Sorry, I can't hear you over the sound of my National Health Service:
But in all seriousness, yes it sucks that the drug companies charge the earth. But then again, no-one said that they had to exist for altruistic purposes.
Like a lot of things, there's some truth to that, but also a lot of misleading stuff.
First off, the idea that no pharmacuetical company would try to develope a cure for diabetes or cancer because treatement is profitible assumes that all companies are making money off of treatment. Even if they were, 100% of the cure market for 20 years is a bigger cake than 10% of the treatment market. Collusion may be a factor, but 10 actors is a lot to get to collude quietly and effectively.
I'd be interested to see if the money spent buying research done in academia counts toward the R&D budget. That might alter the facts a bit.
Where things are genuinely troubling is when you look at the time, enegery, and money spent getting people to buy the drugs. Keep in mind that nobody (or hardly anybody), pays full retail for restless leg meds. They have insurance, and pay a co-pay. That's why drug advertising is so effective: it doesn't really force a person to pay the sticker price, only the down payment, and either an insurance company or the government picks up the rest.
As always, the problem here is the fact that we have the worst combination of free market and command ecnomies in the health industry. When one actor (the federal government) essentially sets prices (by setting medicare allowances) there isn't a free market. But everybody else has to act like it is.
Developing drugs (especially for use on humans) is a costly undertaking. The newer drugs tend to have a higher success/failure development rate, but they cost more to develop.
I have heard that drugs companies will make minor changes to a drug in order to keep the patent/etc on it current so other companies cannot use it, which is a bit of a con.
Well, if they change the drug, they get a new patent, but the original patent will still expire. You just have the exclusive rights to sell the "new" drug. Generics can go nuts.
The other question I have about this chart is that it shows that marketing costs twice of what R&D does. Is that high for an industry? I mean, it seems bad, but it's really a non-sequitor. I'm sure the auto industry spends more on ads than on R&D. So, while it seems outrageous, it may not be.
Polonius wrote:Well, if they change the drug, they get a new patent, but the original patent will still expire. You just have the exclusive rights to sell the "new" drug. Generics can go nuts.
The way I remember it being explained to me is that the alterations are placed on the existing patent, thus extending it. I may be mis-remembering it as it was in a lecture on drug manufacture some time ago
I'm not an expert on IP, but the underlying, original patent will expire. Now, doctors can still tell patients that the "new" drug is "better", and only prescribe it, thus denying them access to a generic.
Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Not including the three or four other 30 million dollar pills that never amounted to a commercially viable product?
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Not including the three or four other 30 million dollar pills that never amounted to a commercially viable product?
Sure. To be clear I'm not trying to defend all of the pharmaceutical industries (I'm not calling it big pharma) practices or pricing, but the first part on cost doesn't give a full picture of what the actual costs are.
I had a class with a teacher who work in pharm last semester. She would not stop talking about the cost of developing drugs, why they cost so much, how the government handles it etc. Granted, it was a very informative class. The only science they made me take I didn't hate so far
Remember, the ancestors of Big Pharma are the same criminals who started out importing Heroin and Morphine into the pre-revolution Colonies. They're still the same snake-oil salesmen. If they really spent so much time and money developing these poisons, then why do they have so many side effects, many of which are worse than the ailment that they allegedly treat?
warpcrafter wrote:Remember, the ancestors of Big Pharma are the same criminals who started out importing Heroin and Morphine into the pre-revolution Colonies. They're still the same snake-oil salesmen. If they really spent so much time and money developing these poisons, then why do they have so many side effects, many of which are worse than the ailment that they allegedly treat?
warpcrafter wrote:Remember, the ancestors of Big Pharma are the same criminals who started out importing Heroin and Morphine into the pre-revolution Colonies. They're still the same snake-oil salesmen. If they really spent so much time and money developing these poisons, then why do they have so many side effects, many of which are worse than the ailment that they allegedly treat?
warpcrafter wrote:Remember, the ancestors of Big Pharma are the same criminals who started out importing Heroin and Morphine into the pre-revolution Colonies. They're still the same snake-oil salesmen.
Woah, leave us out of it! We're already copping enough flak for the oil-spill!
Also, I'm pretty sure Heroin and Morphine didn't exist back in the 1770s.
Automatically Appended Next Post: Turns out I was right.
SilverMK2 wrote:Developing drugs (especially for use on humans) is a costly undertaking. The newer drugs tend to have a higher success/failure development rate, but they cost more to develop.
I have heard that drugs companies will make minor changes to a drug in order to keep the patent/etc on it current so other companies cannot use it, which is a bit of a con.
To the three or four posters who mention R&D---It is well known that most pharma companies spend more on advertising than they do on research.
SilverMK2 wrote:Developing drugs (especially for use on humans) is a costly undertaking. The newer drugs tend to have a higher success/failure development rate, but they cost more to develop.
I have heard that drugs companies will make minor changes to a drug in order to keep the patent/etc on it current so other companies cannot use it, which is a bit of a con.
To the three or four posters who mention R&D---It is well known that most pharma companies spend more on advertising than they do on research.
Well known by who?
You're confusing the latest pill for the whiny Me Generation to keep their willies up vs. something real like heart medicine to keep you from dying.
olympia wrote:To the three or four posters who mention R&D---It is well known that most pharma companies spend more on advertising than they do on research.
Even if that were true, it still doesn't change the fact that it costs more to develop the first pill then the subsequent production of the pill. Yes, the pill may cost .20 to produce after the first one is created, tested, sent through trials, and approved by the FDA, but that first one costs a ton of money. I think you didn't read what we were talking about as one has little to do with the other as to the point being discussed, that is, initial pill vs mass production cost.
Also, i don't know if it is 'well know', so if you can produce some reputable sources on it I'd be happy to see them. Also, as Polonius pointed out, even if it were true, is that unusual or fairly normal?
The problem with the American Healthcare system has never really been where the money comes from, it is where the money goes to.
Lawyers, Insurance Companies and Big Pharma, and their lobbies, are the problem. If you could pay a reasonable amount in order to talk to a doctor and be told that your child's cough would go away, or be given a prescription for a reasonably priced drug, then there would be no need for government healthcare.
But the government hasn't even come close to addressing any of these issues - their hands are out and their pockets are lined by the lobbies from these industries. They'd rather increase taxes and plunge us further into debt in order to fund government healthcare, which simply means that my taxes pay for overpriced drugs.
The whole mess can be solved, easily, by regulating the pharmaceutical industries, in the way that utilities are regulated, and by capping malpractice suits and taking the lawyers and insurance companies out of the picture.
The pharmaceuticals are interesting because investors want to see them as a growth stock (which they shouldn't be), and so their CEOs are pushed to yield consistently higher profits. That's ridiculous. The only way to constantly grow in this market is to either a) encourage people who aren't sick that they need to buy something (ala viagra), or to raise prices.
Pharmaceuticals shouldn't be a growth stock, they should be seen as a value stock. They should be paying dividends and making a consistent, yet reasonable, profit quarter after quarter. No one ever went broke buying stock in GE or ComEd or NiCor, and there's a place for these stocks in all balanced portfolios.
The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion.
olympia wrote:Some of you folks really do live in a bubble...
The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion.
You only answered part of the question. I guess others of us live in their own bubbles. I'm not really sure how asking a question means a person is 'living in a bubble'. No one on here knows everything about every subject, i mean, I know you sure don't, but when you do it is nice of you to share as you are now. Your use of 'living in a bubble' would seem to imply that we either wouldn't inquire or we would have just refuted you outright. Instead we asked you to tell us more and you get all snippy.
That and the fact that the same pharmaceuticals we have also supply Canada, which does have a price cap. This means that any potential profit they could get in Canada needs to be made up for in America.
There's also the fact that unlike a lot of other industries, pharmaceutical companies can face a lot of trouble if a pill is found to be detrimental to certain people.
Zoloft got a lot of flack and was blamed in causing suicidal tendencies to increase in users. The pharmaceutical company then needed to settle with the victims families and to also pay for legal matters. So there are other costs besides R&D and advertising to consider. Plus there's the employees who need to be paid such as the researchers themselves, factory workers, truck drivers, contractors, representatives, CEO's, legal consultants...
Medium of Death wrote:
Seriously though, what are your politicians doing about this?
Nothing, like the medical community they are on big pharma's list of "we'll send you to a CONFERENCE" in Hawaii.
Honestly, its not accepted as a problem by most US citizens. They are of the mindset of "OMFG drugs are EXPENSIVE to make". No noob, they are not (as expensive as we are led to believe). We don't need new drugs every year to treat the same disease SYMPTOMS. Plz stop chasing treatments and start chasing cures. Its all about $$$$
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Frazzled wrote:
You're confusing the latest pill for the whiny Me Generation to keep their willies up vs. something real like heart medicine to keep you from dying.
Don't knock the penis pills til you try em. Levitra is amazing......worth every penny you pay for it. I'm much more concerned with EFFECTIVE diabetes treatments (hello chidhood onset diabetes wtf are you here for?), and getting rid of the pathological view of EVERY ache, pain, and negative emotion that Americans feel. Hello noobs, you don't need a pill to feel better when you are sad. You need to get off your ass and take control of your life.
Same with pain, my father and sister both suffer from Ankylosing Spondylitis. As a result my father was told he would be crippled by age 35, and my sister has been told the same thing. Medical community was horsegak wrong, plus no painkillers other than asprin needed. Oh, but DAMN did they offer all kinds of $$$ treatment when sister diagnosed. lol noobs, nope. She's fine, just suck it up and be real.
Medium of Death wrote:
Seriously though, what are your politicians doing about this?
Nothing, like the medical community they are on big pharma's list of "we'll send you to a CONFERENCE" in Hawaii.
Honestly, its not accepted as a problem by most US citizens. They are of the mindset of "OMFG drugs are EXPENSIVE to make". No noob, they are not (as expensive as we are led to believe). We don't need new drugs every year to treat the same disease SYMPTOMS. Plz stop chasing treatments and start chasing cures. Its all about $$$$
Automatically Appended Next Post:
Frazzled wrote:
You're confusing the latest pill for the whiny Me Generation to keep their willies up vs. something real like heart medicine to keep you from dying.
Don't knock the penis pills til you try em. Levitra is amazing......worth every penny you pay for it. I'm much more concerned with EFFECTIVE diabetes treatments, and getting rid of the pathological view of EVERY ache, pain, and negative emotion that Americans feel. Hello noobs, you don't need a pill to feel better when you are sad. You need to get off your ass and take control of your life.
Same with pain, my father and sister both suffer from Ankylosing Spondylitis. As a result my father was told he would be crippled by age 35, and my sister has been told the same thing. Medical community was horsegak wrong, plus no painkillers other than asprin needed. Oh, but DAMN did they offer all kinds of $$$ treatment when sister diagnosed. lol noobs, nope. She's fine, just suck it up and be real.
DO NOT NEED PILLS FOR EVERYTHING IN UNIVERSE
And you're qualified to make this statement in any way, shape, or form how?
Frazzled wrote:
And you're qualified to make this statement in any way, shape, or form how?
Personal opinion and 14 months working in direct client care in a crisis residential facility. Dealt with the most damaged demographics of culture out here, and it was very sad how many of them were totally and completely addicted to painkillers and/or benzo's. To the degree that we were unable to refer out 40+% of our clients to effective aftercare due to policy in place by organizations like Salvation Army of "NO DRUGS ALLOW"" (including doctor perscribed). Also Kaiser Permanente will not allow ANYONE to take part in their drug treatment program if they are not 100% clean. Hell, they will throw you OUT of the program if you relapse.
Not a research fellow for Genentech, but I've seen my share of the wreckage caused by frivolous use of "medically approved" drugs.
Wut, you never ate a Vicodin for fun?
Comment on Ankylosing Spondylitis and my qualification is that due to the rarity of diagnosis (esp in females) and the fact that my whole family has educated themselves on the genetic disorder so that we can help my sister and father deal with the pain if it becomes too unmanageable. I'd personally reccomend methadone as a chronic pain killer, but people have stigmatized it due to its efficacy in treatment of heroin addiction. FYI the opiate pain blocking effect of methadone lasts 72 hours, and its DIRT CHEAP to produce. TY Nazi scientists for your synthetic morphine invention!
