Drug Companies Going Bankrupt

[RiverDog]

Time for a new subject on something other than Donald Trump.

Here's an article that describes what I fear could happen on a large scale if the government takes over the drug industry and prevents manufacturers from making a profit off the drugs they sell:

At a time when germs are growing more resistant to common antibiotics, many companies that are developing new versions of the drugs are hemorrhaging money and going out of business, gravely undermining efforts to contain the spread of deadly, drug-resistant bacteria.

Antibiotic start-ups like Achaogen and Aradigm have gone belly up in recent months, pharmaceutical behemoths like Novartis and Allergan have abandoned the sector and many of the remaining American antibiotic companies are teetering toward insolvency. One of the biggest developers of antibiotics, Melinta Therapeutics, recently warned regulators it was running out of cash.

Experts say the grim financial outlook for the few companies still committed to antibiotic research is driving away investors and threatening to strangle the development of new lifesaving drugs at a time when they are urgently needed.

The problem is straightforward: The companies that have invested billions to develop the drugs have not found a way to make money selling them. Most antibiotics are prescribed for just days or weeks — unlike medicines for chronic conditions like diabetes or rheumatoid arthritis that have been blockbusters — and many hospitals have been unwilling to pay high prices for the new therapies. Political gridlock in Congress has thwarted legislative efforts to address the problem.

https://www.nytimes.com/2019/12/25/heal ... tance.html

Additionally, you can extend this incident to apply to the entire subject of socialistic health care.

[Hawktawk]

Well RD I dont know what the answer is. Obamacare just turned 10 and despite Trump gutting it, defunding it, pulling support for it it picks up users every year, over 22 million people are insured because of it. I didnt suport it at the time but have talked to a lot of people who are able to insure their family only because of the law. It didn't destroy healthcare in america, my wifes a professional X ray tech and here clinic does better all the time. She makes twice as much money as I do.

It is the rampant costs which have skyrocketed under Trump that are a concern. This problem with antibiotics is growing under trump, the no health care strategy other than erase Obama president. I keep hearing the buzzword "socialism" painted on dems but there are plenty of aspects of socialism in our society and we are still doing just fine. I know I haven't gotten jack squat out of this *republican * administration to help my health care or bottom line or anything else. Not even the Dem party wants medicare for all which is why the moderate is leading the field. We need competence, rational decision making in a bipartisan fashion to address healthcare and it's just not possible right now.

[RiverDog]

Well RD I dont know what the answer is. Obamacare just turned 10 and despite Trump gutting it, defunding it, pulling support for it it picks up users every year, over 22 million people are insured because of it. I didnt suport it at the time but have talked to a lot of people who are able to insure their family only because of the law. It didn't destroy healthcare in america, my wifes a professional X ray tech and here clinic does better all the time. She makes twice as much money as I do.

I was against Obama Care when it was first proposed but now that it's the law of the land, I don't want to get rid of it and leave those that are dependent on it high and dry. Ironically, the Dems want to do away with it as well. I wouldn't mind seeing something to help extend coverage or try to make it more affordable to those that need it but I don't want to throw the baby out with the bathwater and gut the entire health care system. Sure, we'd get our coverage for free, but the consequences would be enormous. We'll suffer in terms of quality, not to mention the amount of taxes we'd be paying and the devasting effect on our economy that a government take over of an industry that's over 10% of our GDP would have. If private industry isn't allowed to make a handsome profit off new drugs, equipment, et al, there will be no more new drugs to combat things like cancer, Alzheimer's, and so on as there won't be a motivation for investors to finance the cost of R&D. We'll end up with nothing but a bunch of basic, generic maintenance drugs. We will be jumping from the frying pan into the fire if we go down the road of socialized medicine.

It is the rampant costs which have skyrocketed under Trump that are a concern. This problem with antibiotics is growing under trump, the no health care strategy other than erase Obama president. I keep hearing the buzzword "socialism" painted on dems but there are plenty of aspects of socialism in our society and we are still doing just fine. I know I haven't gotten jack squat out of this *republican * administration to help my health care or bottom line or anything else. Not even the Dem party wants medicare for all which is why the moderate is leading the field. We need competence, rational decision making in a bipartisan fashion to address healthcare and it's just not possible right now.

You can't blame Trump for the antibiotics crisis, at least not directly. The problem has been festering for decades. Have you read the entire article?

Coming up with new compounds is no easy feat. Only two new classes of antibiotics have been introduced in the last 20 years — most new drugs are variations on existing ones — and the diminishing financial returns have driven most companies from the market. In the 1980s, there were 18 major pharmaceutical companies developing new antibiotics; today there are three.

