every other developed country covers everyone at half the cost. that alone is enough to overlook any negatives that their system may have. dont get me wrong, the usa could definitely fuck things up, but we have no examples elsewhere to think it'd happen here. i know people complain about wait times in canada, but they are the only country with worse wait times than we have. everyone else is better. plus, they can decrease their wait times just by getting more doctors, but they choose not to. it's a problem that can be overcome and isn't a problem anywhere else, and they are half as costly anyway (if we spent half as much as we do now and had canada's wait problem, is that really so bad?), so why the big fear in fixing our broken healthcare system through the government?
which developed country has worse healthcare than we do?
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@n8nrgmi
I actually support medicare for all on the grounds that it is half the cost of our current system.
Other countries have cheaper healthcare because they price fix drugs.
Mixed systems like we have are also quite problematic, but that is a large factor.
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@bmdrocks21
Other countries have cheaper healthcare because they price fix drugs.
In general I do not like price fixing. I am fine with paying $80 for a pair of shoes that only cost $3 to make because I only have to buy shoes every year or so when the old ones get worn out. Paying $400 for a drug that only cost $30 to make and is required for me to live a normal life... That is a bit more of a grey area.
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@Discipulus_Didicit
I can certainly see the appeal of that position.....
I’ll begin with part of my stance on the matter and see if we can’t come to some sort of agreement. I am 100% against companies slightly altering their drug to maintain patents indefinitely. I think this is an issue that very seriously needs to be fixed. After 20 years, the drug should become generic and sold for cheap. However, R&D can cost millions and the FDA takes an average of 10 years to clear a new drug. So, I believe companies should be able to charge high amounts in order to recoup those costs, or we should somehow work on making the FDA more efficient(we currently don’t accept research done outside the US for instance). So, I am against price fixing. It can lead to shortages and decreased medical innovation in the future because of the different pricing systems that make turning a profit more difficult. Larger, more ambitious projects may not be undertaken that could produce even more lifesaving drugs. Money spent on securing patents would be used on more productive business functions.
Let me know what you disagree with.
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@bmdrocks21
Let me know what you disagree with.
I actually don't for the most part, though I think you are basically saying "either allow price gouging because that is currently the best way for companies to be profitable OR fix the system so that price gouging is no longer required" and I would strongly agree that the patent system at least needs to be reformed. Lots I could say on that point that I won't get into because this post would quickly devolve into a multi-page rage against bureaucracy lol.
As for the FDA taking a long time... I don't know as much about how the FDA works as I do about the patent office but I do know about the scientific method and my gut says that "10 years to clear a new drug" is probably not because the FDA is incompetent and more likely because that long of a time period is actually required for trials to be carried out properly.
Like I said I am in general against price controls for much the same reasons that you state. Price controls leading to shortages, shortages leading to government quotas, quotas on unprofitable goods leading to nationalization or governmental subsidization, etc. Over 90% of the time when someone uses the term 'slippery slope' they are bullshitting because they want to advocate for an extremist position of some sort. "Letting the gays marry each other is a slippery slope where next thing you know they will be turning all our kids gay" for example. Governmental control over the economy is one of the few cases where there actually is a slippery slope.
I don't claim to have an answer for how to fix the current healthcare system. I really truly don't and I doubt most people on this site that claim to do either. It is a lot more complicated that many are willing to admit. However, I do have enough experience with it to recognize that it is in need of fixing.
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@bmdrocks21
However, R&D can cost millions and the FDA takes an average of 10 years to clear a new drug.
Fun side note, most R&D is actually paid for with government money. They do most of the ground work research. Drug companies then pick it up, play with the formula a little and patent it. They then slap a massive mark up on it and make absurd amounts of money on something they didn't actually do most of the work developing.
I believe companies should be able to charge high amounts in order to recoup those costs
studies have shown that the primary costs they incur is actually marketing. They spend way more on trying to convince people to buy their overpriced drugs than they do on actually developing drugs.
I am against price fixing. It can lead to shortages and decreased medical innovation in the future because of the different pricing systems that make turning a profit more difficult.
When you take into account that the majority of drug research is government funded and the fact that they spend like 2-3 times more on marketing than on research, it becomes clear this isn't true. If they stopped doing research they would run out of products to sell. Then they would cease to exist.
