Universal Heathcare

[Just Me 2]

Do you believe that this could work here?
Why do you think health care costs are so high?
How do you pay for universal health care?


My answers:


Do you believe that this could work here, please explain answer? No, I think we are a "sue" happy society and hospitals and doctors will no longer be able to afford the health insurance cost. (already happening in my state, we have lost 1/3 of our OBGYN's).

Why do you think health care costs are so high? Two reasons, one people sue and win ridiculous law suits and two, insurance fraud.

How do you pay for universal health care? N/A in my case I think we need to focus more on people and attorney's that sue hospitals and doctors for non-sense. If an person sues a doctor and loses they should be required to pay all of the costs associated with the case.



Ok so what are your thoughts?

 

[BWG]

Your view of rising medical costs is rather myopic, or maybe you know that it is a much more complex issue than tort reform, but prefer to address only that aspect.
Either way, here is some information from different sources that try to dispel the myth that tort reform is a magic cure all.


Here are some quotes from insurance company representatives and the President and the General Counsel of the American Tort Reform Association.

Source


Insurance companies' investment yields have been lower for the past few years, putting pressure on premiums to make up the difference.

Malpractice insurers who buy reinsurance to protect themselves from large losses have seen that part of their underwriting costs rise significantly over the past decade. (Those increases are not related solely to medical malpractice but reflect a general tightening of the reinsurance market in the wake of such catastrophic events as hurricanes, earthquakes, even 9/11)


The Congressional Budget Office concludes

"In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency."

Source


Previous rounds of tort reform that followed the malpractice insurance crises of the 1970s and 1980s have not succeeded in preventing periodic and dramatic rises in insurance premiums.
And tort reform does not address the important and related issues of patient safety and medical errors.

While some reports indicate an alarming increase, others maintain that frequency of claims has remained steady or even shown a slight decline.
What is not disputed is that the percentage of patients injured by medical negligence who actually bring suit is very small. Estimates range from one-in-eight to one-in-ten.
Of those who do sue, only one in three receive any compensation.

During times of high interest rates or a strong stock market, insurance companies keep their premiums low in order to remain competitive, increase their market share, and acquire revenue to invest. This is possible because their income is augmented from the high rate of return on investments. A downturn in the stock market or a drop in interest rates results in a lower rate of return on investments and leads to an increase in premiums.

Source

 

[rathi]

Insurance costs are also high because of insane drug costs. Universal healthcare is possible, given that most other western nations have it, and still manage to spend less than we do.

 

[BWG]

Insurance costs are also high because of insane drug costs.

And we (taxpayers) help pay for it.



First, research and development (R&D) is a relatively small part of the budgets of the big drug companies

Only a handful of truly important drugs have been brought to market in recent years, and they were mostly based on taxpayer-funded research at academic institutions, small biotechnology companies, or the National Institutes of Health (NIH).

Source


Industry R&D risks and costs are often significantly reduced by taxpayer-funded research, which has helped launch the most medically important drugs in recent years and many of the best-selling drugs, including all of the top five sellers in one recent year surveyed (1995).

An internal National Institutes of Health (NIH) document, obtained by Public Citizen through the Freedom of Information Act, shows how crucial taxpayer-funded research is to top-selling drugs. According to the NIH, taxpayer-funded scientists conducted 55 percent of the research projects that led to the discovery and development of the top five selling drugs in 1995.

The Fortune 500 drug companies dedicated 30 percent of their revenues to marketing and administration in the year 2000, and just 12 percent to R&D.

Source


The pharmaceutical and health products industry lobbying and campaign contributions is topped only by the insurance industry.

The U.S. government contributes more money to the development of new drugs—in the form of tax breaks and subsidies—than any other government. Of the 20 largest pharmaceutical corporations, nine are based in the United States. Yet drugs are more expensive in the United States than in any other part of the world, and global drug companies make the bulk of their profits in the United States.

Source

 

[PeteEU]

Well something is wrong in the US.

The US spends 15.1% of its GDP on healthcare and only what 60% have insurance?

European countries spend less between 6 to 10% of thier GDP on healthcare and they have 100% coverage...

Can Universal healthcare work in the US? Would require some big changes, both economically but also more important poltitically. And the latter wount happen overnight as too many people are making billions on the US "healthcare" system.

One of the claims by the right over the years, has been that the US had so high costs because most Pharma companies were US and did all the R&D. (the good old, we paying for your pills argument). Well that is not true as 3 of the top 5 are non US companies and the top R&D spender is non US and 3 of the top 5 are non US. Add to that, that quite a bit of R&D is done on goverment money, both in the US and in Europe.

The problem in the US, is its laws on the area. For example I belive its illegal for Medicare to negotiate prices for drugs. So the free market ideas of the present US administration, and of the right, go out the window when it comes big pharma? It is also illegal to import drugs from other countries. Now I would understand having a ban on importing drugs from Mexico or 3rd world countries, but from Canada and Europe? Most countries have stricter controls on quality of drugs than the US! yet their "drugs" are unsafe?... even though they are exactly the same as the ones sold in the US at much higher prices?

