some thoughts on socialized medicine and the inflation of medicine

[jdub]

hey scooby, i kind of wanted to make sure that this got read and that some people would comment on it, otherwise i would have just posted it under your topic, i just think that it is a great topic for discussion.


socialized medicine

okay . . . to certain point, we do have some socialized health care, ie medicare and medicaid and other private social groups.

i personally think that we need to expand these programs to include everyone in the country that is not insured, at least at some basic level that would include regular check ups and a lot of preventative type stuff.

also, to take the pressure off of docs to want to become a high paid super specialist, i think that med school needs to cost a lot less.

how that would exactly work, i don't know, but i think in the long run they would pay for themselves by having less people getting really sick and less people using emergency rooms as their primary care physicians because they have no insurance, and by having less docs stuffed into big cities trying to all do specialties and sub specialties.

no system around the world is perfect, but it is clear that ours is having more problems with inflation than other developed countries, i don't know if it really is a crisis, but things need to be addressed, and of course they need to be addressed in a form that would fit the united states.

inflation of medicine

from what i understand the main reasons we have huge medical inflation is because of:

1) an over capacity in hospitals, which may be hard to believe, but if one gets outside of the huge cities, i am pretty sure that a lot of hospitals don't get used to capacity.

2) people demand and expect the regular use of all of that new and expensive technology that we have.

3) over specialization of doctors.

4) and of course, prescription drugs. i personally think this is a place where the government needs to step in and do some price regulating (ie our countries health over huge profit, and if you don't believe there is huge profit, why is this sector of the economy one of the largest and fastest growing?).

i am sure there are some more, but these are the main ones i can think of.

anyhow, some info and thoughts for whomever wants them. so feel free to critique and to add your input.

god bless us all.

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[BlackPuma]

I have a question for number #4

Isn't it true that a lot of the money goes for research? That would also explain why we lead the world in terms of new medication? don't you think?

 

[Hopkins2010]

On one hand, I am tempted to believe that pharmaceutical companies do make huge investments in R&D for future drugs.

After all these people are businessmen and realize that their future lies in their ability to come out with effective drugs.

I'm sure however that alot of the money generated from drug profits is pure profit that is not recycled back into drug R&D.

Now, we can try to regulate that, but the more we do it, the less capitalistic our nation becomes. That can be a good thing or a bad thing, depending on how you look at it.

I think simply saying that the drug companies are greedy profiteers oversimplifies the issue. We could simply reorganize the industry to where they hardly make a profit at all, which would surely bring down drug prices.

However, at what cost could we achieve this? Over time, more and more companies would decide to quit being involved in the drug business, and would seek greater profits in other areas. When that happens, drug discovery will slow way down. But maybe thats the price we need to pay for cheaper drugs. I leave that for you to decide. I just think we need to recognize that there will certainly be a tradeoff between highly advanced new drug research and the cost of drugs currently on the market. You cant have the best of both worlds.

 

[simpleton]

My beliefs are that in a capitalistic society that we live in that the government should play a minimal role in all of our lives. For instance, I feel its in everyone's best interest if the free market was kept free without government intervention. The government shouldn't spend millions of dollars in regulation stupid things, like whether a slide in a park should be 2ft instead of 3ft off the ground. This type of frivilousness just pisses our tax money away.

As far as socialized medicine, it doesn't seem to work. I would like to see everyone having equal access to medicine but that's not going to happen unless drastic measures happen which if they do occur will more than likely decrease the quality of care. Just look at the growth of HMO's in the past decade. As it is now and in the past, NO ONE can be turned away from health care. So what's wrong with the way it is now? Also, I feel as a capitalistic country, healthcare is a privalegde and not a right. There is nothing for free! And free-handouts end up costing tax payers! Unfortunately the cost of healthcare is rising rapidly and many companies are not able to provide healthcare benefits to its employess. I think HMO's are part to blame because of their piss/poor management of resources and not to mention their health bonuses for the head honchos. Medical care is expensive to start with and you have to realize that someone is going to have to pay for it. I just hope it's not our tax dollars that are going into a pot to allocate resources for everyones healthcare. As in canada and European countries who as most of us know has a healthcare delivery systems that is mediocre at best.

 

[rohitbest]

Simpleton, i think we disagree on health care systems, my post is on the other thread for socialized medicine, because of one statement you made. You feel health is a privelage, not a right. I feel the other way, I feel health is a right, not a privelage, and hence our disagreement. But i do agree with you that SOCIALized medicine is not the way to go, and also agree that there is nothing tremendously wrong with our system right now, but i think there will be if continued the way it is. Right now, the HMO is in control of the patient care that is recieved, and i think that is inherently wrong, the HMO Administrator did not and extra schooling to learn more about health and medicine, he/she did more business classes. I don't knwo what point that makes, but it says something i guess.

