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Knut Robert Knutsen
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Posted: 17 September 2008 at 10:32pm | IP Logged | 1  

"So what?  There is a huge difference between a business failing, thus costing investors and the government seizing and entire industry and closing it down thus costing the investors.

All the pension plans, 401ks, etc. would be decimated.  So it's okay, to you, for the government to destroy the retirement funds of the poor and middle class?  The rich would shrug it off, take a deduction and make more money.  The poor and middle class couldn't do that."

Ah, so you're saying that no matter how costly, inefficient and detrimental to the health of the citizenry, the private health insurance industry must be sustained so that its investors may continue to profit by providing an inferior service at the potential cost of human lives?

See what I did there? I contrasted the loss of pensions with the loss of human lives. Which is what we're talking about when we're discussing which health care plan is better and covers more people. A fully government financed plan would have to cover 100 percent of the people. The current privately financed plan does not.

Now, bear in mind that I only advocate shifting to a government system if the proposed government system has a credible plan for providing better or more comprehensive service while the private system does not. All things being equal, the existing system would take precedence.

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John Bodin
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Posted: 17 September 2008 at 10:51pm | IP Logged | 2  

 Scott Richards wrote:
4.  Drug prices are higher in the US to recoupe R&D.  Since other countries put caps on what can be charged for drugs in their country it puts all the costs on the US prices where there is no cap.  So, regulate the US drug companies so that the drugs are sold for the same price every where.   Of course they could still donate drugs or offer low cost drugs to third world countries that can't afford the higher costs, but that shouldn't apply to any industrialized nation.  Since they couldn't lower the price in the US down to the level of other countries and still be able to do R&D, they would raise the price to other countries so it was a level playing field.  If a regulation in a country prevented it from being sold at a fair price for everyone, then the drug companies just stop selling to that country until they agree to a fair price.


I'm usually shoulder-to-shoulder with you regarding most everything you've posted in this thread, Scott, but this one brings me up short simply because it won't work.  You are correct about the reason for high drug prices here in the U.S., but price caps in regulated countries are counter-balanced by OTHER laws and regulations.  I'm not sure how it is in other countries, but here in the U.S. if a deaths result from insufficient inventory or production of critical life-sustaining drug compounds, then the company may be penalized for negligence by the FDA (which in this country usually means large fines for the company, along with someone at the drug company doing jail time).  This has nothing to do with the outcome of lawsuits -- this is something that is monitored by the FDA and is handled at the federal level even before the patients and lawyers get involved on the civil side. 

England, Germany, France, Japan, and other nations have their own agencies that serve the same purpose as our own FDA -- these agencies oversee drug approvals and production, regulate pharmaceutical industries who operate within their jurisdiction, and they monitor for infractions just like our own FDA, and I'm guessing that the "interrupted supply" issue is also something that they monitor and levy penalties for.

This alone would make it virtually impossible for pharmaceutical companies to simply stop selling their products in regulated countries -- other countries wouldn't let U.S.-based drug companies get away with simply NOT supplying approved drugs.

If we truly want to see lower drug prices, we should start with patent extensions for drug compounds, along with greater protection against patent challenges.  A patent is good for 20 years, and pharmaceutical companies have to apply for a patent early in the drug development cycle to ensure exclusivity and to protect against infringement from parallel research within the industry by competitors.  The research, development, and clinical trial phases can easily take up to 12 years or more, which would leave a company with as little as 8 years (and often even less) of guaranteed exclusive patent protection in the marketplace in order to recoup their research, development, and clinical trial expenditures . . . and to also generate FURTHER revenue for growth and follow-on product development (that's reinvestment, not just "pure" profit). 

Once a patent expires and a drug becomes eligible for generic status, then the drug ceases to be a viable revenue and profit source for the company that originally invested many years and billiions of dollars in the discovery, development, testing, manufacture, and marketing of the product in the first place. 

Generic drugs are great for consumers, but generic drug companies are little more than unskilled janitors who stand on the shoulders of giants to screw in lightbulbs.

Allow drug companies a larger window of exclusivity on their patents so that they can recoup THEIR investments over a longer period of time, and your drug costs WILL decline.

[EDITED FOR TYPO AND  CLARIFICATION]


Edited by John Bodin on 17 September 2008 at 10:57pm
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Robin Taylor
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Posted: 17 September 2008 at 10:55pm | IP Logged | 3  

When did Canada become a 3rd world country? Nobody tells me anything

RT
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John Bodin
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Posted: 17 September 2008 at 11:00pm | IP Logged | 4  

 Robin Taylor wrote:
When did Canada become a 3rd world country? Nobody tells me anything


It's been that way ever since your finest comic book artist moved to the good ol' U.S. of A -- you must not have gotten the memo.

