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On February 24 2013 01:34 rackdude wrote:Show nested quote +On February 24 2013 00:17 Sbrubbles wrote:On February 23 2013 23:36 rackdude wrote:
This is something covered in Economic Development courses as an interesting externality problem. The problem is that the US system is paying for the research of many drugs. This comes at a high cost to the US citizen and is enforced through patents. However, many of of these patents expire much sooner / are not policed in the world market, so the same drugs end up much cheaper everywhere else. So you have this odd problem that the US healthcare system is basically subsidizing most of the healthcare research for the world. So the rest of the world has a positive externality from this, but we get nothing from it. Also, the rest of the world has no incentive to set up as much healthcare research as long as the US has this system they can keep taking from. It's a new take on the tragedy of the commons ordeal. So ... the US healthcare system is subsidizing the health sistems of the rest of the world? And this is because the rest of the world doesn't properly respect US patents? Care to link where you got this from? It sounds awfully absurd, especially considering that the biggest markets for US pharmaceutical companies are, aside from the US market, markets in other developed countries, countries tend to respect international treaties on intelectual properties. I don't know if the US patent system allows for longer-lasting patents than what is internationally accepted in treaties and conventions, but I would also think it unlikely given the US influence in negotiations of this kind. Still, if it truly does, then it's the US's own fault for not adhering to international standards. It isn't my topic of research and the professor who had the full argument is on leave, but here's a few things I could scrounge together on this. Basically, it's not the whole issue, but there is truth to the claim. Prescription drug companies overcharge US customers to account for the fact that other countries have price controls. This way they can keep funding R&D. This does not account for the entirety of the difference in the costs, but it does give a sense as to why prescription drugs have such a large cost difference. Quick Overview: http://www.consumerwatchdog.org/node/4199A Little Detailed: http://www.nejm.org/doi/full/10.1056/NEJMp048158Some More: http://www.nytimes.com/2006/10/05/business/05scene.html?_r=0http://ostina.org/downloads/pdfs/bridgesvol7_BoehmArticle.pdfThe professor also had a lot of other things to say... I can't find my notes on that though. Something about patents for vaccines and countries without firm rule of law. That's where the whole patent dispute comes in. It was quite awhile ago (3 years?). This should be enough to put you on track towards the right research in journals though. Again, this doesn't account for everything (why are doctors here payed so much more? Why are CT scans so much more?) but it does tell you about one of the factors involved.
Maybe you should read more carefully what you are posting, or at least something that actually strenghtens your point?
From the Consumer watchdog - link 1 you provided for overview.
The author of the health affairs study, Prof. Donald Light, argues that the study shows the U.S. drug industry shouldn't get the protection of exorbitant domestic drug prices.
Today's Health Affairs news release said:
"Congressional leaders and others concerned about high prices of new patented drugs will be heartened by this analysis, because lower European prices seem to be no deterrent to strong research productivity,” writes Light. He cites previous research showing that pharmaceutical companies are able to recover research costs and make a "good profit” at European prices, and he rejects the notion that Europeans are “free-riding” on American pharmaceutical research investments.
In fact, U.S. drug pricing looks more and more like the kind of "protection" money extracted by street gangs.
The new England journal article basically says what Bush will do ("did" in hindsight) differently than Kerry and why - with the author having some sort of "hunch" how it would pan out if the state took more direct action in determining prices. Yet no hard facts by this Richard G. Frank Harvard Medical dude.
What was interesting however is, that there generally is more money involved in the R&D and people working there in the US than anywhere else. So at least it is highly profitable for them I guess, (US) consumers paying the price for that however is not cool.
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I don't know how America handles all the billing system and the treatments being too expensive and such but we in Turkey have a socialist approach to the healthcare system that is working for decades.
We simply collect small health taxes from everyone that is collected in one place and it is being used as part of our social insurance system and used for people who need it. This decreases the costs people personally has to pay for like %80 when compared to USA system. It is not a liberal approach of USA for "everyone takes care of himself" approach though. But again if you are for example healthy and doesn't really use the system you still pay small amounts for it and for example any other person that is cancer for almost 5 years and fighting with it using the part of collected money. In certain moments when many people is suffering from diseases the tax amount increases and such.