So what does the US have to show for its present healthcare system? Highest cost in the world for the lowest coverage in the industrialised world, lower life expantancy, and higher infant mortality rates and so on. Tell me most americans are not happy about that?

 

[hereyago]

i lived in a country where there was universal health care and I thought it was nice

 

[ARealConservative]

Limited universal health care can work.

It won't work very well, but it can work.

Basic health care could be provided to all people. Expensive organ transplants and other procedures will also be too costly to give to everybody.

The reason it won't work well however is it removes another level of personal responsibility from the unwashed masses. If the costs of health care are fully subsidized, the incentive to live a fit life is reduced and overall health care costs will skyrocket as a result.


People need to put their childish illusions of utopia to rest.

 

[ARealConservative]

The US spends 15.1% of its GDP on healthcare and only what 60% have insurance?

European countries spend less between 6 to 10% of thier GDP on healthcare

One of the claims by the right over the years, has been that the US had so high costs because most Pharma companies were US and did all the R&D. (the good old, we paying for your pills argument). Well that is not true as 3 of the top 5 are non US companies and the top R&D spender is non US and 3 of the top 5 are non US. Add to that, that quite a bit of R&D is done on goverment money, both in the US and in Europe.

~sigh

The US has high costs because we recognize IP, including the IP of those top 3 companies you alluded to.

Are you so dense to not see that European Pharma companies sell products here at these marked up prices which does help pay for this R&D? Our lack of socialization makes your plans work at all. You might want to keep that front and center when you tell a sovereign nation how they should run things. :roll:

 

[Real Korimyr #9]

Do you believe that this could work here?

Yes, I do, provided that it wasn't universal health insurance; all of the flaws of our current private health insurance would be retained in a national health insurance program... and would have the unique disadvantage of being able to simply deny coverage.

We need a national healthcare service. As shown in countries that have adopted such a model, it is more efficient than private medicine and has the additional benefit of making the lower end of the workforce more productive-- fewer sick days and fewer disability pensions.

Also, considering how much effort the government is putting into making us afraid of biological terrorism, it surprises me that reform of our healthcare system isn't being treated as a national security issue-- which is exactly what it is.

Why do you think health care costs are so high?

Artificial limit on the supply of doctors and the exorbitant cost of medical training. Combined, of course, with the fact that noone actually pays for their medical care directly-- they're either insured or indigent. There's no market force working to keep costs down.

Drug prices are a problem as well; why are we using taxpayer money to subsidize the creation of "intellectual property" that the taxpayers are then forced to pay 1000% markups for? How, exactly, does that benefit the public?

How do you pay for universal health care?

Same way you pay for "universal" anything: taxation. There's no way of getting around that.

What people are missing is that, by reducing the overall cost of healthcare, the increase in tax would be smaller than what people are already paying for medicine-- even the people in the higher tax brackets.

Not to mention, of course, that taking the burden of healthcare off of employers would be a tremendous benefit in and of itself.

So what does the US have to show for its present healthcare system? Highest cost in the world for the lowest coverage in the industrialised world, lower life expantancy, and higher infant mortality rates and so on. Tell me most Americans are not happy about that?

We praise fuzzy-headed nonsense like raising the minimum wage as "moderate" and "compassionate"... and yet somehow, trying to do something about this-- which as an American I find inexcusable-- is considered left-fringe.

 

[rathi]

The US has high costs because we recognize IP, including the IP of those top 3 companies you alluded to.

Are you so dense to not see that European Pharma companies sell products here at these marked up prices which does help pay for this R&D? Our lack of socialization makes your plans work at all. You might want to keep that front and center when you tell a sovereign nation how they should run things.

Your are entirely incorrect. European or Canadian drugs often aren't even allowed to be sold here. On average, they would severely undercut our own prices.

We praise fuzzy-headed nonsense like raising the minimum wage as "moderate" and "compassionate"... and yet somehow, trying to do something about this-- which as an American I find inexcusable-- is considered left-fringe.

I'd agree. Minimum wage is far less important than this.

 

[ARealConservative]

Your are entirely incorrect. European or Canadian drugs often aren't even allowed to be sold here. On average, they would severely undercut our own prices.

Post proof, I know for a fact you are wrong.

What's not allowed is the the resale of drugs distributed through the socialist systems or drugs marketed in other countries that violate I/P rights here.

 

[rathi]

FDA's Main Concern: Safety

A growing number of Americans obtain their medications from foreign locations, often seeking out suppliers in Canada. But FDA cannot ensure the safety of drugs bought from these sources.

Importing Prescription Drugs from Foreign Sources

The FDA says that safety is the primary concern, not IP reasons.

 

[ARealConservative]

The FDA says that safety is the primary concern, not IP reasons.

Of course they do. The FDA can't know if you are obtaining safe drugs when they play no part in the inspection process.

That has nothing to do with the subject at hand. We don't exclude foreign companies from obtaining FDA approval to market products in this country as you claimed.

The exact same drugs are sold here at a higher mark-up which aids in R&D costs.