So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
EDIT: I'm not saying there is waste, fraud, abuse, and greed. Its a human enterprise, therefor that is rampantly inherent.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Damn you and your so called 'books' and yer litterehsay.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Damn you and your so called 'books' and yer litterehsay.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Its not a strawman. You've attempted to convict one of the largest industries in the world. It would behoove you to support those claims, else you'll be lumped in with the aluminum hat crowd.
Working with drug addicts is not inciative of anything except, well, drug addicts.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Have DSM-IV too? I do, as well as a few courses in behavioral pharmacology. Like I said, not a research fellow but I know much more than the average person on the subject.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Damn you and your so called 'books' and yer litterehsay.
Indeed. We don't cotton to no readin round these parts. Get a rope.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Its not a strawman. You've attempted to convict one of the largest industries in the world. It would behoove you to support those claims, else you'll be lumped in with the aluminum hat crowd.
Working with drug addicts is not inciative of anything except, well, drug addicts.
NO offense Frazz, but you don't know what you are talking about in relation to the background needed in order to efficiently deal with crisis care. Its not about "drug addicts" its about the fact that drug addiction is overly represented as a co-occurring treatment concern with the homeless, teens, LGBTQ's, and the mentally ill. And as anyone knows, you cannot treat co-occurring behavioral concerns separately and expect (statistically) a long term positive out come for your patient/client.
I'm not going to go down the road of pointing out your fallacies, since it will just open me up to the same tactic. Also not gonna argue with yah about this one. I do know what I'm talking about, thats enough for me.
Crisis care and behavioral health (my area of training) =/= drug addiction treatment
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Have DSM-IV too? I do, as well as a few courses in behavioral pharmacology. Like I said, not a research fellow but I know much more than the average person on the subject.
Nope, I prefer immediate results over waiting for them so I'm going for surgery. DSM-IV would be fun to have, but I find texts from pre-70's medicine fun.
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Have DSM-IV too? I do, as well as a few courses in behavioral pharmacology. Like I said, not a research fellow but I know much more than the average person on the subject.
Nope, I prefer immediate results over waiting for them so I'm going for surgery. DSM-IV would be fun to have, but I find texts from pre-70's medicine fun.
And once again ignorance rears its ugly head. I won't bother with your comment about immediate results in a thread that is decrying 20 year patent laws.
DSM-IV is the FOURTH edition of the diagnostic statistical manual for the behavioral health community. It was published in 1994 and the DSM-V should be released by 2012 with an emphasis on spectrum of disorder instead of 100% concrete diagnosis. I've worked with everything from MFT (the only lisence other than LCSW recognized in this state), to post-doctoral PsyD's, to psychiatrists (the MD other is psychologist) in my professional capacity. This establishes that I may just know what I am talking about to a certain degree. Admitedly, my own credentials focus more on the behavioral aspects than the medical....still the two are reliant on each other.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
Psychiatric Diagnoses are categorized by the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition. Better known as the DSM-IV, the manual is published by the American Psychiatric Association and covers all mental health disorders for both children and adults. It also lists known causes of these disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches.
Mental Health Professionals use this manual when working with patients in order to better understand their illness and potential treatment and to help 3rd party payers (e.g., insurance) understand the needs of the patient. The book is typically considered the ‘bible’ for any professional who makes psychiatric diagnoses in the United States and many other countries. Much of the diagnostic information on these pages is gathered from the DSM IV.
The DSM IV is published by the American Psychiatric Association. Much of the information from the Psychiatric Disorders pages is summarized from the pages of this text. Should any questions arise concerning incongruencies or inaccurate information, you should always default to the DSM as the ultimate guide to mental disorders.
The DSM uses a multiaxial or multidimensional approach to diagnosing because rarely do other factors in a person's life not impact their mental health. It assesses five dimensions as described below:
Axis I: Clinical Syndromes
*
This is what we typically think of as the diagnosis (e.g., depression, schizophrenia, social phobia)
Axis II: Developmental Disorders and Personality Disorders
*
Developmental disorders include autism and mental retardation, disorders which are typically first evident in childhood
*
Personality disorders are clinical syndromes which have a more long lasting symptoms and encompass the individual's way of interacting with the world. They include Paranoid, Antisocial, and Borderline Personality Disorders.
Axis III: Physical Conditions which play a role in the development, continuance, or exacerbation of Axis I and II Disorders
*
Physical conditions such as brain injury or HIV/AIDS that can result in symptoms of mental illness are included here.
Axis IV: Severity of Psychosocial Stressors
*
Events in a persons life, such as death of a loved one, starting a new job, college, unemployment, and even marriage can impact the disorders listed in Axis I and II. These events are both listed and rated for this axis.
Axis V: Highest Level of Functioning
*
On the final axis, the clinician rates the person's level of functioning both at the present time and the highest level within the previous year. This helps the clinician understand how the above four axes are affecting the person and what type of changes could be expected.
NO offense Frazz, but you don't know what you are talking about in relation to the background needed in order to efficiently deal with crisis care. Its not about "drug addicts" its about the fact that drug addiction is overly represented as a co-occurring treatment concern with the homeless, teens, LGBTQ's, and the mentally ill. And as anyone knows, you cannot treat co-occurring behavioral concerns separately and expect (statistically) a long term positive out come for your patient/client.
***I don't make the claim to know anything. I also didn't make the claim that an entire industry is evil. However I do know crisis care, although a potentially noble profession, has little to do with the pharmacy industry.
I'm not going to go down the road of pointing out your fallacies, since it will just open me up to the same tactic. Also not gonna argue with yah about this one. I do know what I'm talking about, thats enough for me. ***No, you don't. You know about handling addicts. Thats irrelevant to cancer medicines, heart medicines, liver and kidney medicines, brain medicines etc. etc. Again, I'm not making any overbroad claims here other than the common sense view that industries aren't :EEEEVVVVVILLLLLLL!!!!" **
**Banking, legal, and of course house building contractors of course being an exception.
Crisis care and behavioral health (my area of training) =/= drug addiction treatment
****Thats great but, so? Its nothing to do with the actual topic.
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Sorry Ahtman im going to have to disagree with you... it'll cost alot lot more than 30 million
Now there are certain things you need when making medical drugs.
Clean production line, machines and creating the clean area is very very expensive. Single machines run in the millions of dollars range all before the first pill is even made
This is after R&D (15% of one of these company's earnings is still immense) and advertising (needed for the drug to sell well)
Then you have employees and maintenance.
Machines break down or faulty batches are created, you need employees with high level of education to help figure out these problems and to test the pills.
And yes, I do think that big pharma is evil and corrupt. This is based on the experiences I've had with them personally as well as seen first hand experience working with folks that have serious behavioral and medical concerns.
Plus their advertising is just too damn well designed from a psychological angle.
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halonachos wrote:
Peter Wiggin wrote:
halonachos wrote:
Peter Wiggin wrote:
Frazzled wrote:So you don't have expertise on pharmaceuticals needed for healthcare. Gotcha.
More than most do actually. I'm quite familiar with the manipulation of US patent laws as well as first line treatments with highly addictive drugs by the medial community. Its all about the degree of action said drug has on the mesolimbic pathway pathway.
What is your qualification for attempted Strawman?
Pshaw, I have a Stedman's Medical Dictionary and a Grey's Anatomy so I know way more than you or any doctor does.
Have DSM-IV too? I do, as well as a few courses in behavioral pharmacology. Like I said, not a research fellow but I know much more than the average person on the subject.
Nope, I prefer immediate results over waiting for them so I'm going for surgery. DSM-IV would be fun to have, but I find texts from pre-70's medicine fun.
Please try to treat schizophrenia, diabetes, and a host of other treatment concerns with surgery. Dumb comment is dumb.
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Frazzled wrote:
Crisis care and behavioral health (my area of training) =/= drug addiction treatment
****Thats great but, so? Its nothing to do with the actual topic.
You asked what my qualifications were for decrying big-pharma. I have given you a little bit about my background, and the reasoning behind why I feel that I have at least a small idea of the scope of things.
The fact that you don't like my comments and don't agree does not change the fact that I have a fair amount of training and experience with the medical/behavioral healthcare system.
You do realize that I am a psych minor? I know what the DSM-IV is and I also know that behavioral diagnosis takes a long while to actually diagnose.
Same thing with being a gen. practicioner, you diagnose a disease after tests and then wait to see if the medicine you give works. If I'm a surgeon and I remove a bullet from someone's leg, BAM, instant results.
So yes, lolnoob indeed.
I'm a NREMT-B, can't do anything with it in this state besides work towards getting an ER Tech certification. Would've gone for state, but I was only 17 at the time the state test was going on.
halonachos wrote:God, Wiggins you are infuriating.
You do realize that I am a psych minor? I know what the DSM-IV is and I also know that behavioral diagnosis takes a long while to actually diagnose.
Same thing with being a gen. practicioner, you diagnose a disease after tests and then wait to see if the medicine you give works. If I'm a surgeon and I remove a bullet from someone's leg, BAM, instant results.
So yes, lolnoob indeed.
I'm a NREMT-B, can't do anything with it in this state besides work towards getting an ER Tech certification. Would've gone for state, but I was only 17 at the time the state test was going on.
Lolnoob.
Im under the impression that wiggins is just trolling, especially with the lolnoob talk
halonachos wrote:God, Wiggins you are infuriating.
You do realize that I am a psych minor? I know what the DSM-IV is and I also know that behavioral diagnosis takes a long while to actually diagnose.
Same thing with being a gen. practicioner, you diagnose a disease after tests and then wait to see if the medicine you give works. If I'm a surgeon and I remove a bullet from someone's leg, BAM, instant results.
So yes, lolnoob indeed.
I'm a NREMT-B, can't do anything with it in this state besides work towards getting an ER Tech certification. Would've gone for state, but I was only 17 at the time the state test was going on.
Lolnoob.
For bolded THANKS!
Good, then you have the background to make a comment based on your educational experiences. I however have the background to comment based on both my education and my professional experience.
Psyche minor huh? Thats cool, what is your major?
Im under the impression that wiggins is just trolling, especially with the lolnoob talk
Funny how using leetspeak makes folks think that isn't it? You are not correct. I could troll if I wanted, but this is a serious subject. Besides, why would I troll MY OWN thread?
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Sorry Ahtman im going to have to disagree with you... it'll cost alot lot more than 30 million
I can't list the R&D cost of every single drug out there you know. I was just using the .20 to 30,000,000.00 as an general example. I debated on 30 mill or 300 mill but in the end I flipped a coin.
halonachos wrote: you diagnose a disease after tests and then wait to see if the medicine you give works. If I'm a surgeon and I remove a bullet from someone's leg, BAM, instant results.
not test, diagnostic criteria. can be very different for behavoiral concerns. How does one test for Borderline Personality Disorder? Simple.....look at past history of patient in regards to life difficulty and treatment concern!
Splitting hairs, i know.
Comparing bullet in leg to chronic conditions (ie gonna treat the symptoms TY BIG PHARMA) is a fallacy. Plz no use
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Sorry Ahtman im going to have to disagree with you... it'll cost alot lot more than 30 million
I can't list the R&D cost of every single drug out there you know. I was just using the .20 to 30,000,000.00 as an general example. I debated on 30 mill or 300 mill but in the end I flipped a coin.
Yep i know i was also pointing out the cost of a new production line/ new equipment for the new drug, also the cost of failed runs (bad batches can happen) and broken machinery (A machine being down on an active production line can cost million in a few hours).
wiggins wrote:Please try to treat schizophrenia, diabetes, and a host of other treatment concerns with surgery. Dumb comment is dumb.
it shows that he's either trolling or so dense that he doesn't realise that I don't want to treat schizophrenia and other diseases, but instead would rather have the instant gratification of a job well done.
Plus, its called a Pancreas Transplant. Really dangerous, but it does cure diabetes using surgery.
Besides, going military for it:
Automatically Appended Next Post: Major be Biochemistry, what you got for that homie?
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Sorry Ahtman im going to have to disagree with you... it'll cost alot lot more than 30 million
I can't list the R&D cost of every single drug out there you know. I was just using the .20 to 30,000,000.00 as an general example. I debated on 30 mill or 300 mill but in the end I flipped a coin.
Yep i know i was also pointing out the cost of a new production line/ new equipment for the new drug, also the cost of failed runs (bad batches can happen) and broken machinery (A machine being down on an active production line can cost million in a few hours).
