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About nocl

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  1. The US health care system is like a giant balloon when one program cuts expenses, the balloon just bulges out somewhere else. It is built on a convoluted system of pricing smoke and mirrors where each provider ends up getting paid different amounts depending upon the program and/or company. A lot of energy goes into creating the appearance of price reduction, while skimming money into middlemen.
  2. Of course it does make for an interesting situation in that the product is from a US owned company that is doing the final fill finish in Italy for product that is owned by a British company for an order to the government of Australia. Going to be some rather interesting changes in supply chains when this is done.
  3. While not from a clinical trial and therefor not in the label there is good data coming out (especially from Israel) that is showing substantial reduction is asymptomatic cases, as well as substantial reduction is spread after vaccination.
  4. OF course in trying to build a case against PVSA he is only focusing on the cruise industry and does not mention everything else that are covered and protected by PVSA. Nor does he mention the issues with CBP, and US tax issues that were sufficient by themselves to keep cruise lines from doing cruises to nowhere.
  5. Concerning Medicare, keep in mind that, in general, over all, commercial insurance pays about 1.3 to 1.5 X what Medicare does for physician services. That is why physicians limit the number of patients of each kind of insurance they will take. The difference is actually larger for hospital services.
  6. the law has not changed if a product is approved for use inside the US, physicians may choose to legally use it off label. Of course they also bear any risk for doing so. The difference with hydroxychloroquine was some action taken at the state level to limit and restrict distribution. Another way off label products are limited is that while a physician may prescribe it, government programs and insurance companies may not pay for it, depending upon the indication it is being used for. That was another way hydroxychloroquine use was restricted, but a lot of
  7. From my experience in doing 8 Alaska cruises on 3 different lines you actually sail little of the inside passage (basically pretty much what you have to to reach the ports. Most of which is a couple of hours before your reach port and a couple of hours after leaving port. Did do one cruise on HAL that actually took the inside passage all the way down to Vancouver.
  8. No. It is not related to the period of immunity. What they are saying is that based upon data it appears that one does not spread the virus (shed from nasal passages) for at least the first 90 days after the 2nd vaccination. It may prevent spread for a long period but the data does not yet exist. Since they are relaxing travel rules they are limiting the period to the length of time that data actual exists for.
  9. However, if someone boarded in Florida on the cruise your are mentioning they would not be able to get off in New York. If someone boarded on the West Coast and the cruise stopped in the ABC islands or in Cartagena, Columbia, then they could get off in either Florida or New York because of the far distant port between the west cost and either of the 2 east coast ports.
  10. It is legal because the cruise leaves from Florida, then visits the ABC islands which are considered to be far distant ports, then goes to New York. Doesn't matter where it goes from there.
  11. And that is the crux of the problem these days the number and size of ships means that they descend upon a port like a horde, making it uncomfortable for the people that live there and less attractive for the overnight travelers that make up more of the travel related revenue. As Key West number show cruise ships make up 50% of the visitors but contribute only 20% of the revenue, land based tourists that make up the other 50% contribute 80% of the tourist revenue. The cruise passengers have grown so much that it is negatively impacting the attraction of land based tourists.
  12. According to what I have seen the comments have been that it has not been safety tested and therefore not recommended. I expect that there will probably be some safety tests along these lines in respect to the new booster shots. After all it would be pretty difficult to limit a particular companies booster to only the people that initially received its vaccine. If someone gets one of the vaccines they might as well just wait for the boosters aimed at the variants instead of going for another vaccine a few months later
  13. Keep in mind that different agencies have different jobs. The FDA determines which drugs are approved in the US and what is on label according to the data presented to them. Once a drug is approved, physicians can based upon their own knowledge and opinion use the drug off label The CDC who has the job and responsibility for administering the vaccines program has made such a decision due to some real world issues. They have stated that the time period specified in the label can be exceeded if necessary. Note they are not recommending that it be exceeded or that the U
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