But this is talking about what single payer insurance pays. I am talking retail. Walk into a pharmacy with no insurance and buy the drug. Are you suggesting that retail pricing is same as what the single payer insurance pays? And, I am not talking expensive drugs here. For example, one of the drugs that had to buy in Europe because we forgot it, was a prescription acne cream. 2 simple ingredients. Benzoyl peroxide and some pedestrian antibiotic. Price in the US? $600. Price in Europe, 5 euros. There is no way the above scenario explains this discrepancy.
Seniors lounge (over 50) come on in.
- Thread starter Vanhalen
- Start date
Pete Player
Hall of Fame
Would really be intresting to see the break down on how the US price for @undecided acne cream would build up.
Somehow I get the impression, visiting US too, that you have lots and lots of meds in retail, which are here under prescription only. And no drugs are in the gocery shop, exept for the health food and some supplements, which sometimes fall under the doping rules.
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Somehow I get the impression, visiting US too, that you have lots and lots of meds in retail, which are here under prescription only. And no drugs are in the gocery shop, exept for the health food and some supplements, which sometimes fall under the doping rules.
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No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
movdqa
Talk Tennis Guru
I would have to look at the items you're describing. I'm not saying that there isn't abuses - Shrkeli is an example of that.
But I'm amazed at your attitude. 200 years ago people died without antibiotics. We take them for granted. I guess I'm old enough to remember all of the things that we didn't have a long time ago. Why do we have them today? It sounds really entitled.
movdqa
Talk Tennis Guru
There are lots of OTC drugs in the grocery store or pharmacy that you don't need a prescription for. Some of them are quite powerful.
And Vice Versa. In Europe you can buy Voltaren Gel OTC, in the USA it's prescription. This is another example. I had a prescription for this in US for tennis elbow. 2 Tubes, $700 (Of course insurance co-pay makes it affordable but the pharmacist was flabbergasted at the price when he saw what I would have had to pay with out it.). In the UK, got it OTC for like 10 pounds per tube I think.
ByeByePoly
G.O.A.T.
You missed my edit above ... saw that you were talking about patents with your follow up post.
I would move all drug research to government, and pay off the patents as we transitioned the gougers out of our common good. If each country did this, and shared new drugs/breakthroughs with the world ... you would see the poor people get access. We have truly lost our way when the only reason to develop cancer drugs is for profit, much less patent common good.
We went to the moon without a profit motive, why not life saving drugs?
I agree and to add to that, even if it cost Billions for the government to do this, they already spend billions to reimburse the big pharma in the single payer systems.
movdqa
Talk Tennis Guru
https://www.ibtimes.com/how-us-subsidizes-cheap-drugs-europe-2112662
In Europe, drug prices are set by governments, not by pharmaceutical companies the way they are in the U.S. On average, the difference between the price of one drug in the U.S. and the same drug in France, Germany, Italy, Spain and the U.K. was 50 percent, an analysis by the consulting firm McKinsey has found.
“U.S. consumers are in fact subsidizing other countries’ public health systems, at least with respect to drug pricing,” Jacob Sherkow, an associate professor at New York Law School, said.
These price discrepancies and their implications are well known throughout the industry but rarely discussed outside of it. Pharmaceutical companies have long defended the high price of drugs as necessary to pay for the research and development of new drugs, but the differences in pricing essentially means that consumers in the U.S. are contributing more than those in other countries. The U.S. accounted for 46 percent of global life sciences research and development--the vast majority of which is in biopharmaceuticals--according to the December 2013 issue of R&D Magazine.
“The U.S. is the global leader in biomedical innovation,” Mark Grayson, a spokesman for PhRMA, a pharmaceutical industry trade group that represents many of the world’s biggest drug companies, said in an email. “The research is for medicines that will be sold in the U.S. but obviously will be sold around the world,” he added.
In Europe, drug prices are set by governments, not by pharmaceutical companies the way they are in the U.S. On average, the difference between the price of one drug in the U.S. and the same drug in France, Germany, Italy, Spain and the U.K. was 50 percent, an analysis by the consulting firm McKinsey has found.
“U.S. consumers are in fact subsidizing other countries’ public health systems, at least with respect to drug pricing,” Jacob Sherkow, an associate professor at New York Law School, said.