The cost of production is not proportional to the cost of said drugs under the current healthcare system. I'd link statistical data, but its so glaringly obvious to anyone that's had any contact with medical care that I shouldn't have to.
halonachos wrote:I hope so, with comments such as,
wiggins wrote:Please try to treat schizophrenia, diabetes, and a host of other treatment concerns with surgery. Dumb comment is dumb.
it shows that he's either trolling or so dense that he doesn't realise that I don't want to treat schizophrenia and other diseases, but instead would rather have the instant gratification of a job well done.
Plus, its called a Pancreas Transplant. Really dangerous, but it does cure diabetes using surgery.
Major be Biochemistry, what you got for that homie?
Why would you not want to treat disorders that cripple people for life from either a physical or mental standpoint? Didn't know about the pancreas thing though, very interesting.
My major was secondary education (social sciences) with a minor in modern military theory (yes, strange I know). I also hold a CAADAC certification in the state of California, an AA in Automotive occupational science, Volvo corporate training, and a half dozen tech related certifications. Sister went for neuroscience and did great. Now she works in a pet store and lives with parents cause no jobs out here. :(
Currently I'm slowly plodding away at my LCSW in the hopes of entering the administrative realm.
Peter Wiggin wrote:The cost of production is not proportional to the cost of said drugs under the current healthcare system. I'd link statistical data, but its so glaringly obvious to anyone that's had any contact with medical care that I shouldn't have to.
How's that confirmation bias working out for you?
halonachos wrote:Major be Biochemistry, what you got for that homie?
A tuition bill the likes of which could knock down a skyscraper.
halonachos wrote:Major be Biochemistry, what you got for that homie?
A tuition bill the likes of which could knock down a skyscraper.
Yep, but totally worth it.
Also, confirmation bias, just had my cognitive thinking final today. Funny in my own mind.
Automatically Appended Next Post: I know everything in medicine is different, I help an infectious disease specialist with filing every once and awhile and I see what he has to know/do. I've also shadowed surgeons and really prefer surgery over the medicine part of medicine.
Working in the ER for my EMT class showed me that the ER is pretty cool, personal convictions make me want to help wounded soldiers before they get back to the mainland and maybe help some wounded civvies.
halonachos wrote:
Automatically Appended Next Post: I know everything in medicine is different, I help an infectious disease specialist with filing every once and awhile and I see what he has to know/do. I've also shadowed surgeons and really prefer surgery over the medicine part of medicine.
Working in the ER for my EMT class showed me that the ER is pretty cool, personal convictions make me want to help wounded soldiers before they get back to the mainland and maybe help some wounded civvies.
EMT is like a cult lol. I hang with a few EMT's from Oakland and Richmond on occasion....HARD AS A COFFIN NAIL!!!!!
I can respect the inclination towards surgical as opposed to behavioral. God knows the pay is better!
Personally I'm addicted to the intricacies of the human mind though....people never cease to amaze me in both the beautiful and the horrific.
Final was upsetting, relatively easy and a couple that could've went either way and then there was a section that was more like philosophy than psychology. Stupid 'decision making' and 'rational thinking'.
I did get availability heuristics and conjunction rule confused though, no biggie.
Automatically Appended Next Post:
Peter Wiggin wrote:
halonachos wrote:
Automatically Appended Next Post: I know everything in medicine is different, I help an infectious disease specialist with filing every once and awhile and I see what he has to know/do. I've also shadowed surgeons and really prefer surgery over the medicine part of medicine.
Working in the ER for my EMT class showed me that the ER is pretty cool, personal convictions make me want to help wounded soldiers before they get back to the mainland and maybe help some wounded civvies.
EMT is like a cult lol. I hang with a few EMT's from Oakland and Richmond on occasion....HARD AS A COFFIN NAIL!!!!!
I can respect the inclination towards surgical as opposed to behavioral. God knows the pay is better!
Personally I'm addicted to the intricacies of the human mind though....people never cease to amaze me in both the beautiful and the horrific.
halonachos wrote:I hope so, with comments such as,
wiggins wrote:Please try to treat schizophrenia, diabetes, and a host of other treatment concerns with surgery. Dumb comment is dumb.
it shows that he's either trolling or so dense that he doesn't realise that I don't want to treat schizophrenia and other diseases, but instead would rather have the instant gratification of a job well done.
Plus, its called a Pancreas Transplant. Really dangerous, but it does cure diabetes using surgery.
Major be Biochemistry, what you got for that homie?
Why would you not want to treat disorders that cripple people for life from either a physical or mental standpoint? Didn't know about the pancreas thing though, very interesting.
My major was secondary education (social sciences) with a minor in modern military theory (yes, strange I know). I also hold a CAADAC certification in the state of California, an AA in Automotive occupational science, Volvo corporate training, and a half dozen tech related certifications. Sister went for neuroscience and did great. Now she works in a pet store and lives with parents cause no jobs out here. :(
Currently I'm slowly plodding away at my LCSW in the hopes of entering the administrative realm.
i beleive he was talking about how removing a bullet has an imediate effect....
Automatically Appended Next Post:
Peter Wiggin wrote:
Gibbsey wrote:
Ahtman wrote:
Gibbsey wrote:
Ahtman wrote:Each pill costs twenty cents to manufacture...except the first one. The first one cost 30 million (at least). Bringing a new medication from research through trials and testing to the market costs a boatload of cash.
Sorry Ahtman im going to have to disagree with you... it'll cost alot lot more than 30 million
I can't list the R&D cost of every single drug out there you know. I was just using the .20 to 30,000,000.00 as an general example. I debated on 30 mill or 300 mill but in the end I flipped a coin.
Yep i know i was also pointing out the cost of a new production line/ new equipment for the new drug, also the cost of failed runs (bad batches can happen) and broken machinery (A machine being down on an active production line can cost million in a few hours).
The cost of production is not proportional to the cost of said drugs under the current healthcare system. I'd link statistical data, but its so glaringly obvious to anyone that's had any contact with medical care that I shouldn't have to.
And its glaringly obvious to someone like me who has a family member who is partly responsible for keeping a production line running that this stuff is expensive, not just for the current batch but future batches or different drugs. Do you have any idea how much inestment there needs to be to create a brand new production line? Also RandD is very important to these companies, it not just the cost of the research its the equipment (sometimes research is given the brand new machines for their work).
I know its completely surprizing that a privatly owned company would want to make money off of their new drug.
This is why I dont take meds until Im dying and in the hospital, and I have no other choice. It seems to keep me happy, as well as not give those basterds my money!
Americans may not be aware that some of the world's most successful pharmaceutical companies are British.
I was listening to an interview the other night with the head of Glaxo Smithkline Beecham, discussing their drug R&D strategy.
He said it used to be standard to spend 15% of your profit on R&D, but this was stupid. No-one had analysed whether it was cost-effective, or how the money was spent, or explained why you should stop or start development just because this year you sold a lot more or a lot less flu vaccine.
Polonius wrote:Well, if they change the drug, they get a new patent, but the original patent will still expire. You just have the exclusive rights to sell the "new" drug. Generics can go nuts.
The other question I have about this chart is that it shows that marketing costs twice of what R&D does. Is that high for an industry? I mean, it seems bad, but it's really a non-sequitor. I'm sure the auto industry spends more on ads than on R&D. So, while it seems outrageous, it may not be.
The auto-industry is in the business of manufacture - their primary costs, and the primary value they add to society, comes from taking lumps of steel and turning them into cars.
On the other hand, the primary value that drug companies provide is to research and develop new drugs. So when it turns out that primary service isn't where research companies spend their money, then you have a problem.
In other news, Fraz's new ploy of 'I deem you not allowed to discuss this topic of conversation' is getting really lame.
RLS sucks balls..trust me. My ankle is fused due to some shoddy VA hospital bone graft work...muscles wont relax because I cant move ankle in certain ways. So my ankle "bounces" for HOURS at night. It drives my wife crazy, and not in the good lets rip our clothes off way either.
Muscle relaxants make me hung over but some of the RLS drugs out there have at least cut down the time my leg bounces to about 30min as opposed to 3 hours.
sebster wrote:The auto-industry is in the business of manufacture - their primary costs, and the primary value they add to society, comes from taking lumps of steel and turning them into cars.
On the other hand, the primary value that drug companies provide is to research and develop new drugs. So when it turns out that primary service isn't where research companies spend their money, then you have a problem.
that's true. I guess you can replace that with another industry like software development then.
Polonius wrote:that's true. I guess you can replace that with another industry like software development then.
Sure, and if the software industry was spending more money on advertising than on research and development, they’d be in for just as much criticism. And... as I wrote that I wondered if it were true, a quick look on google didn't help so I wonder if anyone has a breakdown of costs in the software industry.
EDIT - I just looked up the Microsoft Annual report for 2010. They spent $13 billion in sales and marketing, and $9 billion in R&D. So that's not good, either.
Polonius wrote:that's true. I guess you can replace that with another industry like software development then.
Sure, and if the software industry was spending more money on advertising than on research and development, they’d be in for just as much criticism. And... as I wrote that I wondered if it were true, a quick look on google didn't help so I wonder if anyone has a breakdown of costs in the software industry.
EDIT - I just looked up the Microsoft Annual report for 2010. They spent $13 billion in sales and marketing, and $9 billion in R&D. So that's not good, either.
MS is played out. They've been playing catch-up with other companies for at least a decade.
Their main effort now, like a number of established software companies, is to force an unnecessary upgrade cycle that requires users to buy a new computer and suite of software every few years.
I am currently grappling with MS Office 2010, for which I am a pre-deployment compatibility tester in my company. I've haven't found anything good about it, all they seem to have done is pfaff around with the look and feel, the result of which is that many everyday commands have been hidden and changed to different menus, causing me to spend time looking up how to do things I already knew how to do in Office 2003.
Enough people around the internet are so annoyed by this that a shareware utility has been released to convert all the 2010 interface back to the 2003 interface. What does that tell us about MS research and development?
I agree 100% with the OP's OP. I have some business at the only Hospital in the country which has a JCI certificate. It is known as one of the best hospitals in Japan. Patients come from all over Asia for surgery. That said, every time I am there, there is an army of salesmen from Japanese Pharmaceutical companies pushing their drugs on the doctors. The doctors at the hospital are notorious to locals for prescribing way too much medicine for an ailments. In my own case, I had athlete's foot and they prescribed 6 different medicines. All I wanted was some cream...:(
Polonius wrote:that's true. I guess you can replace that with another industry like software development then.
Sure, and if the software industry was spending more money on advertising than on research and development, they’d be in for just as much criticism. And... as I wrote that I wondered if it were true, a quick look on google didn't help so I wonder if anyone has a breakdown of costs in the software industry.
EDIT - I just looked up the Microsoft Annual report for 2010. They spent $13 billion in sales and marketing, and $9 billion in R&D. So that's not good, either.
Yea how much are they spending in advertising for BLOP?
First of all people forget that the government subsidizes a lot of research and development. Its not shouldered entirely by pharma companies.
I don't know where those numbers come from on the first page but I can guarantee you their not right. Drug companies don't produce a 100 20mg prozacs for only 0.11 cents. Not even close. For instance, I work for a company that produces cell culture media for drug companies to grow their cells in which they can then extract drugs from. I just simplified that a lot but you get the gist. Heres a http://www.invitrogen.com/site/us/en/home/Products-and-Services/Applications/Cell-Culture/Mammalian-Cell-Culture.htmllink[/url] for the products I make. Look at the prices for a lot of these things. Even something relatively simple as 500mL of MEM, probably the cheapest thing we make is over 20.00. And trust me, your not going to extract 2 grams of viable product from that little amount of cells. Just the raw materials to either make or study drugs are enormously expensive. Unless you've ever worked in a lab you wouldn't know this, and you would believe the bull crap thats on the first page.
Do I think drug companies charge too much for a lot of their products? Yeah sometimes they do. But thats business Im sorry to say. But please don't keep up these theories that drug companies are this evil entity out to harm people. They've helped millions of times more people than they hurt.
DutchKillsRambo wrote:
Do I think drug companies charge too much for a lot of their products? Yeah sometimes they do. But thats business Im sorry to say. But please don't keep up these theories that drug companies are this evil entity out to harm people. They've helped millions of times more people than they hurt.
