Rationing Health Care - it's a lie!

[ohp]

Have you ever asked yourself why prescription drugs are so expensive in the US but not in France, the UK, Canada, etc? Those governments told the developers of those drugs that they can only charge a fixed amount for their drugs, this doesn't include massive R&D costs. So who pays for the the R&D? The USA does.

It's been interesting watching this discussion. I really thought that the US system was a selfish one, giving the best health care to only those who could afford it.

It turns out that overall they're spending more, and putting up with shorter life expectancies than us socialists, just so they can pay for our R&D costs.

Man, I'm so glad you can get free oesophageal biopsies here, because that kind of altruism really brings a lump to your throat.

boom-tish! I'll be here all night folks

 

[Corsair 115]

I'm sure the Canadians will just applaud that decision, what with them living in poverty after years under unjust tyrants...

Yeah! We last had a federal election ages ago, back on Oct. 14, 2008. And the last federal election before that was on Jan. 23, 2006. And before that, it was on June 28, 2004. The injustice of so few elections!

And the dollar! Oh my, why in November of 2007 it was only worth $1.10 American. Clearly the international market thought poorly of our currency, economy, and country!

 

[Ziggurat]

So WalMart didn't decide to help through altruism but rather because it felt it's customers would demand that it helped?

Individuals within Walmart may indeed have been motivated by altruism. But Walmart is an institution, and as an institution, it acted because it saw a benefit to itself in acting. Whether or not customers demanded it act in this case, I think Walmart believed (and probably correctly) that it would be rewarded in the long run by customers because of what they did.

You want to leave such things to the vagaries of the market place or individual altruistic intent? What if no one steps up to the plate?

You seem to be operating under the mistaken impression that I am calling for the dissolution of FEMA. I am not.

FEMA performed poorly in this instance, and Walmart performed well, though on a smaller scale. Walmart is not in the emergency response business, FEMA is, and so clearly Walmart is no substitute for FEMA. Yet the fact remains, the institution which was supposedly more accountable and had better motives did poorly, while the institution with supposedly no accountability and impure motives did well. So the idea that government will perform better because of superior incentives and more accountability is unsupported.

 

[Delscottio]

Individuals within Walmart may indeed have been motivated by altruism. But Walmart is an institution, and as an institution, it acted because it saw a benefit to itself in acting. Whether or not customers demanded it act in this case, I think Walmart believed (and probably correctly) that it would be rewarded in the long run by customers because of what they did.



You seem to be operating under the mistaken impression that I am calling for the dissolution of FEMA. I am not.

FEMA performed poorly in this instance, and Walmart performed well, though on a smaller scale. Walmart is not in the emergency response business, FEMA is, and so clearly Walmart is no substitute for FEMA. Yet the fact remains, the institution which was supposedly more accountable and had better motives did poorly, while the institution with supposedly no accountability and impure motives did well. So the idea that government will perform better because of superior incentives and more accountability is unsupported.

I know nothing about the clear up but what strikes me is Walmart would have been able to pick and choose what they did, where as FEMA wouldn't have had that luxury. If Walmart didn't perform better they really needed to have a good look at themselves. Cherry pick, always the way to make yourself look good!

Btw I am not knocking Walmart, good on them. But the comparison isn't really a fair one.

 

[Rolfe]

there are not many facts in sicko, apart from a few stunts, a hefty dose of agitprop and trumpeting a sort of utopian healthcare system.

you know what. At the moment, i am watching Sicko. I will tell you what i think.

Just checking, have you watched Sicko previously, or is this your first viewing?

well, tbh it is my first, but i watched Bowling for Columbine, ....

I don't really want to be snarky, but sometimes it's irresistible. This was the culmination of quite a series of posts ranting about the inaccuracies in Sicko, starting from where I mentioned it included some detail relevant to what we were talking about.

I wasn't madly impressed by Bowling for Columbine either, though I found it an interesting insight into the American psyche. It gave me a perspective I hadn't expected, when instead of blaming the guns and the gun laws, he blamed the toxic American relationship with guns. (I had no idea how many Canadians had guns before I watched the film, and after that I started thinking about how common guns are even in Britain - how many pheasants and partridges and grouse get shot here every year? - but we don't have these attitudes.)

I thought Farenheit 911 was a poor film, because making a film to try to influence a presidential election is seldom a good idea.

I thought I'd have another look at Stupid White Men, and while I have to say I find Moore vastly amusing, looking at it dispassionately much of it is a poorly-grounded rant.

I followed several threads on Sicko a couple of years ago, but the computer I had then couldn't stream the video. I got certain impressions about what the film showed, and a lot more ranting about Moore. When I watched the film for the first time a few weeks ago, I found it much better than I expected and much better than his earlier work. I also realised that certain parts of it had been grossly misrepresented by posters who opposed healthcare reform, particularly the section relating to the Cuba visit.

I rechecked the earlier threads, and found almost no discussion of what Moore actually presented. Just rants about Moore.

I intended to start a new thread about the film, and began to compile a summary of the segments for reference. That is not yet finished. However, I think the time has come to start that thread.