;-)
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Robin Taylor
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Posted: 17 September 2008 at 11:04pm | IP Logged | 5  

DAMN YOU MACFARLANE!!!!!


RT
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Didier Yvon Paul Fayolle
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Posted: 17 September 2008 at 11:10pm | IP Logged | 6  

Bwhahahahaha !
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Jeff Gillmer
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Posted: 18 September 2008 at 12:39am | IP Logged | 7  

Change You Can Believe In

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Emery Calame
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Posted: 18 September 2008 at 1:12am | IP Logged | 8  

Once I had to go to an eye doctor and be tortured with bright light and radioactive substances  (well I supposed really they put a radioactive dye into my vein and took pictures of the back of my eye which was damned light sensistive at the time) due to a moderate to sever case of maculitis. This ended with a SHOT (of cortizone) IN MY EYE! When I called they scheduled me to come in at the end of the week but mentioned that my referring eye doctor suspected I had maculitis I was bumped up to "ooh....maculitis? Oh geez. How soon can you get here? " I was there by Nine AM.

It cost me $600 and I had no insurance that would pay it. The "insurance lady" at HR (in Michigan), from my job told me to mail it in but they'd probably reject it since the guy was an out of system specialist who was not himself referred by an in system doctor. They warned me not to have the doctor process the insurance but to seek reinbursement and Marsha, the warehouse supervisor locally said she could cut me an advance or take up a collection. I told her that I had money in the bank but thanks anyway.

When my ordel was over, I wrote the doctor a check and the lady at the front desk didn't seem to know what to do with it. In fact she looked sort of confused and upset. She was clearly expecting an insurance card and was not really too familar with plan B.

The doctor's office called me up the following week and told me that they were looking to charge me $170 dollars instead and planned to return the rest of the $600 or set it up as a credit against further treatement if I preferred. Now I don't know if they got a clinical social worker involved to hook them up with some donation funding to knock to price down, or if the doctor just personally decided to cut me a break and charge me some base cost figure, or if there are two parallel pricing structures, one of which is inflated as a negotiating tactic against insurance companies and the other which is customer/patient oriented.

It was weird. (And yes, I realize that this is anecdotal. Anecdotes often are.)



Edited by Emery Calame on 18 September 2008 at 1:12am
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Adam Hutchinson
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Posted: 18 September 2008 at 4:34am | IP Logged | 9  


 QUOTE:
The hospitals and physicians frequently eat these charges.


Really?  Hospitals and physicians frequently eat thousands of dollars in charges?
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Jeff Alan Hays
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Posted: 18 September 2008 at 5:20am | IP Logged | 10  

Yes.  There's no way to recoup.
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Jeff Alan Hays
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Posted: 18 September 2008 at 5:30am | IP Logged | 11  

"I'm not sure how it is in other countries, but here in the U.S. if a deaths result from insufficient inventory or production of critical life-sustaining drug compounds, then the company may be penalized for negligence by the FDA (which in this country usually means large fines for the company, along with someone at the drug company doing jail time)."

This is an aside to the political discussion, but negligence (just as you said) would be the key.  Drug shortages for all kinds of reasons happen every now and then, but I guess it's up to the FDA to decide if the reason is "good" or not.


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Jeff Alan Hays
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Posted: 18 September 2008 at 5:45am | IP Logged | 12  

"The doctor's office called me up the following week and told me that they were looking to charge me $170 dollars instead and planned to return the rest of the $600 or set it up as a credit against further treatement if I preferred. Now I don't know if they got a clinical social worker involved to hook them up with some donation funding to knock to price down, or if the doctor just personally decided to cut me a break and charge me some base cost figure, or if there are two parallel pricing structures, one of which is inflated as a negotiating tactic against insurance companies and the other which is customer/patient oriented."

They may have had the charge written off.  Some offices do this on a sort of case by case basis or have a general thought process on what to charge cash-pay patients.  They may still take a loss, but it's not terribly uncommon.  Nice to hear that occurred.  The fact you made an effort to pay is very admirable.

Looking at a different population, write-offs for elderly patients with poor funds, indigent patients- etc. were a common practice decades ago and an accepted part of medicine.  Now, it's actually harder to do in the case of medicare recipients.  If such a patient has 80% MC coverage but no supplemental coverage, it is illegal to reduce the fee or fail to charge for the remainder.  Offices can get around this by generating a bill for a patient but telling them to ignore it.

On the private insurance side of things, some fees are set higher by offices and hospitals because insurance companies may not release their fee schedule (what they will pay).  Some insurance companies have been fined for this in individual states but it's still a problem.
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