> -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Deborah Harrell > Sent: Tuesday, July 10, 2007 12:19 PM > To: Killer Bs Discussion > Subject: RE: U.S. health care > > > Dan Minette <[EMAIL PROTECTED]> wrote: > > >[not sure who wrote] > > > > SImply put, the weakest area of the American > > health system is > > > preventative care. Poorer people with chronic > > conditions can end up > > > with repeated emergency hospital treatment for > > conditions which are > > > manageable with drugs which, while not cheap, are > > >far cheaper than repeated hospital admitance. > > > OK, let's try to do an experimental test on this. > > Drug coverage was just > > added to Medicare. To the extent that your > > hypothesis is true, we would see > > a drop in hospital costs that correspond to the > > increase in prescription payments. > > The major problem with the current added coverage is > that _by law_ the gov't can't negotiate with the > pharmas for drug pricing...which will not lower health > care costs at all overall, just shift it back to the > taxpayers ultimately.
Sure, but lowering costs is somewhat of a game. Other countries ration health care, even though it's universal. I remember a friend of mine who was a UK doc interning in the US after interning in the UK. She told me how she witnessed how a lack of insurance drastically changed treatment plans for a baby with a bloody diaper in the US, while in the UK floor nurses decided who got more than the basic treatment based on their assessment of the value of the life they were returning to. We would, of course, lower drug prices if the government did hard line negotiating on buying large quantities of the drugs. A side effect would be, of course, to lower the potential profitability of any new drug that was developed. Right now there are scores, if not hundreds of drug companies, all trying to hit home runs (i.e. get a drug through testing and onto the market). I have several friends who work for small drug companies. These companies are often/usually financed by venture capital. If these capitalists see the potential payoff drop by a factor of two or three, then the economics of producing new drugs changes tremendously....and the money supply available for this will decrease dramatically. Developing a drug is a high risk venture....hundreds of millions can be spent only to find dangerous side effects during or even after the final, large clinical tests...resulting in the money being totally written off. Governments could step in, but in countries with price controls/negotiations...they haven't. Instead, they rely on the US providing the profits that pay for innovation, then negotiate a price for themselves. It's not rock bottom, but that's why the same meds are cheaper in Canada....roughly the same reason why US TV shows sell for less overseas than in the US. This doesn't mean that I'm opposed to negotiations...I don't see why the US should shoulder the lions share of the cost of medical innovation....so I think that negotiating a lower price should be part of the deal. It's just that I'm aware that there is a downside....we'll have to find some other way to make innovation profitable...or else it won't be done. Governments could sponsor drug development, but government support/sponsorship of innovations does not have a good track record. Part of the reason for this is that spending large amounts of tax money is, inherently a political decision. When the means of doing this is clear, (as with Social Security....you provide income to seniors by sending them checks every month), then the government can do a phenomenal job (the overhead on Social Security is 97%). When a government is asked to guess the form of the next innovation in a field, the track record is dismal. Innovations often come from left field, and are obvious only after they succeed. Lots of people trying and failing, losing their own and/or their investors money in the process, but some hitting has been seen to work better. But, going back to my support for government negotiations, it's getting close to the point where we cannot afford health care. It's now about 16% of GDP. If everyone were to get the care available to those with the very best insurance policies....then it would probably jump to 20% or so...immediately (That assumes that the health care denied by reasons of costs represents only a 20% reduction in total care). As it is, without universal coverage, it's projected to reach 20% in a few years. Dan M. _______________________________________________ http://www.mccmedia.com/mailman/listinfo/brin-l