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@HistoryBuff
Don’t have time to respond to everything right now, but this article says that R&D is typically larger than marketing https://www.raps.org/news-and-articles/news-articles/2019/7/do-biopharma-companies-really-spend-more-on-market
Just depends on what you consider “marketing”.
The problem with America is that capitalism is above all else. The 1%ers must be supported at all costs, all costs.
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@disgusted
The problem with America is that capitalism is above all else. The 1%ers must be supported at all costs, all costs.
As long as they lay golden eggs.
They keep all the golden and you guys get chicken shit.
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@bmdrocks21
Think it's a good idea for the US to do the same?Other countries have cheaper healthcare because they price fix drugs.
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@HistoryBuff
Fun side note, most R&D is actually paid for with government money. They do most of the ground work research. Drug companies then pick it up, play with the formula a little and patent it. They then slap a massive mark up on it and make absurd amounts of money on something they didn't actually do most of the work developing.
We have already discussed this... I agree that is unfair if this is what occurs. I would prefer the government make the drugs and sell them at cost instead. Could you provide an article that says companies use mostly government research and do little work themselves, but end up creating the drugs?
When you take into account that the majority of drug research is government funded and the fact that they spend like 2-3 times more on marketing than on research, it becomes clear this isn't true. If they stopped doing research they would run out of products to sell. Then they would cease to exist.
Even if the marketing statement was true, their need for marketing doesn't disappear if they have less profits due to price fixing. People need to know about their products. These companies will, because of reduced profits, have less money to put towards R&D and the smaller profit incentive will prevent them from taking more ambitious projects.
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@Alec
To put another message shortly...
I said price fixing would lead to some shortages and less medical innovation. Also said we need to fix how patents work so that drugs actually become generic, which would make price fixing unnecessary after 20 years(likely by when the companies recoup costs and make decent profits).
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@disgusted
Nah, they recently repatriated about a trillion dollars in capital.
Spilling Maori blood aint as profitable as it used to be.
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@bmdrocks21
Europe innovates new drugs at a comparable rate to the US on a per person basis.
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@bmdrocks21
most of the costs of healthcare come from hospitals, not drug prices, and general medical providers. would you be willing to use price fixing in the general medical provider setting, in the array of medical services provided by the industry? if not, how would you control costs?
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@Discipulus_Didicit
so you dont like price fixing and you say you dont know how to fix our system. aside from fixing patents, do you have any ideas about how to control costs if not price fixing? hospitals and general medical providers are where the major costs are, not drugs.
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@n8nrgmi
Do you have any ideas about how to control costs if not price fixing?
As I said before no, not really. I am not an expert in any of the fields which would be required to give a good solution to the problem. I have zero formal training in the science of economics or medicine and I am one of the rare type of people that is smart enough to not advance opinions on subjects that I know nothing about other than what I spent a few dozen or so hours reading on the internet.
I suppose you are part of the 99% of the population that thinks they do have a genius solution though. Feel free to lay it out for us if this is the case.
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@Discipulus_Didicit
i dont think price fixing is so bad. every other country does it and that's the main way they all spend half as much as we do. we wouldn't even have to go that severely low in costs. but we can do it enough to ensure everyone is covered and costs dont get too out of control. if you offer no alternative to price fixing, i would say stick with what works in the rest of the world wouldn't you? why should the usa be different?
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@Discipulus_Didicit
you would also need to explain more about 'shortages'. most of the problem we'd see with price fixing is that providers would just get paid less, that's mainly all there is. most things can be produced without running out of it, supplies and such. the main problem on the supply and demand side, is the wait time problem, and that's only a problem in canada and no where else, and can be fixed in canada or here too, if we want.
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@n8nrgmi
you would also need to explain more about 'shortages'.
Certainly. I will be using arbitrary numbers in this example to demonstrate the basic idea, this is obviously not an actual litteral example.
Say it takes 1 pound of cotton to produce a towel and 1 pound of cotton to produce a shirt. In this hypothetical market the laws of supply and demand currently put the cost of cotton at $10 per pound. Company A makes towels and sells them at profit for $20 and company B produces shirts and sells them at $20 each (for the sake of simplicity we are ignoring things such as labor costs, this is a forum post not an economic thesis!). The government decides that the cost of towels is too high and institutes a towel price control to fix the price at $12. Company A is still technically profitable but much less so than if they switch to producing shirts instead. After all they already have a bunch of cotton and even if them switching to shirts causes the price of shirts to drop to $15 due to increased supply and competition a $5 margin is better than a $2 margin.