These price discrepancies and their implications are well known throughout the industry but rarely discussed outside of it. Pharmaceutical companies have long defended the high price of drugs as necessary to pay for the research and development of new drugs, but the differences in pricing essentially means that consumers in the U.S. are contributing more than those in other countries. The U.S. accounted for 46 percent of global life sciences research and development--the vast majority of which is in biopharmaceuticals--according to the December 2013 issue of R&D Magazine.
“The U.S. is the global leader in biomedical innovation,” Mark Grayson, a spokesman for PhRMA, a pharmaceutical industry trade group that represents many of the world’s biggest drug companies, said in an email. “The research is for medicines that will be sold in the U.S. but obviously will be sold around the world,” he added.
movdqa
Talk Tennis Guru
We went to the moon with a military motive.
Interestingly enough, the US military funded Ebola vaccinations and cures, one of which was implemented by RJ Reynolds.
Pete Player
Hall of Fame
Often for a given medication the strong is under prescription and the lite on retail.
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movdqa
Talk Tennis Guru
Governments around the world have had the freedom to do this for decades. They don't. Why? The private system works in drug discovery.
Have you ever invented something? Have you ever brought a product to market? Have you ever had to maintain a product or provide customer service on it? People invest their careers and lives in product development or areas around it. Don't you think that a return is reasonable on taking that risk?
In my mind, this is so obvious. Why can't you see it? Do you think that products just show up via magic?
I've been dealing with Planning Board stuff in my town for a few months. It's a real eye-opener as to how much stuff you have to do just to open a retail store or put up a building. The number of regulations and requirements are quite amazing which is why business owners have to hire professionals to do a lot of the planning and work for them. The average person just expects retail, stores, businesses, services to be there without any idea as to the the amount of work that goes on behind the scenes.
In theory I would agree with you but obviously something is rotten in this particular case. The system is flawed when the rest of the world pays a small fraction of what US patients pay for their medications. Basically, without insurance people would either go bankrupt or die or both in the USA. Does that sound ok in the name of profit and return?
movdqa
Talk Tennis Guru
Absolutely.
The problem is that you take drugs for granted and have no conception of the effort it takes to invent, produce and supply them.
With your approach, the drugs that people need would never have been invented in the first place and far more people would have died.
I'm amazed that so many people don't see this.
ByeByePoly
G.O.A.T.
Yes ... generics not necessarily all equal. I was looking into one of my mom's pills that didn't seem to be working as good ... and there was pages of complaints about the generic not working at all compared to the original patented med. They may have different fillers. Add to that, local pharmacists might be alternating between suppliers depending what is on hand at time of refill. I have set one of my mother's meds at the pharmacy to always be the same manufacturer to avoid variation. Of course ... even then ... who is to say they don't change manufacturing (variations in their supplier, or cheaper filler found) ... or just variations in batches.
So ... uh ... enjoy your meds Pete.
ByeByePoly
G.O.A.T.
Oh ... just think how inefficient they could be and still be cheaper than what we pay big pharma. I think the same thing about oil production when the price per barrel gets high enough. We were sold a bill of goods {pun intended} when they told us everything in our life/society had to be outsourced and priced by the private sector. Cars ... of course, healthcare and insurance ... of course not. Now ... that is different than not using the efficiency of the private market to your advantage. Just plug it in where you can ... where it offers advantage, but the market should be treated as the tool ... not us.
ByeByePoly
G.O.A.T.
Add me to the "I don't see it" list.
It took a lot of effort to go to the moon, design and run (but not audit) the military.
Why couldn't we have invented our own drugs?
Pete Player
Hall of Fame
Sounds like big profits for insurance companies and med labs too.
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ByeByePoly
G.O.A.T.
I read the article ... I agree markets should not set the drug prices. Drug patents are a legacy problem that should be dealt with fairly we get rid of them.
But this was the part that lit me up:
"However, it must be noted that Novartis provides Glivec free of charge to 16,000 patients in India, roughly 95% of those who need it via the Novartis “Glivec International Patient Assistance Program”.
A private company should play ZERO role in deciding who gets drugs and who does not in a society. WTF? Kindly shut the door on the way out.
ByeByePoly
G.O.A.T.
The government built the railroads ... and then private wealth was generated. The government invented the internet ... and then private wealth was created.
The common good parts where 1) railroads 2) internet.
