Re: U.S. health care
On 13 Jul 2007, at 04:01, Dan Minette wrote: > > 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 Canadaroughly the same reason why US TV shows sell for less > overseas > than in the US. The BBC recently paid £400,000 ($812,000) per episode for first run of season 2 of _Heroes_. Rising Prices Maru -- William T Goodall Mail : [EMAIL PROTECTED] Web : http://www.wtgab.demon.co.uk Blog : http://radio.weblogs.com/0111221/ Every Sunday Christians congregate to drink blood in honour of their zombie master. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 13/07/2007, at 1:01 PM, Dan Minette wrote: > of GDP. If everyone were to get the care available to those with > the very > best insurance policiesthen 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. That assumes you keep providing care the way you do. Increase preventative medicine and primary nursing, and you reduce other healthcare threefold. Whatever the french are doing? Do that. Charlie ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
> -Original Message- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of jon louis mann > Sent: Friday, July 13, 2007 1:03 AM > To: Killer Bs Discussion > Subject: U.S. health care > > > it that is the dynamic, dan, then anerica is sunsidizing the rest of > the world, which would be justice. If you are talking about Sub-Sahara Africa, and other third world countries, I would certainly favor ways of lowering the cost of drugs in those countries. But, I don't think we need to subsidize Canada, Japan, the EU, and other developed prospering countries. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
U.S. health care
> if that is the dynamic, dan, then anerica is subsidizing the rest of > the world, which would be justice. If you are talking about Sub-Sahara Africa, and other third world countries, I would certainly favor ways of lowering the cost of drugs in those countries. But, I don't think we need to subsidize Canada, Japan, the EU, and other developed prospering countries. Dan M. i doubt they would be doing it if it were not profitable. big pharm doesn't have strong enough lobbies in other developed countries to fix the price of their pills, etc... the poorer countries pay what the market will bear and the profit there is minimal. maybe it limits the black market...? Choose the right car based on your needs. Check out Yahoo! Autos new Car Finder tool. http://autos.yahoo.com/carfinder/ ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
> -Original Message- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Charlie Bell > Sent: Friday, July 13, 2007 7:55 AM > To: Killer Bs Discussion > Subject: Re: U.S. health care > > That assumes you keep providing care the way you do. > > Increase preventative medicine and primary nursing, and you reduce > other healthcare threefold. How? I'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. While the lack of health insurance for about 15% or so of Americans is a horrid fact that must be addressed, these people do not represent the majority of health care costs. For example, most of the lifetime cost for medical service in the US is accrued after age 65. Everyone over 65 is eligible for Medicare. Under basic Medicare, the co-pay (the out of pocket cost) for a primary physician visit is $5. For most on Social Security and Medicare, this is not a major worry...other factors (an unwillingness to bother a neighbor for a ride is my mother's favorite excuse) are more important. Most of the time, the elderly make an appointmentbut when a member of the family living with us this summer became ill, she walked in without an appointment to an urgent care facility, and saw a nurse practitioner within 1.5 hours. So, an inability to afford primary health care is not the most important factor in the cost structure of the US. For the elderly, the cost problem in seeing a physician/nurse is not that they cannot afford $5, but that when they do get sick, the treatment is expensive. My wife has arthritis, and just one of the meds that provides her relief costs about $200/month. My mother is on a number of expensive meds...that are mostly covered by insurance...she has a small co-pay. A major source of cost, in the US, is the legal system. Hospitals are not required to accept every potential patient, but, once a patient is in a hospital, no service can be denied because of cost. If it is, the hospital and the doctors open themselves up to lawsuits that run in the multiple millions. As a result, tens of thousands of dollars are spent prolonging the life of dying people by a few weeks or months. My brother-in-law, a physician, talked about having to code (bring back from clinical death) someone twice a day for a month until the family accepted the fact that he was dying and nothing could be done but prolong the death. In most cases, it takes weeks for the family to come to grips with that, and allow the person to die. There are other factors, like the horrid bureaucracy of paperwork, poor health habits, etc. that contribute to this problem. But, a lack of available primary care medicine is not the critical problem. This has been tested experimentally for the last 15-20 years in the US when HMOs first came out. Primary co-pays were very small (near token), and primary care was encouraged. Indeed, my health insurance paid me $100 to get a physical. Studies of people who had this insurance showed, at most, a modest health gain over those in more traditional plans. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
