3241

They’d pay more, about $245/mo. With that cost+ a higher deductible, they’d likely get private healthcare.

The payments are percentage of income.

If you can get better then the government plan, you’re free to do so.

The main thing I’d want to do with all this is not so much to give everyone the best healthcare in the world, since that’s impractical- but to make sure those who are really sickly or really poor can break a leg without going bankrupt.

3242

Yeah a few years ago on vacation, I fell down a marble staircase, badly hurting my arm but not enough to send me to the emergency room. When we get back home, I go to my regular primary care doctor who wants an X-Ray. Sends me to the local hospital to get it done. Thankfully, just a sprain, no fracture.

Cost me $400 for that x-ray because I went to that hospital & it wasn’t an “emergency”.

3243

This thread suddenly makes me think of how people in East Germany had access to TV and radio from West Germany all through the 70s and 80s and it was blatantly obvious that things were way, way better in the West than at home, and yet the government had to keep running the line that things were actually better here, no way would you want to be stuck in the horrible FRG, thank god you were lucky enough to be born in the GDR, &c &c. And the truth was so obviously something else, and yet it was somebody’s job to keep churning out propaganda and lies that no rational or well-informed person could possibly believe. The American healthcare system is the GDR, the Republican party are the unfortunate propagandists with an impossible job… the only difference is, they’re actually succeeding! However they’re generating their anti-reality field, the now-retired East German propagandists must be gazing on with some mixture of awe and envy…

3244

I wonder what the effects on the pharmaceutical market would be if the US imposed the same price controls that other nations do.

3245

I meant that if they got similar coverage through private health care for near the same cost they’re out significantly less money.

The payments are percentage of income.

If you can get better then the government plan, you’re free to do so.

The main thing I’d want to do with all this is not so much to give everyone the best healthcare in the world, since that’s impractical- but to make sure those who are really sickly or really poor can break a leg without going bankrupt.

My point is that you’re trying to create a welfare program but trying to fund it entirely by the poor. That doesn’t work, you’re just going to bankrupt them through taxes rather than a broken leg. Your plan doesn’t offer the poor anything, they could already get some sort of minimal coverage if they could hand over 6% of their meager earnings. The problem is they can’t afford that, you’re just making the poor poorer with a horribly regressive tax. Why on earth would you think taxing the poor is ever a good way to help them?

3246

That’s no accident. The American Right was seriously freaked out by the presidency of Franklin Roosevelt (“a traitor to his class!”) and by the events of the 1930s followed by WWII, and the can-do spirit of the people acting collectively, first to relieve the human suffering of the Depression, then to defeat Fascism and Japanese Militarism. Immediately following WWII they got in gear funding all kinds of university chairs and think tanks dedicated to the proposition that the government can’t do anything to help people and that “the Market” is the solution to all problems. They’ve been putting out the same message, consistently, for the last 60+ years.

Their crowning achievements were the election of Ronald Reagan in '80, the Gingrich Congress in '94, and W’s (s)election in 2000. Immediately after Obama’s election they got in gear to manufacture the astroturf of the Tea Party. They won’t be happy until we’ve gutted Social Security and Medicare, and even done away with workmen’s comp and unemployment compensation. The glorious 1890’s are their desired end-state Nirvana. You know, with kids working in sweatshops and everything.

3247

The day you can back up your claims with credible evidence is the day people stop calling you a troll. jeffd did a pretty good job (ironically in the Tea Party thread, not here) of summarizing our health care system’s problems and how the HCR bill does - and just as importantly does not - try to address those problems. Your posts just regurgitate the same ol’ right-wing FUD ad nauseum. At least you haven’t invoked “death panels,” which makes you less stupid than Sarah Palin - but honestly, don’t you want to aim a bit higher than “less stupid than Sarah Palin?”

Universal health-care systems are not some airy-fairy ideal beamed in from Narnia. They’re not flawless (Japan’s in particular is headed for a demographic meltdown, IIUC); but they exist, they work, and they provide better overall results than our system. U.S. health care is like a lot of things in this country: the rich have access to the best in the world; everyone below them are varying degrees of fucked, from “good but overpriced” down to “Russian roulette.”

SOCIALISM!!1!

3248

Well, I was thinking more from the perspective of what effect would it have on the R&D, since you’d be removing a huge chunk of the revenues.

3249

Depends. Naturally the pharmaceutical companies paint a picture where they just go Galt and stop making drugs, but they’re probably full of shit.

Assuming that R&D occurs because they’re profit-maximizing entities, eating into their profits doesn’t really reduce the incentive for R&D. As long as it’s still profitable, they’ll do it. The profit margins for that industry is something insane like 16%. Microsoft’s profit margin is much lower, and yet it still invests lots of money in R&D.