In this discussion 3) drugs. We should skip the part where Zuckerberg gets massively rich off our required drugs.
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Pete Player
Hall of Fame
Did I get this right, that you do not approve Novartis policy to provide drugs for those 16,000?
How would you consider charity in general compared to government organized health care and education?
The system is very different - not a number of private colleges nor other schools here, I know, but people getting public schooling still score top points in PISA-tests. The idea is to give everybody a fair chance and not just hope and freedom here.
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Dartagnan64
G.O.A.T.
Much of the invention of drugs comes from outside of big pharma. Big Pharma swoops in and develops the drugs that come largely from scientists on government funded grants. The biggest part of Big Pharma's budget is marketing not R&D or manufacturing.
The system is broken in favor of Pharma and needs to be placed squarely back under public control. Health care is a public issue. Privatization, while it has led to some great discoveries, has also led to cancer treatments that cost a million dollars. It shouldn't cost a million dollars to treat cancer.
There needs to be some give and take. Government regulated cost control in exchange for prolonged patent protection from generic companies. Limits on marketing. Open books from the Pharma companies about their costs.
norcal
Legend
Not sure if I mentioned it in this thread but my healthcare costs are crazy. My daughter was diagnosed with Crohn's about 3 years ago. She's a super healthy eater anyway so we did our best to try and treat it all natural to no avail. She has to get remicade infusions monthly. Each infusion costs 8-9k. Couple that with trips to the specialist, regular MRI/E's, colon/endoscopies, etc etc and her health care alone must be 150k per year. My apendectomy last year was over 40k. Couple years ago my two hip surgeries were ? who knows but my family's healthcare costs have averaged well over 200k per year lately. I am lucky to have great health insurance and when I make life decisions, having good, affordable healthcare for my kid has to my top priority. I think my insurance will cover her till she's 24 (just turned 16). Hopefully she will be in a good place at that time so I can think about retiring LOL.
In better news, I've been hitting the ball really well lately!
ByeByePoly
G.O.A.T.
"The idea is to give everybody a fair chance and not just hope and freedom here. "
Agree 100% ... you don't have an equal chance without equal healthcare and equal education. We don't all agree on that here in Merica ... although you will still hear the claim of meritocracy.
"Did I get this right, that you do not approve Novartis policy to provide drugs for those 16,000?"
I did not approve of Novartis being involved in the "equal chance" you stated above. I am for the "equal chance" ... and it's a government/collective failure when it doesn't provide this as part of it's core function. I felt the same way about the recent rich dude that paid the education for all the current students at a college. A country that is already tending to the common good and "equal chance" does not require hopes of lottery charity actions from the rich. I find it insulting to be at the mercy of the rich.
Do I need to tell you this again in a couple of months when you are off the meds?
"In truth, the pharmaceutical industry in the United States is largely socialized, especially upstream in the drug
development process, when basic research cuts the first pathways to medical breakthroughs. Of the 210 medicines
approved for market by the FDA between 2010 and 2016, every one originated in research conducted in government
laboratories or in university labs funded in large part by the National Institutes of Health."
https://newrepublic.com/article/149438/big-pharma-captured-one-percent
Americans generally do not understand how pharmaceutical research is funded. Then again, as my law school first income-tax course treatise explained, Americans have no clue as to the funding of their health insurance. "Employer-paid premiums for health insurance are exempt from federal income and payroll taxes. Additionally, the portion of premiums employees pay is typically excluded from taxable income. The exclusion of premiums lowers most workers’ taxbills and thus reduces their after-tax cost of coverage." In other words, employer-sponsored plan costs to the employer are deductible for the employer as compensation costs, but are also exempted from income-tax liability to the individual receiving the coverage. What's more, an employee's contribution to the employer-sponsored plan is deductible by the employee.
"The ESI (Employer Sponsored Insurance) exclusion will cost the federal government an estimated $280 billion in
income and payroll taxes in 2018, making it the single largest tax expenditure."
https://www.taxpolicycenter.org/bri...sion-employer-sponsored-health-insurance-work
Pharma scans the NIH research for discoveries that may make big money. It gets an exclusive development right and runs with it. Then it proceeds to make minor changes to the formulation in order to get yet another 20-year monopoly.
As for other nations' pharma companies not contributing enough to innovation, rubbish. One of the best stocks I ever owned was ASTRA, a Swedish pharma co back then.
