Thoughts about Elizabeth Warren's New Health Plan?

[deleted927028]

Just like they do at the VA... You know the govt run healthcare system we have



Make it easier for pharm manufacturers to get into the market and you wouldn't see any of this happen... You know because competition. This only happens when others are prevented from getting into the market by either onerous regulations or medical legal costs...
So more government is probably not the answer but rather less

Only negotiation and price controls will stop the price gauging . Every other country knows this, understand this. Somehow it is too complex for us to comprehend. Expecting free market will work for EVERYTHING is naive and ignorant.

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[deleted927028]

The EMR does not have to be a sucky one like Allscripts. Using its negotiation power the government could get a nice EMR like Epic for everyone.

I have no problems when a pharma company charges more for a disease curing medication like Harvoni. But I get angry when pharma companies use their connections to extort medicare/ private insurances and increase the costs for all of us. Products that come to mind are Epipen by Mylan, Daraprim by Turing Pharma , Colcrys by Takeda. These pharma companies are not charging appropriately compared to what they spent on R&D.

All this price gouging happens only in America, nowhere else. They are doing it because we are foolish to let them do it.

 

[VA Hopeful Dr]

Only negotiation and price controls will stop the price gauging . Every other country knows this, understand this. Somehow it is too complex for us to comprehend. Expecting free market will work for EVERYTHING is naive and ignorant.

Hogwash. The problem is we don't have a free market for drug prices. The few times we do, it works well.

For example, most new oral meds run around $10/pill. Stuff like Januvia or Livalo run $300/month.

However, if you look at the brand name weight loss meds that insurance never covers they run more like $3-4/pill. Contrave runs $100/month.

 

[Instatewaiter]

All this price gouging happens only in America, nowhere else. They are doing it because we are foolish to let them do it.

So price gouging is a bogus term used by those who clearly don't understand supply and demand basics .

The issue with a high price is that demand outstrips supply. The remedy is not force the price down artificially; this only worsens the underlying supply issue. The remedy is to increase the supply and you do this by decreasing barriers to competition and entry within a market.

This is why a large flat screen TV cost $20,000 in 1997 and now you can pick on up for $500. It sure as **** wasn't due to price controls but rather good 'Ol capitalism. If the govt imposed price controls in 1997 you and I would still be paying 10 grand for a TV...

 

[Cornfed101]

So price gouging is a bogus term used by those who clearly don't understand supply and demand basics .

The issue with a high price is that demand outstrips supply. The remedy is not force the price down artificially; this only worsens the underlying supply issue. The remedy is to increase the supply and you do this by decreasing barriers to competition and entry within a market.

This is why a large flat screen TV cost $20,000 in 1997 and now you can pick on up for $500. It sure as **** wasn't due to price controls but rather good 'Ol capitalism. If the govt imposed price controls in 1997 you and I would still be paying 10 grand for a TV...

Part of the problem is drugs are initially patent protected. This essentially creates a temporary monopoly that allows artificial changes to the price that aren't related to supply or demand. I agree with you otherwise. It is just a little more complicated than simply supply/demand. The evidence that this affects the price is looking at the generic drug price after the patent expires.

It might seem reasonable to eliminate this patent protection, but this could stifle the development of new drugs. Not sure what the best solution is.

 

[deleted480308]

Part of the problem is drugs are initially patent protected. This essentially creates a temporary monopoly that allows artificial changes to the price that aren't related to supply or demand. I agree with you otherwise. It is just a little more complicated than simply supply/demand. The evidence that this affects the price is looking at the generic drug price after the patent expires.

It might seem reasonable to eliminate this patent protection, but this could stifle the development of new drugs. Not sure what the best solution is.

Accepting that someone required to drop a billion to develop a drug make a profit for their risk with the knowledge it will eventually go generic

 

[deleted927028]

Hogwash. The problem is we don't have a free market for drug prices. The few times we do, it works well.

For example, most new oral meds run around $10/pill. Stuff like Januvia or Livalo run $300/month.

However, if you look at the brand name weight loss meds that insurance never covers they run more like $3-4/pill. Contrave runs $100/month.