The pharmaceutical market is quite strange. If you buy into the argument that US pharma sales fund R&D, then what you’ve actually got is a model where the US is subsidizing pharmaceutical costs for the rest of the world. You can probably model it pretty accurately as direct foreign aid to Canada, GB, Europe, etc for the purposes of buying drugs (here is where you can watch conservatives heads’ explode with cognitive dissonance).

Honestly I think it’s a nonsense argument myself, being advanced by a bunch of rich people who don’t want to be less rich.

Finally - even if you buy their argument - what else are you going to do? We cut into their profits, they limit R&D, some drugs that might otherwise get made don’t get made. The alternative is a world where nobody except the very rich can afford those drugs anyway.

3250

Well, one of the things that separates the pharma industry from others (like software for instance) is the cost of the R&D, due to how it progresses. Drug research and approval has a cost curve that increases dramatically over time. Because a lot of drugs show promise, but then demonstrate harmful side-effects only once they reach later stage trials, the pharma industry ends up spending a huge amount of money on drugs that then end up being dead-ends. So, there’s some significant minimum investment required to do the research at all, in the hopes that out of 10 drugs, one will end up approved and generate enough money to cover everything else.

However, this is certainly offset by the large profit margins you mention. I’d be interested in knowing what percentage of those profits are from things like OTC drugs such as Tylenol, vs. really expensive drugs which are only sold to a very tiny market.

Now, in regard to what’s better, new drugs which can only be bought by the rich, vs. cheap drugs for everyone but fewer new drugs… I think it may be more complex than that. A pharma company can only really milk a drug for profits while the patent is active. After the patent expires, anyone can manufacture the drug, and the cost plummets, since the actual cost for manufacturing drugs is insignificant.

The one thing that strikes me though, and this may be a fallacy that someone can explain away, is that if the US is paying way more for drugs than other countries, it seems like we’re kind of paying for all the R&D for everyone in the world. Other countries end up benefiting from the R&D, since the pharma companies will sell that stuff to them anyway once its developed, since some money is better than none. But if the US stops propping up the industry through paying much more money, it might hurt the rest of the world since they won’t be getting the free R&D investment. Of course, this again hinges on the notion that the pharma companies won’t keep innovating at their current rate if their profit goes down.

3251

Pharma R&D costs have been disproved. Pharma marketing was shown to be like 3-4x what their R&D costs were in a recent study.

3252

Could you post the study?

3253

I’m looking.

edit:

closest thing i can find on short notice:

pharma research = 7% of expenses. marketing = 20%.

3254

That’s interesting, although I think I had seen that. I was hoping there was a more recent study, as that one is 10 years old. Although, from the context of this discussion it probably doesn’t matter, as I don’t imagine the numbers have shifted dramatically from marketing to R&D recently.

However, it may not really change things much, since while the pharma companies spend tons of marketing, if their profit margins drop, it doesn’t mean they’ll cut marketing. Indeed, they’d likely need to market just as hard or harder to get their drugs into the marketplace.

I’ve never really understood the point of the consumer directed marketing though. I mean, do folks really ask their doctor about drugs they see commercials for? Especially since most of those commercials list ridiculous possible side effects. (“Consult your doctor if your eyes start shooting out blood.”) Some big chunk of that probably includes stuff like marketing OTC drugs though.

While we might say, “Hey, you can just stop marketing things so much, and still do just as much R&D,” that doesn’t mean that’s what the pharma companies would actually do, or even what they SHOULD do from a business perspective.

3255

It’s in pharma’s interest to have profit margins drop. Why do you think they overpay everyone?

And yes, consumers do ask about drugs, even if indirectly. About 7 years ago I convinced myself I had ADHD, at the age of 44.

3256

Incorrect. There aren’t many legal multi-billion dollar business that have margins as good as Microsoft.

3257

Wow I had no idea MS was that profitable.

3258

Heh, check out Apple’s numbers these days.

3259

And that’s after they piss away billions trying to expand out of core markets!

3260

That’s the point. People who earn low enough, will be better off with public healthcare while people better off can use private healthcare.

If you can afford it, you should be able to get better healthcare. The issue that those who can’t afford it, don’t get good enough healthcare.

You can’t promise everyone everything. There will be people who would be better off under this plans, such as the sickly and middle-class, or the poor, who would have cheap healthcare, and cost certainty. Those who make under the poverty level would have free healthcare, as they do now, and those who make Wal-Mart wages (say $20k a year)- would only pay about $45/mo for healthcare.

In return for this, employers would be out of healthcare- which actually sprouted due to socialist policies enacted during WWII. (employer healthcare came about because companies weren’t allowed to raise wages- so they had to give other bennies instead) This would improve the efficiency of the system, and raise wages.