 

[C.J.]

Of course they do. The FDA can't know if you are obtaining safe drugs when they play no part in the inspection process.

That has nothing to do with the subject at hand. We don't exclude foreign companies from obtaining FDA approval to market products in this country as you claimed.

The exact same drugs are sold here at a higher mark-up which aids in R&D costs.

The U.S. does have a relatively closed drug system, but does allow for the importation of foreign drugs. Approvals are manufacturer-specific, product-specific, and include many requirements relating to the product, such as manufacturing location, formulation, source and specifications of active ingredients, processing methods, manufacturing controls, packaging location, container/closure system, and appearance. The foreign manufacturer must also be FDA approved.

Therefore, relatively few foreign prescription drugs are available here.

It's also illegal to import a drug from another country if it was originally manufactured in the U.S. There is only one exception; a U.S. manufacturer may import a drug it previously exported, subject to restrictions.

Many U.S. manufacturers sell their drugs to foreign customers at prices lower than they sell to their U.S. customers; low enough in many cases for for a drug to be sold back to U.S. customers at prices lower (And still maintain a profit) than the U.S. customers pay directly to the manufacturer, but it's illegal to do so.

The bottom line "seems" to me to be that our "relatively closed" (More expensive) system is subsidizing cheaper prescription drug prices in other countries.

Regards,

"C.J."

 

[LaMidRighter]

Yes, I do, provided that it wasn't universal health insurance; all of the flaws of our current private health insurance would be retained in a national health insurance program... and would have the unique disadvantage of being able to simply deny coverage.

With either of the systems coverage could be denied. Many UHC systems routinely deny services or postpone them, but at the governments discretion. Healthcare is not perfect, but at least an open market allows for more personal choice in physicians, coverage, facilities, etc. Also, demand would skyrocket with a system that allows for people to attend a facility for any reason, user discretion would plummet, therefore that two hour wait for emergency care would balloon to ridiculous proportions.

We need a national healthcare service. As shown in countries that have adopted such a model, it is more efficient than private medicine and has the additional benefit of making the lower end of the workforce more productive-- fewer sick days and fewer disability pensions.

False, in many of these countries, doctors are moving on to other avenues, when the government sets and pays compensation rates, it removes the initiative to improve on skills or provide the best product for the money.

Artificial limit on the supply of doctors and the exorbitant cost of medical training. Combined, of course, with the fact that noone actually pays for their medical care directly-- they're either insured or indigent. There's no market force working to keep costs down.

Absolutely correct, but what is not mentioned is that the government limited the supply of doctors to begin with, most medical problems have come from an overreach of government authority, and we want to give them universal control of it?

Same way you pay for "universal" anything: taxation. There's no way of getting around that.

Three problems:
1) It is the entitlement mentality that creates all of these programs, it creates a cycle that only adds to itself, never stops. What will be the next "right" cars? car insurance? cable?
2) Taxes are constantly increasing to pay for these "rights", you can only increase taxes so much, outside of that fact, many people will benefit from these entitlements at others expense, many will get a free ride at the expense of the few. Then, the next program is created which requires funding, and, more taxes.
3) The amount that people spend in taxes takes away from their capitol and these losses could easily fund options already in place. Taking people's money to fund entitlements only leaves them less money to fund their own basic needs such as insurance, food, shelter, etc. furthering the need for more programs.

What people are missing is that, by reducing the overall cost of healthcare, the increase in tax would be smaller than what people are already paying for medicine-- even the people in the higher tax brackets.

Not necessarily, bureaus are historically ineffecient, costs could actually increase because of the natural waste that is associated with government offices, someone has to do the filing and paying for these services. Even if somehow costs were reduced, the shock to the economy that would come from the displacement of independent medical companies and the insurers who pay for doctors would invalidate all benefits of saving on the front side.

Not to mention, of course, that taking the burden of healthcare off of employers would be a tremendous benefit in and of itself.

In most states, that is a voluntary benefit provided as an incentive to stay with the company. If that was such a huge headache, most employers would simply discontinue coverage, history has proved that.

We praise fuzzy-headed nonsense like raising the minimum wage as "moderate" and "compassionate"... and yet somehow, trying to do something about this-- which as an American I find inexcusable-- is considered left-fringe.

I don't. I think the minimum wage is a huge farce and mainly a political tool.

 

[Real Korimyr #9]

Healthcare is not perfect, but at least an open market allows for more personal choice in physicians, coverage, facilities, etc.

Assuming that there are multiple physicians or facilities to choose from, and that both are either covered by your plan or within your price range. Most people don't have a lot of "personal choice" under our current system, and there's no reason that they would have less under a nationalized system.

Also, demand would skyrocket with a system that allows for people to attend a facility for any reason, user discretion would plummet, therefore that two hour wait for emergency care would balloon to ridiculous proportions.

Healthcare services don't need to be free-- merely affordable for everyone. And I seriously doubt that the number of people using emergency services for trivial reasons would skyrocket, especially if non-emergency care were more readily available. Maintenance medicine is much less expensive and time-consuming than emergency medicine.