I don't think anyone is saying they're evil, they do help people. But, they ARE greedy. Not evil, not out to harm people, but rather, out to make as much value for themselves (and their shareholders) as possible.
Some (pure capitalists) would say that this is actually 'good'. You can't look at anything in a vacuum, and many retirees depend on getting a return on their investments to make their ends meet.
The problem isn't the companies, it's the rules that they play under. Granted, the pharma industry lobbies hard to keep those rules the way they are, but it's on the government to redress this, not on the industry. One sign that there's a problem... you have a fairly fixed market, that has seen ever increasing profits over the last decade (at least). For example, look at pfiser's annual profits: (http://finance.yahoo.com/q/is?s=PFE&annual). 37 billion dollar profit in 2007, 40 billion in 2008, 41 billion in 2009. And that's profit, not revenue. There aren't that many more people needing these drugs every year. How do they keep increasing their profit, year after year after year? At the expense of the public. There's little competition because of patents, and the prices are too high.
It's like people complaining about GW - ever increasing prices, no real alternatives exist - with the difference that GW is a hobby and a luxury that you don't need, and heart medicine and insulin keep you alive. Their customers really are trapped.
Oh thats definitely whats being stated, that they are EEEEEEEEEEEEVVVVVVVVVIIIIIIILLLLLLLLL!!!
Just from the first page.
-Big pharma have run amok in America
-There’s no money in curing diabetes when treatment is more profitable.
-Remember, the ancestors of Big Pharma are the same criminals who started out importing Heroin and Morphine into the pre-revolution Colonies. They're still the same snake-oil salesmen. If they really spent so much time and money developing these poisons, then why do they have so many side effects, many of which are worse than the ailment that they allegedly treat?
I understand what your saying Redbeard I just guess that Im a little biased as I don't reap any of those multi-billion dollar benefits lol so. Plus working for them is going to also skew my view as to where I tend to their side. But trust me there is a lot more drugs that get made that you've never heard of because they failed somewhere down the line. There is just so much money involved in this stuff it boggles my mind.
And for the record this is a prime example of why I support a state-sponsored healthcare system
A state-sponsored system doesn't alter the fact that companies will take whatever they can, within the rules that govern them.
One of the reasons that drug companies charge such outrageous prices is because of the insurance companies. They know that no one is going to pay $300/month on their own, but, if someone's insurance allows them both a group rate and will then pick up the tab, the company gets to sell the drug. The only ones who lose out are the uninsured.
Let's say the insurance companies didn't pick up these drug costs. Now the pharmaceuticals have to lower their prices to the point where people can actually afford it again.
Government sponsored healthcare doesn't change this (unless you're also talking about government sponsored pharmaceutic companies), all it does is shift that cost from the insurance companies to the taxpayers.
The correct 'fix' is to regulate the industries where the money is going to, not to change where the money come from. Treat insurance and pharmaceuticals as commodities, like water, electric, and gas. Cap malpractice awards. Change the underlying financial rules that the healthcare industry operates under, and it will become affordable again.
Imagine a world where a parent can take a child to see a doctor for a five-minute consultation (about all the time you spend with a doctor anyway) over a fever, and pay $10 for the visit. Not a $10 copay, but a $10 all-included cost. Assuming the doctor's time is well-scheduled, he's still billing roughly $200/hour, and that payment isn't breaking anyone's back. That's what five minutes of a doctor's time should cost, once you get all the BS out of the way. All the other money is going to leech industries.
A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.
Ahtman wrote:A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.
Which shows the entire problem with the healthcare industry, also doctors and hospitals regularly overcharge for services which results in insurance companies having to negotiate claims
What people don't realise is the whole system is being paid for, not just the 30 seconds to see the doctor.
The admin assistant who filled out the forms, the nurse who came in and tutted, the doctor who came in and said "don't worry about it, have a lollipop", the admin assistant who would do the paperwork to show you were discharged and put the stats forms into the system. The accounts clerk who arranged for the billing to appear on hospital records, the stores staff who stole/ordered the lollipop and the guy who cleaned the blood and lollipop flavoured goop on the floor. Heating, eletrical, maintenance as well as contents and buildings insurance.
None of it is free. Whilst it is a rip off and extortion a lot of this is driven by the economics from medical companies who charge stupid amounts for trolleys and healthcare waste disposal.
The UK system is funded by the Government but that is maintained by NHS contributions from our pay, we have no say in the matter. If the US went into that type of system it would be better for everyone as the costs even out but as a side result you could be supporting those who don't work and the insurance industry, as they know it, would collapse due to the medical insurance companies no longer being needed.
Ahtman wrote:A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.
Which shows the entire problem with the healthcare industry, also doctors and hospitals regularly overcharge for services which results in insurance companies having to negotiate claims
If only the government could order that properly. Imagine a world where the government set those prices and costs, where someone couldn't over charge because of their greed. We could have $10 dollar visits any time. In fact all our healthcare would only cost $10. Wait, what did you say-unintended consequences, whats that?
Ahtman wrote:A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.
Which shows the entire problem with the healthcare industry, also doctors and hospitals regularly overcharge for services which results in insurance companies having to negotiate claims
If only the government could order that properly. Imagine a world where the government set those prices and costs, where someone couldn't over charge because of their greed. We could have $10 dollar visits any time. In fact all our healthcare would only cost $10. Wait, what did you say-unintended consequences, whats that?
what does that have to do with what i said?
Overcharging a bill can mean that the services were overcosted, it can also mean that they are charging you for 4 sets of something when you only used 2. This is what gets negotiated.
Elmodiddly wrote:What people don't realise is the whole system is being paid for, not just the 30 seconds to see the doctor.
No, we realize that. In that regard, it's no real different than the billing hours charged by software consultants, lawyers or CPAs. They all have receptionists, aides, and the like too.
The UK system is funded by the Government but that is maintained by NHS contributions from our pay, we have no say in the matter.
Otherwise known as taxes. Spin it however you want, if the government is taking your money, it's a tax. Rose by any other name and all that.
If the US went into that type of system it would be better for everyone as the costs even out but as a side result you could be supporting those who don't work and the insurance industry, as they know it, would collapse due to the medical insurance companies no longer being needed.
The costs would also even out in a regulated private system, arguably better. First, what has the government ever run that really works well, without a ton of bureaucratic overhead? Almost without exception, private business works better and cheaper than government agencies, because they have a reason to.
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.
I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.
I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.
And also freeing up valuable dollars er pounds that would have been spent on a higher standard of care because the rich now have theirs and screw everyone else. Just because everyone can be served does mean it doesn't suck.
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.
I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.
And also freeing up valuable dollars er pounds that would have been spent on a higher standard of care because the rich now have theirs and screw everyone else. Just because everyone can be served does mean it doesn't suck.
While you have a point it is better than the poor being left without health care and people being denied by health insurance companies, while i do think that the NHS could be improved with more funding.
The difference with the system in the US is the poor go without coverage and everyone else except the rich get decent coverage. The rich can affort better healthcare than everyone else.
Redbeard wrote:
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
I didn't say that it wasn't a tax, I know it is but I do take this bit a little bit bemusingly. What private system behind the NHS? I know a LOT about the NHS and I know what it can and does do, I also know what it doesn't do very well but what is this private system behind the NHS?
Elmodiddly wrote:
I didn't say that it wasn't a tax, I know it is but I do take this bit a little bit bemusingly. What private system behind the NHS? I know a LOT about the NHS and I know what it can and does do, I also know what it doesn't do very well but what is this private system behind the NHS?
The one Ketara also mentioned. The one where you can pay to go to a doctor outside the NHS, and get better treatment.
Frazzled is right, in this country, the poor can go to emergency rooms. That's another sign that there's a problem with the system, I've never said that the US system is good. It's been proven that trips to the ER are more expensive than even a minimal routine visit, and this is another way in which the US system is inefficient. Because they wait until they need to go to the ER, the poor don't get the preventative care that would eliminate those ER visits at a lower cost.
The US system is horribly flawed. What I really dislike is how the solutions, especially from those in countries with nationalized healthcare all seem to revolve around making the government fund the system. Most nationalized healthcare systems aren't as good as the private system in the US (provided that you can afford it). The problem with the American system isn't how it is funded, but rather, how much everything costs. The solution to this does not involve moving the costs around, it requires that the costs (largely overhead due to the insurance, legal and pharmaceutical industries) be eliminated.
Frazzled wrote:Poor go to emergency rooms now. Poor have Medicaid.
The former is not a fix, any more then buying bottles of aspirin because you need the cotton is a wise way to roll. People who do this tend to wait longer to get care, thus making for a more expensive trip; and of course this is no way to treat a chronic condition.
I don't know the solutions to our health care problems, but this frequently cited example is not a good one. It should remain the very last safety net, not the only possible option.
Ahtman wrote:A buddy took his soon to a doctor when his son fell and bit the end of his tongue off. The doctor looked at it for 5 minutes, told them it wasn't enough to worry about, gave him a lollipop and charged them $260 for the trouble...and that was the price with health insurance.
This isn't uncommon, but not nearly as common as other pricing issues. The biggest pricing issues is actually undercoding.
See, when a doctor/private practicioner wants to use a more expensive test for diagnosis the health insurance company fights the doctor to make them prove that the test is necessary. This is because the insurance companies don't want to pay for anything either. What this typically leads to is the doctor undercoding so a less expensive test is used(even if the more expensive one really is necessary) because it saves time and hassle.
Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
We do have the option of a private service, and its ten times better than the NHS, in that it cuts all the wait times and bullcrap out of the way. Yet ultimately, you find that anyone who falls sick in this country will be treated with or without insurance, which is the advantage of the NHS.
I wouldn't regard it as a dirty little secret, I know a number of people who consider it morally right to go private if you can afford it, thus freeing up waiting time for poorer people who can't afford private care.
And also freeing up valuable dollars er pounds that would have been spent on a higher standard of care because the rich now have theirs and screw everyone else. Just because everyone can be served does mean it doesn't suck.
How does that work? The NHS is funded by the taxpayer. We don't pay again upon entering the NHS ward.
The people who choose to go private are still paying for NHS care as well. No money is lost to the NHS when they go private, indeed the opposite occurs, because they're paying for their treatment privately instead of on the NHS. This frees up money on the NHS, and places less of a strain on the system.
Therefore, when I go private, I've already paid for the NHS. I've paid for healthcare I'm not using. Instead, I'm choosing to pay twice, and more money to boot, in order to ease the burden placed on the national system.
Ketara wrote:
The people who choose to go private are still paying for NHS care as well. No money is lost to the NHS when they go private, indeed the opposite occurs, because they're paying for their treatment privately instead of on the NHS. This frees up money on the NHS, and places less of a strain on the system.
Therefore, when I go private, I've already paid for the NHS. I've paid for healthcare I'm not using. Instead, I'm choosing to pay twice, and more money to boot, in order to ease the burden placed on the national system.
Wait, so you think it is a good thing that you are paying for an extra service that you choose to use because the service that you're forced to pay for isn't good enough for you to use? And don't tell me that you're "choosing to pay twice in order to ease the burden placed on the national system". I don't think I've heard of anyone being that altruistic. You're choosing to pay twice because the NHS isn't very good. It's either too slow, or doesn't provide adequate options, or it is flawed in some other way that makes you choose to pay this extra money. Easing the burden on the NHS might be a positive side effect of your choice, but it's not the reason you're doing it.
Redbeard wrote:The correct 'fix' is to regulate the industries where the money is going to, not to change where the money come from. Treat insurance and pharmaceuticals as commodities, like water, electric, and gas. Cap malpractice awards. Change the underlying financial rules that the healthcare industry operates under, and it will become affordable again.
One of the better proposals in the HCR was to regulate where the insurance companies could spend their money. Right now a tremendous proportion is being spent on advertising and marketing, which results in less money for actual care, and higher premiums. By capping the amount spent on advertising and marketing, you'll see a greater proportion of the total premiums charged being used to treat people.
I think a similar thing could probably work for drug companies. Unfortunately, as we all saw, the drug companies had their claws in the HCR...
Elmodiddly wrote:No easy answer.
Definitely, it's an extremely difficult subject, where setting the right policy requires constant analysis and consultation with a wide range of experts. Even then you basically have to accept that you'll need to keep jigging and correcting things. Unfortunately that's made almost impossible when ideological warriors come in on both sides, with little or no interest in what's being discussed or how the system actually operates and instead just spout their tired old rhetoric.