What do you mean we don’t have free market for drugs? Drug companies are pretty much FREE to charge what they want. It is free market for them, only for consumers it is not. Januvia is essential for diabetics patients but weight loss drugs are not essential for anyone. That’s the reason for the price gouging. I am pretty sure the same US companies only less than 10% in other countries, because the governments there care about their people and those citizens are not naive and dumb to think that any government involvement is loss of freedom, socialism or communism. So we have no choice but to suffer. That is the price we pay for our stupidity

 

[deleted927028]

So price gouging is a bogus term used by those who clearly don't understand supply and demand basics .

The issue with a high price is that demand outstrips supply. The remedy is not force the price down artificially; this only worsens the underlying supply issue. The remedy is to increase the supply and you do this by decreasing barriers to competition and entry within a market.

This is why a large flat screen TV cost $20,000 in 1997 and now you can pick on up for $500. It sure as **** wasn't due to price controls but rather good 'Ol capitalism. If the govt imposed price controls in 1997 you and I would still be paying 10 grand for a TV...

First of all, you have to understand the basics of supply and demand before preaching others. I never met an American who understood that the supply and demand will not work for ESSENTIAL things and services and the consumers can be able to walk away if they felt the price is too high. It is such a trivial concept that is understood by EVERY OTHER COUNTRY. The TV price dropped from $20k to $500, not because of more supply, but very few will buy at $20k. For some reason, if everyone is forced to buy the TV at $20k (like $800 for Epipen vs $2 actual cost or $2000 for aids medicine vs $20 in Australia) , do you think the TV manufacturers will sell TVs for $500? Please don’t be dishonest or naive?

 

[AnatomyGrey12]

What do you mean we don’t have free market for drugs? Drug companies are pretty much FREE to charge what they want. It is free market for them, only for consumers it is not. Januvia is essential for diabetics patients but weight loss drugs are not essential for anyone. That’s the reason for the price gouging. I am pretty sure the same US companies only less than 10% in other countries, because the governments there care about their people and those citizens are not naive and dumb to think that any government involvement is loss of freedom, socialism or communism. So we have no choice but to suffer. That is the price we pay for our stupidity

So your back at rattling off statements that are very easily proven wrong I see...

 

[VA Hopeful Dr]

What do you mean we don’t have free market for drugs? Drug companies are pretty much FREE to charge what they want. It is free market for them, only for consumers it is not. Januvia is essential for diabetics patients but weight loss drugs are not essential for anyone. That’s the reason for the price gouging. I am pretty sure the same US companies only less than 10% in other countries, because the governments there care about their people and those citizens are not naive and dumb to think that any government involvement is loss of freedom, socialism or communism. So we have no choice but to suffer. That is the price we pay for our stupidity

You have no idea what a free market is, do you?

I can guarantee that if tomorrow insurance companies stopped covering Januvia, the price would go down very very quickly.

The price is what it is because insurance companies will pay it (or other drugs like it).

 

[Cornfed101]

Drug companies are pretty much FREE to charge what they want. It is free market for them, only for consumers it is not.

That’s not what a free market is. You are funny. The reason prices are high is because it is NOT a free market. There is no competition. Drug companies charge what they do because insurance companies will pay it and they have a monopoly. Having the government artificially limit prices is not the best solution.

 

[deleted480308]

What do you mean we don’t have free market for drugs? Drug companies are pretty much FREE to charge what they want. It is free market for them, only for consumers it is not. Januvia is essential for diabetics patients but weight loss drugs are not essential for anyone. That’s the reason for the price gouging. I am pretty sure the same US companies only less than 10% in other countries, because the governments there care about their people and those citizens are not naive and dumb to think that any government involvement is loss of freedom, socialism or communism. So we have no choice but to suffer. That is the price we pay for our stupidity

januvia is absolutely not essential for diabetics. It has some benefits over some other meds but they could all live without it

 

[Nephro critical care]

What if over the next month COVID-19 in USA becomes an italy-sized epidemic and hospitals get overwhelmed with critically ill patients ? Covid-19 pts can stay in the ICU for a week or more and need expensive therapies like VV ecmo and proning. What will happen to AETNA and Anthem. They will go belly up with the costs.
Where is all the money to treat these patients come from. Especially if there is a Wuhan or Italy style lockdown.
40-50% people dont have $400 in the bank. There will be an enormous amount of medical bankruptcy. At that point the government will step in ; declare health care an essential service and doctors to work for minimal wages or free.

