Topic: Private enterprise bankrupting America? - page 2. (Read 10905 times)

asdf - the problem is the US is that your government refuses to control prices.  Even now, politicians are competing to ensure that they do most to stop price reductions.

http://www.nytimes.com/2012/03/23/us/politics/house-votes-to-kill-a-medicare-cost-control-board.html?ref=health

Every other well run country does control prices so Americans pay more for the same service.

You are of course correct that health is not a free market.  But most Americans are told that it is a free market! You end up with confused folk making slogans like:

http://4.bp.blogspot.com/_dDBCv4k4awU/S86ryvu59cI/AAAAAAAAAdE/NU6SUauTjok/s1600/s-MEDICARE-large.jpg



The 2 point of the article are that

(1) Americans get particularly shafted and that
(2) the people responsible insist that any control on their pricing is "socialised medicine."

The government mandates that employers provide insurance to employees. People can't choose what they're covered for. They'll claim on things they otherwise wouldn't have just because they're already paying for it. It also reduces competitiveness in insurance.

Malpractice legislation means that doctors have to raise their prices to cover the risk of being sued.

Medical research is heavily regulated. Instead of just bringing a viable product to market, companies have to pass a ridiculous set of expensive, overkill double blind studies for many years just to get fda approval.

Patents grant a monopoly on drugs leading to monopoly prices.

Medicaid and Medicare hides the true cost of medical insurance from the consumer. socializing the cost is a tragedy of the commons situation, which leads to poor resource allocation.

God know what other laws are on the books that I don't know about.

So yes, “it’s the prices, stupid.”, but the prices are the governments fault. What America and basically every socialist country in the world needs, is a competitive free market in health care. Voluntary trade results in a vastly more optimal allocation of resources than any violence based solution the government can come up with.

Explain to me why electronics keep getting cheaper, but health care keeps getting more expensive.

Also, another take on this:
http://mises.org/daily/4434

Read the article please.  Its pathetic to post platitudes without informing yourself of the facts.

High health care costs are 100% the fault of government intervention. why should it be different from any other industry? computers get cheaper every year because the government doesn't have it's tenticles all over it; distorting resource allocation. The market in health care is far from free, that's the problem.


related:

John Stossel
http://www.youtube.com/watch?v=3WnS96NVlMI

Peter Schiff
http://www.youtube.com/watch?v=u6eIBvrMY5w

I think reading the WaPo article makes you less informed. I guess it got me looking stuff up though. I need to get back to this eventually, the 5% thing is interesting.

Same is true of UK and the rest of the developed world.

Read the article and try to make an informed comment.

Well its what everyone says - its true.  The point of the WaPo article is not that the US pays more but that the reason it pays more is that the US government doesn't set a price cap and allows "the market" to set the price. 

This is what the original Wapo article said.

The percentage is much the same everywhere as far as I know.  I don't see how it could be otherwise.  When will you need medicine?  When you are sick.  When will you be sickest? In the period before dying.  So that's when you will have the bulk of your medical costs. 

What's unusual about the US system is that it costs a lot more for the same treatments. 

Incorrect. It's more like this:

1. Standard medical treatment for minor to moderate things which happen several times such as: sliced finger, concussion, broken arm, skin irritations, etc. Many people do nothing about these because they can't afford them. These things add up.

2. Expensive events which typically happen once or twice or three times in a lifetime and can extend life thirty years or more, such as: appendicitis, breast cancer and mastectomy, triple bypass surgery, skin cancer removal, etc.

3. End of life care. Very expensive.

Now, scenarios 1 and 2 are simply not affordable to a huge portion of the population, often with health insurance, and definitely without health insurance. In such situations, they don't get treatment and die. Those who do get treatment go on live life for twenty, thirty, or even forty or more years.

No doubt, but is that bulk larger in the US than elsewhere?

15 million people account for $1 trillion in expenses. What percentage of these people are costing over a million dollars per year, 100k per year, etc? How much are people in similar circumstances being charged in other countries? Does the treatment/care differ? What is a reasonable amount for society to spend?

I know its the news, but for a quick estimate:

http://www.sacbee.com/2012/03/11/4328036/million-dollar-hospital-bills.html

So as an estimate for the entire US, 7% of $1 trillion comes to 70 billion, while 0.2% of 15 million is 30 thousand people... for an average of $2.3 million per person in this group. That is just hospital bills though. We need to know what is spent on outpatient care, etc.

