Healthcare & rationing

[TallDave]

I meant a reference stating that the pharmaceutical companies will go out of business if the US was paying less for their medication.

http://www.cato.org/testimony/ct-rp012605.html

We come then to the second question: Why such a disparity between domestic and foreign drug prices? Some question whether there is a disparity, so let me grant first that for a number of reasons—including, most recently, the falling value of the dollar—international price comparisons are not easy to make. Nevertheless, domestic prices tend generally to be well above those abroad. In 2002, for example, patented drug prices here were 67 percent higher on average than in Canada, according to that country's Patented Medicine Prices Review Board. For the average American, however, what matters is the disparity in the prices of the drugs he uses, and that's what's driving the debate. So what explains the disparity?

There are two main reasons. First, when drug companies look at the world they see essentially one free market—America. Here they can set prices at levels that aim at maximizing profits. In the rest of the world, companies tell us, socialized medical systems set prices: "monopsony" buyers make take-it-or-leave-it offers. Because a company's marginal cost for the second pill is so low, as noted earlier, it can accept those offers and still come out ahead. But it can do so only because it has America—half the world market—to fall back on. In effect, the rest of the world rides free—or at least at well below cost—while American citizens pick up the tab for drug R&D. And that, too, is driving this debate.

And a reference to the rest of the world being "free riders" and all the burden being on the poor US to save the rest of the world as you stated it. I somehow doubt that.

It is what it is. Why do you think so much innovation comes from here?

How did you think you guys got those magically lower prices? Are you really that surprised your free lunch turns out not to be so free?

You guys got a messiah complex.

Lucky for you guys. We didn't have to save the world from Nazism and Communism. We could have stayed home instead.

[Skipjack]

This is just one mans opinion. Where are the studies his opinions are based on. Where are the statistics? Who is coming up with this?
I do very well know about the cost of certifying medical treatments, medical equipment etc (pretty much anything they let loose on a patient) in the US and the rest of the world. The US is not the only country that requires that. In fact the whole process has to be redone for (almost) every single country. However once approval in one country of high standard, such as the US, Canada, France, Japan, Germany, etc has been granted, the process is faster in the other countries. Basically this process involves many case studies in multiple steps and is simillar though not entirely the same for both equipment and medication. Anyway, I dont quite get the argumentation here. FDA approval is necessary in most countries, not just the US.
One more reason why the approval can be expensive is, because the competition might try to stop or delay you from being granted approval via lobbying the reviewers, or by simply having their people in there. All these things have happened before.
Anyway, the whole article is a gross miss representation of the situation.
Heck I am into medical imaging software which has a simillar situation to pharmazeutical products. The US is not our biggest market even, Japan is.

[Aero]

Here is an article about a bunch of people (focused on one individual) who are facing hard times through no fault of their own.

http://apnews.excite.com/article/200908 ... 10F00.html

Does society owe them medical coverage and/or perhaps even a minimum wage job opportunity? And in case you wonder why they need the job opportunity, I can tell you from experience that it is nearly impossible for a person with an education and career experience to get an entry level job. Employers look at you and know that you will accept your first opportunity to get back into your career field, ie. you are overqualified.

[Skipjack]

German cars are cheaper in the US than they are in Germany and Austria (e.g.). A lot of R&D and cost goes into the development of a new car. Does the cheaper price in the US make the US a "free rider"?
If you look at it that way, I would say the whole argument looses its bite.

[MSimon]

German cars are cheaper in the US than they are in Germany and Austria (e.g.). A lot of R&D and cost goes into the development of a new car. Does the cheaper price in the US make the US a "free rider"?
If you look at it that way, I would say the whole argument looses its bite.

Except that you are unable to tell the difference between market mandated costs and government set costs.

If BMW wants to raise its prices in the US there is nothing to stop them.

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It is amazing that even in the very simplest ideas a correct view of the fundamentals (let alone their effects) is missing.

Mention government to a socialist and even the thinking of the simplest thoughts about what government does and how it does it is close to impossible.

And for many on the right you can get the same effect by mentioning illegal drugs. Or if you really want to shut down their thinking - HEROIN.

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As an engineer I try to have as few beliefs as possible. RLCgm. I find that the more beliefs I have the harder it is to find solutions.

A free market conforms most closely to open source. - All bugs are shallow with enough eyeballs. OTOH socialism is more akin to closed source - the grand poobah tells you how it is going to be. Every one must fall in line. There are things the grand poobah doesn't understand? Well tough.

I'd rather live in an open source world. At least mostly open.

[choff]

Out of curiosity, if the US health care system works just fine, why is there a sufficiently large movement/majority determined to change it. If the cancer survival rate is higher than anywhere else, and life expectancy comprable, something else must be killing off Americans at a much higher rate.