That might spout stuff like, say... "If only the government could order that properly. Imagine a world where the government set those prices and costs, where someone couldn't over charge because of their greed. We could have $10 dollar visits any time. In fact all our healthcare would only cost $10. Wait, what did you say-unintended consequences, whats that?"
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Redbeard wrote:Second, the dirty little secret of the NHS is that it has a private system behind it to offer better, faster services to people willing to pay for them. I'm not saying that's wrong, but it does indicate that NHS isn't really meeting all the needs very well, and the same can be said for government healthcare in any country.
It's no dirty little secret, it's an explicit feature of the system. If you have enough money that you'd like to pay for shorter waiting times on non-emergency treatment and a nicer, bigger room, then you do that, and you take pressure off the system.
What's more, having a base level of care means that private insurers have to make sure they're really offering something worthwhile for people to take them up.
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Frazzled wrote:Poor go to emergency rooms now. Poor have Medicaid.
You've tried this argument before, that you wouldn't want to have two tiers of healthcare so you couldn't have a public/private hybrid, and it's just ridiculous. The split is not in the quality of actual care, but in the waiting time for non-emergency care, and in how pleasant your stay in hospital is (shared or private room, for instance). Meanwhile you have a system where people who don't have insurance are denied non-emergency care entirely...
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Redbeard wrote:The US system is horribly flawed. What I really dislike is how the solutions, especially from those in countries with nationalized healthcare all seem to revolve around making the government fund the system. Most nationalized healthcare systems aren't as good as the private system in the US (provided that you can afford it). The problem with the American system isn't how it is funded, but rather, how much everything costs. The solution to this does not involve moving the costs around, it requires that the costs (largely overhead due to the insurance, legal and pharmaceutical industries) be eliminated.
Except that much of the increased costs comes from the waste in your current private insurance system. They spend a stupid amount on marketing, and just as much on fighting legal battles to deny treatment (because no matter how costly those legal battles are, they're cheaper than actually providing healthcare). If you had a base level public system, the insurance companies would have to offer an appealing level of service for the amount they charge - suddenly they're dealing with selective consumers and not a captive market.
Also, decoupling private insurance from your employer would go a long way to improve competition in the market.
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Redbeard wrote:Wait, so you think it is a good thing that you are paying for an extra service that you choose to use because the service that you're forced to pay for isn't good enough for you to use? And don't tell me that you're "choosing to pay twice in order to ease the burden placed on the national system". I don't think I've heard of anyone being that altruistic. You're choosing to pay twice because the NHS isn't very good. It's either too slow, or doesn't provide adequate options, or it is flawed in some other way that makes you choose to pay this extra money. Easing the burden on the NHS might be a positive side effect of your choice, but it's not the reason you're doing it.
I did my ACL a couple of years back, and went to hospital. I was given x-rays to ensure no bone had fragmented, then I started to a specialist, while I waited a couple of weeks for the swelling to go down so I could have an MRI. When I got the MRI result, he said the padding had been ripped up pretty badly and I'd have to avoid walking as much as possible, until I could get surgery - which would take about a month. I said that was too long, as I was going to India in two months, and he replied it'd be different if I had private insurance. I told him I had private insurance, and he said he'd be able to perform the surgery himself the very next day. In recovery I got a private room, and that was that.
Thing is, if I was to get very sick and need emergency care, I would be taken to the nearest hospital and treated, because it doesn't matter if I have private insurance or not, I would be treated by the same doctors, as quickly as any other system. After I'd been stabilised, and was about to spend a week in a hospital ward, they would find out if I'm on public or private care, because then I'd get a nicer room and stuff like that. But in terms of the quality of actual care, it's the same.
Redbeard wrote:
Wait, so you think it is a good thing that you are paying for an extra service that you choose to use because the service that you're forced to pay for isn't good enough for you to use?
The service is good enough for me to use. I do use it. I personally, am not rich enough to afford to do otherwise. I can get a doctors appointment whenever I need it, and when I fell ill with nerve pain, I had it all sorted within a month. The waiting time is longer for more complex procedures, but if you have a more serious condition, they bump your priority notch. For example, my mother is currently a cancer risk, and she had special dispensation which meant that she never had to wait longer than a week between each stage of the process (appointments with specialists, scans, etc). The NHS is not as good as it could be, no government service ever is. But it is adequate, and available to all.
And don't tell me that you're "choosing to pay twice in order to ease the burden placed on the national system". I don't think I've heard of anyone being that altruistic.
Two of my family friends do. They like the better service as well, but they claim this as their primary reason. As highly moralised , decent people, I believe them. What proof do you have they lie?
You're choosing to pay twice because the NHS isn't very good. It's either too slow, or doesn't provide adequate options, or it is flawed in some other way that makes you choose to pay this extra money. Easing the burden on the NHS might be a positive side effect of your choice, but it's not the reason you're doing it.
I fail to see the flaw here. Yes, the private service is more efficient, and more luxurious. Some people might prefer to use it instead simply for that. However, considering the original point I was responding was that using private healthcare removes monies from the NHS, I fail to see how this is relevant. The NHS guarantees that if I lose my job and can no longer afford private, I'll still be treated. Why on earth would I resent paying twice? Its a safety net. Sure, if I can afford it, I'll take the more luxurious route, the same way I'll drive a porsche rather than an Aston Martin from Bobs second hand motors. I fail to see why the human tendency to seek out more luxurious conditions for itself is damning to the NHS though.
For being slow, as I've already said, in high priority situations, dispensations are granted guaranteeing faster treatments. The way you insist it must be 'flawed in some way' tells me that regardless of knowing very little/next to nothing about the NHS, you're frantically trying to make it out to be bad in some way. Why, I have no idea. Is this the stereotype where Americans call all forms of socialism communism or something?
I'll chime in on the private stuff too - the NHS acts as a downward pressure on the pricing options of private hospitals. I dont have insurance but sometimes when I have a holiday booked or dont want to wait, I'll pay out of pocket for treatments or consultants at a private hospital and it works out cheaper than paying for insurance and not using it for a year. For example, a trip to a consultant and a full MRI of a leg, getting a complete copy of it on a CDR at the end, with a waiting time of 5 minutes (walked in, chat to consultant about issues, MRI recommended, MRI done) cost £150 3 years ago without any insurance. How much would the same be in the states and how long would you have to wait after seeing the initial consultant?
legoburner wrote:I'll chime in on the private stuff too - the NHS acts as a downward pressure on the pricing options of private hospitals. I dont have insurance but sometimes when I have a holiday booked or dont want to wait, I'll pay out of pocket for treatments or consultants at a private hospital and it works out cheaper than paying for insurance and not using it for a year. For example, a trip to a consultant and a full MRI of a leg, getting a complete copy of it on a CDR at the end, with a waiting time of 5 minutes (walked in, chat to consultant about issues, MRI recommended, MRI done) cost £150 3 years ago without any insurance. How much would the same be in the states and how long would you have to wait after seeing the initial consultant?
What you describe is not really possible in the states unless you are a celebrity. However, after jumping through hoops and paying for several office visits, an out of pocket MRI costs between $3000-$5000.
I had an MRI done on my shoulder a few years back. I went to the doctor, waited perhaps a little longer than 5 minutes in a waiting room, was told to get an MRI, went downstairs, had the MRI done, and went back to the doctor to talk about the results. My out-of-pocket cost, I believe, was a $10 copay.
But, I work for a really big software company that has pretty good benefits and all. If I had to pay for it myself it would have cost the $3-5k as Olympia mentioned.
legoburner wrote:I'll chime in on the private stuff too - the NHS acts as a downward pressure on the pricing options of private hospitals. I dont have insurance but sometimes when I have a holiday booked or dont want to wait, I'll pay out of pocket for treatments or consultants at a private hospital and it works out cheaper than paying for insurance and not using it for a year. For example, a trip to a consultant and a full MRI of a leg, getting a complete copy of it on a CDR at the end, with a waiting time of 5 minutes (walked in, chat to consultant about issues, MRI recommended, MRI done) cost £150 3 years ago without any insurance. How much would the same be in the states and how long would you have to wait after seeing the initial consultant?
What you describe is not really possible in the states unless you are a celebrity. However, after jumping through hoops and paying for several office visits, an out of pocket MRI costs between $3000-$5000.
bs. I know people who have had MRI's scheduled and done within a week. In fact ALL the MRI's / CT scans were done in a week.
olympia wrote:@frazzled, perhaps if it's for something serious like back cancer you can get an MRI quickly. Did the people you know have health insurance?
The thing is, MRI's are usually done within the week or even a day due to the fact that nearly every hospital has one. The delay in treatment we see is usually due to the patients themselves thinking they know more than the doctor or not wanting to go to the doctor's office.
We had a diabetic come in and cleaned him up and gowned him before we took him to an MRI machine to see if he had hit his head when he fell within 10 minutes. It took awhile cuz he had soiled himself and he wasn't the skinniest fellow in the world.
I messed my knee up and they didn't use an MRI, they used an X-ray and could tell based off of that what had happened. Next thing I know I was in a surgeon's office being consulted and scheduled surgery for a week later. He gave me a list of options with the plus and negative sides and we made a decision. Went with just getting the loose cartilage fragments out as opposed to a graft or knee replacement.
We actually had two insurances, one from my dad who was in the service(which almost nobody accepts because the government doesn't like to pay) and a private insurance(because they actually do pay).
As to having to pay the NHS and a private person for seeing the private person, yes there is a flaw there.
It would be like having to pay the USPS(United States Postal Service) whenever we use FedEx or UPS.
sebster wrote:
You've tried this argument before, that you wouldn't want to have two tiers of healthcare so you couldn't have a public/private hybrid, and it's just ridiculous. The split is not in the quality of actual care, but in the waiting time for non-emergency care, and in how pleasant your stay in hospital is (shared or private room, for instance). Meanwhile you have a system where people who don't have insurance are denied non-emergency care entirely...
Never mind that he's also argued, frequently in the next breath, that medicaid should be done away with entirely.
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Frazzled wrote:
Missed the Medicare part there hoss.
Did medicare suddenly become something other than state funded health insurance?
With my current insurance I get all the pills and champagne I want. Plus I also get a gold gurney studded with diamonds and IV's filled with liquid caviar.
Now, are you telling me that people without insurance DON'T get that kind of treatment?
Frazzled wrote:
Thats what everything is. Your point is nonsensical.
No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.
I'm differentiating between types of insurance, not insurance and no insurance.
This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.
Honestly, it isn't that difficult to understand.
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halonachos wrote:With my current insurance I get all the pills and champagne I want. Plus I also get a gold gurney studded with diamonds and IV's filled with liquid caviar.
Now, are you telling me that people without insurance DON'T get that kind of treatment?
No.
Admittedly, I did not explicitly state that I've had insurance since I was born, but that is the stance I'm arguing from. One which indicates that all insurance is not equivalent.
Frazzled wrote:
Thats what everything is. Your point is nonsensical.
No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.
I'm differentiating between types of insurance, not insurance and no insurance.
This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.
Frazzled wrote:
Thats what everything is. Your point is nonsensical.
No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.
I'm differentiating between types of insurance, not insurance and no insurance.
This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.
Wikipedia - the almighty source of all knowledge wrote:In the U.S., patients on Medicaid, the low-income government programs, can wait three months or more to see specialists. Because Medicaid payments are low, some have claimed that some doctors do not want to see Medicaid patients. For example, in Benton Harbor, Michigan, specialists agreed to spend one afternoon every week or two at a Medicaid clinic, which meant that Medicaid patients had to make appointments not at the doctor's office, but at the clinic, where appointments had to be booked months in advance.[55] A 2009 study found that on average the wait in the United States to see a medical specialist is 20.5 days.
And as I said before not everyone qualifys for medicare/medicaid and still cannot afford healthcare (This isnt even taking into account the practice of denying "Experimental Procedures" like liver transplants).
Frazzled wrote:
What insurance is worse than Medicare?
The fact that you think medicare is bad speaks volumes.
Just about any HMO is worse than medicare given a person that travels frequently.
Similarly, low-end PPOs are universally worse than medicare, as they frequently have no drug coverage, and minimal technical levies (ie. they don't pay for MRIs).