As shown in countries that have adopted such a model, it is more efficient than private medicine...

False, in many of these countries, doctors are moving on to other avenues, when the government sets and pays compensation rates, it removes the initiative to improve on skills or provide the best product for the money.

A smaller percentage of their GDP for better ratings in infant mortality, life expectancy, and essentially every other objective measure of quality of healthcare. That fits my definition of "efficient". and if they're having so many problems retaining doctors, their healthcare statistics aren't showing them.

1) It is the entitlement mentality that creates all of these programs, it creates a cycle that only adds to itself, never stops. What will be the next "right" cars? car insurance? cable?

I've never said that healthcare-- national or otherwise-- is a "right". It does not bother me that the unemployed homeless and petty criminals don't receive the same healthcare standards as more responsible citizens.

My argument is strictly that a national healthcare program is more cost-effective and more socially beneficial than our current system-- and that subsidizing the healthcare of the useless and the criminal is worth it for ensuring that productive American citizens and their families are kept healthy.

2) Taxes are constantly increasing to pay for these "rights"...

What is this "constantly increasing" nonsense? Our tax rates are lower than they were in the Seventies, and much lower than they were in the Fifties.

... many people will benefit from these entitlements at others expense, many will get a free ride at the expense of the few.

Yes, the vast majority of American citizens-- including ones traditionally described as "wealthy"-- will end up paying less for their healthcare, at the expense that a very small percentage will end up paying slightly more.

This is a good trade-off.

Not necessarily, bureaus are historically ineffecient, costs could actually increase because of the natural waste that is associated with government offices...

Except for the fact, which is readily verifiable, that the American people spend more money on healthcare than any other nation on the planet, and get less benefit from it than those countries which have national health services.

If your theory is correct, that such a system is automatically wasteful and will cause prices to go up and services to go down... then why do the countries that have such systems also have better healthcare for less money?

 

[LaMidRighter]

Assuming that there are multiple physicians or facilities to choose from, and that both are either covered by your plan or within your price range. Most people don't have a lot of "personal choice" under our current system, and there's no reason that they would have less under a nationalized system.

I am a licensed Life/Health agent in my state and can tell you that many of the plans I sell cover every HCP in the immediate area, and when there are issues such as travel where an accepted provider is unknown there is a benefit to cover those costs as well, most of your better plans run this way and if someone shops around a little, they can find many affordable options, some plans are even less expensive than the one's I can offer with minor trade-offs. If a plan doesn't offer any kind of choice, such as many HMO's then you would be correct, otherwise, the previous statement stands. Coverage does vary when you look at traditional, ppo, hmo, hsa, etc.

Healthcare services don't need to be free-- merely affordable for everyone. And I seriously doubt that the number of people using emergency services for trivial reasons would skyrocket, especially if non-emergency care were more readily available. Maintenance medicine is much less expensive and time-consuming than emergency medicine.

This has happened in many countries where it has been tried. My state has a University Medical System and was offered for free or otherwise affordable and couldn't stay in the black, they had to completely overhall the structure to prevent both overcrowding and charge on an "as can afford" basis to prevent both an over burdening and economic collapse of the UMC system.

A smaller percentage of their GDP for better ratings in infant mortality, life expectancy, and essentially every other objective measure of quality of healthcare. That fits my definition of "efficient". and if they're having so many problems retaining doctors, their healthcare statistics aren't showing them.

I will have to look at the data behind that, along with the methodology to determine the accuracy. For now I will just say that I can't comment on it.

I've never said that healthcare-- national or otherwise-- is a "right". It does not bother me that the unemployed homeless and petty criminals don't receive the same healthcare standards as more responsible citizens.

I'm not saying that you are making that particular statement, but that is one of the arguments for many entitlement programs and whether or not it is directly stated, it becomes a "right" when it is paid for at government expense. The problem is that nationalizing one segment of the economy will lead to other programs, this has always happened and unless it is curtailed will never stop.

My argument is strictly that a national healthcare program is more cost-effective and more socially beneficial than our current system-- and that subsidizing the healthcare of the useless and the criminal is worth it for ensuring that productive American citizens and their families are kept healthy.

Fair enough, but I don't see how it can be. I see it more as a shifting of the payment method. I will still assert that most people would be better off getting less taxation and privately seeking their own solutions.

What is this "constantly increasing" nonsense? Our tax rates are lower than they were in the Seventies, and much lower than they were in the Fifties.

This is true for the moment, it came from a reform effort that made many programs more efficient and allowing for tax breaks. However, the very statement used to justify the spending for this NHCP would be higher taxes. Let's look at this in a circle, every time a new social program is introduced it must be funded, that means tweaking the budget and expanding the revenue base to pay for it, the current party in power does that through taxes. Following that logic, taxes will start to increase again and the cycle will restart itself. Outside of the fact that taxes are lower than the seventies, they are still punitive and burdensome. If you also look at things from a historical perspective, not just a ten year cycle, you will find since the passage of the 16th amendment that taxes have in fact been in a constant state of increase.