As far as i know some politicians talked about this in USA but people just didn't want to pay for other people's sickness' and such. So the argument closed very fast. But since i experience this system a lot i think it is not as "scary" as it sounds like. Actually in the long run it is really beneficial for public health.
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The reason medical bills are killing the US is because they have neither a free market nor a socialized system. It is a bastardized amalgamation of the two, which prevents the market from working the way it ideally could, and prevents cost reducing measures of socialized care.
You cannot blame the market for this. The medical system is not a market. If I could provide a form of medical care for $500 and yet every single medical establishment is charging $4000, it means there are severe barriers to entry into the market which prevents competition and costs from being driven down.
People blaming the market when there isn't even a real market make me want to pull my hair out. Capitalism is the new permanent scapegoat for all things wrong in the world, even though it established wealth and liberty for billions.
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On February 23 2013 15:50 Stratos_speAr wrote:Show nested quote +On February 23 2013 15:38 Fuzzmosis wrote:
Medical Care in the US is strange.
Even Government programs "overpay", in absolutely no small part due to lobbyists. If during program creation, you not only have a loud and presumed knowing voice arguing to make as much money as possible, and people who agree that is right and are willing to make it happen during the price negotiation (See, Medicare). Especially if it leads to jobs after their price negotiations.
Stolen from Wikipedia: "Estimating how much money could be saved if Medicare had been allowed to negotiate drug prices, economist Dean Baker gives a "most conservative high-cost scenario" of $332 billion between 2006 and 2013 (approximately $50 billion a year), and a "middle cost scenario" of $563 billion in savings "for the same budget window"" (http://en.wikipedia.org/wiki/Medicare_Part_D).
So, basically Medicine is a business in America. To most of the rest of the world, it is a basic human right given to their citizens with varying levels of options of private care. In America, it's.... not. So that may make the conversation confusing to any international people. If by strange, you mean a complete fucking joke (like so many other things in this country), then yes, you are correct. It fucking boggles my mind how ignorant, ultra-patriotic conservatives can brag about this country being the "best country on earth" when the average American's quality of life is quite lacking compared to other developed countries. Yes, you can love America, and I love this country just as much as the next SANE individual, but loving your country doesn't mean that you ignore its absolutely horrific faults. You FIX THEM.
This so much!!
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I'm glad that I saw this here on TL, when I saw this on the Daily Show it really got me thinking. I know that when I had my appendectomy, it cost me close to 4 grand even with insurance...really ridiculous, I was living paycheck to paycheck as it was, now I pretty much have to defer all my bills to a collection agency, and that's no fun.
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On February 24 2013 03:39 mierin wrote:
I'm glad that I saw this here on TL, when I saw this on the Daily Show it really got me thinking. I know that when I had my appendectomy, it cost me close to 4 grand even with insurance...really ridiculous, I was living paycheck to paycheck as it was, now I pretty much have to defer all my bills to a collection agency, and that's no fun.
Stories like this one really make me shake my head in disbelief...
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On February 23 2013 14:23 Millitron wrote:Show nested quote +On February 23 2013 14:04 Dagan159 wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help. Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand. Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now. If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice. I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it should be done.
No. it. won't.
You just contradicted yourself, you say demand falls while at the same time admitting people don't stop getting sick. No, the demand is still THERE regardless.
Also, most serious illnesses can be prevented had said sick person gone to a doctor to see why they were feeling like such shit every day. Instead, they go to the doctor when they collapse on the floor at work and find out in the hospital that they have had cancer for a year.
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On February 24 2013 03:44 cydial wrote:Show nested quote +On February 23 2013 14:23 Millitron wrote:On February 23 2013 14:04 Dagan159 wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help. Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand. Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now. If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice. I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it should be done. No. it. won't. You just contradicted yourself, you say demand falls while at the same time admitting people don't stop getting sick. No, the demand is still THERE regardless. Also, most serious illnesses can be prevented had said sick person gone to a doctor to see why they were feeling like such shit every day. Instead, they go to the doctor when they collapse on the floor at work and find out in the hospital that they have had cancer for a year.
Flawed premise: All medical demand comes from illness.