> -Original Message- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of jon louis mann > Sent: Friday, July 13, 2007 12:23 PM > To: Killer Bs Discussion > Subject: U.S. health care > > > if that is the dynamic, dan, then anerica is subsidizing the rest of > > the world, which would be justice. > > If you are talking about Sub-Sahara Africa, and other third world > countries, > I would certainly favor ways of lowering the cost of drugs in those > countries. But, I don't think we need to subsidize Canada, Japan, the > EU, and other developed prospering countries. > Dan M. > > i doubt they would be doing it if it were not profitable. big pharm > doesn't have strong enough lobbies in other developed countries to fix > the price of their pills, etc... Huh? That's not how it works. Let's say the a new cholesterol drug is developed, that not only reduces the level of cholesterol, but over a year, virtually eliminates the buildup that causes heart attacks. It's a hot commodity, and will sell well. In the US, they charge what the market will bear. Folks lobby their insurance companies to put it on the formulary, and it goes on It costs about 10 cents/pill to make, but can be sold for $5.00/pill. The company can see 1 billion of these pills per year in the US for gross profit of almost five billion dollars per year. Now, other countries are interested in this pill, and start to negotiate prices for use in their nations. Even if they negotiate for only $2.00/pill, it's a lot of profit for the drug company. If it sells another billion pills/year overseas, that's another 1.9 billion/year profit. So, what happens if the US negotiates on drug pricesand the price available in the US is only $1.90/pill. Don't they still make billions? Yes, but...that's knowing the pill will work. When the particular drug starts testing, odds are long against it working without unacceptable side effects. People doing cost-benefit analysis beforehand make decisions concerning whether starting on the path to develop the drug based on the expected profits. Profits in the drug industry are high as a percentage basis...I think something like 15%-$20 of revenue for net profits is typical. FWIW, this is not too unusual for high risk ventures. Most new drugs never make it to market. It's the relatively few multi-billion drugs that pay for all. The US can, today, mandate lower prices on may drugs, remove patent protection on these drugs, etc. and get lower prices. One side effect will be a drop in research into new drugs...the amount it drops is dependant on how much the projected income for a successful new drug drops. This is not, at all, a bad thing. I hope the price in the rest of the developed world rises to meet the falling US price, so the cost of research is born more evenly. But, if not, we will see more and more field match what is seen in vaccines...you can find companies to manufacture them, but there is little interest in new research because it doesn't pay. > the poorer countries pay what the > market will bear and the profit there is minimal. maybe it limits the > black market...? Right now, companies are afraid that cheap Third World drugs would find themselves back in developed countriescompeting with their own product there. It took strong arm tactics by governments in the developed world to initiate such programs. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
U.S. health care
dan, are you certain only 15% of americans lack health care coverage? i agree that this does not represent the majority of health care costs. do you believe a single payer system would reduce costs effectively? http://www.pnhp.org/facts/why_the_us_needs_a_single_payer_health_system.php i agree that red tape is a bureaucratic nightmare and poor health habits contribute to the problem, even if there was available primary care. i have a friend who has excellent insurance and refuses to see a doctor. i don't know the solution. do you have any suggestions how to reduce escalating costs from the legal system, without increasing the amount of malpractice. i was a victim, myself and was intimidated from seeking redress. what can be done about prolonging life when death is inevitable? in my brother's case, the doctors asked me to sign in order to remove him from life support and i refused. that was 10 years ago, my brother's liver recuperated and he recently completed interferon treatment for hepatitis c. fortunately he lives in hawaii, which has an excellent health care system. he is a lifelong alcoholic and is only off the sauce when he is on probation or institutionalized. if was anyone but my brother i might say pull the plug. Finding fabulous fares is fun. Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains. http://farechase.yahoo.com/promo-generic-14795097 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
U.S. health care
Huh? That's not how it works. dan, i'm confused i realize that it doesn't work that way in other countries, but are you defending the way it works in america, or denying that lobbies have enormous influence in congress? i realize there are costs in creating new drugs and marketing them. do you believe there are instances when drugs are kept on the market when the side effects can be dangerous and law suits contribute to the cost? i have a friend who was given viagra when it was still being tested; he had a massive heart attack. the fact there is little interest in new research on vaccines because it doesn't pay, yet any new drug for ed is a great investment, make me wonder if capitalism is the right incentive for health care? this is what "sicko" points out... i have no problem with cheap third world drugs flooding the market and putting big pharm out of business. perhaps governments would then realize its responsibility is to promote research that saves rather than kills people. as long as powerful lobbies are controlling governments, that will not happen Moody friends. Drama queens. Your life? Nope! - their life, your story. Play Sims Stories at Yahoo! Games. http://sims.yahoo.com/ ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