Yes, the vast majority of American citizens-- including ones traditionally described as "wealthy"-- will end up paying less for their healthcare, at the expense that a very small percentage will end up paying slightly more.

This is a good trade-off.

Not necessarily, the wealthy may pay less at the office, but the increased taxes mean that they will have to pay a greater percentage of taxes. Therefore, they aren't just paying for their own healthcare, they are picking up the tab for the entire populace.

Except for the fact, which is readily verifiable, that the American people spend more money on healthcare than any other nation on the planet, and get less benefit from it than those countries which have national health services.

Don't have the data currently, but you are also arguing this about a system that has been made inefficient by government overregulation, therefore, giving the government total control cannot fix the problem.

If your theory is correct, that such a system is automatically wasteful and will cause prices to go up and services to go down... then why do the countries that have such systems also have better healthcare for less money?

That is an arguable point. We typically have great healthcare in this country. I have heard nothing but horror stories from people who visit here about there experiences under socialized medicine and have also seen reports of people in bordering Canadian provinces jumping across for our "lousy, inefficient, wasteful, sub-par" healthcare. I trust personal accounts more than accrued data which doesn't list it's complete methodology.

 

[Real Korimyr #9]

My argument is strictly that a national healthcare program is more cost-effective and more socially beneficial than our current system...

Fair enough, but I don't see how it can be. I see it more as a shifting of the payment method.

Could be any number of factors responsible. I lean towards economies of scale-- with increased bargaining power-- and removing the need for medicine to be profitable at every transaction step. I'm not qualified to explain it in detail... but the evidence speaks for itself.

Not necessarily, the wealthy may pay less at the office, but the increased taxes mean that they will have to pay a greater percentage of taxes.

I meant total, including their greater share of taxes. That's based on percentage of the GDP that is dedicated to healthcare-- if that number goes down, it means that almost everyone is paying less, regardless of how they're paying for it.

Therefore, they aren't just paying for their own healthcare, they are picking up the tab for the entire populace.

They're doing that already. Part of the reason that medical bills are so obscene is the fact that for-profit hospitals and clinics have to gouge paying customers to make up for bad debtors and indigents. It's reflected in our insurance premiums, as well.

Don't have the data currently, but you are also arguing this about a system that has been made inefficient by government overregulation, therefore, giving the government total control cannot fix the problem.

Our current regulations are certainly making the system inefficient. But I'd argue that is more a factor of how they're regulated, than the level and strictness of those regulations.

You're right that more regulations aren't going to solve this problem. But if you think that simply deregulating the industry will...

That is an arguable point. We typically have great healthcare in this country.

It isn't entirely bad. I'm not claiming that it is. We're certainly better off than some parts of the world. The problem is, we are at the bottom of the industrialized world; according to the WHO, our life expectancy and mortality rates are slightly better than the Republic of Korea's.

Except that we spend five times as much money per capita to accomplish that-- $5711 per person per year, as compared to $1074.

WHO | Countries

Go look for yourself. They've got all the statistics, by country, nice and neat and organized.

I have heard nothing but horror stories from people who visit here about their experiences under socialized medicine and have also seen reports of people in bordering Canadian provinces jumping across for our "lousy, inefficient, wasteful, sub-par" healthcare. I trust personal accounts more than accrued data which doesn't list it's complete methodology.

Funny, I've heard plenty of good things about socialized medicine-- from people who've had the opportunity to use it. And I've also seen that the number of Canadians "jumping across our border" to take advantage of our healthcare system is laughably small; those stories are just as much flights of fantasy as the horror stories of poor people dying in the street next to hospitals that won't admit them.

Noone's coming to this country for healthcare, unless you're willing to count cosmetic surgery.

 

[PeteEU]

Many U.S. manufacturers sell their drugs to foreign customers at prices lower than they sell to their U.S. customers; low enough in many cases for for a drug to be sold back to U.S. customers at prices lower (And still maintain a profit) than the U.S. customers pay directly to the manufacturer, but it's illegal to do so.

The bottom line "seems" to me to be that our "relatively closed" (More expensive) system is subsidizing cheaper prescription drug prices in other countries.

Regards,

"C.J."

Drug prices in the US are higher because there is no law to prevent drug companies for setting whatever price they want. The normal market powers are so out of wack from pro drug company laws that the drug companies know that the people will be forced to pay it, because the people cant complain nore import drugs. Add to that, that the Medicare program is not allowed to negotiate for the best price and have to accept the price the drug company offers and you have a seriously broken system, feeding off the misery of the sick and dieing.

As for subsidizing drug prices in other countries.. thats been in the right wing talking points for ages, and its impossible to prove and is highly unlikely considering the restrictive pro big Pharam system the US consumer has to deal with. Any company will charge the maximum amount for a product if it can get away with it, and in the US they can and people still blame "outsiders" for the high drug prices and yet its "insiders" thats the problem...

Guess its easier to blame Europe, arabs, gays or commies for your selfmade problems.

 

[C.J.]

