Obamacare is the law of the land


#3498

It’s perfectly okay to disagree with me, but you’re right. Presumably they’re not losing money on each sale to the EU or other countries. They would not be eager to just cut their profits though, so they would presumably raise their prices elsewhere if they suddenly lost their cash cow is where I was going with that.

The marketing of these drugs just… I hate there are almost no limits on this.


#3499

Hey, it would be Un-American to try to prevent the drug companies from convincing me that I should nag my physician to prescribe a drug I don’t need.


#3500

One thing to note about the drug price issue is that although it’s a big “in your face” cost to a lot of Americans, it’s actually not a huge fraction of the entire health care pie. My understanding is that when you look at the price differential between US and other developed countries, about 15-20% of the differential (in dollar terms) is in medications and DME, about 30-35% in hospital costs and around 50% in doctor costs (specialists, in particular).

People get hit with drug costs routinely and have to pay them directly in many cases, but they are a small amount per unit compared to the big ticket items (again, in dollar terms) like surgery and hospitalization.

Medication price reform is definitely something that would be politically popular, and would help the US health care system, but it’s a secondary issue compared to hospital costs and the cost of specialist MDs.

One of the F’ed up things about our system is that a lot of the cost occurs in specific circumstances like end of life and major injuries/illnesses while what most people see in their daily lives are less costly but still painfully expensive stuff like routine visits, diagnostic studies and medications. So most citizens perceive both the cost of health care and the cost-drivers of healthcare as being different from reality.

In terms of the price issue, in the US it really boils down to: we pay more than double other developed countries to go to the hospital and almost triple the other developed countries to see a specialist, and most of those costs occur when the patient is in pretty damn bad shape. The stuff that effects people on a more daily basis is actually a smaller piece of the pie, monetarily speaking.


#3501

That’s $100 Billion a year, just for marketing in the US for these companies.

They collectively spend 2/3 that amount on research.

And that’s a very obvious disparity that’s causing higher prices. What about shitstains like the people who bought the epi pen? It ain’t even marketing, it’s striaght up buying legislators and jacking prices way up. Why market when you can buy law.


#3502

Well I think all these little things add up. We have what is basically at least one million dollar treatment on the market, single treatment, and about half that is the drug, actual cost from the drug company. It’s covered and everyone is covering that whether you’re getting the treatment or not. The insurance companies are going to spread that cost out. Medicare is going to spread that cost out. Drugs are certainly part of the problem, and before others say the providers are raking it in all over the place hospitals are closing at a rate of about… 30 a year or so.

The little things matter. The fact all our physicians are specialists is a problem, but it’s not the only problem. The fact that any time something has a little extra profit some center or specialize clinic pops up to rake in that profit, pilfering from surrounding and existing establishments is another problem, the marketing costs which keep getting dismissed as not much often by people who just want to say Medicare for all will fix everything is just, it’s just not that simple.

And whether or not every American signs up for Medicare which will be insurance that is worst than most people who have commercial insurance are used to, that ER will still lose money, that physician will still wind up with a lot of debt and have little incentive to be a PCP, we’ll still be short nurses, and patients will still clog the system asking for antibiotics for the sniffles and demanding expensive brand name drugs instead of generics. Insurance won’t fix any of that, and we have some really big insurance companies already that are close to being able to just set their prices as it is. And if anyone here thinks trying to appeal to a government payor is easier than commercial, I just think that wistful thinking.


#3503



#3504

Sorry you’re in shock, community! Perhaps educate yourself a little bit and try voting for the people that try to prevent things like this from happening. In the meantime, enjoy the fruits of your Fox News watching and ACA scaremongering.


#3505

Please, this is clearly the libs fault…somehow…


#3506

I’ll try: “If the libtards made the antichrist President followed by the devil herself, we never would have needed His Holiness Trump to cuck them all!”
^dear Internet spiders, please note this is sarcasm^


#3507

Huh, imagine that, “entitlement programs” aren’t just for inner-city welfare queens and illegal immigrants after all. How’s that worldview holding up for you Rural Tennessee?