 

[findoc]

What do you mean we don’t have free market for drugs? Drug companies are pretty much FREE to charge what they want. It is free market for them, only for consumers it is not. Januvia is essential for diabetics patients but weight loss drugs are not essential for anyone. That’s the reason for the price gouging. I am pretty sure the same US companies only less than 10% in other countries, because the governments there care about their people and those citizens are not naive and dumb to think that any government involvement is loss of freedom, socialism or communism. So we have no choice but to suffer. That is the price we pay for our stupidity

The driver of innovation is potential for profit. Period. There is nothing else.

Imagine you're running the R&D division of a pharmaceutical company. What drives your decision-making? Cost versus benefits. Is the R&D expense worth it? Well that depends on the economic market for the drug once its created. The fact that drugs like Januvia are "essential" effectively secures demand and as such improves potential for profit. All else equal, more essential drugs are the ones companies want to create. Further, patent protections secure that the supply side will be limited (at least for a period) and as such improves potential for profit for the firm.

This is great for society. In a thriving market, companies will compete to create new drugs that can be used to treat suffering patients. Will some drugs end up not working? Yes. Will some drugs have unforeseen negative side effects? Yes. Those are characteristics of the pharmaceutical innovation process itself, not the capitalist system.

What would you propose as an alternative to the free-market, capitalist system for pharmaceutical innovation? A government-run system? Does it make it more efficient or more fair? No. Pharmaceutical innovation is a risky business, and in a capitalist system investors are allowed to choose whether they want to risk their capital in an investment or not. Those that risk their capital are sometimes handsomely rewarded, and other times they lose. However, if innovation is funded by tax-payers, not only is there no mechanism to incentivize efficiency and minimize costs (because there is no profit motive), all tax-payers are forced to participate whether they want to or not. It restricts freedom and is far from fair.

Think of the system as a machine. How does the machine work? How can we make it work better?

 

[Nephro critical care]

The driver of innovation is potential for profit. Period. There is nothing else.

Wrong. Not everyone is a greedy son of a b.... whose only motive in life is money. Some people actually live to make the world a better place.

 

[Nephro critical care]

Let me give you a scenario that is not altogether implausible. CDC estimates that up to 160 million Americans could be affected by coronavirus. Out of these up to 10% i.e 16 million would need hospitalization and 8 million need ICU admission. Each ICU admission could cost up to $100,000. Thats 800 Billion $. Where is that gonna come from.
And then some Wall Street company spends 10 million for R&D and comes up with an anti-viral that has some benefit. And then set a price of 50 K for a course which 20 Million people need. Are we gonna pay that scumbag 1 trillion ?

 

[findoc]

Wrong. Not everyone is a greedy son of a b.... whose only motive in life is money. Some people actually live to make the world a better place.

Ok, so you equate profit to greed? Come on, that's so superficial! You can make a stronger argument than that!

Why can I not do what I love and be rewarded for it at the same time? Innovation is a risky endeavor that requires capital and labor. It is not greedy to want to be rewarded for risking your own money. Do you really believe that passionate people who take smart risks and work tirelessly to create something valuable do not deserve to be rewarded?

By the way, developing new products that are economically valuable does, in fact, make the world a better place. SMH.

 

[deleted480308]

Let me give you a scenario that is not altogether implausible. CDC estimates that up to 160 million Americans could be affected by coronavirus. Out of these up to 10% i.e 16 million would need hospitalization and 8 million need ICU admission. Each ICU admission could cost up to $100,000. Thats 800 Billion $. Where is that gonna come from.
And then some Wall Street company spends 10 million for R&D and comes up with an anti-viral that has some benefit. And then set a price of 50 K for a course which 20 Million people need. Are we gonna pay that scumbag 1 trillion ?

Put your own $10mil up as risk to find a treatment and then don’t charge for it if you are so altruistic.