As for subsidizing drug prices in other countries.. thats been in the right wing talking points for ages, and its impossible to prove and is highly unlikely considering the restrictive pro big Pharam system the US consumer has to deal with.

I wouldn't know, and do not care about has been right wing talking points for ages. Additionally it is very easy to prove on several levels.

For instance the pricing structure of prescription medication while complicated is at least partially based on a percentage of a country's median income. Poorer countries pay less, richer countries pay more. A particular average to produce a particular return is almost always important to a company.

Some countries have price controls, some do not. Again the manufacturer is looking for a return. If they must sell to one cheaply, then in turn they must sell to another at higher prices.

Any company will charge the maximum amount for a product if it can get away with it, and in the US they can and people still blame "outsiders" for the high drug prices and yet its "insiders" thats the problem...

Guess its easier to blame Europe, arabs, gays or commies for your selfmade problems.

Actually I did not blame anyone, but if pricing is partially based on a percentage of a country's median income, I do not believe my statement (The bottom line "seems" to me to be that our "relatively closed" (More expensive) system is subsidizing cheaper prescription drug prices in other countries) is too far "right wing," or off the mark.

Regards,

"C.J."

 

[LaMidRighter]

Could be any number of factors responsible. I lean towards economies of scale-- with increased bargaining power-- and removing the need for medicine to be profitable at every transaction step. I'm not qualified to explain it in detail... but the evidence speaks for itself.

I can see where you're logic is coming from. One thing that scares me is the very thought of a centralized system of medicine which would take competition out of the market, where you see efficiency, I see a loss of innovation. One big reason that profits must be maximized are lawsuits, these increase the risk of loss at the practitioner's and administrative ends which leads to exhorbitant malpractice insurance rates, I actually looked into getting the required level of license to sell malpractice insurance because of the commissions and was discouraged by many of my colleagues because of the rate of company dropouts(i.e. no profitability vs. the loss ratios therefore many insurers are leaving the market) this leads me to believe that tort is killing the med industry in this country. A point could be made that some(but certainly not all) doctors are in it for the money and their salaries change the curve a little in spending, but even doctors who make only a decent living have worked almost half a year just to pay their insurance premiums, we also must take into account those who are still new in their practice who must pay back their school costs, fees, etc. The second part of course, we probably agree is part of the problem along with arbitrary limits on licensed practitioners and like minded controls.

I meant total, including their greater share of taxes. That's based on percentage of the GDP that is dedicated to healthcare-- if that number goes down, it means that almost everyone is paying less, regardless of how they're paying for it.

I am familiar with how the numbers should work, however I get a very bad feeling that this is a case of paper looking better than reality.

They're doing that already. Part of the reason that medical bills are so obscene is the fact that for-profit hospitals and clinics have to gouge paying customers to make up for bad debtors and indigents. It's reflected in our insurance premiums, as well.

This is absolutely correct, but my own opinion is that an open ended system will further the problem, we will probably have to agree to disagree on this point.

Our current regulations are certainly making the system inefficient. But I'd argue that is more a factor of how they're regulated, than the level and strictness of those regulations.

Agreed, how the industry is regulated and also why are very important to the situation. Strict regulations in areas such as sanitation, testing, competence, etc. are certainly understandable, but the breadth of many regulations far overreach what is necessary for public safety.

You're right that more regulations aren't going to solve this problem. But if you think that simply deregulating the industry will...

Deregulation is definitely not the answer, but an overhaul will be necessary under any system. Smart regulations are the only way to improve this particular situation.

It isn't entirely bad. I'm not claiming that it is. We're certainly better off than some parts of the world. The problem is, we are at the bottom of the industrialized world; according to the WHO, our life expectancy and mortality rates are slightly better than the Republic of Korea's.

Except that we spend five times as much money per capita to accomplish that-- $5711 per person per year, as compared to $1074.

WHO | Countries

Go look for yourself. They've got all the statistics, by country, nice and neat and organized.

I'm going to check those out when I have some time, thank you for the link. I certainly want to see the reporting criteria and how the statistical data is obtained. While I don't doubt the numbers, I have a huge mistrust in statistics since taking the course in school, my stat teacher taught us that statistics can be skewed in any number of ways.

Funny, I've heard plenty of good things about socialized medicine-- from people who've had the opportunity to use it. And I've also seen that the number of Canadians "jumping across our border" to take advantage of our healthcare system is laughably small; those stories are just as much flights of fantasy as the horror stories of poor people dying in the street next to hospitals that won't admit them.

Could be. I just go with what I've heard and assume you are doing the same. It would be neat if people would take a census of this kind of activity though to get some kind of solid idea.

 

[LaMidRighter]

Noone's coming to this country for healthcare, unless you're willing to count cosmetic surgery.

:rofl Especially in Beverly Hills.

 

[Real Korimyr #9]

I can see where you're logic is coming from. One thing that scares me is the very thought of a centralized system of medicine which would take competition out of the market, where you see efficiency, I see a loss of innovation.