So, can we stop this semi-derail of this one, and move to a new one? I'll post the link when I've got the OP up.

Rolfe.

ETA: New thread specifically for discussing Sicko. What if Michael Moore had not made "Sicko"?
Please can we go there for that topic?

 

[Ziggurat]

I know nothing about the clear up but what strikes me is Walmart would have been able to pick and choose what they did, where as FEMA wouldn't have had that luxury.

Irrelevant. FEMA screwed up in Katrina. They've handled some hurricanes well, so it's not simply a matter of them not being able to choose what they do.

Btw I am not knocking Walmart, good on them. But the comparison isn't really a fair one.

Sure it is, because it's relative performance which is what's being examined. I'm not arguing about who should be in charge of disaster relief, I'm arguing about the effects of incentives, and against the illusion that the incentives government has are intrinsically purer or more effective. But perhaps Milton Friedman can make that point better than I can:
http://www.youtube.com/watch?v=RWsx1X8PV_A

 

[Delscottio]

Irrelevant. FEMA screwed up in Katrina. They've handled some hurricanes well, so it's not simply a matter of them not being able to choose what they do.

Was Katrina not on another scale to other hurricanes? Thats the impression from theI got from the news coverage over here.

Sure it is, because it's relative performance which is what's being examined. I'm not arguing about who should be in charge of disaster relief, I'm arguing about the effects of incentives, and against the illusion that the incentives government has are intrinsically purer or more effective. But perhaps Milton Friedman can make that point better than I can:
http://www.youtube.com/watch?v=RWsx1X8PV_A

Relative performance, what are you comparing Walmart to? FEMA?

How can you compare one to another when they had completely different roles, responsibilities and expectations?

 

[Newtons Bit]

I'm making my comparisons with Canada, please excuse me if things aren't quite identical in other countries with socialized medicine. I'm also going to use Pfizer as an example. Here's their financial report.

Evidence that the US unfairly subsidises other countries? Or is it just that you guys are getting ripped off?

Evidence that you invest a disproportionate amount to R&D?

Evidence that this is funded from the private healthcare sector anyway, as opposed to separate central government bodies?

The Facts:

Canada has a government agency called the Patented Medicines Prices Review Board(PMPRB). This agency regulates the price of all medicine that is still covered under patent (thus there being no competition). They apparently take the median of France, Germany, Italy, Sweden, Switzerland, U.K. and the U.S. I assume France, Germany, Italy, Sweden, Switzerland and the U.K. have similar systems of price controls. Correct me if I'm wrong.

Pfizer, in 2008, had total assets of 111.1B, total debt of 17.2B, a net income of 8.1B and research expenses of 7.9B. That gives a total invested value of the stakeholders of 93.9B. They have a rate of return of 8.6%. I call that reasonable return on an investment.

Pfizer is not screwing anyone. They make a reasonable profit and spend a reasonable amount of money on new R&D. Socialized medicine in Europe and Canada on the other hand, take advantage the USA by fixing costs. Drug companies have to increase the cost of medicine in the USA so that they still generate enough revenue to pay for all of the R&D that they need. And then on top of that, they still need to maintain a good financial outlook to attract investors.

I think it's pretty self-evident that the USA shoulders the financial responsibility of new drug development. I don't mind subsidizing the medical development for poor areas of the world. They need all the help. But let's face it, Western Europe is not poor. You fekkers can afford to pay your fair share of medical R&D.

This problem wouldn't even exist in a free market (at least within the West).

 

[Newtons Bit]

It's been interesting watching this discussion. I really thought that the US system was a selfish one, giving the best health care to only those who could afford it.

It turns out that overall they're spending more, and putting up with shorter life expectancies than us socialists, just so they can pay for our R&D costs.

Man, I'm so glad you can get free oesophageal biopsies here, because that kind of altruism really brings a lump to your throat.

boom-tish! I'll be here all night folks

It's not altruism. It's called getting screwed over by your friends.

Imagine going to a pub with your mates. The four of you drink an equal amount and run up a bar tab of $50. Each of your three mates pays $10 bucks, calls it a fair value for what they received and then takes off. The bartender then makes you pay the last $20. That's what's going on here.

Now what happens if the USA finds a way to prevent other countries from fixing the price of medicine? Well then, our friends the Canadians, British and French are now paying $2.50 more and the USA is paying $7.50 less.

(Please don't take this metaphor too far)

 

[GreyICE]

It's not altruism. It's called getting screwed over by your friends.

Imagine going to a pub with your mates. The four of you drink an equal amount and run up a bar tab of $50. Each of your three mates pays $10 bucks, calls it a fair value for what they received and then takes off. The bartender then makes you pay the last $20. That's what's going on here.

Now what happens if the USA finds a way to prevent other countries from fixing the price of medicine? Well then, our friends the Canadians, British and French are now paying $2.50 more and the USA is paying $7.50 less.

(Please don't take this metaphor too far)

Like into the realm where nothing you actually say is happening? Oddly enough, what the other countries pay covers manufacturing costs and research. The formula most countries use even leaves room for good profits, and dead-end research. Not so good on advertising, but in other countries, advertising drugs isn't a big ticket industry, so they don't raise a stink.