There isn't any appreciable number of people trying to change the system in Canada. I think I'd know if there was, and my family has used the system quite a bit recently, including me. I can tell you there is a big push in the system to spend more on neo natal care/child care/prevention.

The impression I do get of the Obama health care plan is that the American people won't tolerate any namby-pamby Canadian socialism or Mickey Mouse European socialism. No, you're going for big tent, red blooded All American Gold Plated Cadillac socialism, 20% GDP, nobody left uncovered, not big pharma, not the insurance industry, and especially not the lawyers, even the patients are allowed in.

[vankirkc]

Out of curiosity, if the US health care system works just fine, why is there a sufficiently large movement/majority determined to change it. If the cancer survival rate is higher than anywhere else, and life expectancy comprable, something else must be killing off Americans at a much higher rate.

There isn't any appreciable number of people trying to change the system in Canada. I think I'd know if there was, and my family has used the system quite a bit recently, including me. I can tell you there is a big push in the system to spend more on neo natal care/child care/prevention.

The answer to your question is obviously that it doesn't work for a large swath of the population. It works great for people who have no medical need, however, or whose condition is covered by their workplace and doesn't interfere with their ability to continue working, or for the desperately poor or elderly. But if you fall in between all those groups, as some 49 million people do, you're out of luck.

The impression I do get of the Obama health care plan is that the American people won't tolerate any namby-pamby Canadian socialism or Mickey Mouse European socialism. No, you're going for big tent, red blooded All American Gold Plated Cadillac socialism, 20% GDP, nobody left uncovered, not big pharma, not the insurance industry, and especially not the lawyers, even the patients are allowed in.

I can't speak for the Obama administration, but as I understand it the goal is to reduce cost, not increase it. I would not be a supporter of the initiative at all if not for the fact that such systems that exist elsewhere are in fact cheaper than what we have. The neocons and libertarians aren't going to disappear if the initiative passes, and so there will continue to be relentless pressure to minimize the spending of the program.

[choff]

I hope you're right, because otherwise you might get hit by sticker shock the first year in. If that happens, your government will end up scrambling to cut costs in other areas to contain the deficit. Cutting small Navy programs could look attractive at the worst time.

[MSimon]

Out of curiosity, if the US health care system works just fine, why is there a sufficiently large movement/majority determined to change it. If the cancer survival rate is higher than anywhere else, and life expectancy comprable, something else must be killing off Americans at a much higher rate.

There are only the socialists who want change (they represent 20% of the electorate). The majority (60+%) are fine with their health care. Which is why you see such agitation in American town halls. Which is why there will be no bill passed.

You have to remember that newspapers (and most media outlets) are not representative of the USA electorate. They represent the socialists (mostly). Raving Dave has been doing a good job on this in another thread. In other words you are getting faulty intelligence and then trying to understand what is going on by that.

In terms of the American electorate - America is a center right country. Let me be a bit more helpful. In most of Europe the Democrats would be considered on the right. Our central value is liberty. The center right in America are the "leave us alone" people. Or more trendy and hearkening back to our founding "don't tread on me".

http://www.gadsden.info/



It has nothing to do with medical care. It is about Power and Control. AGW was the previous vehicle until we started having cool summers in the USA. The plot is always the same: government shuts down markets, sets prices, provides large subsidies, or fills markets with uneconomic mandates. Where is the cry to do research to make the alternatives (in whatever market) cheaper?

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Free riders:

We also may be at risk of squandering our high-tech advantage in medicine. As Scott Atlas of the Hoover Institution points out, the top five American hospitals conduct more clinical trials than all the hospitals in all other developed countries. America has outpointed all other countries combined in Nobel Prizes for medical and physiology since 1970.

http://townhall.com/columnists/MichaelB ... creativity

[MSimon]

The impression I do get of the Obama health care plan is that the American people won't tolerate any namby-pamby Canadian socialism or Mickey Mouse European socialism. No, you're going for big tent, red blooded All American Gold Plated Cadillac socialism, 20% GDP, nobody left uncovered, not big pharma, not the insurance industry, and especially not the lawyers, even the patients are allowed in.

Yeah it does seem stupid to spend more to get less (including a cut of $350 billion in senior care). Unless you realize that costs don't matter. Up. Down. Whatever.

Power and Control is what matters.

[MSimon]

I can't speak for the Obama administration, but as I understand it the goal is to reduce cost, not increase it. I would not be a supporter of the initiative at all if not for the fact that such systems that exist elsewhere are in fact cheaper than what we have. The neocons and libertarians aren't going to disappear if the initiative passes, and so there will continue to be relentless pressure to minimize the spending of the program.

