What is your life worth ...

[Zbu]

You know, maybe we should just raise taxes (or create a flat tax in America, really) so we could fund non-corporate R&D into medicine. Let's face it, if you're selling defective medicine for a grand to cure cancer, it's time to admit that putting business in charge of medicine is just plain ineffective and stupid.

 

[Freakshow]

You know, maybe we should just raise taxes (or create a flat tax in America, really) so we could fund non-corporate R&D into medicine. Let's face it, if you're selling defective medicine for a grand to cure cancer, it's time to admit that putting business in charge of medicine is just plain ineffective and stupid.

What about all the great medicines that have been developed by businesses? Are you just discounting that, because this one incident happens to enforce an anti-business stance you already had?

 

[Kaylee]

{skip}
I assume most people on this $100K pa treatment will be relying on insurance to pay for it in the US.

Just an FYI because I don't know if all Europeans know this. Not all Americans have health insurance. Per this web site: http://www.nchc.org/facts/coverage.shtml
About 45 million Americans, or 15.6 percent of the population, were without health insurance coverage in 2003.

Not all elderly Americans have health insurance either. Per this web site: http://www.aafp.org/x26875.xml
About 354,000 senior citizens in the year 2000 did not. I don't know why because I thought Medicare covered all senior citizens but apparently it does not. The web site didn't explain why these seniors were not covered by Medicare.

Even among Americans that do have health insurance not all of them have coverage for prescriptions. That would include Americans that have Catastrophic Health Insurance and senior citizens that are not aware that they need to purchase Part D of Medicare. If my understanding is correct, until this year, senior citizens did not have coverage for prescriptions unless they had bought supplemental health insurance from private companies, and not all of them did so.

There may be other American health insurance plans out there that don't include coverage for prescriptions. Regrettably I don't know a lot about this area -- that is why I was hoping someone more knowledgeable than me would post about this.

 

[Kaylee]

You know, maybe we should just raise taxes (or create a flat tax in America, really) so we could fund non-corporate R&D into medicine. Let's face it, if you're selling defective medicine for a grand to cure cancer, it's time to admit that putting business in charge of medicine is just plain ineffective and stupid.

What about all the great medicines that have been developed by businesses? Are you just discounting that, because this one incident happens to enforce an anti-business stance you already had?

You might want to read this article:
http://www.nybooks.com/articles/17244

Per the authors most pharmaceutical research in the USA is paid for by the American consumer twice, first through taxes and than later through patent protection. What happens is that most of the pharmaceutical research is now done at the universities through funding by the taxpayers through government grants (via the NIH). The universities since 1980 are allowed to sell their taxpayer financed results to private industries who then gets the patents, so the taxpayers pay again through higher prices for the patented drugs. Before 1980 these drugs could not have been patented because the taxpayer-funded research was regarded as belonging to the public. <sarcastic mode> Nice huh? </end sarcastic mode>

Other topics covered by the authors explain why:

* The number of Americans who don't have health insurance have increased and ironically why the uninsured pay more for prescriptions than the States ** and the private insurance companies do. (Mainly because as individuals they are not in a position to bargain for lower prices like the state governments and large private companies.

* Until this year seniors didn't have their prescription costs covered by Medicare (the USA government * insurance for the elderly); to get this they had to pay for private supplemental health insurance. Many of them didn't and it was not uncommon for the average prescription costs to be about $9,000 for the uninsured senior citizen. That changes this year and now seniors have the option to purchase prescription insurance for a sharply discounted amount (Medicaid part D). That is not discussed in this article, but I'm willing to bet that this changes the financial picture for a lot of pharmaceutical companies because Medicaid has limits on how much they are willing to pay for prescriptions.


**Note: FYI to the non-Americans -- the poor get free health insurance through Medicaid managed on the state level (and not the national level). In New York some of the lower middle class are eligible for discounted health insurance managed by the state also under various programs, and the disabled (if they met certain criteria) can buy into the Medicaid program. Perhaps other states have similar programs.

 

[CapelDodger]

What happens is that most of the pharmaceutical research is now done at the universities through funding by the taxpayers through government grants (via the NIH).

This is particularly of cures rather than palliative drugs. Cures do not make for long-term customer relationships, which is where the real money is.

 

[Freakshow]

...most of the pharmaceutical research is now done at the universities...

I didn't see any references in the article to support that. I know the article said it. But it didn't provide the references for it.

* The number of Americans who don't have health insurance have increased

Not my concern.