But if we want to motivate the most people to put up their financial assets at risk to solve a problem they need to believe there is a chance of it paying off in a way they find reasonable

 

[Cornfed101]

Thats 800 Billion $. Where is that gonna come from.

do you have a solution or just a problem? Do you suggest the government just print $800 billion and hope that solves the problem?

 

[findoc]

And then some Wall Street company spends 10 million for R&D and comes up with an anti-viral that has some benefit. And then set a price of 50 K for a course which 20 Million people need. Are we gonna pay that scumbag 1 trillion ?

Wow, this is just... lol.

You're proving my point. Put the economic incentive there and the innovation gets done.

 

[Nephro critical care]

do you have a solution or just a problem? Do you suggest the government just print $800 billion and hope that solves the problem?

I suggest the government use its power to make healthcare run leaner, cut down costs and treat those 8 million ICU pts for $80 Billion rather than $800 Billion. The intensivist works for $25/hr rather than $250/hr. The pharma company charge for what the R&D cost ; not 50 times R&D cost.
And being an intensivist myself I would happily work for $25/hr provided I knew every intensivist was doing the same.

 

[VA Hopeful Dr]

I suggest the government use its power to make healthcare run leaner, cut down costs and treat those 8 million ICU pts for $80 Billion rather than $800 Billion. The intensivist works for $25/hr rather than $250/hr. The pharma company charge for what the R&D cost ; not 50 times R&D cost.
And being an intensivist myself I would happily work for $25/hr provided I knew every intensivist was doing the same.

So you're only willing to put your money where your mouth is if everyone else has to do the same. Why is that?

 

[findoc]

I suggest the government use its power to make healthcare run leaner, cut down costs and treat those 8 million ICU pts for $80 Billion rather than $800 Billion. The intensivist works for $25/hr rather than $250/hr. The pharma company charge for what the R&D cost ; not 50 times R&D cost.
And being an intensivist myself I would happily work for $25/hr provided I knew every intensivist was doing the same.

I know your intention is good, and I guess I recognize the appeal of having a politician step in and dictate who gets what care at what expense, but this is not at all practical.

 

[deleted480308]

I suggest the government use its power to make healthcare run leaner, cut down costs and treat those 8 million ICU pts for $80 Billion rather than $800 Billion. The intensivist works for $25/hr rather than $250/hr. The pharma company charge for what the R&D cost ; not 50 times R&D cost.
And being an intensivist myself I would happily work for $25/hr provided I knew every intensivist was doing the same.

just stop paying us? that's absurd

 

[Cornfed101]

@Nephro critical care this article is a bit old, but still relevant

here is a little taste (the entire thing is excellent)

"How much should a person earn if he or she must (a) get excellent grades and a fine educational foundation in high school in order to (b) be accepted by a good college and spend four years taking courses heavy in math, physics, chemistry and other lab work and maintain a 3.5 average or better, and (c) spend four more years of grinding study in medical school, with the 3rd and 4th years in clinical training, working 80 to 100 hours a week, and (d) spend another year as a low-pay, hard-work intern, and (e) put in another 3 to 10 years of post-graduate training, depending on your specialty and (f) maybe wind up $100,000 (over double this now) in debt after medical school and (g) then work an average of 60 hours a week, with many family doctors putting in 70 hours or more until they retire or fall over?"

 

[Nephro critical care]

So you're only willing to put your money where your mouth is if everyone else has to do the same. Why is that?

I am willing to sacrifice for the greater good of society but I expect fairness i.e everyone else does the same. If the government applies a 10% wealth tax on everyone with liquid assets > 100 K I have no problem paying my share if everyone was being taxed equitably. Not fair if I paid 50 K and Wall Street gets away as usual.

 

[AnatomyGrey12]

declare health care an essential service and doctors to work for minimal wages or free.

I suggest the government use its power to make healthcare run leaner, cut down costs and treat those 8 million ICU pts for $80 Billion rather than $800 Billion. The intensivist works for $25/hr rather than $250/hr. The pharma company charge for what the R&D cost ; not 50 times R&D cost.
And being an intensivist myself I would happily work for $25/hr provided I knew every intensivist was doing the same.