 

[sandflea]

our tax dollars are *already* going into a pot to help out others. how do you think federal aid programs--medical, social, etc--get funded? at some point it is always tied back to the average citizen's tax dollars.

 

[6 to 8 Weeks]

Prescription Drugs: Several new drugs like Prozac and Viagra are held by single firms like Roche and Pfizer. They charge quite a bit for these drugs and reap in large profits because they developed these drugs privately. However, once the copyrights run out, Prozac in 2003, generics can be made at a much lower price. There is an endless cycle where new drugs appear and are expensive while older drugs become cheaper. Its really these "new" drugs that have a large profit margin. Most other prescription drugs (generics) are more conservatively priced.

Increasing Health Care Costs: HMOs are not the sole responsibility of increasing health care costs. They take most of the blame, but really we have to look at standard inflation of the economy. Things just get expensive after a few years, prices never go down for a coke, so I doubt health care costs will. However, health care costs are rising at a greater rate than standard inflation. This may be due to the increasing number of malpractice lawsuits and the huge sums patients are awarded (1.5 million on average). These lawsuits undoubtedly raise malpractice insurance premiums which are passed on to patients.

 

[Bruin4Life]

I think a BIG factor in the inflation of medicine is the ADMINISTRATIVE WORK. The paperwork is very hairy, especially with the growth of managed care, I don't remember the exact percentage of money spent of administrative work relative to all other costs, but I remember being surprised.

 

[md2be06]

On average, it costs about $500 million in R & D costs to bring a drug to market. Granted this varies from drug to drug, but if it's a blockbuster, the potential profits far exceed the costs. I was talking to a drug rep the other day about the patents on these things. Most are for 20 years or so. Imagine that, 20 years of steady profits, and the only thing you really have to worry about is production costs which are next to nothing. Also at the end of 20 years, most companies receive extensions on their patents, so they can make even more money. I have numerous relatives in the medical field, and it pisses them off to no end that their patients can't even afford these drugs b/c of their ridiculuous prices. Pharmaceutical companies are making a killing.

 

[SMW]

Originally posted by md2be06:
•On average, it costs about $500 million in R & D costs to bring a drug to market. Granted this varies from drug to drug, but if it's a blockbuster, the potential profits far exceed the costs. I was talking to a drug rep the other day about the patents on these things. Most are for 20 years or so. Imagine that, 20 years of steady profits, and the only thing you really have to worry about is production costs which are next to nothing. Also at the end of 20 years, most companies receive extensions on their patents, so they can make even more money. I have numerous relatives in the medical field, and it pisses them off to no end that their patients can't even afford these drugs b/c of their ridiculuous prices. Pharmaceutical companies are making a killing.•

Plus, there's a new development, in which companies whose drug patents are about to run out, "tweak" or "improve" the drug in some minor way so that they can declare it a new drug and get a new patent, thus insuring another 20 years of high profits.

 

[jdub]

6-8 weeks,

i just wanted to say that i don't agree with you blaming inflation on hmos, in fact, they have helped keep costs down. they just have lost there grip on things as of late because of inflation, and i imagine, a higher set of morals. managed care is not some crazy idea, it is necesary and practical. on the other hand, i don't like the idea of a for-profit hmo, that just seems to be a conflict of interest.

also, how can one say that socialized medicine does not work? people hear a few extreme examples of canada and britain and all of a sudden these systems don't work?

they all have their problems, as ours does, but we spend a lot more of our gnp on health care than anybody. and we have more uninsured (btw canada is at one extreme, ie almost all run by government, and we are at the other end, ie almost all run by the free market and germany is somewhere in the middle.)

i have a lot of gripes against capatalism, but i really hope that poeple can agree that health care is a right. where's the love?

i just can't imagine how somebody could be comfortable marginalizing anybody, especially in the united states, one of the most powerful and wealthy nations in the world.

as for pharmacueticals, yeah there is a lot of overhead to make a finished product and actually get a patent and to put it on the market, but many companies are doing more than okay.

that whole industry is just sketchy, i can't remeber how many times in the last year i have read of false or misleading results to get a drug out. even med journals are fed up with it, they are all starting to agree that they won't publish stuff that can't verify that their report is valid and is not misleading.

also, like it or not, companies like pfizer, and god knows how many others, are very wealthy. why do they have to make so much? when is enough enough?

greed has nothing to do with medicine.