Dude. You are getting baited and switched. Look at the costs of Medicare as proposed vs actuals.

Based on Medicare RESULTS for sure costs will go up. Quite possibly service will go down.

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Think of this: 1/2 the uninsured are young. Suppose instead of just collecting Medicare (with a promise to take care of them in their old age) from them you now have to provide them services as well? Where is the money going to come from? Especially when we are at the beginning of a depression - further shocks to follow.

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Here is an interesting sentiment that expresses the American center.

I am not going to buy a pig in a poke on the slim chance that the pig might be able to get me 20% off an echocardiogram.

http://meganmcardle.theatlantic.com/arc ... nkrupt.php

[MSimon]

The American center isn't going to disappear if the initiative passes, and so there will continue to be relentless pressure to minimize the spending of the program.

FIFY.

BTW the cost problem is an incentive problem. Turning the whole American system into Medicare (the wrong incentives) will insure too much spending. Which is why the center-right is going to kill this bill before it has a chance.

[Skipjack]

Oh, dear Msimon, please leave the drugs out. Your "socialist" Austrian here is totally against legalization of drugs.
Why?
http://www.nature.com/neuro/journal/v12 ... .2369.html
http://www.sciencedaily.com/releases/20 ... 104017.htm
http://www.aan.com/press/index.cfm?fuse ... elease=338
http://www.aan.com/press/index.cfm?fuse ... elease=578

Just to give you a few.
You libertarians would legalize child molestation ("if the child is consenting...") and child porn if it got you enough profit. Shudders.

On the topic of healthcare. I am still not old, yet I do need healthcare. My wife is still not old, but she is grateful for our system here.
It is all fun and games until someone gets hurt. Do you have children Simon?

[choff]

I still have that other question. I'm being generous and saying life expectancy is equal. I'm told superior levels of technology from superior levels of spending means the USA cancer survival rate is 3x to 5x superior to socialist western countries. So if life expectancy is the same something else kills US citizens at a compensating rate. What is it?

How can a massive project like socialized medicine get passed if only 20% of the electorate support it and 60% oppose, I thought the USA was a democracy. Unless elites can subvert the will of the electorate, is this true?

The level of health care afforded the average western world citizen is superior to that of an English monarch from 200 years ago or a US president 150 years ago. The average global citizen has superior health care to that of an Egyptian Pharoah. The p**sing match going on here is really splitting hairs.

Normally, I don't involve myself in the political debates of the USA, since I'm not a US citizen, don't pay US taxes, don't vote in US elections. But since my countries health system is being compared I'll allow myself some fun. Polywell support being the exception.

[MSimon]

Oh, dear Msimon, please leave the drugs out. Your "socialist" Austrian here is totally against legalization of drugs.
Why?
http://www.nature.com/neuro/journal/v12 ... .2369.html
http://www.sciencedaily.com/releases/20 ... 104017.htm
http://www.aan.com/press/index.cfm?fuse ... elease=338
http://www.aan.com/press/index.cfm?fuse ... elease=578

Just to give you a few.
You libertarians would legalize child molestation ("if the child is consenting...") and child porn if it got you enough profit. Shudders.

On the topic of healthcare. I am still not old, yet I do need healthcare. My wife is still not old, but she is grateful for our system here.
It is all fun and games until someone gets hurt. Do you have children Simon?

OK then there are two things that make you lose your mind. Government and genetic disease.

Now this is really going to screw with your mind. The US Government has determined that addiction is a genetic disease. But fortunately for you it is not covered. Anywhere.

http://powerandcontrol.blogspot.com/200 ... sease.html
Addiction Is A Genetic Disease

and the Drug War in America was started as a method of covert racism.

http://www.druglibrary.org/schaffer/History/whiteb1.htm
Drug War History

and just to top it off it is a class war:

http://powerandcontrol.blogspot.com/200 ... s-war.html
Class War

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So let me see if I can explain to you the difference between the ills of child pornography and the ills of food. If you engage in child porn you are harming another. If you eat too much food you only are harming yourself. Unless your medicine is socialized.

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And BTW marijuana is safer than beer.

http://powerandcontrol.blogspot.com/200 ... ption.html

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And the relationship between illegal drugs and mental illness? In the broken American medical system it is considered self medication. Or so a psychological intake nurse in this country once told me.

http://powerandcontrol.blogspot.com/200 ... ystem.html

nice one here on schizophrenia and self medication:

http://www.classicalvalues.com/archives ... t_439.html

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And on top of all that prohibition is socialism for criminals. Or if you prefer: government price supports for criminals.