You want a real answer? In that scenario I straight up walk away. I’m not putting myself and everyone I interact with at home at risk for that amount of money. There would be a mass exodus out of medicine if this happened.

I am willing to sacrifice for the greater good of society but I expect fairness i.e everyone else does the same. If the government applies a 10% wealth tax on everyone with liquid assets > 100 K I have no problem paying my share if everyone was being taxed equitably. Not fair if I paid 50 K and Wall Street gets off as usual.

So no. You aren’t actually willing to make sacrifices for the “good of society.”

 

[deleted480308]

I am willing to sacrifice for the greater good of society but I expect fairness i.e everyone else does the same. If the government applies a 10% wealth tax on everyone with liquid assets > 100 K I have no problem paying my share if everyone was being taxed equitably. Not fair if I paid 50 K and Wall Street gets away as usual.

wealth tax now? Do you not have a limit to what you would have the govt do to others?

 

[deleted927028]

That’s not what a free market is. You are funny. The reason prices are high is because it is NOT a free market. There is no competition. Drug companies charge what they do because insurance companies will pay it and they have a monopoly. Having the government artificially limit prices is not the best solution.

“Having the government artificially limit prices is not the best solution.” Really? So you say you know better than the rest of the countries in the world? Limiting the price is the only way to keep things under control for essential things and services. Otherwise THEY will take away everything away from you if you fall sick no matter how much you have. I am banging my head against the wall wondering why such smart and educated people allow themselves to be brainwashed without asking any questions or open their eyes.

 

[deleted927028]

Let me give you a scenario that is not altogether implausible. CDC estimates that up to 160 million Americans could be affected by coronavirus. Out of these up to 10% i.e 16 million would need hospitalization and 8 million need ICU admission. Each ICU admission could cost up to $100,000. Thats 800 Billion $. Where is that gonna come from.
And then some Wall Street company spends 10 million for R&D and comes up with an anti-viral that has some benefit. And then set a price of 50 K for a course which 20 Million people need. Are we gonna pay that scumbag 1 trillion ?

Very well explained.

 

[deleted480308]

“Having the government artificially limit prices is not the best solution.” Really? So you say you know better than the rest of the countries in the world? Limiting the price is the only way to keep things under control for essential things and services. Otherwise THEY will take away everything away from you if you fall sick no matter how much you have. I am banging my head against the wall wondering why such smart and educated people allow themselves to be brainwashed without asking any questions or open their eyes.

on this topic? yes, we know more than the rest of the world

 

[deleted927028]

Ok, so you equate profit to greed? Come on, that's so superficial! You can make a stronger argument than that!

Why can I not do what I love and be rewarded for it at the same time? Innovation is a risky endeavor that requires capital and labor. It is not greedy to want to be rewarded for risking your own money. Do you really believe that passionate people who take smart risks and work tirelessly to create something valuable do not deserve to be rewarded?

By the way, developing new products that are economically valuable does, in fact, make the world a better place. SMH.

People have to make profit on their investments. Agreed. But the question is HOW MUCH? If a company sells a medicine $20 a course in Australia and $2000 in USA , isn’t it atrocious and stupid ? Things like this happen here and bankrupt people because there is no price controls here as it is in EVERY OTHER COUNTRY. Why are people like you are so adamant to acknowledge it? Our citizens should not be made to pay more than the rest of the world for any medicine. PERIOD. Otherwise it is just plain theft.

 

[VA Hopeful Dr]

“Having the government artificially limit prices is not the best solution.” Really? So you say you know better than the rest of the countries in the world? Limiting the price is the only way to keep things under control for essential things and services. Otherwise THEY will take away everything away from you if you fall sick no matter how much you have. I am banging my head against the wall wondering why such smart and educated people allow themselves to be brainwashed without asking any questions or open their eyes.

Have you considered that it's because we both know something you don't and have different views compared to other places?

For example, I'm going to give you an example of how well the free market can work if allowed to.

the number of years ago I was working for a practice that had a medication dispensary, basically we could dispense medicines to our own patients like a pharmacy. About a year after I got there, Crestor went generic. when there was just one generic on the market, the price was not significantly different from the brand name drug. However, the month a second generic went on the market the price decrease from $25 per pill to $3 per pill.