Redbeard wrote:
The one Ketara also mentioned. The one where you can pay to go to a doctor outside the NHS, and get better treatment.
Ah, the penny drops. BUPA. There are lots of other private medical firms as well but BUPA is the best known and most advertised.
Not exactly a dirty little secret "behind" the NHS! I am dissapointed that hysterical descriptions creep back in with little or no substance to the factual reality. Again.
Frazzled wrote:
What insurance is worse than Medicare?
The fact that you think medicare is bad speaks volumes.
Just about any HMO is worse than medicare given a person that travels frequently.
Similarly, low-end PPOs are universally worse than medicare, as they frequently have no drug coverage, and minimal technical levies (ie. they don't pay for MRIs).
So you don't have any information to support your statement. In that case
Frazzled wrote:
So you don't have any information to support your statement. In that case
What
The
Ever.
Do you want general categorical information, or information about a specific plan?
Honestly, I didn't provide any because you have a history of ignoring any information that is provided. At first glance it appeared to be a waste of my time.
To paraphrase, despite acknowledging that MRIs of the breast are useful in detecting breast cancer, CIGNA will not cover breast MRIs because they consider the procedure to be, arbitrarily, experimental. This is generally indicative of managed health care organizations, who often use technical exclusions in order to remove from coverage certain otherwise useful procedures. This is worse than medicare, which has no such restriction policies. Depending on the part restriction, they might pay for a variable amount of the procedure, but they will never pay for none of it.
halonachos wrote:As to having to pay the NHS and a private person for seeing the private person, yes there is a flaw there.
It would be like having to pay the USPS(United States Postal Service) whenever we use FedEx or UPS.
Just wanted to point out here though that the quality of care with private in the UK is equal to the best of the US, and while you are technically paying twice (really though it is more like paying for a more luxurious service like an upgraded seat on an airplane), you could pay about 15 times over and still come out cheaper than the US cost for the equivalent best case options for a treatment. That is the crux of the debate in my opinion - the crazy inflated cost of the US's healthcare rather than any subjective quality measures.
legoburner wrote: That is the crux of the debate in my opinion - the crazy inflated cost of the US's healthcare rather than any subjective quality measures.
I wonder how the American public would feel about their healthcare system, if it transpired that it wasn't the best in the world, despite the cost of it?
The Dreadnote wrote:I wonder how the American public would feel about their healthcare system, if it transpired that it wasn't the best in the world, despite the cost of it?
The problem in my opinion fraz is that the US uses wimpy ways of describing diseases, whereas here in the UK we use nice long names that make things sound much more serious, giving us a much stronger ability to whine to friends and co-workers:
pinkeye = conjunctivitis
mono = glandular fever
canker sore = mouth ulcer
etc etc
legoburner wrote:The problem in my opinion fraz is that the US uses wimpy ways of describing diseases, whereas here in the UK we use nice long names that make things sound much more serious, giving us a much stronger ability to whine to friends and co-workers: pinkeye = conjunctivitis mono = glandular fever canker sore = mouth ulcer etc etc
ZOMG, LEGOBURNER HAS INVADED THE OFF-TOPIC FORUM!
And we dumb down disease names 'cause there are some uneducated rabble still within their constitutional right to forgo a public education and be home-tutoreded.ed
WarOne wrote:And we dumb down disease names 'cause there are some uneducated rabble still within their constitutional right to forgo a public education and be home-tutoreded.ed
They has a right to be edjumacated however they want!
WarOne wrote:And we dumb down disease names 'cause there are some uneducated rabble still within their constitutional right to forgo a public education and be home-tutoreded.ed
They has a right to be edjumacated however they want!
halonachos wrote:As to having to pay the NHS and a private person for seeing the private person, yes there is a flaw there.
It would be like having to pay the USPS(United States Postal Service) whenever we use FedEx or UPS.
Just wanted to point out here though that the quality of care with private in the UK is equal to the best of the US, and while you are technically paying twice (really though it is more like paying for a more luxurious service like an upgraded seat on an airplane), you could pay about 15 times over and still come out cheaper than the US cost for the equivalent best case options for a treatment. That is the crux of the debate in my opinion - the crazy inflated cost of the US's healthcare rather than any subjective quality measures.
Actually, I was just pointing out that paying for something you don't use is kind of silly. Unless you also decide to look at it like the same deal, with the NHS being basic and private being the First Class seats that gets an in flight movie.
Also, we have a higher ratio of specialists to gen.practicioners than you fellows do. You have more of a 50-50 split while we have about a 65-35 split with specialists in the 65%. I also believe that in terms of why things cost so much, we really don't have the 'free' university educations like you guys do, our medical students must take a thing called the MCAT in order to get into medical school, and for the most part they have to attend graduate school in order to even think about going to med school.
That's an additional 3 years for graduate school on top of the 4 for medical school that most people have to take a loan out for.
Then there's the fact that we don't accept the medical degrees from some of your institutes, not saying that we don't accept any, but only certain schools of yours are 'certified' for the degrees to transfer.
Now I'm not tooting our medical system's horn, but you guys made it easier to get into med school than we did and that means it costs more so our doctors are going to want more to pay it all off. In 2009, the average debt was $157,990. I can't find the comparable cost for the british students so I guess that you guys have free medical school as well.
Seriously though, I can't find the costs so if someone can for comparison that would be fantastic. The stat above is from 2009.
halonachos wrote:Also, we have a higher ratio of specialists to gen.practicioners than you fellows do. You have more of a 50-50 split while we have about a 65-35 split with specialists in the 65%. I also believe that in terms of why things cost so much.
Thats because even for simple procedure you are recommended to a specialist
halonachos wrote:Also, we have a higher ratio of specialists to gen.practicioners than you fellows do. You have more of a 50-50 split while we have about a 65-35 split with specialists in the 65%. I also believe that in terms of why things cost so much.
Thats because even for simple procedure you are recommended to a specialist
That's because they 'specialize' in those 'simple' procedures.
halonachos wrote:
Actually, I was just pointing out that paying for something you don't use is kind of silly. Unless you also decide to look at it like the same deal, with the NHS being basic and private being the First Class seats that gets an in flight movie.
Not really. Not if you consider it to be the fallback system. Its like the welfare estate. You might not need it at this exact point in time, because you have a well paid job, but the safety net is there if anything ever happens. Think of it as paying into a guaranteed medical fund. You'll always be treated for illness, not matter how well your job pays. Or an adult who sends their children to private school paying for state education with their taxes. If you lose your job, and can't afford to send your child there any more, your child will still be educated.
It's the basic socialist principles, that everyone should be guaranteed a basic standard of life. gak happens to everyone, and whilst you might bemoan paying for it whilst you're rolling in money, you'll be thankful its there if the day comes when you're not.
legoburner wrote:That is the crux of the debate in my opinion - the crazy inflated cost of the US's healthcare rather than any subjective quality measures.
Yes, everyone agrees that the US pays a whole lot for its healthcare. The debate, such as it is, comes from a certain portion of the US population who refuse to recognise what is driving those additional costs (very high overhead costs, very high legal costs for hospitals to pursue patients and insurance companies for payment, very high legal costs for patients to force insurance companies into paying for treatment, very high costs of drugs) and refuse to accept that despite paying so much more, US health metrics are equivalent to other developed countries at best, and frequently much worse.
This isn't to criticise individual doctors and healthcare professionals in the US, who are amongst the best in the world, but to criticise a system that three or four decades overdue for a massive overhaul.
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Frazzled wrote:As long as its still better than Britain's
It is no better, and it cost you almost twice as much. At some point you really just have to start accepting the basic realities of the situation, and begin to build an argument from there.
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halonachos wrote:Now I'm not tooting our medical system's horn, but you guys made it easier to get into med school than we did and that means it costs more so our doctors are going to want more to pay it all off. In 2009, the average debt was $157,990. I can't find the comparable cost for the british students so I guess that you guys have free medical school as well.
Seriously though, I can't find the costs so if someone can for comparison that would be fantastic. The stat above is from 2009.
Thing is, US expenditure on healthcare is about 15% of GDP, almost double what it is in the UK. If that cost difference was being driven by education being privately funded, you'd see the UK spending much more public money on it's tertiary eduction, somewhere around 7 or 8%. The actual difference is about a third of that, and that's for all education, not just medicine.
So that really isn't much of an explanation at all.
At some point you really need to accept that the US system is very badly broken, for no other reason than that the system is badly broken. There's a real debate to be had on how to fix that problem, but all this stuff that tries to explain why it costs so much to get no better treatment than anyone else is nonsense.
halonachos wrote:
That's because they 'specialize' in those 'simple' procedures.
Needlessly, in many cases.
Ever had to go to a specialist in order to discover that your GP's diagnosis of a hairline fracture was correct?
I mean really, I could have read the X-Ray with that level of certainty.
Sometimes a doctor isn't sure and they want a second opinion to make sure they don't cause bodily harm, I guess that second opinions are a bad thing?
As far as treatment goes, we get a lot of bangin' treatment. Does it cost money, hell yeah it does.
The problem is that not everyone can get the treatment right? Oh wait, our system costs a lot too I guess. So if we add more costs then everyone can get champagne and pills right?
So we need a way to get everyone care while lowering costs. If we just look at the medical issue at the hospital level we're going to miss solving it.
Doctors are a hot commodity, the hottest available. They're also one of the most expensive commodities in the market today(save for maybe a gold plated escalade), we reduce the cost of doctors and increase the number of doctors then we can start with lowering costs.
The medical system itself isn't the issue, its the availability/cost that is. If we had free med school or didn't have to take 4 years of undergraduate studies before even trying to become a med student then I think we could reduce the cost and increase availability. When a hospital sees 10 new doctors that he can hire for the price of one old doctor a couple of things are going to happen; old doctor works harder to make himself seem worthy of the pay, old doctor gets a pay cut, or old doctor gets fired and 10 new doctors are added to the staff. So, we could see the cost stay the same, but the new doctors are a source of revenue that has now increased 10 fold so the hospital may have a higher profit with which they can lower prices or offer more services to those without insurance.
We also have a medical system set up similar to the NHS, except that our government doesn't like to pay doctors for their services so it often gets turned away. If the government decided to pay on time, then maybe we could see an improvement.
Now, the uninsured do get treatment in the ER that's a given. However, who pays for their services?
I'll use the same example I've used before because I was actually there to see everything done.
Illegal immigrant(knew he was illegal because he had no identification on him and because his friends who brought him said so) comes in suffering from a bad reaction to cocaine.
His heart is messing up and there's a medicine that can take care of that, it costs a lot of money though but it calms his heart down and returns him to almost normal. A catheter is inserted so he doesn't pee all over the place seeing as though his motor skills are impaired as is his mind. The patient calms down and starts returning to normalcy so the catheter is removed. He later starts to pee so I quickly grab some gloves and put a plastic jug next to his member and direct him to pee into said jug. He makes a full recovery and is sent off with papers(in spanish) that tell him the bad things about drug use.
Okay we have; the cost of the medicine given to the patient, the cost of the catheter used on the patient, the cost of cleaning the area, the cost of the gloves, the cost of cleaning the other supplies, and of course the nice paper gown.
Overall the visit cost over a thousand dollars and then some and no one was going to pay for it. This happens all the time and its part of why hospitals charge so much, they have to absorb costs attributed to the uninsured. Would mandatory insurance fix this, no because in this case the guy was an illegal immigrant.
I guess all I can say is that our health system is all sorts of screwed up, but its not the system's fault. The government needs to actually pay for services rendered, the government needs to either remove medicare/medicaid and replace it with a new system or fix both, the government needs to give incentives for people to become doctors, and of course we need to solve our illegal immigrant problem. Couple that with changing the american mind set to work less and we could hit the 80 year lifespan Germany is.
halonachos wrote:I guess all I can say is that our health system is all sorts of screwed up, but its not the system's fault. The government needs to actually pay for services rendered, the government needs to either remove medicare/medicaid and replace it with a new system or fix both, the government needs to give incentives for people to become doctors, and of course we need to solve our illegal immigrant problem. Couple that with changing the american mind set to work less and we could hit the 80 year lifespan Germany is.
No, you don't end up paying twice your GDP as other countries for an equivalent level of care because your government isn't paying some bills on time. That makes no fething sense. Stop inventing silly things and just accept that your healthcare system isn't working because of the system.
