Obamacare 5 years later. Crow, anyone?

[anduin]

People have died waiting for coverage in these utopias, in the UK the death rate is 4x higher
http://www.dailymail.co.uk/health/article-195277/NHS-death-rates-times-higher-US.html

Ah, the Daily Mail, the last refuge of the Internet uninformed. This study is not peer-reviewed, and has been highly criticised because it is comparing figures from different types of hospitals. For example, 30% of terminal and acute patients in the US tend to be transferred to other facilities precisely because of healthcare insurance reasons (so they don't die in hospital), while UK hospitals only transfer 5% of these types of patients elsewhere.

In fact, a review was established to study the claims, and it heavily criticised the methods used:

http://www.theguardian.com/society/...misses-unreliable-claims-over-nhs-death-rates

 

[sunmaster14]

I live in the UK, and while the Tories have been attacking the NHS in the last 5 years, it's still an excellent model. I look at the US and I can't understand how people put up with a more expensive system that doesn't cover all of the population.

Our politicians scare people with the American model.

Well, they should also hope the American model doesn't change. Because right now, the American model is effectively paying the lion's share for R&D in medicine, and the rest of the world is getting a free ride. We even have laws preventing the reimportation of drugs into the US from other countries. That tells you a lot right there.

 

[3point14]

Well, they should also hope the American model doesn't change. Because right now, the American model is effectively paying the lion's share for R&D in medicine, and the rest of the world is getting a free ride. We even have laws preventing the reimportation of drugs into the US from other countries. That tells you a lot right there.

I've heard this argument before. I've never seen it demonstrated. Can you prove it?

 

[anduin]

Well, they should also hope the American model doesn't change. Because right now, the American model is effectively paying the lion's share for R&D in medicine, and the rest of the world is getting a free ride. We even have laws preventing the reimportation of drugs into the US from other countries. That tells you a lot right there.

You are talking about something entirely different, which is pharmaceutical research, and you are wrong when it comes to outcomes, namely patented medicines. One of the best objective indicators of research outcomes in medicine are patents for pharmaceuticals. I searched for all of the awarded patents from 2000 to 2013 in the class of pharmaceuticals, and I attach the results. You will see that it changes from year to year, and while the US had more pharmaceutical patents issued in 2013, for most of the previous decade Europe had more patents issued.

Don't take my word for it, you can check the stats yourself here:
http://ipstats.wipo.int

There is however one area in which the US is clearly doing really well when it comes to R&D, about half of all US R&D in health and medicine is PUBLIC, and the EU only funds one third of what the US funds through public funds.

The reason for the disparity is because the US healthcare system has managed a nifty trick, it encourages basic public spending in R&D, thus making the risky and unprofitable basic research public, and it privatises the benefits of that research through technology transfer schemes.

By the way, sources for my figures are:
http://apps.who.int/medicinedocs/en/d/Js6160e/4.html (for the 50% figure)

http://www.janssen-emea.com/sites/d...-in-European-Health-R&D-Executive-Summary.pdf

Regarding re-importation of drugs, that is another question entirely, it's more to do with parallel import rules, and particularly it is about US pharma defending its own pricing strategies, as medicines are more expensive in the US than anywhere else. See:

http://www.drugwatch.com/2014/10/15/americans-pay-higher-prices-prescription-drugs/
and
http://bit.ly/1HAnGhL

 

[anduin]

I've heard this argument before. I've never seen it demonstrated. Can you prove it?

I've read it as well, it usually is highly exaggerated, and it also fails to take into account the fact that the US has the highest public R&D expenditure in the world.

 

[sunmaster14]

You are talking about something entirely different, which is pharmaceutical research, and you are wrong when it comes to outcomes, namely patented medicines. One of the best objective indicators of research outcomes in medicine are patents for pharmaceuticals. I searched for all of the awarded patents from 2000 to 2013 in the class of pharmaceuticals, and I attach the results. You will see that it changes from year to year, and while the US had more pharmaceutical patents issued in 2013, for most of the previous decade Europe had more patents issued.

Who develops the drugs and where the patents are issued has nothing to do with it. It could be that 100% of medical advances are made by Europeans, and it wouldn't affect my claim one iota. It is the US market which provides the incentive for R&D. The high prices paid by Americans for the newest and most advanced drugs and technology are what drives companies all over the world to do the R&D in the first place.

 

[sunmaster14]

I've heard this argument before. I've never seen it demonstrated. Can you prove it?

How about you doing a little work yourself and actually contribute to the discussion? Other than tedious demands for evidence that is.

 

[RandFan]

Europe is dying and the welfare state is partly to blame.

This is when you provide evidence that Europe is 'dying', correct?

Does anyone else have evidence that Europe is 'dying'?

 

[RandFan]

How about you doing a little work yourself and actually contribute to the discussion? Other than tedious demands for evidence that is.

This is a skeptics forum. For crying in the dark "skeptic" is in the name of the forum. Basing decisions on evidence and not some one flapping his or her gums is what skeptics do. When someone asks me for evidence I either provide it or I withdraw the claim.

So, how about you stop making baseless claims and provide your citations like the rest of us.

Burden of Proof

When debating any issue, there is an implicit burden of proof on the person asserting a claim.[citation needed] An argument from ignorance occurs when either a proposition is assumed to be true because it has not yet been proved false or a proposition is assumed to be false because it has not yet been proved true.[1][2] This has the effect of shifting the burden of proof to the person criticizing the proposition, but is not valid reasoning.[3]

 

[paulhutch]

How about you doing a little work yourself and actually contribute to the discussion? Other than tedious demands for evidence that is.

Asking others to support your claims is absolutely ridiculous, support it yourself or retract your claim.