 

[Kaylee]

I didn't see any references in the article to support that. I know the article said it. But it didn't provide the references for it.

I agree the references were not as specific as they could be, that seems to be a common problem with articles on the web. However, these references in the article might be a good place to start:
http://www.nybooks.com/articles/17244#fn7

Notes
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[7] For excellent summaries of public contributions to drug company research, see Public Citizen Congress Watch, "Rx R&D Myths: The Case Against the Drug Industry's R&D 'Scare Card,'" July 2001 (www.citizen.org); and NIHCM, "Changing Patterns of Pharmaceutical Innovation," May 2002 (www.nihcm.org).

[8] This is probably an underestimate. One source that indicates it is at least this is CenterWatch, www.centerwatch .com, a private company owned by Thomson Medical Economics, which provides information to the clinical trial industry. See An Industry in Evolution, third edition, edited by Mary Jo Lamberti (CenterWatch, 2001), p. 22.
{skip}

Not my concern.

From what I've read about the USA health insurance system compared to the one-payer systems, its incredibly inefficient and as a result it's claimed that most people who do pay for health insurance end up overpaying. The reason is that people who don't pay into the system do end up getting publicly funded health care after their health gets much worse and reaches the emergency stage because they did not treat their illness or health emergency at an earlier stage. So although you may not care that health insurance coverage is decreasing in the USA, it is probably one of the reasons that your health care costs are increasing beyond inflation -- and you might care about that.

BTW, there are also statistics that indicate that people get locked into jobs they may not necessarily want in order to make sure that they and their families have health care. The fact that in the USA health insurance is not purchased directly but is usually obtained through one's employers really distorts the market and removes choice for many individuals. I really dislike that aspect of the USA health insurance system and I'm not in favor of sharecropping either

I would be happy to try a different system of health insurance where everyone pays premiums directly to the health insurance companies and employers are left out of this purchase process. The health insurance companies could be regulated like the telephone companies are regulated now. I bet after an adjustment period that would work out well or at least be an improvement.

 

[Kaylee]

double post

 

[Freakshow]

I agree the references were not as specific as they could be, that seems to be a common problem with articles on the web. However, these references in the article might be a good place to start:
http://www.nybooks.com/articles/17244#fn7

I went and looked (before I made my previous post) at the web site they listed, but was not able to find the info using the site's search engine. It may be buried in there somewhere, but I wasn't going to put forth that much effort for it. My reason for that is that the site was so obviously partisan, that I am a bit wary of it, anyway. I would have put forth more effort to find it if the site would have been a bit more neutral. And if I was REALLY bored.

 

[TragicMonkey]

I would be happy to try a different system of health insurance where everyone pays premiums directly to the health insurance companies and employers are left out of this purchase process.

You can do this. This is how I have medical insurance, since my last couple of employers didn't offer any benefits.

Of course, I pay four or five times what I'd be paying if I got the same exact coverage, from the same exact insurer, via an employer. They get discounts. Individuals don't.

 

[Kaylee]

You can do this. This is how I have medical insurance, since my last couple of employers didn't offer any benefits.

Of course, I pay four or five times what I'd be paying if I got the same exact coverage, from the same exact insurer, via an employer. They get discounts. Individuals don't.

Right, because the employers get involved (or at least the larger employers) they mess up the market system and health insurance costs for individuals are much higher as a result.

Imagine how much more telephone services | [substitute any other product or service you like] would cost purchased as an individual or family if it were the established custom to purchase it indirectly through an employer.

That's why I also compared the USA system of health insurance to sharecropping, although not as explicitly as I could have.

Edited because I didn't say what I meant the first time around.

 

[Kaylee]

I went and looked (before I made my previous post) at the web site they listed, but was not able to find the info using the site's search engine. It may be buried in there somewhere, but I wasn't going to put forth that much effort for it. My reason for that is that the site was so obviously partisan, that I am a bit wary of it, anyway. I would have put forth more effort to find it if the site would have been a bit more neutral. And if I was REALLY bored.

Heh, just because they're partisan doesn't mean they're wrong.

But I hear you about the research. I'm not doing anymore either unless I need it to write a letter to one of my congress reps or I end up doing some amateur lobbying like some of my friends have in the health insurance area.

 

[Darat]

...snip...

Not my concern.

But it should do - it actually means you have to pay more for services, goods etc. then you would do if there was a national health service of comparable quality to the UKs.