So company A switches to making shirts and the price of cotton remains stable due to the fact that the demand for cotton remains the same. The problem here is that company A no longer produces any towels. People still need those towels though. The government has, through their good intentions, created a towel shortage.
We could delve deeper into this by discussing how a more economically authoritarian government might try to fix this. Should they institute a towel production quota? Should they put a price control on cotton so that the price is low enough for the margins on shirts and towels to be virtually the same, thus incentivising company A to switch back to towel production on their own to avoid the competition of the shirt market? Both of these solutions and more have their own problems but if you wish to discuss them more in depth I would rather do so in a different thread so as to not derail this one. I would happily explore this rabbit hole with you further if you made such a thread in the economics forum and tagged me in it.
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@n8nrgmi
most of the costs of healthcare come from hospitals, not drug prices, and general medical providers. would you be willing to use price fixing in the general medical provider setting, in the array of medical services provided by the industry? if not, how would you control costs?
Well, one factor about this is that unions lobbied the government to put quotas on the number of medical licenses given out per year. This reduces supply and therefore increases medical costs. One way to reduce costs would be to get rid of these quotas and simply allow anyone with the required skills to practice medicine.
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@Discipulus_Didicit
the problem is that you are being too abstract. in the abstract, price fixes cause shortages. but they dont always. what are some specific healthcare shortages that would result? for example of why you are too in the sky, is that we can mandate that bandaides can't cost more than a buck each. so is there a shortage of bandaids? probably not. it costs little to make them, and the producers would just make more and absorb the hit. they would just get paid less. the whole point.
medicare already does price fixtures. should we get rid of that and pay even more? if you like it in medicare why not everywhere else? what if insurance had to follow the same price fixtures that medicare has, plus maybe a little extra? i know people say the industry and providers can't do medicare prices, but why does it work in every other country?
you still haven't argued why we can't dabble in price fixtures if that's how every other country saves so much.
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@Discipulus_Didicit
As for the FDA taking a long time... I don't know as much about how the FDA works as I do about the patent office but I do know about the scientific method and my gut says that "10 years to clear a new drug" is probably not because the FDA is incompetent and more likely because that long of a time period is actually required for trials to be carried out properly.
I am not quite sure of why it takes this long. It could be incompetence, as typically happens in government bureaucracies, or it could be that trials take long periods of time. My guess would be a combination of both. Like I said, we could begin taking information verified by other developed countries, like Switzerland, into account. That could speed things up by reducing the burden of proof for drug companies.
Governmental control over the economy is one of the few cases where there actually is a slippery slope.
Yup. Precisely why I am trying to find fixes that will prevent such an event.
I don't claim to have an answer for how to fix the current healthcare system. I really truly don't and I doubt most people on this site that claim to do either. It is a lot more complicated that many are willing to admit. However, I do have enough experience with it to recognize that it is in need of fixing.
I don't think that this will solve all of our problems, but I certainly believe this could improve it.
Glad we could agree on most things.
:)
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@bmdrocks21
u've shown labor can be helped through more free market, and patents can be helped with tweeks, but there's a whole healthcare industry out there of medical suppliers who are also too expensive. the bulk of the costs. and you haven't shown how to approach that.
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@n8nrgmi
Could you elaborate more on the details of that issue and how you think we should fix it?
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@n8nrgmi
the problem is that you are being too abstract.
Yeah, that is pretty unavoidable. Again this is a forum post about the basic concept, not an economics thesis.
And again I think it would be better to take the discussion of government intervention in the economy to the economics forum if you wish to continue it.
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@bmdrocks21
price controls to control cost. every other country does that as the main way to cost half as much as we do, and they cover everyone with better results and less wait times to wait for a doctor. medicare spends a fifth less than insurance does, because they use price controls. medicaid spends a third less than medicare for that reason. these practices could in some form be extended to the whole industry.
here is some general information on all that plus a whole lot more for anyone looking at providing universal affordable care to the country.
insurance companies spend a third of their revenue on profit and adminstrative costs. medicare spends three percent on administrative costs and none on profit. due to all the actors involveas middlemen like insurance and the government, there are more medical billing specialists than there are nurses in many hospitals. we can see that the whole insurance industry can be streamlined on how it charges and maybe even minimized or reduced. just some more ideas on how to reduce costs through the government.