 

[anduin]

Who develops the drugs and where the patents are issued has nothing to do with it. It could be that 100% of medical advances are made by Europeans, and it wouldn't affect my claim one iota. It is the US market which provides the incentive for R&D. The high prices paid by Americans for the newest and most advanced drugs and technology are what drives companies all over the world to do the R&D in the first place.

You are quickly moving the goalposts, and you make an astounding unsupported claim. I would love to see the evidence for your assertion that Europe is filing patents because of the incentive of the US market.

Here is the pharmaceutical market at the moment: Companies are ripping-off US citizens, you are already paying for 50% of the R&D that results on drugs and medical advances through your taxes, and you also have to pay exorbitant amounts for the finished product, more than everyone else in the world by a large margin.

That is not supporting more R&D elsewhere, it's supporting eye-watering margins not found in any other industry.

But hey, if you don't mind your tax money being used to support the highly-profitable phrama industry, then be my guest. Just don't come telling us that somehow your model is the best in the world.

 

[RandFan]

You are quickly moving the goalposts, and you make an astounding unsupported claim. I would love to see the evidence for your assertion that Europe is filing patents because of the incentive of the US market.

Here is the pharmaceutical market at the moment: Companies are ripping-off US citizens, you are already paying for 50% of the R&D that results on drugs and medical advances through your taxes, and you also have to pay exorbitant amounts for the finished product, more than everyone else in the world by a large margin.

That is not supporting more R&D elsewhere, it's supporting eye-watering margins not found in any other industry.

But hey, if you don't mind your tax money being used to support the highly-profitable phrama industry, then be my guest. Just don't come telling us that somehow your model is the best in the world.

I was on contract to UCLA's Jonsson Comprehensive Cancer Center for one year helping them get a government grant for cancer research. The amount of money is considerable.

$95 billion a year spent on medical research

Americans pay for their medicine coming and going.

 

[3point14]

How about you doing a little work yourself and actually contribute to the discussion? Other than tedious demands for evidence that is.

How about you stop making unsupported assertions. You know the rules: You make the claim, you demonstrate it. Asking me to prove it is simply an attempt to distract from the crux of the mater which is yet another unsupported claim you've made.

 

[anduin]

I was on contract to UCLA's Jonsson Comprehensive Cancer Center for one year helping them get a government grant for cancer research. The amount of money is considerable.

$95 billion a year spent on medical research

Americans pay for their medicine coming and going.

Absolutely, I usually stay out of US healthcare discussions, but when I join I am astounded by the level of misinformation about public funding and actual costs.

It's one of those loveable American quirks, like the refusal to use the metric system, or the insistence in using the month/day/year standard

 

[RandFan]

Absolutely, I usually stay out of US healthcare discussions, but when I join I am astounded by the level of misinformation about public funding and actual costs.

It's one of those loveable American quirks, like the refusal to use the metric system, or the insistence in using the month/day/year standard

All true. Let's not forget America's historic contribution to fashion. The leisure suit. We also put pressurized semi-liquid cheese product in a can. We're a fun lot.

 

[RandFan]

BTW:

It needs to be noted that a popular fallacy on this thread (and others) is the appeal to fear.

Appeal to Fear - Logically Fallacious

argumentum in terrorem

(also known as: argumentum ad metum, argument from adverse consequences, scare tactics)

Description: When fear, not based on evidence or reason, is being used as the primary motivator to get others to accept an idea, proposition, or conclusion.

Logical Form:

If you don’t accept X as true, something terrible will happen to you.

Therefore, X must be true.
​

Example #1:

If we don’t bail out the big automakers, the US economy will collapse. Therefore, we need to bail out the automakers.
​

Explanation: There might be plenty of legitimate reasons to bail out the automakers -- reasons based on evidence and probability—but a “collapsed economy” is not one of them.

Now, this isn't going to stop people from doing it but just know that when they make these arguments they are dealing in what is known as demagoguery when a politician or public leader does it. It doesn't make it any better that those who do so are not public leaders.

 

[sunmaster14]

You are quickly moving the goalposts, and you make an astounding unsupported claim. I would love to see the evidence for your assertion that Europe is filing patents because of the incentive of the US market.

If you understood economics, you would see that I did not move the goalposts. Supporting eye-watering margins for the pharmaceutical market will spur R&D. The market is competitive you know. If one company starts making eye-watering margins, other companies will be formed and race in to try to grab a piece of the almost $400 billion dollars Americans spend on prescription drugs every year. For example, the rate of biotech company formation in the US is astounding. Almost every research doctor I know is involved with two or more startups.

 

[sunmaster14]

How about you stop making unsupported assertions. You know the rules: You make the claim, you demonstrate it. Asking me to prove it is simply an attempt to distract from the crux of the mater which is yet another unsupported claim you've made.

The rules? I don't see that in the MA. Some of my claims I justify with logic and reason. Some I provide citations for. Some I make to stimulate discussion. I have no obligation to respond to you or anybody else, and nobody is forcing you to read my posts.

 

[twinstead]

So let me get this straight: the exceedingly high prices I am paying for health care are to subsidize massively profitable medical and pharmaceutical companies?

 

[anduin]

If you understood economics, you would see that I did not move the goalposts. Supporting eye-watering margins for the pharmaceutical market will spur R&D. The market is competitive you know. If one company starts making eye-watering margins, other companies will be formed and race in to try to grab a piece of the almost $400 billion dollars Americans spend on prescription drugs every year. For example, the rate of biotech company formation in the US is astounding. Almost every research doctor I know is involved with two or more startups.

Yet more goalpost moving noted.

That doesn't answer the question, and I understand economics. Please provide evidence that without the US market there would be no R&D spending in Europe and other countries.

And you still ignore the fact that R&D in the US is supported in large part by public spending.