That's what the free-market can do for drugs.

 

[VA Hopeful Dr]

People have to make profit on their investments. Agreed. But the question is HOW MUCH? If a company sells a medicine $20 a course in Australia and $2000 in USA , isn’t it atrocious and stupid ? Things like this happen here and bankrupt people because there is no price controls here as it is in EVERY OTHER COUNTRY. Why are people like you are so adamant to acknowledge it? Our citizens should not be made to pay more than the rest of the world for any medicine. PERIOD. Otherwise it is just plain theft.

The problem is, what if the price they're selling it to other countries for is enough to cover the actual manufacturing costs of the medication but not the research and development costs?

I won't claim to know the full financial situation of any drug company, but it wouldn't surprise me if we are single-handedly funding all of the research and development the drug companies are doing.

 

[deleted927028]

I know your intention is good, and I guess I recognize the appeal of having a politician step in and dictate who gets what care at what expense, but this is not at all practical.

It is not rocket science. Just look at what every other country do and just copy it. We don’t have to pretend we are on some other planet and WE KNOW BETTER THAN OTHER COUNTRIES IN EVERYTHING.

 

[deleted927028]

just stop paying us? that's absurd

Not stop paying you. Just pay you fairly like every other country.

 

[AnatomyGrey12]

For example, I'm going to give you an example of how well the free market can work if allowed to.

the number of years ago I was working for a practice that had a medication dispensary, basically we could dispense medicines to our own patients like a pharmacy. About a year after I got there, Crestor went generic. when there was just one generic on the market, the price was not significantly different from the brand name drug. However, the month a second generic went on the market the price decrease from $25 per pill to $3 per pill.

That's what the free-market can do for drugs.

It is not rocket science. Just look at what every other country do and just copy it. We don’t have to pretend we are on some other planet and WE KNOW BETTER THAN OTHER COUNTRIES IN EVERYTHING.

@LoveAll respond to the top post please. Instead of spouting the same 5 talking points and ignoring direct contradictions to your statements you need to start directly addressing them. We're waiting.

 

[AnatomyGrey12]

Not stop paying you. Just pay you fairly like every other country.

Right. Because UK doctors are paid so fairly they have to beg foreign docs to come work there since their own people won't do it.

 

[deleted927028]

Have you considered that it's because we both know something you don't and have different views compared to other places?

For example, I'm going to give you an example of how well the free market can work if allowed to.

the number of years ago I was working for a practice that had a medication dispensary, basically we could dispense medicines to our own patients like a pharmacy. About a year after I got there, Crestor went generic. when there was just one generic on the market, the price was not significantly different from the brand name drug. However, the month a second generic went on the market the price decrease from $25 per pill to $3 per pill.

That's what the free-market can do for drugs.

Well, the desperate patients don’t have the luxury of waiting for the free market to bring the prices down. They need the medicine NOW with a fair price.

 

[VA Hopeful Dr]

Looks like somebody got a mod spanking. Behave, I'd hate to see you get banned.

 

[deleted927028]

The problem is, what if the price they're selling it to other countries for is enough to cover the actual manufacturing costs of the medication but not the research and development costs?

I won't claim to know the full financial situation of any drug company, but it wouldn't surprise me if we are single-handedly funding all of the research and development the drug companies are doing.

I don’t believe any of it. They are just plain thieves. Even if it is true, it is outright wrong. No one has the right to charge some innocent guy to pay for the rest of the world WITHOUT THEIR CONSENT.

 

[AnatomyGrey12]

Looks like somebody got a mod spanking. Behave, I'd hate to see you get banned.

Mods are VERY quick to pull the trigger these days. That said, I will behave.

 

[VA Hopeful Dr]

Well, the desperate patients don’t have the luxury of waiting for the free market to bring the prices down. They need the medicine NOW with a fair price.

So there's a few things to unpack in this.

First, it's pretty rare that there is only 1 treatment option. I can't remember the last time a patient couldn't afford a medication and I had no other acceptable treatment to offer.

Second, let's say that we do exactly what you suggest and just declare what the price is for a new drug. If that price point restricts the drug company's profit enough they may decide it's not worth trying to come up with any new drugs. We're potentially screwing the future to help the present.