I haven't even got to the physicians yet: 50% of the cost of medical school operations is paid for by federal government outlays. $100,000 of taxpayer money is paid by the federal taxpayer annually for every Resident in training. My physicians in the US make vastly more for the same work as my physicians in Sweden and Spain. Why? I don't have time to explain how legislatures function....
ByeByePoly
G.O.A.T.
Like was not enough for that one. There was no "hug" version of the "like". Does it make you uncomfortable that I want to hug you right now.
I'm moving to frickin Canada when I win the lottery here.
ByeByePoly
G.O.A.T.
You are one of my favorite people here ... but I'm not getting near you are your family ... or going to Vegas with you.
You are a perfect example of why healthcare needs to be separate from the employer {don't want to know your personal details here}. There is risk with pre-existing conditions of being "job locked" due to health insurance. That is the opposite of what I think we would want when most people will change jobs/careers much more often than past generations.
ByeByePoly
G.O.A.T.
Great post ... try explaining that in your 2 minutes allotted to you in a presidential debate.
"Americans have no clue as to the funding of their health insurance. "
It's time to "get a clue" ... because it's all coming to a head. I know one thing ... I would watch that video, read that book ... probably not take a college class
.
movdqa
Talk Tennis Guru
You have the profit motive. It's a pretty powerful incentive. Gold stars just don't cut it.
What's the gold ring in the public sector? The pension of course. And what have we done with pensions? We've promised unimaginable amounts of money that we can't deliver on. So we will have to renege on those promises.
Have you ever started a company, built a product, sold a product, etc.? Do you know how much work and risk this entails? Yes, it is very easy for governments to take the work of others and run for a while. Venezuela is a fantastic example of that. They were the richest country in South America and decided that they wanted to nationalize oil production. So how did that work out?
You see stuff out there that someone has already done and ask why can't I have all of those things for free or very little? If you started and ran a business, the answer would be so obvious. Because you take huge risks with your own capital and work so incredibly hard; and then the odds are 20 to 1 that your business will fail. Is it not reasonable for some kind of reward for this risk and effort?
We do some great things in the public sector. NCI is an example. But once they invent a process or make a discovery, they give it to the private sector, and, to some degree, the non-profit sector. They are really not equipped to make products for sale. I'd guess that the scientists and clinicians there are really more into discovery than they are engineering. So they do what they want to do and what they are good at. And leave the stuff that they don't want to do and aren't good at to someone else. That's incredibly pragmatic.
Why don't you start up a small business? I've started up several in my lifetime. Find an idea that you can do that's unique that can make a profit. Then take out a loan at a bank to find development, research and production. Maybe you need to take out a second mortgage on your house or hit up all of your relatives to loan you some money. That's how a lot of it works, whether it's for a laundromat at the strip mall or a cure for cancer.
movdqa
Talk Tennis Guru
Insurance companies have done well under the Affordable Care Act. But they work pretty hard to keep costs down on drugs.
There are all sorts of sizes, shapes and purposes of medical labs so it is hard to understand what you are saying.
Just pointing a finger at some unknown person and denigrating them is not useful to the conversation. If you say someone has big profits, point them out and tell us what those profits are and why you think that they are unreasonable.
movdqa
Talk Tennis Guru
Then the company doesn't exist and the drugs don't get invented, nor does the production and delivery systems get built.
movdqa
Talk Tennis Guru
I think that government provided a lot of funding for research; not so much for development.
There were several networks developed at private companies and they were bigger than the internet at the time. These also contributed to the development of the internet.
The actual buildout was private. A lot of the actual buildout of railroads and the interstate system was private. The funding may have been public though.
movdqa
Talk Tennis Guru
You would have to provide documentation on individual drugs for demonstration. I can guarantee you that there is no marketing for 5-FU or Oxaliplatin, two commonly used cancer drugs.
Big Pharma is now developing gene therapies and personalized medicine with treatments easily in the $500,000 to a million range. They take your own DNA and modify it to enable repairs. It's not mass-produced stuff. They are custom-engineering your DNA. I would assume that it takes some very sophisticated equipment and some very talented people to do this work. The UK Government contracts with Gilead Sciences for this stuff and it appears that they can't reveal the negotiated price but I really doubt that it's $4 per pill.