It is something I am concerned with, as well. However, it seems that a considerable amount of the medical research and development monies going into our healthcare system are already coming from public sources.

Government programs have too much of a tendency to grow stagnant, though.

One big reason that profits must be maximized are lawsuits...

Profits have to be maximized because profits have to be maximized. That's simply how things work in capitalistic industry. You're right that the lawsuits are contributing to the problem, however, by making it more expensive to provide medical services.

I'm not sure I can support tort reform, however. If I have to pay fifteen thousand dollars to have my foot amputated, and the doctor amputates the wrong foot-- meaning I've lost both of them-- I don't think paying me back for both procedures and time lost for work is sufficient recompense.

One big problem is that our current system doesn't seem to have any other means of penalizing malpractice.

A point could be made that some(but certainly not all) doctors are in it for the money...

I don't think it matters. It isn't immoral to make a profit, and doctors who are "only in it for the money" don't make any more money than real doctors, except by choosing more profitable specialties. Reckon that's only fair.

As for the costs doctors pay... that is definitely part of the problem. The exorbitant costs of medical school end up going straight into our medical bills-- and medical school is ungodly expensive primarily because the AMA has convinced lawmakers to make it so.

Limited supply, again.

Agreed, how the industry is regulated and also why are very important to the situation. Strict regulations in areas such as sanitation, testing, competence, etc. are certainly understandable, but the breadth of many regulations far overreach what is necessary for public safety.

Likewise agreed. And many of the regulations are nothing more than "entry barriers" to keep the number of doctors artificially low-- even when there's a greater number of people who could become competent doctors.

It would be neat if people would take a census of this kind of activity though to get some kind of solid idea.

Actually, the Canadian government did. Guess they got a little worried about their healthcare system when they kept hearing that their citizens were fleeing from it. That's where I got the claim that the number of border-jumpers was ridiculously low-- but I didn't remember the exact number to quote.

I believe it was studied by the Canadian Institutes of Health Research-- the acronym seems familiar-- but I can't recall off-hand. I found the information through FactCheck, whose mission is to generally to cut through all the crap that goes on in political campaigns.

 

[LaMidRighter]

It is something I am concerned with, as well. However, it seems that a considerable amount of the medical research and development monies going into our healthcare system are already coming from public sources.

Government programs have too much of a tendency to grow stagnant, though.

Not sure about the exact funding channels. But stagnation of government programs does seem to be the norm

Profits have to be maximized because profits have to be maximized. That's simply how things work in capitalistic industry. You're right that the lawsuits are contributing to the problem, however, by making it more expensive to provide medical services.

I'm not sure I can support tort reform, however. If I have to pay fifteen thousand dollars to have my foot amputated, and the doctor amputates the wrong foot-- meaning I've lost both of them-- I don't think paying me back for both procedures and time lost for work is sufficient recompense.

One big problem is that our current system doesn't seem to have any other means of penalizing malpractice.

I can meet you halfway on this one. Legitimate malpractice certainly calls for not only recovery of losses but punitive damages as well, I can certainly agree as this is the reason tort law was created to begin with, recover losses, discourage unsafe/unfair behavior. I think tort law is the most efficient way to deal with malpractice when applied justly and properly but have seen quite a few tort abuses that penalize on the theory of malpractice versus actual malpractice(ambulance chasers, class action lawsuits with biased/inaccurate backing data, etc.), with appropriate use of tort under the proper circumstances, malpractice might actually fix itself by not only forcing more care, but actually weeding out the truly bad practicioners.

I don't think it matters. It isn't immoral to make a profit, and doctors who are "only in it for the money" don't make any more money than real doctors, except by choosing more profitable specialties. Reckon that's only fair.

As for the costs doctors pay... that is definitely part of the problem. The exorbitant costs of medical school end up going straight into our medical bills-- and medical school is ungodly expensive primarily because the AMA has convinced lawmakers to make it so.

Limited supply, again.

I pretty much agree with you here. I only included those in it primarily for profit as an example that they will naturally find ways to increase costs past their actual value to make said profit(although I am pro-profit I like to see people get value per dollar). I must kind of change my profit stance though becuase I agree that if someone wants to specialize for higher profits that is absolutely fair. I do worry about doctors who push extra testing to pad the bill a little, don't know if that's a myth, fact, or necessity because of the above mentioned tort abuses.

Actually, the Canadian government did. Guess they got a little worried about their healthcare system when they kept hearing that their citizens were fleeing from it. That's where I got the claim that the number of border-jumpers was ridiculously low-- but I didn't remember the exact number to quote.

I believe it was studied by the Canadian Institutes of Health Research-- the acronym seems familiar-- but I can't recall off-hand. I found the information through FactCheck, whose mission is to generally to cut through all the crap that goes on in political campaigns.

Cool, will have to check that out as well.

 

[PeteEU]

I wouldn't know, and do not care about has been right wing talking points for ages. Additionally it is very easy to prove on several levels.

For instance the pricing structure of prescription medication while complicated is at least partially based on a percentage of a country's median income. Poorer countries pay less, richer countries pay more. A particular average to produce a particular return is almost always important to a company.

