits start really moving forward, or the HMOs will go bankrupt and close their doors. Either way, there will be many people that will end up out of coverage and out of options for their healthcare needs.

The drug companies also give huge discounts to countries like Canada and Mexico. Since they have given out all of these discounts, they need to make money off of someone. The American consumer takes the brunt of this, since the United States allows the drug companies to charge different prices to individuals and institutions. Mexico and Canada do not allow this cost shifting, and this is one of the theories behind why the prescription drugs are so inexpensive in those countries (Committee, 1998).

Another government study, this one by the Special Committee on Aging, stated in 1993 that the reason Canada's drug prices were so low was because they had a special board set up to review drug prices and deal with those that were getting out of line (Special, 1993). We have no such board here in the United States, although it seems that we may need one. Canada makes sure that the prices for prescription drugs are held down, and Canada also allows companies to use patented formulas to produce the generic equivalents of many drugs, although there is a waiting period.

The competition between the generic drugs and the original drugs keeps prices low, since consumers in Canada understand that the ingredients in the generic drug and the process of making it are identical to the original drug. Only the name is different, and there is no need in paying a great deal extra for a name. Because the generics were available, the cost of the originals stayed low to compete. During the waiting period, prices still stay low, because the Patented Medicine Prices Review Board makes sure that any prices found to be getting out of line are quickly reduced (Special, 1993).

Besides cost shifting and the review board, there is one other concern often brought to light about Canadian drug prices. Many drugs aren't available in Canada, so some Canadians are coming to the United States to fill prescriptions for drugs that they need but cannot buy in their own country. A study done in 2000 by the National Center for Policy Analysis also shows that not all of the drugs purchased in Canada are actually any cheaper than the ones purchased in the United States. According to the author of the study, William McArthur, "The Canadian government purposely restricts the overall availability of prescription drugs through a combination of a lengthy drug approval process and oppressive price controls. The result is that patients are often harmed" (McArthur, 2000).

Allegedly, many people have been hurt by the length of time required to get approval for drugs. Another harmful issue for patients in Canada is that the Canadian government requires that the patient take the cheapest drug possible. A generic, for example, or even a drug that is not the same as the one prescribed but has been shown to have similar results. This is not always good for the patient, as many patients are required to switch medications back and forth, depending on which one is cheaper, which can result in dangerous side-effects and worsening of symptoms. It is clear that, while some drugs may be cheaper in Canada, the Canadians have not found all of the answers to the problem of rising drug costs (McArthur, 2000).

So why should it be a concern to the researcher and the drug companies? The reason is twofold. Firstly, if there is truly danger in filling prescriptions in Canada, people have the right to know what all of those dangers are so that they can keep themselves and their family safe from harm. Secondly, there is a concern about why the prices of prescription drugs need to be so high. If Canada can sell them so cheaply, why can the United States not do the same? It is possible that the costs of regulating the drugs are higher, and it is also possible that the drug companies just assume that they can charge what they like -- if people really need the medication, they will pay whatever price they have to.

Cost shifting seems to be a large factor in why the price of prescription drugs in the United States is so much higher than in many other countries. After all, if the practice is allowed in one country, and the price of prescription drugs is high, but the prices are low in countries that do not allow the practice, it only makes sense that the cost shifting is a large part of why the prescription drug prices are so high in the United States.

It seems the general opinion among the American people is that drugs in the United States cost entirely too much. Most people happen to agree with that opinion. A news program just weeks ago carried a story about a childhood illness called 'RSV.' Apparently it is very similar to the common cold at first glance, but it quickly causes problems with the throat and lungs and makes it very difficult for the child to breathe, swallow, or eat. It can get to a very severe stage in some children, and has proved to be fatal in some cases.