If you want more information on Pharma, buy a company and look at them yourself. There's a lot of information required by regulations but you don't understand the costs.
Again, start up a company to get an idea of what the corner grocery store has to go through. You'll learn a lot more than arguing on a tennis board.
movdqa
Talk Tennis Guru
Astrazenica? They had an R&D office in ... Massachusetts. It really doesn't matter where the corporate headquarters is. What matters is where the R&D is.
Yes, our NIH, NCI and the huge amounts that we spend on research is well-spent. The system we have works in developing some great drugs and treatments. Do you want to blow that system up? Think game-theory.
Pete Player
Hall of Fame
"The idea is to give everybody a fair chance and not just hope and freedom here. "
Agree 100% ... you don't have an equal chance without equal healthcare and equal education. We don't all agree on that here in Merica ... although you will still hear the claim of meritocracy.
"Did I get this right, that you do not approve Novartis policy to provide drugs for those 16,000?"
I did not approve of Novartis being involved in the "equal chance" you stated above. I am for the "equal chance" ... and it's a government/collective failure when it doesn't provide this as part of it's core function. I felt the same way about the recent rich dude that paid the education for all the current students at a college. A country that is already tending to the common good and "equal chance" does not require hopes of lottery charity actions from the rich. I find it insulting to be at the mercy of the rich.
Do I need to tell you this again in a couple of months when you are off the meds?
Yeah, the last part was about comparision to charity, childrens hospitals and special schools for instance in the US.
Point being, which companies may give to charity in drugs.
Say, if IBM would give the same, all you would cheer in a chorus, but since it is a med lab company, it is wrong. Is it?
PS. Poly, I think I’ll never get off the pain killers. [emoji22]
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I think you are jumping to extreme conclusions. The original argument was that costs are high. Your point is that the business is expensive and they also need to make a reasonable return on investment. No one is arguing that that is a valid argument in a free market. What we are seeing though, is distortions in this market where drug prices do not reflect a reasonable ROI. We say we do not know what the root cause is and that something needs be done (at least some research as to what is going on). You say leave it alone. I disagree with the leave it alone argument.
movdqa
Talk Tennis Guru
I see you guys arguing that drug development should be part of the public sector and think that's nuts. Unless you can provide an example where that works.
I have the argument that the rest of the world should pay more for drugs so that we aren't subsidizing our drug companies. US healthcare is redistributionist. We pretend not to pay for other people so that the providers are forced to charge us more so that we pay for other people. In pharma, it's the rest of the world.
I agree that costs are high. But so are the benefits to drugs that are developed. Do you want to fund that development some other way? That's up for discussion. But the private sector provides some pretty serious incentives for development. Do you want to work with human nature or against it?
movdqa
Talk Tennis Guru
Could you be specific about what you don't like about medical labs?
Virtually no Big Pharma executives put their own money into the development phase of R&D. Even the smaller start-up companies go to Sand Hill or Wall Street to fund their efforts.
The question, if one is being asked, isn't whether we should nationalize the Pharma industry. It is whether we should stop offering extraordinary benefits, including statutory moats, for various areas of the medicine-industrial complex.
The choice isn't "Be the US, or be Venezuela." Venezuela gets most of its medical staff as semi-trained slave labor from Cuba.
The uninsured in the US face a bizarre reality. For 45 minutes in a Trauma Center (versus nearby emergency room) they are billed $47,000 or more, and (at least in PA) a specific statute forbids any challenge of the bill. $22,000 of that bill is a "facilty fee." The rest is routine radiological procedures itemized at rates more than 5x the typical health-insurance negotiated price. I have specific knowledge of the case from which the number is drawn.
A good start to fixing the US system would be to make this law: That an uninsured person can not be billed more than 120% of the average negotiated price a hospital or doctor receives from insurance companies for the same procedure. A next good step would be to have Medicare reimbursement rates for physicians set by panels which include some non-physicians (perhaps some economists) instead of off-loading such tax-payer-significant decisons to the AMA-arranged committees that meet privately to decide who much they get to charge.
Another instant "no-brainer" would be to allow CM&M (HHS) to negotiate drug prices for all Medicaid-covered pharmaceuticals. It is that single-negotiator practice which leads to 67%-lower prices in most European nations.
Most of the First World recognizes that consumers in need of non-elective medical services are in no position to bargain.