 

[Rolfe]

Newton, think about this.

You want a new car. The trade magazine says that a discount of $4,000 off the list price is achievable. You have a couple of friends who got the same car from the same dealer, and you know they got that discount. You go to the dealer, who of course quotes the list price. You accept this with no attempt to bargain, and pay the extra $4,000.

Why on God's green earth would you do that?

Well, apparently you believe that if you don't, Ford won't be able to afford the R&D it needs to produce the next new model.



Producing the next new model is vital to Ford's business model. It knows its price structures, and it knows how it's going to achieve that. It hasn't singled you out to hold a gun to your head and insist that you alone must pay list price, and neither have any of your mates.

Your mates urge you to get real, and bargain with the dealer for a better price. They realise that maybe the prices they can get in future may be a bit less keen, with you not behaving like a sucker any more, but they're cool with that.

But no. You want instead to force everyone else to pay the list price too.

Are you completely out of your tree???

(And by the way, this is a lot more relevant an analogy than the bar tab, and you can run with it if you like.)

Rolfe.

 

[Newtons Bit]

Like into the realm where nothing you actually say is happening? Oddly enough, what the other countries pay covers manufacturing costs and research. The formula most countries use even leaves room for good profits, and dead-end research. Not so good on advertising, but in other countries, advertising drugs isn't a big ticket industry, so they don't raise a stink.

So it's okay to screw over your neighbors so long as you "have a good formula" for screwing them?

 

[Rolfe]

Nobody, but NOBODY, is preventing you from doing exactly what everybody else is doing, and bargaining for a better price.

That's the free market. You seem curiously reluctant to take advantage of it.

Rolfe.

 

[Newtons Bit]

Newton, think about this.

You want a new car. The trade magazine says that a discount of $4,000 off the list price is achievable. You have a couple of friends who got the same car from the same dealer, and you know they got that discount. You go to the dealer, who of course quotes the list price. You accept this with no attempt to bargain, and pay the extra $4,000.

Why on God's green earth would you do that?

Well, apparently you believe that if you don't, Ford won't be able to afford the R&D it needs to produce the next new model.



Producing the next new model is vital to Ford's business model. It knows its price structures, and it knows how it's going to achieve that. It hasn't singled you out to hold a gun to your head and insist that you alone must pay list price, and neither have any of your mates.

Your mates urge you to get real, and bargain with the dealer for a better price. They realise that maybe the prices they can get in future may be a bit less keen, with you not behaving like a sucker any more, but they're cool with that.

But no. You want instead to force everyone else to pay the list price too.

Are you completely out of your tree???

(And by the way, this is a lot more relevant an analogy than the bar tab, and you can run with it if you like.)

Rolfe.

How is that analogy even remotely accurate? I can't get the bargain that my friends get. My friends went to the car dealer and told the dealer, "you will charge me X amount". My "friends" have the power to make that happen.

 

[Newtons Bit]

Nobody, but NOBODY, is preventing you from doing exactly what everybody else is doing, and bargaining for a better price.

That's the free market. You seem curiously reluctant to take advantage of it.

Rolfe.

Setting price controls is a free market? Can you explain that one to me? I don't get it.

 

[Rolfe]

What mystical "power" do your friends have that you don't have?

Rolfe.

 

[Newtons Bit]

What mystical "power" do your friends have that you don't have?

Rolfe.

Lack of morals.

Let's be clear here. What Canada, the UK, France and all others countries that set price controls on medicine are doing is no better than theft from the pockets of people in the USA.

To make it worse, it's generally theft from people who are sick.

 

[Rolfe]

What? Your mates who got the $4,000 discount by negotiating on the free market are stealing from you, because you have decided you don't want to bargain with the dealer for a similar deal?

That's crazy talk, man!

Rolfe.

 

[ddt]

It's not altruism. It's called getting screwed over by your friends.

Imagine going to a pub with your mates. The four of you drink an equal amount and run up a bar tab of $50. Each of your three mates pays $10 bucks, calls it a fair value for what they received and then takes off. The bartender then makes you pay the last $20. That's what's going on here.

Now what happens if the USA finds a way to prevent other countries from fixing the price of medicine? Well then, our friends the Canadians, British and French are now paying $2.50 more and the USA is paying $7.50 less.

(Please don't take this metaphor too far)

I like the metaphor. But you phrase it in the wrong way. The "fourth" friend in your story leaves earlier and says the bartender to write it on his tab, whatever the price is. The three other friends haggle with the bartender over the price and talk it down to $10, and so the bartender writes $20 on the tab of friend 4.

The US system itself has said to itself: we don't haggle, we pay whatever the pharma companies ask.

ETA. You want to win a discussion about bargaining from Scots and Dutch?

 

[GreyICE]

So it's okay to screw over your neighbors so long as you "have a good formula" for screwing them?

You mean it's okay to pay a fair price for a good with an inelastic demand curve if it saves lives? No! We must worship the free market as people die! This is hysterical. You'd put the free market above lives.