Better Health Care at Lower Cost for Every American

Yeah, I’m not quite so convinced it is that easy to dismiss, but maybe I’m just a skeptic.

I’m actually really curious to see if America would get the same deals as other countries or if it would take some sort of price cap law.

My counter-argument: Price cap laws cap profits. W/o profits, there is less investment. W/o investment there are fewer drugs.

lifestyle drugs make a big profit. Profit spurs more R&D. More R&D leads to more necessary drugs.

There can be a counter-argument that the govt. should fully fund the NHS to do all research and then testing. But w/o a price or profit motive, how does the NHS decide where to research or when to pull a plug?

I don’t want to debate the pros/cons of universal care but I’d just like recognition that moving to a universal system means tradeoffs. The tradeoff isn’t that everyone else does everything much more wonderful than the US but there is a tradeoff between 1) waiting 2) innovation/invention 3) more intensive, aggressive treatment in the US.

That’s the argument to me. Is switching to a universal care government system worth the downside?

But wouldn’t that very R&D focus on profitable designer drugs, if profit were the motivator?

The invisible hand hasn’t been acting very impressively of late. Deregulated markets shaking their wild thang may not always give society the best results. It didn’t work for the financial markets, and I would argue that it is clearly not working for our health care system either.

Our gold-plated health care system is fantastic if and only if:
A) you can get the coverage in the first place.
B) you don’t actually need to use that coverage more than once in a great while.

So I’d say, yes, switching to a universal care government system is almost certain to be worth the downsides.

To back up where you’re going, you’re going to have to show that if the feds change the incentives, we’ll automatically get to the desired end faster. I’m going to have to say I have a different worldview on that one, but our government fathers can keep on trying over and over if they want.

2007: I was curious about Viagra sales, so I took a look. Looks like world drug market was $430 billion in sales, with the USA share being 51%.

Top 2007 US drugs by sales:

Lipitor: 6.1 Billion (Statin. Cause: Eating too much fat.)
Nexium: 4.3 billion (PPI. Abused. TV ads. Overprescribed $5 pill for simple heartburn.)
Advair Diskus 3.4 billion (Asthma. Breathing is good, so we’ll leave that one alone.)
Prevacid: 3.3 billion (PPI. Pink.)
Plavix: 3.0 Antiplatelet.
Singulair: 3.0 (Asthma)
Seroquel: 2.5 b (Supposed to be anti-schizophrenia but being used for everything from anxiety, OBCD, dementia and autism.)
Effexxor XR (Like prozac. Take two after watching news.)
Lexapro: (Same as above)
Actos: (Diabetes.)
Protonix: 2.1 b (PPI.)

That’s the top 11.

Viagra is 0.8 billion dollars in sales. People buy twice more Ambien (more abuse!) than they do ED pills. Nice to rail against, but not very significant.

Lipitor: 6 billion - that’s 3% of all drug sales in the US. Note it used to be higher, it is now generic.
PPI: 6.4 billion
Happiness Pills: 5 billion
Asthma stuff: 6.4 billion

I agree with Aeon - Bring back the 90s and get rid of freaking TV ads. ASK YOUR DOCTOR ABOUT ANOTHER OFF-LABEL USE OF AN OVERPRESCRIBED DRUG. Side effects include budget deficits, prior authorization paperwork, republicans in congress, CEO golden parachutes, and nationalization of healthcare.

By a public good accomplished metric? I would think that the NHS could use the exact same decision making criteria that a private company does with the exception that instead of comparing development costs with expected revenues over the life of the drug to calculate ROI, they instead calculate public good in terms of how serious and widespread the condition they are seeking to treat is. No, that’s not simple to calculate but neither are the models that a drug company might use to calculate ROI so in terms of difficulty I would imagine the calculations are about a wash.


I need to take five.

Honest question, do you have any stats on how much private money gets put into actual research for necessary drugs? I would think that a lot of that research is conducted by universities and funded by NIH.

Condescending exasperation posts aren’t helping your credibility one bit.

We already have a system whereby researchers petition NIH, NSF, etc for grants and they are awarded based on some set of rules and criteria that takes these things into account. I don’t see why it wouldn’t work for drug research, in fact it probably already does.

Not everyone experiences the listed side effects. People who do experience those side effects will generally switch to a different medication, when multiple medications treating an ailment exist.

“Hey, the listed side effects are worse than the disease” is always good for a laugh, but it distorts the actual situation.

Seriously though. How can someone think that? The unintended consequences would make a room full of experienced CEOs and supercomputers cry.

(Yeah, yeah, not politicians and bureaucrats though. I get it.)

I honestly do think it. I’m not mathematician though, perhaps I’m missing something. Would you care to elaborate on why you don’t think some rough metric of public utility could be computed for a drug in development?

I never joined the debate team in high school, but I do believe that if you assert something, you have to elaborate.

Anyway, economists kill people arguing about utility metrics, don’t they? Calling it “about a wash” is a distortion.

[EDIT] Okay, to be fair, I can think of a scenario where it would be pretty similar.

People would totally buy Halo 4. Get to it!
People would totally use cancer cures. Get to it!

Point taken.

Wait, why do I have to back up where I was going? Mine was a plain question on the original assertion. I was looking for the backup for that.

Because the focus is irrelevant. Phizer can spend 99% of their R&D bucks on pills to make my dick hard if we also get that cancer cure.

Would the feds changing incentives from on high necessarily get us to that end faster? Maybe.

You really are worthless in terms of contributing to the discussion at hand.

You know, I can accept that, but I’m continually amazed at the faith some people have that we can make sweeping changes merely with better management. There’s so much hand waving about critical things, and it gets under my skin. Sorry if I’m annoying everyone. Unicorn will probably come in and yell at me now. :(

I can appreciate your frustration.

Originally, the thread was less about government fixing everything and more about the market not fixing everything. That the solutions to the health insurance industry were being directly linked with the financial industry - at perhaps the absolute worst time to do so.

For myself, I’m not counting on a miracle, just a change in our general direction.