The DISARM Act, a bill introduced in Congress this year, would direct Medicare to reimburse hospitals for new and critically important antibiotics. The bill has bipartisan support but has yet to advance.

One of its sponsors, Senator Bob Casey, Democrat of Pennsylvania, said some of the reluctance to push it forward stemmed from the political sensitivity over soaring prescription drug prices. “There is some institutional resistance to any legislation that provides financial incentives to drug companies,” he said.

[Aseahawkfan]

The antibiotic crisis has nothing to do with socialized healthcare and everything to do with over-prescription of antibiotics leading to a weakening of immune systems of humans and the creation of strains of bacteria that adapted to the antibiotic. Bacteria, viruses, and other microscopic organisms reproduce and adapt quickly. It is very hard to create drugs to keep up with such organisms. The main resistance is your immune system which is also comprised of organisms that adapt to fight bacteria and viruses as fast as possible.

Vaccines are an example of preparing your immune system to fight against an infection or sickness. Vaccines are forced adaptation.

The reality is that for profit healthcare does not provide better outcomes than socialized healthcare. Most of the money spent on drugs leads to nowhere. Just a huge wasted amount of money or a drug produced that doesn't do much, but costs enormous amounts and gets forced into the system because dying people will try anything to stay alive.

We could do a better job improving health and longevity by focusing less on pharmaceuticals and more on fitness and nutrition.

My biggest fear with socialized medicine isn't the lack of money to create drugs or procedures. That money would come because medicine is one of those areas wealthy people will always donate to because they die from the same maladies as everyone else. The profit motive for medicine won't drive creation as much as the desire to live by even the wealthiest folks who are plagued by the same diseases as the poor.

The bigger fear I have is all the terrible habits of humans. The over-eating, the smoking, the drinking, the lack of willingness to exercise, the way they sit around watching TV for hours, and the like. An unmotivated, lazy, unhealthy obese population of humans will bankrupt a socialized medical system faster than anything else. Americans on the whole are extremely unhealthy and would fight against any forced attempts to get them healthy even if it would save billions on medicine. Americans would demand "free" healthcare while at the same time demanding complete freedom to eat and do whatever they want even though it vastly increases the costs of medicine.

You see the 'Healthy at Every Size Movement"? It's a movement to convince people that being fat is healthy. It's total rubbish, but the group is pushing anti-fat discrimination while not acknowledging any of the clear science showing obesity is one of the biggest dangers to human health and costs we face today. That is what I fear causing the biggest problems with socialized health care.

We have a very poor culture of nutrition, health, and fitness to implement socialized healthcare. I don't see Americans taking kindly to the methods of other nations to reduce healthcare costs like forcing people to pursue fitness and health as a social duty and hammering the food and drink industry to make them pay the extra costs of the medical problems caused by over consumption of their crap food.

Personally, i would force Americans to get in shape and eat better. I'm ok with it. They need to be pushed. At the same time that is another can of worms that liberals could get a hold of and take too far like their microaggression BS and twenty different forms of sexuality as well as trying to force everyone to become vegan or some such trash.

At the moment, there are a lot of advantages to socialized healthcare. I like those too. Decoupling health care from the job would lead to more freedom so you couldn't have your healthcare taken away for saying the wrong thing or what not. The government would absorb the moral quandaries of healthcare like abortion or doctor-assisted suicide without religious organizations attempting to overly influence medicine.

We'll see what they eventually do. There will always be pros and cons. At the moment I'm not seeing any financial advantages to private healthcare in terms of health outcomes. If medical is there to improve health and mortality, then private healthcare isn't doing a better job than socialized healthcare. I'm not sure what other metrics to use other than cost and healthcare outcomes for rating healthcare.

[Aseahawkfan]

I was against Obama Care when it was first proposed but now that it's the law of the land, I don't want to get rid of it and leave those that are dependent on it high and dry. Ironically, the Dems want to do away with it as well. I wouldn't mind seeing something to help extend coverage or try to make it more affordable to those that need it but I don't want to throw the baby out with the bathwater and gut the entire health care system. Sure, we'd get our coverage for free, but the consequences would be enormous. We'll suffer in terms of quality, not to mention the amount of taxes we'd be paying and the devasting effect on our economy that a government take over of an industry that's over 10% of our GDP would have. If private industry isn't allowed to make a handsome profit off new drugs, equipment, et al, there will be no more new drugs to combat things like cancer, Alzheimer's, and so on as there won't be a motivation for investors to finance the cost of R&D. We'll end up with nothing but a bunch of basic, generic maintenance drugs. We will be jumping from the frying pan into the fire if we go down the road of socialized medicine.