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On February 23 2013 14:23 Millitron wrote:Show nested quote +On February 23 2013 14:04 Dagan159 wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Demand never falls. People dont stop being sick. Insurance companies usually get 40-50% of chargemaster prices. You will initially be charged 100% of chargemaster costs unless you get outside help. Demand will fall. Yes people keep getting sick, but they can't actually get the care, because they can't afford it. That counts as falling demand. Yes, it will suck like shit at first, but things will improve eventually, and once they do they will be better than they are now. If you have a serious illness, you don't pussyfoot around and try tons of half-measures, you take the prescribed medicine, regardless of how bad the side-effects are. Likewise, the healthcare industry is seriously flawed, and only extreme measures will suffice. I suppose you could lessen the impact by slowly phasing out insurance instead of just dismantling it overnight, but I think it should be done.
Or, you know try what other countries are doing, that also lessens the costs , but does not cause countless people to die, suffer and go bankrupt like your solution.
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On February 23 2013 14:28 Scarecrow wrote:
So what's different about the US system compared to other western countries? The prices just seem ridiculous as does the notion of removing insurance -.-
They don't have public healthcare system, because that would be socialist/communist. And so they suffer consequences.
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On February 24 2013 03:31 rusedeguerre wrote:
The reason medical bills are killing the US is because they have neither a free market nor a socialized system. It is a bastardized amalgamation of the two, which prevents the market from working the way it ideally could, and prevents cost reducing measures of socialized care.
You cannot blame the market for this. The medical system is not a market. If I could provide a form of medical care for $500 and yet every single medical establishment is charging $4000, it means there are severe barriers to entry into the market which prevents competition and costs from being driven down.
People blaming the market when there isn't even a real market make me want to pull my hair out. Capitalism is the new permanent scapegoat for all things wrong in the world, even though it established wealth and liberty for billions.
That's one way to look at it, but the most pressing problem with the Health system is the fact that it has become too big as an entity in the US, and there are just too many offsprings (or you could call them leeches) that depend on the healthcare economics, which each of them has also become too gigantic. This is really what makes the US healthcare the most unique and different from any other countries who run theirs based on a socialized medicine. This is also the reason why US has the most sophisticated health system and the most advanced treatment in the world. Healthcare in US needs a reform, I agree, but it will only work if states are given more power to reform from within rather than anything that is federally run program.
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On February 24 2013 03:51 mcc wrote:Show nested quote +On February 23 2013 14:28 Scarecrow wrote:
So what's different about the US system compared to other western countries? The prices just seem ridiculous as does the notion of removing insurance -.- They don't have public healthcare system, because that would be socialist/communist. And so they suffer consequences.
You are ignoring the ten thousand details and reasons that make up the US health care system in order to simplistically push your political beliefs. You really aren't doing anything for the discussion here.
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On February 23 2013 23:36 rackdude wrote:
This is something covered in Economic Development courses as an interesting externality problem. The problem is that the US system is paying for the research of many drugs. This comes at a high cost to the US citizen and is enforced through patents. However, many of of these patents expire much sooner / are not policed in the world market, so the same drugs end up much cheaper everywhere else. So you have this odd problem that the US healthcare system is basically subsidizing most of the healthcare research for the world. So the rest of the world has a positive externality from this, but we get nothing from it. Also, the rest of the world has no incentive to set up as much healthcare research as long as the US has this system they can keep taking from. It's a new take on the tragedy of the commons ordeal.
I doubt that cost difference comes even close to cover the gap between costs in US and other countries. Plus a lot of countries develops new drugs, for example we develop a lot of new drugs, that are then bought by US/other pharma companies in late development stage, put through trials and .... Companies pay for the trials, which are horrendously expensive, but they also get the money back by selling the drug, and not only in the US. Most developed countries does not ignore patents.
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On February 24 2013 02:03 emythrel wrote:Show nested quote +On February 23 2013 14:02 Angry_Fetus wrote:On February 23 2013 13:54 Millitron wrote:
Insurance is the problem. Hospitals and pharma companies can charge that much because most of their "customers" costs are covered by huge insurance companies. Get rid of insurance, demand falls, and so will prices. Your solution is to get rid of insurance? Really? its what the rest of the civilized world did. Well, in the UK we have the option to get private health insurance but its very cheap and covers EVERYTHING. If you don't want or can't afford that, you pay a small tax (its very small, about £5 per week for most people) and get all your medical treatment, save foir paying £7 for a prescription and paying £50 for dental works.
