Americans set to get standardised/universal healthcare

[Walsingham]

As I say, epidemiology says you aren't a discrete organism. You're a species. So if I understand correctly then you can be as selfish as you like and still support nationalised health.

 

Your question about living free in the UK is interesting. Yes, you can. And people do. It annoys me, and there's been a lot of talk for some time about tests to establish if someone is just taking the piss. But in principle, yeah, with the right disabilities you get a total ticket.

 

I'm no expert on the NHS, but to my mind it seems pretty obvious how we got it. During WW1, for the first time the political classes were put into close proximity to, and made responsible for the lower classes. Trench warfare was extremely intimate for officers and ranks. That mentality and awareness of interconnectedness continued in civilian life; alongside a respect for the sacrifices everyone had made together for the state. Then you had the big Spanish Flu outbreak that killed millions, and POW! Suddenly people got on board the idea of shared health.

[Humodour]

No, I didn't say US does all the research, I said the US market is what makes that research profitable.

 

I could conversely say it's the non-US market that makes the research profitable and I'd be no less correct than you.

[Wrath of Dagon]

No you wouldn't, because they make a lot more profit in US from a given drug than the rest of the world.

[Monte Carlo]

The idea that US pharmaceutical companies are somehow a font of generosity and benevolence is risible.

 

I repeatedly make the link, in a non-Mike Moore type way, about the relationship between these companies, the health insurance industry and lobbyists but you keep ignoring it. It's a closed market, a stitch-up, a con. In a genuinely free market, cartels wouldn't be able to dominate in the way they do.

 

Jeez, this forum is full of geeks who rail about Micro$oft yet ignore the US pharmaceutical and healthcare industries. Trust me, they make MS look like Medicine Sans Frontieres.

[Meshugger]

The idea that US pharmaceutical companies are somehow a font of generosity and benevolence is risible.

 

I repeatedly make the link, in a non-Mike Moore type way, about the relationship between these companies, the health insurance industry and lobbyists but you keep ignoring it. It's a closed market, a stitch-up, a con. In a genuinely free market, cartels wouldn't be able to dominate in the way they do.

 

Jeez, this forum is full of geeks who rail about Micro$oft yet ignore the US pharmaceutical and healthcare industries. Trust me, they make MS look like Medicine Sans Frontieres.

 

I am guilty of that ignorance.

 

We have slashdot for having fun at MS' shady business practices (and Apple, Sony and Google as well). Where can you find any info on the healthinsurance/pharmaceutical industries and their business practices?

[Wrath of Dagon]

The idea that US pharmaceutical companies are somehow a font of generosity and benevolence is risible.

Who said that?

[Walsingham]

I don't think it's descending into conspiracy theory to suggest that the multi-billion dollar private healthcare industry is going to try and do something about nationalised healthcare.

[Atreides]

I think drop the "either or" and go with a system that takes the benefits of both where possible.

[Humodour]

I think drop the "either or" and go with a system that takes the benefits of both where possible.

 

I'm pretty sure that's Obama's plan. Wouldn't you say that's certainly what Britain and Australia have? I don't know enough about Scandinavia and co to comment on their systems.

[Atreides]

I wouldn't say that's what Britain has. Again, read the chapter in the Undercover Economist if you have the chance to.

[Humodour]

I wouldn't say that's what Britain has. Again, read the chapter in the Undercover Economist if you have the chance to.

 

Link me and I'll probably read it when I get bored later today.

 

I dunno about Britian. I'm assuming their system is similar enough to ours. Perhaps wrongly? Ours is certainly about 30 years younger than theirs. But I figure that considering half of Australians have private healthcare insurance, that's a fairly vibrant private market. Or did you have something else in mind when you said a mix of private and public healthcare?

[Pop]

The employer-based health care we have in America is failing at an increasing rate. Whether or not single-payer health care is the solution, it's a solution, and there ought to be a solution implemented. Given the insurance industry's preoccupation with moral hazard a market-based solution is unlikely to work (that is, if you see the uninsured as a problem in the first place)

 

On paper there's nothing stopping the Democrats, but we don't know yet how Arlen Specter will swing in his voting habits, and of course Joe Lieberman is going to continue to be a total pain in the ass.