It doesn't work because it has all the problems of a market system (entities placing their profit over the health of customers) without any of the benefits (because individual consumers can't actually pick their own health insurer).
halonachos wrote:
Sometimes a doctor isn't sure and they want a second opinion to make sure they don't cause bodily harm, I guess that second opinions are a bad thing?
When they're excessively used, yes.
One of the things we should all learn in life is that certainty doesn't exist outside the incredibly stupid. Its all about making educated guesses according to our best standards of judgment.
Indeed, that's a large part of the argument for tort reform.
halonachos wrote:
As far as treatment goes, we get a lot of bangin' treatment. Does it cost money, hell yeah it does.
The problem is that not everyone can get the treatment right? Oh wait, our system costs a lot too I guess. So if we add more costs then everyone can get champagne and pills right?
No, the problem is that it costs too much compared to other nations that have similar returns.
This is a really basic idea, and it boggles my mind that many people refuse to accept it. I guess its just another pathetic grasp at exceptionalism?
halonachos wrote:
I guess all I can say is that our health system is all sorts of screwed up, but its not the system's fault.
Of course it is, it can't be the fault of anything else as the "system" is a totality.
halonachos wrote:
The government needs to actually pay for services rendered, the government needs to either remove medicare/medicaid and replace it with a new system or fix both,
Medicare and Medicaid have no impact on the overall cost of health care. Because, you know, the government does pay for services rendered.
halonachos wrote:
the government needs to give incentives for people to become doctors,
They already do.
halonachos wrote:
and of course we need to solve our illegal immigrant problem.
A minuscule percentage of the overall health expenditure.
You're literally arguing that a group athat constitutes about 7% of the population makes up about 50% of the excess expenditure. Its a ludicrous argument.
halonachos wrote:
Couple that with changing the american mind set to work less and we could hit the 80 year lifespan Germany is.
How does one change a mindset?
Honestly, your solution is terrible. Absolutely terrible. Maybe if you stopped making excuses you could come up with something better.
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sebster wrote:Stop inventing silly things and just accept that your healthcare system isn't working because of the system.
That can't be the case, America is the best at everything. Everyone else just leaches off our greatness. Especially Australia.
halonachos wrote:
The medical system itself isn't the issue, its the availability/cost that is.
Errr......So you have no problem with poor people going un or under-treated?The fact is, unless you have some sort of social program set up where everyone can get healthcare regardless of station, or income, I would regard the medical system as flawed.
If we had free med school or didn't have to take 4 years of undergraduate studies before even trying to become a med student then I think we could reduce the cost and increase availability. When a hospital sees 10 new doctors that he can hire for the price of one old doctor a couple of things are going to happen; old doctor works harder to make himself seem worthy of the pay, old doctor gets a pay cut, or old doctor gets fired and 10 new doctors are added to the staff. So, we could see the cost stay the same, but the new doctors are a source of revenue that has now increased 10 fold so the hospital may have a higher profit with which they can lower prices or offer more services to those without insurance.
So your solution to people not being able to afford healthcare, and ridiculously expensive drugs is to train more doctors? I'm not so sure it works that way....
We also have a medical system set up similar to the NHS, except that our government doesn't like to pay doctors for their services so it often gets turned away. If the government decided to pay on time, then maybe we could see an improvement.
Please outline it to me. I actually have no knowledge of this program, and would be interested to hear it operates, how it differs from the NHS, and what its pros/cons are.
Now, the uninsured do get treatment in the ER that's a given. However, who pays for their services?
I would assume the government who runs the hospitals. Or are ALL hospitals privately owned over there?
I'll use the same example I've used before because I was actually there to see everything done.
Illegal immigrant(knew he was illegal because he had no identification on him and because his friends who brought him said so) comes in suffering from a bad reaction to cocaine.
His heart is messing up and there's a medicine that can take care of that, it costs a lot of money though but it calms his heart down and returns him to almost normal. A catheter is inserted so he doesn't pee all over the place seeing as though his motor skills are impaired as is his mind. The patient calms down and starts returning to normalcy so the catheter is removed. He later starts to pee so I quickly grab some gloves and put a plastic jug next to his member and direct him to pee into said jug. He makes a full recovery and is sent off with papers(in spanish) that tell him the bad things about drug use.
Okay we have; the cost of the medicine given to the patient, the cost of the catheter used on the patient, the cost of cleaning the area, the cost of the gloves, the cost of cleaning the other supplies, and of course the nice paper gown.
Overall the visit cost over a thousand dollars and then some and no one was going to pay for it. This happens all the time and its part of why hospitals charge so much, they have to absorb costs attributed to the uninsured. Would mandatory insurance fix this, no because in this case the guy was an illegal immigrant.
Soooooo.......illegal immigrants leeching off the system are a reason not to provide everyone with free healthcare? To be frank, I'd say treat the immigrants. They're a tiny minority, and as human beings, they have no less right to good health then I do, on a humanitarian level. They just had the bad fortune to be born elsewhere. Stick 'em back together, and then send them home. If there's a man bleeding to death on the porch, I don't care where he's from, I'd rather he survives. Its looking out for your fellow man. I don't resent my taxes paying for such a thing.
I guess all I can say is that our health system is all sorts of screwed up, but its not the system's fault. The government needs to actually pay for services rendered, the government needs to either remove medicare/medicaid and replace it with a new system or fix both, the government needs to give incentives for people to become doctors, and of course we need to solve our illegal immigrant problem. Couple that with changing the american mind set to work less and we could hit the 80 year lifespan Germany is.
Sooooo.......the system is screwed up, but its not the systems fault? Who's is it then? If the system is screwed up, as you've just acknowledged, its a bad system. Get rid of it.
So seriously, out of the entire post you guys decided to say that my prime reason for why healthcare is so expensive is because of illegal immigrants?
Well that would be true except for the fact that I was using my own personal experience to outline the general outcome for ANY uninsured person. I guess that as soon as someone sees "illegal immigrants" and imply a negative aspect to them others have to put on their blinders and run in saying "Illegal immigrants are people too!". Again, you guys missed the point there.
As to our system, hospitals tend to be privately owned with funding for free clinics coming from local or state governments. New York and most major cities have free clinics for the homeless/poor.
As to our system, it can be fixed and left the way it is as soon as we can find a way to make medical care cheaper. Increasing the amount of doctors and reducing the cost/time it takes to become a doctor is one way to reduce costs. Unless supply and demand don't apply to medical staff for some reason...
As to the cost of medicine itself, I never said that training more doctors would lower the cost of the medicine. I said that having more doctors will increase the profit for the hospital which can be used to either fund private free clinics or to allow free preventative care for the uninsured.
Now, this part is just an opinion, but I believe that people don't want to pay for some guy's healthcare when that guy is a complete and total stranger to them so the republicans will want to fight it. Now if the hospital was distributing its own wealth as a private entity then the republicans or any government official has no say in how the money is spent. If the government decides to entice the hospital with a nifty tax break if it does carry out charitable activities(such as providing preventative medicine to the uninsured) then the hospital would be more willing to do so.
As to our government paying for services rendered, they do, but it arrives months to years later which is why doctors tend not to accept it. Having insurance is good unless its not accepted anywhere. When we had the government insurance through the military I could only go on base for my prescriptions and only one hospital outside of the bases would accept it. Hell, my optometrist at SEARS didn't even accept it so we had to get another insurance on top of that.
halonachos wrote:
Well that would be true except for the fact that I was using my own personal experience to outline the general outcome for ANY uninsured person. I guess that as soon as someone sees "illegal immigrants" and imply a negative aspect to them others have to put on their blinders and run in saying "Illegal immigrants are people too!". Again, you guys missed the point there.
The problem is that your argument against mandatory insurance turned on the illegal status of the person in question, which is basically the same thing as claiming that illegal immigrants are responsible for excessive health care costs in the US.
Had you not brought up the guy's illegal status, or not used him as an example of why national insurance wouldn't work, there wouldn't have been a problem.
halonachos wrote:
As to our system, hospitals tend to be privately owned with funding for free clinics coming from local or state governments. New York and most major cities have free clinics for the homeless/poor.
Most hospitals also take state funding.
halonachos wrote:
As to our system, it can be fixed and left the way it is as soon as we can find a way to make medical care cheaper. Increasing the amount of doctors and reducing the cost/time it takes to become a doctor is one way to reduce costs. Unless supply and demand don't apply to medical staff for some reason...
The number of doctors isn't the issue. Our physicians per capita statistic is not significantly different from many of the Western nations with superior health care services (right between England and Australia), and is actually significantly worse than the same statistic in a number of nations with inferior health care (Cuba, Argentina, Latvia, Uzbekistan, etc.).
Either way, you're also basically arguing that we should try and fix a complicated issue, health care, by taking another complicated issue, the cost of education. If you're correct, it may be efficient in the sense that two issues would be dealt with simultaneously, but it may not be any easier, and could actually be far more difficult.
halonachos wrote:
If the government decides to entice the hospital with a nifty tax break if it does carry out charitable activities(such as providing preventative medicine to the uninsured) then the hospital would be more willing to do so.
That's basically what happens now, only its not generally tax breaks that are applied, but state subsidization on the condition of admitting emergency patients.
One way or another, people in this country will pay for the health care afforded to others. The question is merely about how open we are about acknowledging that fact.
halonachos wrote:
As to our government paying for services rendered, they do, but it arrives months to years later which is why doctors tend not to accept it. Having insurance is good unless its not accepted anywhere. When we had the government insurance through the military I could only go on base for my prescriptions and only one hospital outside of the bases would accept it. Hell, my optometrist at SEARS didn't even accept it so we had to get another insurance on top of that.
That's not especially different from any basic HMO. Try getting an out of network provider to accept your insurance, or the insurance company to pay, for that matter.
halonachos wrote:So seriously, out of the entire post you guys decided to say that my prime reason for why healthcare is so expensive is because of illegal immigrants?
No, I pointed out that your claim that US system wasn't working because government didn't pay on time made no sense. You'd ignored this because it was easier to make some vague claim about being jumped on for mentioning illegal immigrants than it was to defend your claims.
Now, this part is just an opinion, but I believe that people don't want to pay for some guy's healthcare when that guy is a complete and total stranger to them so the republicans will want to fight it.
How do you think insurance works?
As to our government paying for services rendered, they do, but it arrives months to years later which is why doctors tend not to accept it. Having insurance is good unless its not accepted anywhere. When we had the government insurance through the military I could only go on base for my prescriptions and only one hospital outside of the bases would accept it. Hell, my optometrist at SEARS didn't even accept it so we had to get another insurance on top of that.
You attempted to claim that this was the reason US health services are in a mess. Which is ridiculous.
Again, the fact that the person was illegal was not the issue. The issue was that the person lacked healthcare and that there was a good amount of fees that were reacked up during the care for the patient. The illegal immigrant status was used to provide background as to why the person lacked insurance in the first place.
If I said "a person with no insurance" instead of an "illegal immigrant" then I'm sure you would have not responded in the way you did.
Insurance is a service that is payed for on a gamble of whether or not you will get ill. People with pre-existing conditions are turned down because it is an almost guaranteed loss of profit while people who are healthy pay less because they have less of a chance that they will get ill. The money earned by insuring x amount of healthy people and y amount of unhealthy people is enough to cover the expenses when one of the y people get ill or in the statistically unlikely event that one of the x people get ill. Would a government policy be the same, yes and no.
Would it follow the same basic principle of gambling with illness, yes. But instead of a publicly owned corporation, which follows the typical american tradition of capitalism, it would be a government agency, which follows a non-typical american policy.
Another thing is when you buy insurance you are adding to a collective pot of others who have paid insurance. I will dare to say that this loosely fits the concept of depositing money into a bank. When you deposit money you give it to the bank to hold(instead of keeping the money for later use if you get sick) and that money is then used by the bank to help loan other members of the bank with the promise of earning a small amount of interest for the use of your money(similar to how the insurance company may use your money to help pay for the care of another policy holder in promise that you will receive similar help in turn).
A government healthcare would be like giving money to the bank without receiving any interest and best of all the bank gives the money away instead of loaning it. Similar to how we would be paying a tax for a service that we will not receive if we already have insurance and would instead give it to those who are most likely not contributing to that amount of money being used.
As to solving two issues at once being more difficult, yes it would be but taking the easy way out isn't going to help anyone. A half-assed universal healthcare bill will do more damage than good and all possible outcomes need to be considered.