That is one hell of an asumption. Yes prices in a country are often dictated by the median income of said country.. thats kinda logical. After all you cant pay 2 dollars for a cola in a country where the mean income is 30 dollars. Now this is so for all products sold, food, cars, and so on. On top of that we have taxes and other stuff that also influence the price.

Now for your idea to work and to justify the much higher prices for drugs and healthcare in the US as a general, it would mean the median income in the US would have to be much higher than that of European countries to explain the difference, and I hate to break it to you, but several European countries have higher median incomes, and most are near or the same as the US.

Some countries have price controls, some do not. Again the manufacturer is looking for a return. If they must sell to one cheaply, then in turn they must sell to another at higher prices.

Yes its called price discrimination and it only works if the consumer is not 100% informed about prices and able to get at alternative products or the same product in another area. One way to prevent the consumer in doing this is, is banning the import of drugs from other countries. Another way is to ban the biggest single consumer in negotiating prices with the supplyer freely. Add the 2 together and you have the perfect enviroment to charge almost any price you want and with goverment approval. If you can get the other companies in the industry to start a cartel (secretly of course) then bang you got a nice deal going. You typically see clear price discrimination near border areas, where locals go across the border to buy beer and so on because its cheaper in the other country. Goverments usually put limits on what you can bring in to slow down or stop said buying.

But lets think about the math a bit. The US has 300 million people.. the world has over 6 billion. So your idea is that the 300 million of the US pay higher prices so that the rest of the world gets lower prices, dispite at least the same amount of people in Europe (acutally more) have similar or higher median incomes than the people in the US? Does not add up even without doing any numbers, if we consider that drug prices are "the same" world wide in production.

The North American pharama sales account for about 48% of the world sales in dollars, but we have to remember the prices are higher so that is only natural that the total sales amount is higher too. But the question is will the 48% cover not only the costs in country, but also part of the 6 billion other people on the planet? I have my doubts, but would love to see any studies done on it if anyone has any.

Add to that, that European prices are on average higher than American prices, because of tax and so on, and the idea kinda falls apart.. not to mention the currency difference through the years.

I know for a fact that drug prices in Denmark are higher than American prices, as we have several companies attempting to import stuff to sell in Denmark and they could not do that if american prices were higher. Now they have been blocked for safety reasons quite often (funny eh?) but some have succeded after taking it to the courts. This goes on a wide variety of goods btw, from contact lenses to computers and so on.

Also your idea has to mean the manufacturer is "fair" and "ethical".. and since when have they ever been that? They are greedy, its in their nature. If they can take a higher price for a life or death giving drug because no regulation or oversight prevents this, then they will. If a car manufacture does not have to recall 3 million cars because 2 cars blew up, then they dont. The fear of billion dollar lawsuits or regulation requiring recalls, forces them to do it. If they can dumb thier waste free of charge without getting caught or if the price is low for getting caught.. then they will. History has shown this time and time again. The free market is not perfect, far from it. It is however the best we got and sometimes it needs a bit of "checking" so it does not go totaly wacko.

The facts of drugs prices, healthcare costs and similar things are just not in the US favor. You pay over double the amount in healthcare costs per capita and in % of GNI than similar nations, your infant mortality rate is one of the highest in the western world, your life expectancy is one of the lowest and your system does not cover every person living in the US. The question is how can Americans keep accepting to pay so much for so little? And will blaming outsiders for this keeping going on even though there is no proof to back up such claims?

Actually I did not blame anyone, but if pricing is partially based on a percentage of a country's median income, I do not believe my statement (The bottom line "seems" to me to be that our "relatively closed" (More expensive) system is subsidizing cheaper prescription drug prices in other countries) is too far "right wing," or off the mark.

As I have stated, I think its off the mark As for right wing comment, its more the attitude towards it all. Blame outsiders or the weak for ones own problems.

The debate so far has always been centered on 2 things as far as I can see.

1. Prices are high because we subsidize other countries drugs. Prove it.

2. Prices are high because people sue so much. Partly true, but that is again blaming someone else instead of looking at the system it self.

Why no debate over the laws preventing a free market? Why no debate over your whole healthcare system? HMOs? and so on? Why constantly blaming "outsiders" or the weak or those you dont like?

Now I am not saying that the Europeans have a better system, but we have a different one. Very few countries have price controls (its kinda illegal with in the EU), which is another argument the right has thrown into the debate to sour it... as price controls = communist and that turns off most Americans right off.

We have at worst price oversight, which means goverments keep an eye on prices to make sure that drug companies dont charge exessively. We also have a free market, which means that hospitals and so on, can acuatlly negotiate for better prices instead of being forced to accept whatever price the drug company dictates. We can also import drugs from other countries within the EU and other "safe" areas. And its not illegal for me to buy drugs in Spain and import them to Denmark for personal use. Of course I would need a licience to set up shop to do that, but so would you in the states.

Its time America has an honest and total debate, not dismissing things off hand because they are socialsist, communist or "european" ideas or ways of doing things.