[Enoch]

Well, this has gone predictably. Doctrinaire Euros belittling the U.S. Some accurate facts thrown about, as well as some less so. Taks pretending that an unregulated free market for healthcare wouldn't be plagued by market failures and negative externalities, and sticking to the dubious ideology that every dime collected in taxes by a representative government is somehow an affront to basic human rights. WoD picking a talking point and driving it into the ground.

 

As I see it, the basic problem is that healthcare in the U.S. is expensive, and is getting more expensive every day. (Quality increases, too, but not nearly at the rate that costs have.) So long as costs are high, the people paying those costs-- be they insurers, governments, charities, wealthy relatives, or whoever-- are going to have a strong incentive to deny services to people from time to time. Most people don't like this outcome, and in a democratic (notice the small "d") government, that matters. But, as shifting the payer from private insurers over to the government would only change the identity of the person denying service, IMO, any feasible plan to solve this should have as its first goal the reduction of costs.

 

There are a lot of theories on how these costs could be controlled. Some would argue that market discipline is the best way, but there are reasons to believe that this may not be as effective (huge informational inefficiencies, moral hazards and adverse selection in insurance markets, the 'immediate need' nature of many decisions that consumers of medical services make, etc.). Others argue that more governmental involvement can help, using governmental 'bulk buying' power, cutting out the insurers' cost of capital (shareholders' ROI), putting high-paid providers (i.e., surgeons) on salary instead of doing piecemeal work, etc. There are other reasons to believe that these efforts may do more harm than good, too.

 

I'm willing to admit that I'm not nearly expert enough in the field to really have a handle on what a good solution might look like, though. And it's bedtime, so I'll leave this post at that.

[Wrath of Dagon]

WoD picking a talking point and driving it into the ground.

Hey, if you're going to make an accusation like that, at least show where I did that. My point was actually quite similar to yours, any solution proposed seems to introduce as many problems as it solves.

[Humodour]

On paper there's nothing stopping the Democrats, but we don't know yet how Arlen Specter will swing in his voting habits, and of course Joe Lieberman is going to continue to be a total pain in the ass.

 

Lieberman is one of the most liberal Democrats around. He certainly won't vote against the administration on anything but foreign policy (he's extremely hawkish). Specter is a health nut (it saved his life - cancer), and is all for extra health funding and research, so I imagine he'd also be for better health insurance.

Edited April 30, 2009 by Krezack

[Enoch]

WoD picking a talking point and driving it into the ground.

Hey, if you're going to make an accusation like that, at least show where I did that. My point was actually quite similar to yours, any solution proposed seems to introduce as many problems as it solves.

I was referring to the whole "America subsidizing pharmaceutical research" argument. It's weaksauce. Yes, the U.S. is the only major country where individuals make the purchases and usually pay retail prices, while the rest of the world buys in bulk at a heavy discount. The argument implies that, were the U.S. to switch to the bulk-buying model, the pharma companies would cease or reduce their research, which is ludicrous-- research is their core moneymaking function. Their whole business model is to keep coming up with new treatments and make money on them before the patents expire and they have to compete with generics. What would really happen is that the bulk buying discount would decline for everyone around the world to make up for the loss of all the retail-price sales in America.

[Walsingham]

moral hazard

 

Very interesting article. I don't know why I'm surprised, except I don't take the New Yorker often. I didn't realise that medical bills were such a huge part of being declared bankrupt over there. I don't think I'm being a euro-weenier when I say that's just shocking. But I guess it makes sense. You pull something nasty in teh prize draw and you have to grit your teeth and spend your life savings. That's a terrifying prospect.

[Wrath of Dagon]

WoD picking a talking point and driving it into the ground.

Hey, if you're going to make an accusation like that, at least show where I did that. My point was actually quite similar to yours, any solution proposed seems to introduce as many problems as it solves.

I was referring to the whole "America subsidizing pharmaceutical research" argument. It's weaksauce. Yes, the U.S. is the only major country where individuals make the purchases and usually pay retail prices, while the rest of the world buys in bulk at a heavy discount. The argument implies that, were the U.S. to switch to the bulk-buying model, the pharma companies would cease or reduce their research, which is ludicrous-- research is their core moneymaking function. Their whole business model is to keep coming up with new treatments and make money on them before the patents expire and they have to compete with generics. What would really happen is that the bulk buying discount would decline for everyone around the world to make up for the loss of all the retail-price sales in America.