It still works as insurance, just not necessarily for-profit one. You can consider it a tax, but it still needs to cover the healthcare costs and so it is basically mandatory insurance.
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On February 24 2013 03:31 rusedeguerre wrote:
The reason medical bills are killing the US is because they have neither a free market nor a socialized system. It is a bastardized amalgamation of the two, which prevents the market from working the way it ideally could, and prevents cost reducing measures of socialized care.
You cannot blame the market for this. The medical system is not a market. If I could provide a form of medical care for $500 and yet every single medical establishment is charging $4000, it means there are severe barriers to entry into the market which prevents competition and costs from being driven down.
People blaming the market when there isn't even a real market make me want to pull my hair out. Capitalism is the new permanent scapegoat for all things wrong in the world, even though it established wealth and liberty for billions.
People are commenting on the "real" market, that is the one at work here, that is the one that through lobbying and other practices creates the situation in US. The market you are thinking of is imaginary as it cannot in reality be implemented in healthcare. So yes, it is not the "free market" and it should be pointed out, but it is the only market that will exist in first world country in healthcare.
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On February 24 2013 03:53 rusedeguerre wrote:Show nested quote +On February 24 2013 03:51 mcc wrote:On February 23 2013 14:28 Scarecrow wrote:
So what's different about the US system compared to other western countries? The prices just seem ridiculous as does the notion of removing insurance -.- They don't have public healthcare system, because that would be socialist/communist. And so they suffer consequences. You are ignoring the ten thousand details and reasons that make up the US health care system in order to simplistically push your political beliefs. You really aren't doing anything for the discussion here.
Nope, the US system is bastardized amalgam of "free market", public healthcare and lobbying. You can tinker with it to make it slightly better, but not much. You can theoretically go in the "free market" direction, but that is imaginary possibility, due to the fact you will never have public support for any meaningful move in this direction. And even then you have no idea if it would be better as there are no data. Or you can do what other countries do with reasonable success.
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Guys, don't you want a CAPITALIST ECONOMY? You can't just introduce this "socialist" medicare system that spreads the cost over the country as a whole!! It's not like this whole country/world revolves around social interaction and communication, cooperation, etc with other individuals. When someone gets in a car accident, it's clearly all their fault and they deserve to die because I sure as hell was not responsible! Our current system works great!! Demand is always high on medical anything, and so the the costs are too!! Simple economics.
In all srsns, one of the flaws here is that a capitalist system when it comes to hospitals just isn't viable. When you are in an accident and are bleeding to death, you don't moan to the ambulance, "Hey, don't go to that hospital, go to the cheaper one 10 miles away! They have better deals!" It's stupid to leave it to capitalism or economics to decide the price for necessities of life. Hell, it's barely economics at this point. It's just abuse of a social society. For any progressive nation, this is clearly detrimental. Literally EVERY developed nation EXCEPT the United States has a national healthcare system in place. This semi-free market is a joke, especially so when it comes to the medical department. Believe me, medical costs aren't free.
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On February 24 2013 04:15 Blargh wrote:
Guys, don't you want a CAPITALIST ECONOMY? You can't just introduce this "socialist" medicare system that spreads the cost over the country as a whole!! It's not like this whole country/world revolves around social interaction and communication, cooperation, etc with other individuals. When someone gets in a car accident, it's clearly all their fault and they deserve to die because I sure as hell was not responsible! Our current system works great!! Demand is always high on medical anything, and so the the costs are too!! Simple economics.
In all srsns, one of the flaws here is that a capitalist system when it comes to hospitals just isn't viable. When you are in an accident and are bleeding to death, you don't moan to the ambulance, "Hey, don't go to that hospital, go to the cheaper one 10 miles away! They have better deals!" It's stupid to leave it to capitalism or economics to decide the price for necessities of life. Hell, it's barely economics at this point. It's just abuse of a social society. For any progressive nation, this is clearly detrimental. Literally EVERY developed nation EXCEPT the United States has a national healthcare system in place. This semi-free market is a joke, especially so when it comes to the medical department. Believe me, medical costs aren't free.