 

[a_unique_person]

Seems a tad immoral to me.

It's market forces, do you want a free market or not?

 

[Freakshow]

But it should do - it actually means you have to pay more for services, goods etc. then you would do if there was a national health service of comparable quality to the UKs.

There are other ways to address that than by moving to a national health service.

 

[Darat]

There are other ways to address that than by moving to a national health service.

How? Without universal health coverage the problem would remain, its a result of not having effective universal health coverage.

 

[Freakshow]

How? Without universal health coverage the problem would remain, its a result of not having effective universal health coverage.

Or it is a result of having too much social spending on health care and giving money to those that have not earned it, as opposed to not enough. We do spend A LOT of government money on health care in this country, as well as a lot of other social services. You are saying that we could go fully to an NHS system, and end up spending less. I am saying that we could also go the opposite direction, and end up spending less.

 

[Beerina]

Cue market fundamentalists: "It's absurd that a company has to 'justify' the price of their drugs at all! The 'morality' of the matter is this: private entrepeneurs competing for profits; trading what they created with their MINDS for dollars. Simply allow the free-market to "discipline" those who charge "too much". When consumer sovereignty reigns supreme, everyone wins (except for those who don't). It's like Ayn Rand says in _Atl--."

Well, tell the whole story now instead of just the straw man.

1. At least the drug is available. The real choice isn't between an expensive drug and a cheap drug. The choice foisted by reality is between an expensive drug and no drug at all. Politicians can huff and puff and bloooooooooooooooooowwwwwwww the house of straw men down in exchange for votes, but that won't conjure more, new, expensive drugs into existence any faster. It will slow it down. End of story. See last century for hundreds of murderous experiments with government command and control of things vs. rate of development.

2. In this particular case, I don't know, but are they necessarily being all that greedy? Do we know the amount of money that company has spent developing this drug? And other drugs that may not be ready yet or have failed? Also, again I don't know about this drug in particular, but are more socialist nations absconding with it because they refuse to pay the higher prices to help amortize all these costs? If they've gotta make up the difference somewhere, well, the US and their population has to shoulder the burden while other nations get a free ride (ironically, all the while slowing development because of not paying more money. Ingrates. I'd use a smiley if it wasn't cumulatively, actually murderous due to slowing technological development.)

The fact remains, to save the most people over the long run, you want to develop drugs the fastest, and that includes both government dumping tens of billions into research as well as every last greedy capitalist striving after new drugs.

Hell, if some drug company were to develop a drug that cured a big chunk of cancer or heart disease or strokes, the governments of the world should just issue them a trillion dollars and be done with it. Good job, you saved more lives than all the blowhard politicians touting socialized medicine ever could (which, ironically, may be a negative number, the world is worse off for them having existed. Oh, and yeah, it's possible the 98% of Canadians who like their system are wrong. As the guy in Contact pointed out, "95% of the world believes in a supreme being of one form or another". Liking something doesn't mean it's actually the best for you in the long run. The placebo effect on a massive, sad scale.)

Buy that drug now and to hell with slower technological development.

 

[Kaylee]

{skip}
See last century for hundreds of murderous experiments with government command and control of things vs. rate of development.
{skip}

Sorry, I don't know what you are referring to (maybe I was out that day in history class or I didn't catch those newspaper articles). Could you give a little more description or even some links? Thanks.

The fact remains, to save the most people over the long run, you want to develop drugs the fastest, and that includes both government dumping tens of billions into research as well as every last greedy capitalist striving after new drugs.

Anything goes in the pursuit to save lives? I assume you are joking, but if not that would backfire also.

It could very easily create a class of robbers under the disguise of life-saving scientists (if it hasn't done so already). You need some checks and controls, and you need some sense of fair play.

So do you think its OK for companies to be able to patent products funded by government grants? (Either directly or through "technology transfer" programs where universities sell the rights to the products to private companies. See post # 84.)

I believe that's wrong -- those products in principal belong to the people who paid for them, the taxpayers. Its wrong to make taxpayers that paid for the research pay more for the resulting product because of patents.

At the very least that is corporate welfare, most likely it is government sanctioned robbery, but it is definitely not capitalism or fair market rules.

 

[Cleon]

Sorry, I don't know what you are referring to (maybe I was out that day in history class or I didn't catch those newspaper articles). Could you give a little more description or even some links? Thanks.

Essentially Beerina is saying that if you're morally outraged by the $100,000 price tag, you're a communist.