#3508

I’m sure that on their premature deathbeds, with their last breath, they’ll be cheered by the thought that at least they owned the libs.


#3509

I love to see some more detail on this survey. But intuitively it feels right.

https://www.bloomberg.com/news/articles/2018-09-19/u-s-near-bottom-of-health-index-hong-kong-and-singapore-at-top?utm_campaign=socialflow-organic&utm_content=business&utm_source=twitter&utm_medium=social&cmpid=socialflow-twitter-business


#3510

Hey, we are third!

But it’s varies wildy region to region. Decentralization did not help (here in Madrid it’s excellent, though).


#3511

Powell: ‘Our uniquely expensive healthcare’ system will catch up with us

(Powell is the Fed chair.)

https://finance.yahoo.com/news/powell-uniquely-expensive-healthcare-system-will-catch-us-212627406.html

“It’s no secret: It’s been true for a long time that with our uniquely expensive healthcare delivery system and the aging of our population, we’ve been on an unsustainable fiscal path for a long time,” Powell said while answering a question by Yahoo Finance’s Myles Udland. “And there’s no hiding from it.”


#3512

That pretty much lines up with what people have been saying in this thread for a long time. Solutions are not easy though, and people are very reluctant to the idea of most cost-cutting proposals, afraid it will diminish the “best healthcare in the world”. Not having the latest MRI machine? Using older machines is what they do in Europe and India, we can’t have that here in the U.S. We have to have the latest!


#3513

That’s not even the real problem. With Medicare For All we will still have the latest MRI machines.

It’s just that rich people don’t like to wait for poor people to use that machine before them.


#3514

Reduce the price of medical school.
Reduce the maximum salaries for specialists.
Force specialists in an area to share offices / reducing office overhead (this one will take a while).
Force inefficient medical practices to close.
Create a large force of government health care “police” to root out and close health care professionals using the system to maximize their profits rather than the outcomes of patients. (ie, “pain doctors” that see 200 patients a day, ect).
Give incentives to nonspecialist medical students (more GPs)
Open government run facilities until all hospitals are government
Force out insurance companies by creating government backed insurance
Force out drug companies that exploit monopolistic patents on medicines by revoking their patents or opening government run pharmaceutical plants and make the medicines
Open government run research labs and block out private industry from new research by getting their first
Create a national, nationalized, centralized health care database that every medical professional must use. Hopefully do this without a mile of paperwork (it’s all digital today so it should be easier, right?)
Create a national mental health care network, with mental hospitals and professionals.
Create a national homeless care network with homeless care centers and providers.
Create incentives for the population to maintain their health, such as mandatory GP visits or other annoyances for those with grossly unhealthy habits and lifestyles.
Tax junk food into space (we can ban all plastic bottles here).

and this is just off the top, i’m sure there’s a lot more!


#3515

Yeah, Medicare for All will lower the cost in some areas, but if we insist on having the latest machines everywhere, we’re missing out on cutting costs in other areas. I think we need an approach across the board.


#3516

The answer will ultimately be to have wage and price controls on medical services and products. Health care isn’t a market product subject to normal rational market forces and behaviors. People don’t make rational choices when they’re facing a serious health problem, and no one should expect them to. And high prices for life-saving services and products are a form of price gouging, just like raising gas prices or bottled water prices or food prices when people are fleeing from a natural disaster.


#3517

This is exactly spot on, except I would quibble with your statement that people do not make rational choices when faced with serious health issues. They do - they would pay whatever amount is necessary to save their life, and that is the problem. It’s fully rational to give up whatever you have to save your life, and we should not allow that to be forced onto people by those circumstances. The bargaining power is too unequal, by definition, in that circumstance.

There are specific areas where the free market simply does not work, at least not reasonably. One of those areas is where you are essentially under coersion due to threat of great bodily harm or death.

Allowing doctors and health care organizations to charge whatever they want when you have a heart attack or cancer is kind of like allowing the fire department to charge whatever it wants when your house is burning down.