 

[6 to 8 Weeks]

jdub: I think you may be addressing the socialized medicine argument of someone else. I did not talk about a national health plan at all.

Also pharm. co's are that, they are companies. They have a right to run their business as they wish, even at the expense of patients. That's just a by-product of our free economy, and what makes it the best in the world. Maybe we are better off subsidizing the expensive drugs instead of cripling pharm companies.

I'm just a little weary of government intervention in private companies, especially as a california resident who pays soo much for flaky electricity.

 

[Smoke This]

Over the last 20 years (according to a recent book I read), health care spending has increased at a 6% inflation-adjusted rate. Half of that increase is due to technology.

I don't think HMOs are to blame to such an extent. They are trying to control spending, not encourage it, but almost everything they have been able to do to save money are one-time fixes (like vertical integration, streamlining the administrative stuff, etc.), and they can't keep spending down without curtailing necessary care. That's why premiums and copayments are (or at least were) going up.

 

[SicVic]

Don't you think that HMO's might actually be increasing the long term costs due to denying necessary preventive treatments?
I grew up with the notion of
"Prevention is better than cure" and I am sure there other words of wisdom with the same idea.
The Healthcare system in the U.S is not concerned about prevention at all. Many of the diseases that are costing the taxpayers are preventable. As a volunteer at an E.R. in NY long Island ...Majority of the visiting patients diagonosed with heart disease !

 

[8675309]

Okay, first everybody needs to quit living a utopian America and look at how the country really works to find a pragmatic solution.

The Drug Companies:

You REALLY think that our government officials at any level are going to put significant restrictions are drug companies. These companies bankroll entire campaingns and have entire departments (ie "PR") developed to buy politicians, just like any profitable, well run corporation. So forget about these pie in the sky regulations that you "hope" will be put into place sometime in the "future" (ie never).

Managed Care, Socialized Medicine, whatever:

Look America has a long tradition of pluralism as individuals and as groups. If there's one thing most Americans hate it's being told what they HAVE to do and where they HAVE to go. It's as American as mom, apple pie, and baseball (okay baseball isn't as popular as it used to be)

You want to know what the two best "drugs" for anyone at any age? A responsible diet and regular exercise. We've known this for over forty years yet, we're fatter and sicker today than we were back then. Why?
Americans don't like to be told what they HAVE to do. It's easier and tastes better to order pizza and sit on the couch watching a game or movie all afternoon than it is to eat well and exercise instead.

Therefore Managed Care had a great start because of its initial cost savings but now even Managed Care can't keep Americans from doing what Americans WANT to do. They WANT to go to whatever doctor they choose. They WANT to get the very best treatment available for themselves and their families, as would anyone. It's easy to talk about the need for healthcare rationing when its not your mother or wife or father or husband whose dying or suffering. Try it when it is.

You think socialized medicine would be a good idea. Maybe in other countries it can and does work but not this country, not at this time. Either the patients will reject it or the politicians and their endless bureaucracies will make it so cumbersome and wasteful that we'll wish for the good old days (ie now). There will still be people falling through the cracks.

The only pragmatic solution to these and other problems facing medicine is to have a national committee or convention or whatever you want to call it. Bring together economists, business officials, politicians, doctors, administrative personnel, patients, etc to discuss the various options and find the most acceptable for the U.S., not for the world.

What you thought I was going to give you the answers, no one person or group has the answer to such complicated problems, anyone who does shows her or his ignorance and arrogance.

 

[synite]

i think it would be insane to regulate drug pricing. how would one regulate it? you can't say "your profit margin cannot exceed 50% of development costs." all that would do is incentivize each company to charge up to whatever limit imposed on them. you take away a company's profits, you shut down the company. bam, no new drugs.

socialized medicine cannot work in the USA. lots of people say socialized medicine is equal access to care for all. BULL. healthcare is a scarce good that has to be rationed. this may sound less than humane, but it's the truth. in socialized medicine, you take away the natural supply-demand dynamic, and everyone demands more care than they would if healthcare was completely privatized. the result is huge waiting lists, lines, and substandard care. why substandard care? because telling a doctor he will make $150,000 whether he sees 10 patients or 200 patients is taking away any incentive to work harder, help more, and do better.

that said, there IS a role for government in the healthcare industry. healthcare is not only an individual and private quality. the effects of ill health ripple through society in the form of lost productivity, unhappiness, and unrest. the gov't should provide some kind of minimal care to all people. right now, this is done by ensuring that NO ONE is denied emergency care. however, this can be taken a step further to provide basic preventive care, reducing the need for more expensive emergency care in the future.