I won't even get into the dental area, beyond noting that the typical porcelain crown costs the dentist 1/2-3/4 of an hour in time, and $45-80 to the off-site lab producing the crown, yet the dentist in the US typical charges $1,000 or more. Competition? You should go to a Dental CDE Conference and listen to the dentists chanting to each other in the hallways "a crown costs $1,000." Been there, done that.
ByeByePoly
G.O.A.T.
I can't do any better than the two great posts above ... @Dartagnan64 and @Curiosity. When the experts arrive ... I should just get out of the way.
I don't think inventing drugs by the government has anything to do with starting a business, any more than building roads, or a military.
"We do some great things in the public sector. NCI is an example. But once they invent a process or make a discovery, they give it to the private sector, and, to some degree, the non-profit sector. They are really not equipped to make products for sale. I'd guess that the scientists and clinicians there are really more into discovery than they are engineering. So they do what they want to do and what they are good at. And leave the stuff that they don't want to do and aren't good at to someone else. That's incredibly pragmatic. "
My belief (got it out of a book by Mario Cuomo ... Why Lincoln Still Matters) is the private sector is ALWAYS given the first shot in our country. No one in the right mind should want any bigger government than we need ... it's always messy and hard. BUT ... always a but ... the failure of the private sector to provide something we want (which includes affordable) ... is not a reason to not have it. Big Pharma has failed ... we don't need anymore experiments, or hope with smarter regulations/laws/tweaks ... they would work for our country.
My speculation on how this could work .... trying to use the private sector to our advantage when we can:
I would have the government in charge of healthcare ... all of it ... development , research, production, distribution, pricing (no marketing ... no drug or cancer treatment facility ads on tv), .I would look for every opportunity to outsource work similar to utilities. If you are a quality research lab, meet guidelines ... maybe you spawn/shotgun the highest priority research to a broad network of labs. Maybe this already happens. I suspect some things have to stay in house (government) ... just guessing. The big pharma companies already have distribution channels ... and manufacturing capacity ... offer to pay them as a utility ... save a large part of the business and infrastructure. (btw ... I think you may be able to do this with private insurance companies also ... not sure). Our local utility companies seem to serve their purpose without $billions in profits ... that is the direction I would look at first. To me, much of the infrastructure, including retail pharmacies can stay in place ... just cut out big pharma profiteering and you probably are on your way.
OK ... US healthcare solved ... what next?
movdqa
Talk Tennis Guru
The Pharma executive may have a lot of stuff already in place but he reports to the BoD and the BoD and shareholders demand profits from management. If an executive doesn't understand that and produce profits, he's fired.
The uninsured rate in MA is 2.8%. Figure out how they did that and expand it to the rest of the country. Maybe ask Mitt Romney to work on it.
Crowns? My guy charged $250 to $1,000 for crowns depending on difficulty. Do you charge based on value to the customer or based on lower cost?
I had a bunch of amalgam fillings replaced with porcelain. If we want a cheap solution, go with amalgam.
Pete Player
Hall of Fame
If you have to pay $600 for a tube of simple acne cream, I think someone is pulling your leg!
I do not have any specific examples, and I don’t need to have. I am just thinking of the shere madness of a simple formula being valued for 600 bucks a tube 200 grams, yet it only cost a fraction in other countries and to produce it, where you don’t think it is an industrial secret, that these few substances reduce the amount of black heads.
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That's not the argument. Drug discovery is already paid for by the tax-payer. It is exploitation of the discoveries which is handed off to Wall Streat/Venture Capital. European countries haven't nationalized pharmaceutical manufacture. What they have done is created national boards to negotiate coverage and pricing. They buy from the world, including US manufacturers. The tax-payer isn't asking for nationalization of the companies, but simply the end of government tied-hands reality, despite the fact that tax-payers pay more than half of all medical bills, including drugs. Every dollar the medical-industrial-complex gains due to legislative favors is a dollar out of the tax-payers' pockets. Medical bills, incidentally, are the #1 cause of bankruptcy filings in the US.
movdqa
Talk Tennis Guru
I can't do any better than the two great posts above ... @Dartagnan64 and @Curiosity. When the experts arrive ... I should just get out of the way.
I don't think inventing drugs by the government has anything to do with starting a business, any more than building roads, or a military.