Edit= Actually we should be accounting for what percentage of the total expenditure goes to "hospital stays", which is 30-40%. This gives us an average of 900k or so for each person in the "million dollar" group. So something is wrong with the stats or estimate.

Perhaps I've been watching TV too much (Royal Pains), but could part of the reason that 5% spends so much be because 5% is very very wealthy, and spends WAY more than average to get the best care they can? (Even if it's possibly a huge waste of money)

Lets assume you only get healthcare when you need it.

There are some born with disabilities and they probably consume more healthcare than anyone else.

Then there is the rest of us.  We consume some care immediately after birth, we get some immunisation and most people have at least one accident/minor illness that requires hospital treatment.  Then we get seriously sick, need a lot of care and we die.

Isn't it obvious that the bulk of the medical expenses will be spent in that final short period?  That's when you need it and if you are not ready to die, that's when you will throw money at the doctors to save yourself.  As the old saying goes "You can't take it with you."

Interesting, lets take Sorafenib as an example. I know nothing about it besides reading the wikipedia page. From that I have found it non-specifically inhibits multiple tyrosine kinases (tyrosin kinases mostly play important roles in pro-growth and pro-replication signalling cascades). I can tell you straight away that it is not specific enough, it will lead to messed up skin, mucus membranes, immune system, and blood vessels. All of this will impede living a fulfilling life, very similar to old school chemo. For most patients, it will not be effective in the long run (the dose needs to stay low to limit side effects). The low dose will give cancer cells opportunity to mutate to metabolize the drug or become "immune" to it. Yea sure, if dosed just right it might work (cure cancer) for any individual patient, but it is a long shot. This is what current biomed science is capable of producing right now. We need more data about each patient (ie the specific mutations present in each tumor), better ways of getting this data, and to streamline the drug development process so that we can design personalized drugs.

What you get with this strategy is people kept alive slightly longer (perhaps longer than they should be, but who am I to say) so the doctors can try something else. This is not necessarily good, and definitely very expensive. On the other hand, this practice is generating interesting data that may lead to a breakthrough.

Is this occurring more often in the US than in other countries? Is that what accounts for half of healthcare expenses going towards 5% of the population?

I'm totally Ok with that.

Please read the article.  Of course Bayer gets royalties - the Indian government isn't stealing their IP.  Its merely enforcing the terms of the patent monopoly. 

I'm fairly consistent, too. I think Bayer should charge what they want, but also that a generics manufacturer should create whatever they want, and charge whatever they want, too. People who want brand name can pay for Bayer, and people who want generic patent infringing pills can pay for the cheaper ones. Bayer can make back their R&D expenses by focusing more on service, customized drugs, and by providing overall health maintenance (boutique medicine?). Since they will already have the drug manufacturing infrastructure in place, they can really underprice any generics manufacturer, and still keep customers by showing they they are competent, understand their products, and provide a better service. Much like it not really costing anything to set your own broken bone and stitch your own cut, but people still pay people who know what they are doing to take care of that.

It's kind of ironic though. Patents encourage R & D. Would Bayer have invested in the R & D if they knew their patents were going to be ignored? Is the generic company going to pay Bayer royalties? Does the price the generic company is going to sell the product at account for the R & D costs?

Do you want to see well made movies where a great deal of effort goes into making them? Then make sure the producers are compensated for their efforts by not allowing copying.

I'm a little surprised at the irony here from both sides. Rassah wants to ignore movie copyrights, but likely thinks Bayer should charge what they want. Hawker thinks copyrights should be supported, but says screw the patents.

At least I'm consistent. Don't steal and distribute copyrighted material. Give the company that did the R & D their fair share.

http://www.nytimes.com/2012/03/13/business/global/india-overrules-bayer-allowing-generic-drug.html?ref=business

Here is an example of how governments are able to encourage fair pricing in a way that private enterprise cannot.


Of course, as well as the German drug company, one other body sees this as a defeat.


So not content with price gouging the American public, the US intervenes in India to ask that a German company be allowed to price gouge the Indian public. 

There is no correct point at which to give up the fight.  I've an aunt going through it now and she's effectively given up before she even entered hospital.  I saw someone I love die and whenever the morphine was wearing off he would start screaming for someone to save his life.  He would have given everything he had and sold his soul for even a week more of life.  There is no right answer.

Americans pay more because they are charged more for the drugs and the doctor has the option to say "Get your check book."  In the UK its free at the point of delivery so that doesn't happen.  Fix the pricing problem and you fix the end of life costing so much problem.