You posted an article proving your own assertion false. Public funds in excess of 30 billion matching what the private industry puts in goes to new medical technology development. Money would not stop flooding into medicine. Both private individuals and the public sector have a vested interest in improving healthcare. Rich people get diseases too. They would flood universities or research organizations with money to stay alive.

Healthcare is not like construction or other industries. It's life and death. A wealthy person has just as much need for quality healthcare including new drug and medical technology development as poor people. That would not change public or private. Universities and public research centers are almost always well funded to find new drugs for this reason.

You can't blame Trump for the antibiotics crisis, at least not directly. The problem has been festering for decades. Have you read the entire article?

Hawktawk would blame Trump for stubbing his toe. The skyrocketing cost articles have been there for ages. I saw those skyrocketing cost articles under Obama too. I heard Republicans blaming Obamacare for skyrocketing costs. I tried to explain to those same folks that the costs were rising for other reasons. Companies really don't want to absorb the cost of healthcare. They will do as little as they can to provide it. Companies in general would support a single-payer system if it didn't cost them more than they pay now. People just like to blame whoever they hate on opposing team whether it makes sense or has true factual support.

Coming up with new compounds is no easy feat. Only two new classes of antibiotics have been introduced in the last 20 years — most new drugs are variations on existing ones — and the diminishing financial returns have driven most companies from the market. In the 1980s, there were 18 major pharmaceutical companies developing new antibiotics; today there are three.

The DISARM Act, a bill introduced in Congress this year, would direct Medicare to reimburse hospitals for new and critically important antibiotics. The bill has bipartisan support but has yet to advance.

One of its sponsors, Senator Bob Casey, Democrat of Pennsylvania, said some of the reluctance to push it forward stemmed from the political sensitivity over soaring prescription drug prices. “There is some institutional resistance to any legislation that provides financial incentives to drug companies,” he said.

Antibiotics are a rough area. You're right. It's not just the lack of science or money. It's very hard to create a medicine to combat some of these dangerous bacteria and viruses that reproduce and adapt so quickly.

[RiverDog]

Both private individuals and the public sector have a vested interest in improving healthcare. Rich people get diseases too. They would flood universities or research organizations with money to stay alive.

Lots of publicly held companies help fund R&D at our colleges and universities. They do so because they are profitable and have substantial funds available to make such donations and stand to benefit financially from the research they provide. If you hurt those companies by making it more difficult for them to make a profit, they will no longer make such contributions. When a company gets into trouble, the first and easiest item to get cut are charitable donations, whether they be for colleges or the local Little League team, as they don't put anyone that works for them out of work, which itself has costs.

Healthcare is not like construction or other industries. It's life and death. A wealthy person has just as much need for quality healthcare including new drug and medical technology development as poor people. That would not change public or private. Universities and public research centers are almost always well funded to find new drugs for this reason.

Health care is similar to other industries in their funding mechanisms. Publicly held companies, which most are, sell stock in order to finance R&D, more efficient equipment/production methods, etc. Investors are speculating on the success of that company. As the value of that stock increases, so does the company's ability to borrow against it. Their stock price is their life blood.

That's where the article relates to socialized health care. Companies are not investing R&D money in antibiotic medicine because there's no profit in it. Most antibiotics are prescribed for short term illnesses, infections, etc, so revenue off those drugs are hit-and-miss vs. something like high blood pressure, high cholesterol, maintenance type drugs, that are taken for the rest of the patient's life and provide the drug company with a steady, dependable stream of income.

If the government restricts the price companies can charge for drugs, which is what will happen in a socialized, controlled system, the same thing that's happening with antibiotics will happen with all drugs that are not commonly used. We'll end up paying less for Tylenol and Ibuprofen, drugs that they can produce much more efficiently, but no new, experimental drugs to combat diseases like Alzheimer's as it would be too expensive to produce because they won't be sold in large enough quantities to justify mass production that would lower the cost per unit to the point where they could turn a profit or be sold with a high enough price to cover what they've invested in R&D and low volume production.

As far as your take on the source of health issues being due to controllable causes like fitness and avoidance of unhealthy habits, that's certainly part of the equation but not by any means all of it. My wife hasn't been more than 10 pounds overweight in her entire life, doesn't smoke or use recreational drugs, worked as a nurse on her feet constantly for 40 years, yet she acquired both MS and rheumatoid arthritis. She is on 11 prescription drugs, including drugs for high blood pressure and cholesterol that many associate with an unhealthy lifestyle.