"We do some great things in the public sector. NCI is an example. But once they invent a process or make a discovery, they give it to the private sector, and, to some degree, the non-profit sector. They are really not equipped to make products for sale. I'd guess that the scientists and clinicians there are really more into discovery than they are engineering. So they do what they want to do and what they are good at. And leave the stuff that they don't want to do and aren't good at to someone else. That's incredibly pragmatic. "
My belief (got it out of a book by Mario Cuomo ... Why Lincoln Still Matters) is the private sector is ALWAYS given the first shot in our country. No one in the right mind should want any bigger government than we need ... it's always messy and hard. BUT ... always a but ... the failure of the private sector to provide something we want (which includes affordable) ... is not a reason to not have it. Big Pharma has failed ... we don't need anymore experiments, or hope with smarter regulations/laws/tweaks ... they would work for our country.
My speculation on how this could work .... trying to use the private sector to our advantage when we can:
I would have the government in charge of healthcare ... all of it ... development , research, production, distribution, pricing (no marketing ... no drug or cancer treatment facility ads on tv), .I would look for every opportunity to outsource work similar to utilities. If you are a quality research lab, meet guidelines ... maybe you spawn/shotgun the highest priority research to a broad network of labs. Maybe this already happens. I suspect some things have to stay in house (government) ... just guessing. The big pharma companies already have distribution channels ... and manufacturing capacity ... offer to pay them as a utility ... save a large part of the business and infrastructure. (btw ... I think you may be able to do this with private insurance companies also ... not sure). Our local utility companies seem to serve their purpose without $billions in profits ... that is the direction I would look at first. To me, much of the infrastructure, including retail pharmacies can stay in place ... just cut out big pharma profiteering and you probably are on your way.
OK ... US healthcare solved ... what next?
If this kind of medicine is a paradise, why not just move to one of these places?
You cannot argue that the US produces a lot of drugs and cures using the current method. You do not know what will happen if you radically change the structure and costs.
But I again ask the question: has anyone here started a business from scratch, built, developed a product or just owned a laundramat?
movdqa
Talk Tennis Guru
If it were that big a problem, I'd just go to another country and buy the stuff. And then you'd have arbitrage and the prices would come down.
movdqa
Talk Tennis Guru
Most people are happy with their healthcare and insurance. We have some people that aren't. Let's fix the problems instead of tearing down the system.
We have a drug discovery system that works. I don't see the point in tearing that down.
I do not see the big profits in medical companies that you do. Insurance companies do make a lot but they work to lower costs of services. Perhaps you could point out a few companies making obscene profits off of medical care.
Pete Player
Hall of Fame
Don’t really understand, what you are asking. My post was in relation to the Novartis case in India.
Anyway, it seems that the charity part of a meds company is not approved by someone. I think it is wonderfull, considering the market and supply in that market.
I was only conserned, of the charity part. Some seemed to get pissed off, by the idea of a med lab company giving their products to charity, which is really controvercy to, what I am seeing in CBS Golf Chanel and other proadcastings from US, where celebs shine in the spotlight organizing an event to support schools for special kids and childrens hospitals.
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No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
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The Pharmas lobbied to make that illegal.
ByeByePoly
G.O.A.T.
I actually doubt most people are happy with their health insurance ... particularly those who can't afford it. I think there is a big difference between being afraid of the replacement, and being happy with their current health insurance. Yes ... if you have access to good policies ... and you make enough ... you can weather the $2000-$4000 yearly caps. But my guess is the vast majority live in fear of having to go to the hospital and waiting for the copay bill. What else in our free market do we buy and not really know how much it costs until you are told what it costs.
But I think the main point here is many of us think 1) there be a lot of bad pricing behavior going on that would should questiond/fixed ... 2) and you thinking it's all about right, fair and expected. That's all this comes down to.
I really don't think most people are happy with insurance companies. If they are ... just wait.
Good discussion ... I always learn a lot from you. I don't like it when it ends up like piling on ... hope you just enjoy a good debate also.
Edit: you want to know who isn't usually happy with the insurance companies ... doctors and pharmacist that have to deal with them every single day. Go talk to a few of them.
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Pete Player
Hall of Fame
And they have done it for other substances.
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No more on -sorry, again on pain meds - all contributed matter and anti-matter are subject to disclaimer
ByeByePoly
G.O.A.T.
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