I'm not sure what bulk-buying means in the context of national drug purchases. Do they guaranty a certain amount ahead of time in the way US can't? I believe it's more accurate to say that drug prices are government controlled, and I doubt the rest of the world would be willing to pay more if US suddenly starts paying less. Thus I would expect a decrease in expensive research.

[Trenitay]

You think the other countries would quit buying because they are now paying the same as the U.S.

[Calax]

WoD picking a talking point and driving it into the ground.

Hey, if you're going to make an accusation like that, at least show where I did that. My point was actually quite similar to yours, any solution proposed seems to introduce as many problems as it solves.

I was referring to the whole "America subsidizing pharmaceutical research" argument. It's weaksauce. Yes, the U.S. is the only major country where individuals make the purchases and usually pay retail prices, while the rest of the world buys in bulk at a heavy discount. The argument implies that, were the U.S. to switch to the bulk-buying model, the pharma companies would cease or reduce their research, which is ludicrous-- research is their core moneymaking function. Their whole business model is to keep coming up with new treatments and make money on them before the patents expire and they have to compete with generics. What would really happen is that the bulk buying discount would decline for everyone around the world to make up for the loss of all the retail-price sales in America.

I'm not sure what bulk-buying means in the context of national drug purchases. Do they guaranty a certain amount ahead of time in the way US can't? I believe it's more accurate to say that drug prices are government controlled, and I doubt the rest of the world would be willing to pay more if US suddenly starts paying less. Thus I would expect a decrease in expensive research.

I think what you're misunderstanding is that America as a whole is paying MUCH more than other countries because the countries buy bulk from the companies while we make microtransactions with the company. The fastest way to reduce costs would be for somebody to buy bulk amounts of meds from a country and then sell them at a similarly reduced cost to the consumer. Amazingly a go between actually CUTS costs rather than skyrockets them in this case.

[Atreides]

I think it's likely too that the drugs for the general public aren't the latest too so that a limited budget covers more people.

[Wrath of Dagon]

I think what you're misunderstanding is that America as a whole is paying MUCH more than other countries because the countries buy bulk from the companies while we make microtransactions with the company. The fastest way to reduce costs would be for somebody to buy bulk amounts of meds from a country and then sell them at a similarly reduced cost to the consumer. Amazingly a go between actually CUTS costs rather than skyrockets them in this case.

It doesn't matter, the medicine is made in bulk, pharmacies buy in bulk. Your theory would only work if the government distribution chain was more efficient than a private one, which has been proven to be false over and over again. So far as I know in Canada medicine is still sold through private pharmacies, but the price is government controlled. Edited May 4, 2009 by Wrath of Dagon

[taks]

I think what you're misunderstanding is that America as a whole is paying MUCH more than other countries because the countries buy bulk from the companies while we make microtransactions with the company.

um, no, this is not true. we pay more because we are offsetting the "deals" other governments have made with the drug companies. the "deals" with other governments are for drugs at pennies over cost to manufacture, so we in the states are left to pay all the development costs and the majority of profits. drug companies are forced into doing this since they'd lose too much business (likely to patent violations). since we are still pseudo-free market (w.r.t. medicine) in the US, consumers here wind up paying the difference. it's not just other governments, btw, it is our own, too (medicare, medicaid, government employee health insurance, and HMOs are all part of the problem).

 

taks

[Hurlshort]

Plus we have to cover the costs of exorbitant lawsuits somewhere along the way.

[taks]

Plus we have to cover the costs of exorbitant lawsuits somewhere along the way.

while bad, and often ridiculous, i think it is but a drop in the bucket for drugs. it probably effects the medical practitioners themselves more than anything, with overpriced malpractice premiums as the result. many end up leaving the profession because they cannot afford the insurance. better to be an engineer, like i chose, make similar money*, sleep knowing you didn't leave the knife inside the patient, and live without the ongoing threat of lawsuit.

 

taks

 

*the top-3 professional careers used to be doctor, lawyer, engineer, in order of average pay. you can't count "international banker" or "certified financial analyst" because they are really "business professionals" and get averaged in with the millions of run of the mill stock brokers that are all now broke.

Edited May 4, 2009 by taks