[RiverDog]

Hawktawk would blame Trump for stubbing his toe. The skyrocketing cost articles have been there for ages. I saw those skyrocketing cost articles under Obama too. I heard Republicans blaming Obamacare for skyrocketing costs. I tried to explain to those same folks that the costs were rising for other reasons. Companies really don't want to absorb the cost of healthcare. They will do as little as they can to provide it. Companies in general would support a single-payer system if it didn't cost them more than they pay now. People just like to blame whoever they hate on opposing team whether it makes sense or has true factual support.

Neither Trump, the Republicans, or the Democrats are to blame for rising health care costs. The biggest culprit is our changing demographics. With longer life expectancies and a shrinking birth rate, there are more and more Americans demanding medical services and fewer and fewer younger people entering the work force to pay into the system and not take out of it. It's the same root cause as Social Security, Medicare, and private insurance is having. Socialized medicine would have the same problem: Too many people taking money out, not enough putting money back in.

That's why I advocate a reasonable, controlled increase in immigration. Allow well vetted, law abiding, educated, healthy applicants ages 18-35 that have a good chance of contributing to our economy to immigrate. Absent an increase in the birth rate or raising the retirement age, it's the only way we're going to come close to balancing the worker/retiree ratio and pay for our health care and other legacy costs associated with old age.

Not to go off on a tangent, but I read the other day where the average age of a licensed electrician in the United States is 56 years old, and that's in an occupation that is very well paid and in a field that is projected to expand with not a huge amount of education or training to endure. A similar situation exists with truck drivers. Native born Millennials aren't going into these blue collar-type fields. If the demand for those jobs aren't addressed, our economy will begin to shrink, putting even more pressure on our health care system. That's one of my major problems with DJT. He cannot articulate his claim that we're "full", the lack of which leads me to believe that his objections to legal immigration is race based.

[Hawktawk]

What I mean by "under trump" is hes the dude right now. "the buck stops here" The last few guys its been "the buck never got here". Both Obama and Trump ran on health care. Obama passed the most sweeping program modifying health coverage in my lifetime. Trump to my knowledge has done nothing but gut it with no real alternative. Correct me if i'm wrong on that. One would have to live under a rock not to understand costs have been rising forever..

It's just mister best this and best ever that and art of the deal hasn't done a damn thing to stop it. Quite the opposite.

[RiverDog]

What I mean by "under trump" is hes the dude right now.

Using that logic, you could blame him or anyone else that holds that office for a whole bunch of stuff.

[Aseahawkfan]

[Lots of publicly held companies help fund R&D at our colleges and universities. They do so because they are profitable and have substantial funds available to make such donations and stand to benefit financially from the research they provide. If you hurt those companies by making it more difficult for them to make a profit, they will no longer make such contributions. When a company gets into trouble, the first and easiest item to get cut are charitable donations, whether they be for colleges or the local Little League team, as they don't put anyone that works for them out of work, which itself has costs.

Lots of public funds go into medical research as well. What of it? Medicine has been created with and without socialized healthcare. Profit alone does not drive drug or medical creation.

Health care is similar to other industries in their funding mechanisms. Publicly held companies, which most are, sell stock in order to finance R&D, more efficient equipment/production methods, etc. Investors are speculating on the success of that company. As the value of that stock increases, so does the company's ability to borrow against it. Their stock price is their life blood.

No, it is not. You can have a great stock price and no money. Their life blood is funding for research to get off the ground from both public and private financing prior to even going to the equity markets. Equity funding comes later if they can pass the initial steps of a possible FDA approval. Drug development is an extremely lengthy and involved process with very few drugs making much of an impact. The biggest hits if we moved to socialized medicine would be for orphan drugs, not drugs like antibiotics. Antibiotics are plenty profitable. There is more to the antibiotic question than money.

That's where the article relates to socialized health care. Companies are not investing R&D money in antibiotic medicine because there's no profit in it. Most antibiotics are prescribed for short term illnesses, infections, etc, so revenue off those drugs are hit-and-miss vs. something like high blood pressure, high cholesterol, maintenance type drugs, that are taken for the rest of the patient's life and provide the drug company with a steady, dependable stream of income.

This isn't true. They have been investing in new antibiotics. They are not easy to make. Not sure why you think you can just throw money at something and it will magically happen.

If the government restricts the price companies can charge for drugs, which is what will happen in a socialized, controlled system, the same thing that's happening with antibiotics will happen with all drugs that are not commonly used. We'll end up paying less for Tylenol and Ibuprofen, drugs that they can produce much more efficiently, but no new, experimental drugs to combat diseases like Alzheimer's as it would be too expensive to produce because they won't be sold in large enough quantities to justify mass production that would lower the cost per unit to the point where they could turn a profit or be sold with a high enough price to cover what they've invested in R&D and low volume production.