> dan, i'm confused i realize that it doesn't work that way in other > countries, but are you defending the way it works in america, or > denying that lobbies have enormous influence in congress? Lobbies do have an influence in Congress, and changes that they oppose are often beneficial. However, getting rid of the lobbies does not get rid of the fundamentals of the problem. If you take the profitability out of drug development by private companies, you will stop private drug development. The history of the latter half of the twentieth century has shown the disadvantages of economies where the government owns/controls major > i realize there are costs in creating new drugs and marketing them. do > you believe there are instances when drugs are kept on the market when > the side effects can be dangerous and law suits contribute to the cost? That's part of it, but it the cost of eliminating any drug that might have a dangerous side effect is having no new drugs. The gauntlet that a drug has to run through before being approved is fairly formidable. Even then, when it is given to millions, after a careful study of thousands, side effects may be seen at levels too low to have observed in the study of thousands. > i have a friend who was given viagra when it was still being tested; > he had a massive heart attack. And, without large, statistically significant studies we won't know if that is a coincidence. > the fact there is little interest in new research on vaccines because > it doesn't pay, yet any new drug for ed is a great investment, make me > wonder if capitalism is the right incentive for health care? this is > what "sicko" points out... There are a couple of obvious conclusions that can be made here. First, people are more willing to spend money on ed than on vaccines. Second, this is a case where the uninformed public outcry on the danger of vaccines makes people very leery about spending money in this area. Third, wouldn't this be a perfect place for the more socialist countries than the US to show the disadvantages of capitalism by developing new vaccines through public spending? Since virtually all of the innovation first targets the US market, I think Gautam quoted here a site where 85% of the major innovations in the last 5 years were in the US and the other tended to target the US first. Isn't it logical to assume that, if the US market for this innovation dries up, that the source of the innovation would also. > i have no problem with cheap third world drugs flooding the market and > putting big pharm out of business. Well, it would put the small pharm out of business too. And, then, who would develop new drugs? I assume you favor governments? Historically, governments have had a much worse track record in technical innovation than private concerns. Planned economies tend to be ponderous and very bad at reacting to changes in demand, available possibilities, etc. They are particularly bad at innovation. perhaps governments would then > realize its responsibility is to promote research that saves rather > than kills people. Before I answer this, let me check my assumptions. I assume that you think that far too much is spent on the US military, and that a military with, say, the combined capacity of the EU would be adequate? Is that a good read of your position? Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
> Lobbies do have an influence in Congress, and changes that they oppose are > often beneficial. However, getting rid of the lobbies does not get rid of > the fundamentals of the problem. If you take the profitability out of > drug > development by private companies, you will stop private drug development. > The history of the latter half of the twentieth century has shown the > disadvantages of economies where the government owns/controls major sections of the economy. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
> -Original Message- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of jon louis mann > Sent: Friday, July 13, 2007 3:26 PM > To: Killer Bs Discussion > Subject: U.S. health care > > dan, are you certain only 15% of americans lack health care coverage? The number's I've seen quoted are in the high 40s of million. I was rounding to the nearest 5% when I said that. If you look at a website that advocates insuring these people: http://www.nchc.org/facts/coverage.shtml They quote nearly 47 million. With slightly over 300 million people in the US, this comes close to 15.5%..maybe 15.6%. I'll accept 16% as slightly more accurate, but I don't think my rounding to 15% vs. their rounding to 16% is worth quibbling over. . > do you believe a single payer system would reduce costs effectively? Well, I do know that the present system is, in many ways, the worst of both worlds. It's a mess. It should be very possible to construct a single payer system that's better. > > i agree that red tape is a bureaucratic nightmare and poor health > habits contribute to the problem, even if there was available primary > care. i have a friend who has excellent insurance and refuses to see a > doctor. i don't know the solution. > do you have any suggestions how to reduce escalating costs from the > legal system, without increasing the amount of malpractice. i was a > victim, myself and was intimidated from seeking redress. The obvious recourse that would be available would be to let medical review panels handle complaints (I think most other countries do this)..I know it's much harder and riskier to sue in Great Britain. > what can be done about prolonging life when death is inevitable? in my > brother's case, the doctors asked me to sign in order to remove him > from life support and i refused. that was 10 years ago, my brother's > liver recuperated and he recently completed interferon treatment for > hepatitis c. fortunately he lives in hawaii, which has an excellent > health care system. he is a lifelong alcoholic and is only off the > sauce when he is on probation or institutionalized. if was anyone but > my brother i might say pull the plug. >From what I understand, the US is unique in that hospitals and physicians worry about the consequences of using their best medical judgment. From what my physician friend in the UK told me, your brother would not have been a candidate for intensive care in Great Britain. That saves money. So, I don't think a system more like other Western systems would be likely to spend money on someone in your brother's conditions. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 14/07/2007, at 4:04 AM, Dan Minette wrote: >> > >> That assumes you keep providing care the way you do. >> >> Increase preventative medicine and primary nursing, and you reduce >> other healthcare threefold. > > How? ...because hospital stays reduce and recovery times increase. Good prevention and primary treatment is the most effective way of maximising returns on healthcare investment. > 'm not sure you have an adequate picture of the US system and how it > works for the average person who works for a big company. I have an adequate picture of the US system being ranked well below several European ones... Charlie. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