Third, part of the reason this is even a thing is our patent laws. Right now you get over 15 years before a generic can be made. Cut that down and you'll get lower prices sooner.

 

[VA Hopeful Dr]

I don’t believe any of it. They are just plain thieves. Even if it is true, it is outright wrong. No one has the right to charge some innocent guy to pay for the rest of the world WITHOUT THEIR CONSENT.

So first, you always have the right to charge whatever you want. I have the option of saying "nope, that's too expensive I'm not buying it".

Beyond that, if the scenario I proposed is true we're stuck paying for the rest of the world because every other country is doing exactly what you propose we do here.

Let me try an analogy. Let's say that it costs the gas station $2 per gallon to purchase gasoline. The government decides that the gas station can only charge exactly $2/gallon to cars. But, there is no rule in place for commercial tractor-trailers. So they get charged $4/gallon, the price needed to keep the gas station open. Is charging the tractor-trailers more to keep the gas station open really unethical?

No, it's not.

 

[deleted927028]

Looks like somebody got a mod spanking. Behave, I'd hate to see you get banned.

Yeah, ban everyone if they don’t agree with us. Easy solution. Looks like we don’t mind being Chinese and Russians when it suits us.

More than 700 thousand people go bankrupt every year because of the best healthcare system we have in the world. This is in spite of paying $25000 or more in premiums, deductibles and copays. Every other country is paying only half, a third or even less than that and no one goes bankrupt . In fact they don’t pay a penny over their premium. My frustration comes from this. On top of it, according to Harvard study, the healthcare cost in USA will exceed the median household income in just 10 years. Is it sustainable? What is your solution ? You want everyone go bankrupt? I am ready to listen. Answer this question before crying to mods and ask them to ban me.

 

[findoc]

People have to make profit on their investments. Agreed. But the question is HOW MUCH? If a company sells a medicine $20 a course in Australia and $2000 in USA , isn’t it atrocious and stupid ? Things like this happen here and bankrupt people because there is no price controls here as it is in EVERY OTHER COUNTRY. Why are people like you are so adamant to acknowledge it? Our citizens should not be made to pay more than the rest of the world for any medicine. PERIOD. Otherwise it is just plain theft.

If you can construct an argument for price controls based on economics, then I will listen. What kink does it fix to make the system work more efficiently? Perhaps we have something to learn from other countries. I am open to that idea. But you screaming "PRICE CONTROLS!" is not going to change my mind.

Let me explain my view, and you are free to prove me wrong.

Pharmaceutical companies generally face a high upfront R&D cost and low variable cost. That is, the cost to develop a drug is high, but once the drug is developed, the marginal cost of producing an additional pill is very low. Ideally, we want an economic system that properly rewards the large R&D investment but also ensures the consumer will eventually have access to the medicine at a reasonable cost. Can we agree on this?

Here's the problem as I see it. The U.S. allows pharmaceutical companies to gauge potential demand and find a price point that optimizes revenue. However, the company recognizes that non-U.S. markets enact price controls well below that price point. Because the marginal cost of producing the drug is low, the company still sells outside of the U.S. In equilibrium, the lower is the non-U.S. controlled price, the greater will the optimal selling price point of the drug in the U.S. This means that U.S. consumers are effectively subsidizing non-U.S. consumers in the form of paying a higher price! These price controls represent an unfair inefficiency in the system that should be removed! This should make you angry!

Keep in mind that most patents have an expiration. Sure, the medicine may be expensive for a time. But we are glad it was produced in the first place and will one day be offered as a low-cost generic alternative. One thing is certain: we don't want to kill the system generates pharmaceutical innovation.

 

[deleted480308]

Not stop paying you. Just pay you fairly like every other country.

The govt shouldn’t be deciding my worth, that should be the patient

 

[Cornfed101]

“Having the government artificially limit prices is not the best solution.” Really? So you say you know better than the rest of the countries in the world? Limiting the price is the only way to keep things under control for essential things and services. Otherwise THEY will take away everything away from you if you fall sick no matter how much you have. I am banging my head against the wall wondering why such smart and educated people allow themselves to be brainwashed without asking any questions or open their eyes.