We could fix overpriced medicine by capping the prices, but what possible outcomes would we see from that? We could see companies leaving america or we could see them producing less. Or we could see no change except for the price.
As for insurance companies and a universal healthcare comparison. Insurance companies will pay on time if the doctors can prove the charges necessary, the government will pay months after the doctor proves charges to be necessary. The issue with doctors today is that they will try to avoid the more expensive diagnostic tests if there is a chance they may be considered unnecessary.
Overall, insurance is another key issue in healthcare. Its a more common belief though, so why stick with just that?
IMHO our healthcare system is like a dam with varying levels of cracks in them. There are cracks that are more obvious like the insurance companies and cost of medicine. Then there are cracks that are less likely to be seen, like medical education and illegal immigrants. After we solve the insurance and medicine cost issues the others will still remain and allow for leaks. These cracks may grow in time to be the same level of concern as the two original major cracks until they get solved.
Universal healthcare will be applied to american citizens, not to illegal immigrants so that issue will come up soon after the universal healthcare bill comes along and at that point it will need to be solved. Once that occurs we will see more people seeing doctors and at that point we will need to see to the demand of doctors and along with that education.
You can use all of the statistics you want; life span, quality of care, and others all you want, but this issue will most likely only dabble in political science waters. There are too many personal opinions and justifications to allow science to overcome philosophy so in the end it will come to how people feel about it. On that we can agree dogma, everything else not so much.
halonachos wrote:Again, the fact that the person was illegal was not the issue. The issue was that the person lacked healthcare and that there was a good amount of fees that were reacked up during the care for the patient. The illegal immigrant status was used to provide background as to why the person lacked insurance in the first place.
Yes, generally, but you also explicitly stated that national, or mandatory, health insurance wouldn't fix the problem because the person in question was illegal. And that, as a result, national health insurance was an insufficient solution. This can only be taken to mean that the number of illegal immigrants in this country is central to the high cost of health care. Maybe that's not the point that you intended to make, but that's certainly what you wrote.
halonachos wrote:
If I said "a person with no insurance" instead of an "illegal immigrant" then I'm sure you would have not responded in the way you did.
Of course not, why would we? Using an illegal immigrant as a specific example explicitly changes the nature of what you're arguing. You could not, for example, say that national health insurance wouldn't be an effective solution, on its face, simply because there are people without insurance; because the explicit point of national health insurance is to reduce the number of people without insurance.
halonachos wrote:
The money earned by insuring x amount of healthy people and y amount of unhealthy people is enough to cover the expenses when one of the y people get ill or in the statistically unlikely event that one of the x people get ill.
Its actually as close to statistically certain as you can get. Anyone who has health insurance will use it. The question isn't regarding usage, its regarding cost when its used. Healthy people are statistically less likely to incur high medical bills, but not necessarily fewer medical bills. In fact, it has been argued that part of being a health person is regular doctor visits for the purposes of preemptive diagnosis; hopefully averting the aforementioned high medical bills.
halonachos wrote:
Would it follow the same basic principle of gambling with illness, yes. But instead of a publicly owned corporation, which follows the typical american tradition of capitalism, it would be a government agency, which follows a non-typical american policy.
Why does the "Americanness" of a thing matter at all? All wondering about that does is gravitate the debate towards "What is America?" That's a cute rhetorical trick, but it isn't particularly conducive to developing physically (as opposed to politically) pragmatic solutions.
halonachos wrote:
A government healthcare would be like giving money to the bank without receiving any interest and best of all the bank gives the money away instead of loaning it.
That's already a significant portion of what insurance companies do. You don't think that covered cancer patients actually pay an amount commensurate with the difference between their health care costs, and those of your average policy holder, do you?
halonachos wrote:
Similar to how we would be paying a tax for a service that we will not receive if we already have insurance and would instead give it to those who are most likely not contributing to that amount of money being used.
Unless of course said service also decreases the overall cost of health care, and thus causes insurance premiums to drop.
halonachos wrote:
As to solving two issues at once being more difficult, yes it would be but taking the easy way out isn't going to help anyone. A half-assed universal healthcare bill will do more damage than good and all possible outcomes need to be considered.
Simply because something is difficult does not indicate that it is the better course of action. Again, that's a cute bit of rhetoric, but it really is meaningless.
halonachos wrote:
We could fix overpriced medicine by capping the prices, but what possible outcomes would we see from that? We could see companies leaving america or we could see them producing less. Or we could see no change except for the price.
And if both of the outcomes were acceptable, then that would be a fine solution.
Either way, I'm not sure what you're trying to illustrate here. Well, other than the basic premise that certain choices involve certain outcomes, which isn't really a point, so much as a matter of self-evidence.
halonachos wrote:
The issue with doctors today is that they will try to avoid the more expensive diagnostic tests if there is a chance they may be considered unnecessary.
From nearly everything I've heard the exact opposite is true, and that the reality is that many doctors over use diagnostic testing. As such, it seems the goal should be to have more doctors be more cautious about the tests they order, which is where tort reform enters the equation.
halonachos wrote:
You can use all of the statistics you want; life span, quality of care, and others all you want, but this issue will most likely only dabble in political science waters. There are too many personal opinions and justifications to allow science to overcome philosophy so in the end it will come to how people feel about it. On that we can agree dogma, everything else not so much.
Actually, my point was that how people feel about the matter is basically irrelevant, and that the state should behave in consistence with a policy of "You're nearly all ignorant plebes." and work to develop the best possible system given the limitations of such an attitude.
But the best possible system will not be gained by compromise. Basic political philosophy follows that very principle and the fact that political philosophy follows to gain what is "just" and "good" means that by its nature it is not objective, but subjective. When you fall into the world of political science then we see more objective evidence being presented and that's when we see compromises being made and the solution we get is not the best one possible. If we want to get the BEST healthcare we will need to argue that it is "just" and sway people based on that concept. We do have two parties with two different concepts of what is just though. Democrats want hugs for everyone and the republicans want to push old people own the stairs.
Cute rhetoric, no, political philosophy, yes.
halonachos wrote:Insurance is a service that is payed for on a gamble of whether or not you will get ill. People with pre-existing conditions are turned down because it is an almost guaranteed loss of profit while people who are healthy pay less because they have less of a chance that they will get ill. The money earned by insuring x amount of healthy people and y amount of unhealthy people is enough to cover the expenses when one of the y people get ill or in the statistically unlikely event that one of the x people get ill. Would a government policy be the same, yes and no
It seems that I did acknowledge the fact that people with conditions do pay more than people who are healthy.
mgma wrote:The audits revealed that, as a group, under-insured patients received the highest percentage of under-coded services. Despite the information – including how undercoding affected their production-based compensation – some providers said they were reluctant to charge under-insured and uninsured patients the full amount knowing that patients would have to cover the fees out-of-pocket.
When they stopped undercoding they had an increase of profit in the amount of $145,000 in office-visit revenue.
As to the system causing insurance premiums to drop, the system would have to be competitive. If we can use the USPS as an example, its hardly competitive.
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dogma wrote:
halonachos wrote:Again, the fact that the person was illegal was not the issue. The issue was that the person lacked healthcare and that there was a good amount of fees that were reacked up during the care for the patient. The illegal immigrant status was used to provide background as to why the person lacked insurance in the first place.
Yes, generally, but you also explicitly stated that national, or mandatory, health insurance wouldn't fix the problem because the person in question was illegal. And that, as a result, national health insurance was an insufficient solution. This can only be taken to mean that the number of illegal immigrants in this country is central to the high cost of health care. Maybe that's not the point that you intended to make, but that's certainly what you wrote.
Or it could be taken that under universal healthcare they would not receive healthcare(because they lack citizenship) and that later on we would have to deal with it, most likely because people would argue that they have the right to universal healthcare as well.
There are a lot of possibilities Dogma, sorry for not clarifying what I meant exactly.
halonachos wrote:But the best possible system will not be gained by compromise.
Why not? I mean, the legislative history of the United States doesn't support that idea (Social Security has performed remarkably well for an institution that hasn't been significantly modified in 60 years), and neither does the massive body of literature which states that consensus democracy (Sweden, Canada, Belgium, etc.) produces the best legislative outcomes.
halonachos wrote:
Basic political philosophy follows that very principle and the fact that political philosophy follows to gain what is "just" and "good" means that by its nature it is not objective, but subjective.
What sort of basic political philosophy? I only ask because I've studied political philosophy extensively, and the only real way to make the statement that you just did is to presume that what you learned first, or accept most freely, is the fundamental tenet of an entire body of thought. That's not the case outside the hard sciences which, despite its best attempts to the contrary, political science is not.
Additionally, political philosophy is not necessarily about gaining what is just or good. That's what Platonic political philosophy is about, sure, but we've gotten a lot more sophisticated in the ensuing 2500 years.
halonachos wrote:
When you fall into the world of political science then we see more objective evidence being presented and that's when we see compromises being made and the solution we get is not the best one possible.
The inverse is also true. If what you want is the best possible system, and "best" is defined by a given subjective consideration, then any system that functions in accordance only with one such consideration is going to be something other than the best when considered against all others. This implies that the real question is realizing the best possible solution given all parties involved, even when those parties are mistake as regards what they really want to achieve. Essentially, its the age old question of "What do you really want, X or Y?"
Do you want cheaper health care, or do you want health care based on free market principles? And no, "They're one and the same." is not a valid response, as the question is about personal valuation.
More to the point, there are certain goods that can be considered "objective" in the sense that they only subjective outside the human experience. Health care is an objective good, and you will not find anyone that argues otherwise. Just deserts are not objective goods, because the ideas of who is deserving, and what is just, are not objectively verifiable. As such, the best possible system is the one extends the most care to the most people because objective considerations always outweigh subjective ones in matters where social contracts (read: citizenship), or systemic merit (the worth of a thing across all possible members of a given system) are concerned.
halonachos wrote:
If we want to get the BEST healthcare we will need to argue that it is "just" and sway people based on that concept.
Why? Why not simply argue from what is best? Why change the question into one that is, by your own admission, at least as contentious?
halonachos wrote:
We do have two parties with two different concepts of what is just though. Democrats want hugs for everyone and the republicans want to push old people own the stairs.
Cute rhetoric, no, political philosophy, yes.
No, that's not political philosophy. Its cute rhetoric. The moral arguments put forth by the Republican and Democratic parties are so juvenile and contradictory that calling them philosophy is an injustice; especially seeing their ultimate point is not the creation of a coherent idea of just politics, but swaying voters according to existential biases.
halonachos wrote:
It seems that I did acknowledge the fact that people with conditions do pay more than people who are healthy.
That's not what I asked you. I asked you whether or not the additional amount they pay is commensurate with the additional expenditure incurred in the course of treating them; ie. do they pay for all their additional expenses, or do other people make up the difference in overall cost?
halonachos wrote:
Or it could be taken that under universal healthcare they would not receive healthcare(because they lack citizenship) and that later on we would have to deal with it, most likely because people would argue that they have the right to universal healthcare as well.
That's not a particularly good reason to avoid instituting universal health care, as you're basically contending that a fix for one problem shouldn't be used because it neither fixes, nor worsens, an entirely separate problem.
mgma wrote:The audits revealed that, as a group, under-insured patients received the highest percentage of under-coded services. Despite the information – including how undercoding affected their production-based compensation – some providers said they were reluctant to charge under-insured and uninsured patients the full amount knowing that patients would have to cover the fees out-of-pocket.
When they stopped undercoding they had an increase of profit in the amount of $145,000 in office-visit revenue.
Those links aren't about the under use of diagnostic tests. They're about under reporting, and therefore under billing, with respect to what diagnostic tests are used.
In short, people without insurance (or insufficient insurance) are receiving free services, and the cost is being indirectly passed on to all other consumers.
It doesn't support your argument at all.
halonachos wrote:
As to the system causing insurance premiums to drop, the system would have to be competitive. If we can use the USPS as an example, its hardly competitive.
Not necessarily. Competition isn't the be all end all of reducing prices, that's just ideological nonsense. Competition can be effective in reducing costs, but it isn't always. Particularly in an environment where so many expenses go undocumented per the undercoding, among other things, that you mentioned above. Recall, the presence of accurate cost assessments, which expanded insurance promotes, naturally reduces costs.
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