There is a vaccine for this virus, but the child must have an injection once a month from October through May. The cost of each monthly injection -- $3,000 to $5,000. Even if a person had good insurance, the co-payments or deductibles would still add up. If a person didn't have insurance, they could pretty much forget getting this vaccine for their children, unless they made a great deal of money. The American people need to ask themselves if they really think that prescription drugs should be costing consumers this much. Most will find that the answer to that question is 'no.'

As for solutions to the problem, that is difficult to say. Obviously, prescription drugs should be cheaper. There is no question about that. But how to make them cheaper and still maintain their quality is a concern faced by drug makers, law makers, and consumers. If the standards for prescription drugs are lowered too much, they will be unsafe, and in many cases the cure may end up being worse than the illness.

Canada has shown that trying to keep prices equal between all original and generic drugs doesn't always work, either. It can be a dangerous waiting game for approval, and a dangerous switching game for patients forced to take a different drug because it is cheaper than the one that was working so well for them for so long. This is unfair, and doing that in the United States would not solve anything.

If the standards are not lowered, then the drug companies will have to be content with making less profit, and it would be a logical bet that most of them do not want to do that. The elimination of cost shifting may help, but it will likely not cure the whole problem. The price of prescription drugs has been getting steadily higher in the United States, and it is not going to allow for some quick fix. Requiring the prices to be lowered would help, but until someone has the authority to do that, and does it, people will continue to go to Canada to buy their drugs.

Each year, both children and adults in this country go untreated for their healthcare needs, and many of them die because they cannot afford to go to the doctor for care. If they had insurance, they would live longer, happier, and more productive lives, but many of them are forced to do without insurance. They are stuck in that inconvenient place between being poor enough for Medicaid and rich enough to afford their own health insurance. Often, they are working-class families with children, and while they work every day and contribute to taxes and other requirements, they are rewarded by an inability to afford decent healthcare coverage for their dependents (Wheeler, 2002). This is a tragedy that can easily be avoided, and the government must realize that it is doing its citizens a great disservice by not implementing a plan whereby all Americans could have access to adequate healthcare. There are three basic reasons that the government should provide adequate healthcare insurance to everyone, and they will be discussed below, so that the seriousness of this situation can be seen.

The first reason that the government should provide health insurance is because many children are suffering due to their parents' inability to pay for insurance and other health issues such as doctor visits and prescriptions. This is especially true of African-American children and other minority children, but white American children also have difficulty with health care insurance issues. While it is true that 88% of children in this country have health insurance, many of these children have Medicaid, which does not pay for much of what children really need (Payne, 1994). Mostly, it only covers the basics, and anything additional that is needed such as dental care or eye care does not get covered by Medicaid insurance. Twenty-three percent of Caucasian children in this country have Medicaid insurance, and 58% of African-American children have Medicaid (Payne, 1994). While Medicaid is helpful in paying for doctor visits, parents and children are extremely limited as to what doctors they can see, and many doctors will not take Medicaid patients. Children who need eyeglasses or dental work often cannot have these important services because they have no insurance to cover them, and their parents cannot afford the cost of fillings or glasses. Government insurance would allow everyone in the country to have access to things that are important, and these would include dental and eye care needs as well as basic health care needs. The choice of doctors would be much better, as all doctors would participate in this system and there would be no short list of doctors to pick from as there is on Medicaid.

The second reason is the elderly. They are another group in society that desperately needs government health insurance. Many people argue that the elderly have plenty of help from Medicare and Social Security, but in truth Social Security does not pay a great deal of money, and Medicare often does not cover everything that an elderly person needs. They still have to pay a lot of money for prescriptions, and if they make a certain amount of money from a pension or other income they will not qualify for Medicare. Many elderly people have to choose between purchasing the lifesaving drugs that they need or paying their rent and electric bills. This, as well as the 40 million people in this country that do not have health insurance, makes the greatest nation in the world looked as though it doesn't care as much about its people as it should, and reflects badly when looked at against many other nations that provide health-care coverage for everyone who lives there (Reiss, 2002).