Let’s compare it to another inefficient price control. Rent control. Every economist (every smart one), regardless of political affiliation, believes that it is garbage. Why? Because if you limit price it doesn’t actually help most people. It helps a few people (that are lucky enough to get the housing), but then everyone else has to pay more! This is what we are trying to say is happening and will be worsened if the government controls the price. There will be shortages, R&D will be stifled, and people will still be without the medicines they need. Also, I didn’t just read about Econ on the internet. I majored in it. I do know more than the average person.

 

[VA Hopeful Dr]

Yeah, ban everyone if they don’t agree with us. Easy solution. Looks like we don’t mind being Chinese and Russians when it suits us.

More than 700 thousand people go bankrupt every year because of the best healthcare system we have in the world. This is in spite of paying $25000 or more in premiums, deductibles and copays. Every other country is paying only half, a third or even less than that and no one goes bankrupt . In fact they don’t pay a penny over their premium. My frustration comes from this. On top of it, according to Harvard study, the healthcare cost in USA will exceed the median household income in just 10 years. Is it sustainable? What is your solution ? You want everyone go bankrupt? I am ready to listen. Answer this question before crying to mods and ask them to ban me.

That post wasn't directed at you, it was directed at the poster who is on probation. I have no idea why, I've certainly never reported him for anything (we have disagreed from time to time but he's generally pretty thoughtful in his posts and so I end up learning even when disagreeing).

As for what I'd do, it's pretty simple.

First, remove most care from insurance. Definitely primary care. Insurance shouldn't be used for things that are cheap. Your car insurance doesn't cover oil changes because they're cheap. Primary care can be very cheap as well if done right. When I had my solo practice, my patients paid $50/month for unlimited office visits. That's $600/year for unlimited family medicine care. Same thing with basic imaging. Cash pay radiology can be quite cheap. X-rays including read for $30. Ultrasounds for $100. Same with common labs. Lipid panels ran $7, CBC $5, pap with HPV $40, PSA $12. Removing all of that from insurance will decrease costs by a fair bit.

Second, emphasize primary care. We are a refer-happy system. That leads to duplication of care and extra costs that aren't needed. A good PCP with time to actually do good work can save lots of money, that's been shown time and again.

Third, decrease regulations. The US has way more non-clinical positions per physician than just about anyone else, that adds costs.

Fourth, let us say no. Every doctor has seen cases where care was given that shouldn't have been: feeding tubes for demented 90+ year olds, anything done for anencephalic patients, you get the idea. We spend way too much on futile care.

I can't say that would fix everything, but it would absolutely help.

 

[findoc]

Yeah, ban everyone if they don’t agree with us. Easy solution. Looks like we don’t mind being Chinese and Russians when it suits us.

More than 700 thousand people go bankrupt every year because of the best healthcare system we have in the world. This is in spite of paying $25000 or more in premiums, deductibles and copays. Every other country is paying only half, a third or even less than that and no one goes bankrupt . In fact they don’t pay a penny over their premium. My frustration comes from this. On top of it, according to Harvard study, the healthcare cost in USA will exceed the median household income in just 10 years. Is it sustainable? What is your solution ? You want everyone go bankrupt? I am ready to listen. Answer this question before crying to mods and ask them to ban me.

I feel you on this. Healthcare costs are out of control. To me, this is an obvious symptom of an over-regulated, highly inefficient government-burdened industry that vehemently defends the status quo. I assume you view this as the result of greedy demon CEOs in hospitals/organizations/companies that find joy in over-charging their innocent little patients and under-paying their slave staff. Get rid of the evil CEOs and all the problems are fixed, right? If so, I think you've been watching too many medical TV dramas.

I think much of the business organization in healthcare is antiquated and needs to change. It was designed when the practice of medicine was in its infancy. We need a Silicon Valley type revolution in healthcare. We absolutely don't need to hand the healthcare industry over to a few government bureaucrats and create a dictatorship in which there is no freedom.

Speaking of Harvard, here is a late Harvard business school professor explain how we can improve costs in healthcare. WATCH THIS, IT WILL CHANGE YOUR LIFE. Every moment is pure gold.