But why should people who don't want in on the system be forced to pay for it? If I don't want health insurance, why should I be forced to buy it?
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On February 24 2013 03:09 Doublemint wrote:Show nested quote +On February 24 2013 01:34 rackdude wrote:On February 24 2013 00:17 Sbrubbles wrote:On February 23 2013 23:36 rackdude wrote:
This is something covered in Economic Development courses as an interesting externality problem. The problem is that the US system is paying for the research of many drugs. This comes at a high cost to the US citizen and is enforced through patents. However, many of of these patents expire much sooner / are not policed in the world market, so the same drugs end up much cheaper everywhere else. So you have this odd problem that the US healthcare system is basically subsidizing most of the healthcare research for the world. So the rest of the world has a positive externality from this, but we get nothing from it. Also, the rest of the world has no incentive to set up as much healthcare research as long as the US has this system they can keep taking from. It's a new take on the tragedy of the commons ordeal. So ... the US healthcare system is subsidizing the health sistems of the rest of the world? And this is because the rest of the world doesn't properly respect US patents? Care to link where you got this from? It sounds awfully absurd, especially considering that the biggest markets for US pharmaceutical companies are, aside from the US market, markets in other developed countries, countries tend to respect international treaties on intelectual properties. I don't know if the US patent system allows for longer-lasting patents than what is internationally accepted in treaties and conventions, but I would also think it unlikely given the US influence in negotiations of this kind. Still, if it truly does, then it's the US's own fault for not adhering to international standards. It isn't my topic of research and the professor who had the full argument is on leave, but here's a few things I could scrounge together on this. Basically, it's not the whole issue, but there is truth to the claim. Prescription drug companies overcharge US customers to account for the fact that other countries have price controls. This way they can keep funding R&D. This does not account for the entirety of the difference in the costs, but it does give a sense as to why prescription drugs have such a large cost difference. Quick Overview: http://www.consumerwatchdog.org/node/4199A Little Detailed: http://www.nejm.org/doi/full/10.1056/NEJMp048158Some More: http://www.nytimes.com/2006/10/05/business/05scene.html?_r=0http://ostina.org/downloads/pdfs/bridgesvol7_BoehmArticle.pdfThe professor also had a lot of other things to say... I can't find my notes on that though. Something about patents for vaccines and countries without firm rule of law. That's where the whole patent dispute comes in. It was quite awhile ago (3 years?). This should be enough to put you on track towards the right research in journals though. Again, this doesn't account for everything (why are doctors here payed so much more? Why are CT scans so much more?) but it does tell you about one of the factors involved. Maybe you should read more carefully what you are posting, or at least something that actually strenghtens your point? From the Consumer watchdog - link 1 you provided for overview. Show nested quote +The author of the health affairs study, Prof. Donald Light, argues that the study shows the U.S. drug industry shouldn't get the protection of exorbitant domestic drug prices.
Today's Health Affairs news release said:
"Congressional leaders and others concerned about high prices of new patented drugs will be heartened by this analysis, because lower European prices seem to be no deterrent to strong research productivity,” writes Light. He cites previous research showing that pharmaceutical companies are able to recover research costs and make a "good profit” at European prices, and he rejects the notion that Europeans are “free-riding” on American pharmaceutical research investments.
In fact, U.S. drug pricing looks more and more like the kind of "protection" money extracted by street gangs. The new England journal article basically says what Bush will do ("did" in hindsight) differently than Kerry and why - with the author having some sort of "hunch" how it would pan out if the state took more direct action in determining prices. Yet no hard facts by this Richard G. Frank Harvard Medical dude. What was interesting however is, that there generally is more money involved in the R&D and people working there in the US than anywhere else. So at least it is highly profitable for them I guess, (US) consumers paying the price for that however is not cool.
I told you it's not my topic of research and I threw those together really quickly. Guess I didn't read those enough. Still, there is a large debate in the Economic Development community about this being one of the potential causes (at least 3 years ago) and all I was doing was pointing that out to help the discussion move from normal internetness to something that has journal papers on (somewhere, someone here has to be a poliecon guy) and moving along.
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EPT