This is not true. Not sure why you are painting this false supposition as true. And it is not what your article indicated. There are plenty of companies trying to develop new antibiotics, but it is not easy.

https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2014/antibiotics-currently-in-clinical-development

As far as your take on the source of health issues being due to controllable causes like fitness and avoidance of unhealthy habits, that's certainly part of the equation but not by any means all of it. My wife hasn't been more than 10 pounds overweight in her entire life, doesn't smoke or use recreational drugs, worked as a nurse on her feet constantly for 40 years, yet she acquired both MS and rheumatoid arthritis. She is on 11 prescription drugs, including drugs for high blood pressure and cholesterol that many associate with an unhealthy lifestyle.

Those are genetic disorders.

Your take on the drug business is not supportable by evidence. It is theoretical. After having invested in the medical device and drug business, I can say it is not how it works. The topic is immense, but I'll list a handful of considerations:

1. We are already socialized through jobs, corporations, and medicare. Current insurance employed by most people is similar to socialized medicine. You pay for the insurance and the insurance provider decides what medical procedures and medicine they will cover according to their agreements with the providers. This idea that people are getting this great medical care compared to socialized medicine haven't taken much time to talk with people in nations with socialized medicine. I don't mean all the horror story BS that talking heads use to argue with each other. I'm talking real people using the medical systems of their nation. I've talked to Germans, Canadians, and English folk. They seem very happy with their medical system. In operation it doesn't sound much different from ours from what they've told me of their experience, about the worst part of it appears to be the waiting.

2. Drug development usually fails. And even drugs that get approved, most aren't more effective than what already exists. So we have billions wasted to create drugs no more effective than current drugs to drive up stock prices artificially as investors take the money and run. There is a huge amount of this going on. They hang out on penny exchanges or disappear from stock exchanges as time goes on. Suffice it to say there are a lot of charlatans making money grabs in drug development. Socialized medicine could clean this up some as the money would be very focused on effective medicines versus creating medicine businesses to make a money grab on a popular idea like Crisper tech or cloning meat.

3. Profit motive versus human life. How do you make these decisions? If an insurance company refuses a procedure due to the wealth level of the sick person, are we ok with that? Do you tell the parents of a sick child because they are poor, sorry you're kid is going to die because you're in the right income bracket? I don't know that I am ok with that. Does profit trump human life? Where do we draw those lines?

4. Health outcomes. Socialized medicine is less costly and equally effective to private medicine. There is currently no evidence to suggest that socializing the health care system will reduce spending on drugs and medical procedures. In fact, many medical procedures and drugs come from nations with socialized health care. The entire world invests in health care, not just the United States. It would be very easy for the entire world to put forth incredible sums of money public and private to improve health care.

If anything removing the profit motive from health care would allow medical development organizations to focus less on maximizing profits and more on improving health outcomes and putting drugs and medical procedures that are effective and safe rather than pushing them out to save investors money or maximize their gains. Contrary to what some thing, profit does not motivate everyone. The medical profession is definitely a profession where people are motivated by a desire to help others. It's a hard, hard job that requires years of education. People do not enter it unless they wish to help others. They could make equal or more money in some other job like investing or finance or law with less schooling. They often chose medicine for personal interest and a desire to help. I believe we could create a medical system similar to our military or police force more interested in improving human health and wellness even without the profit motive based on duty and altruism.

I'm willing to lose the investment opportunities from biotech to make for an overall better world. Sure, you can make a crap ton of money investing in biotech if it hits. I would rather see a more egalitarian and less expensive healthcare system in place that would make for an overall more humane society.

That's my take on the matter. My main concern is what I've already stated: that our government will not do what is necessary to force people to better nutrition and fitness or at least make those unwilling to take the steps to improved health and fitness pay the price. If I were in charge, I would take those steps including weighing people for their tax rate like a yearly tab, taxing the hell out of fast food and junk food companies, and implementing nutrition education in school as well as having a PE system that requires children to exercise daily, not play a handful of games in class. The fact we don't teach humans how to properly care for their bodies as part of our education system shows how far we have to go to have a truly useful and effective education system in America.

[RiverDog]

Lots of public funds go into medical research as well. What of it? Medicine has been created with and without socialized healthcare. Profit alone does not drive drug or medical creation.

That's true. My point was that you're inevitably going to change the research funding equation by going on an attack on companies.

As far as your take on the source of health issues being due to controllable causes like fitness and avoidance of unhealthy habits, that's certainly part of the equation but not by any means all of it. My wife hasn't been more than 10 pounds overweight in her entire life, doesn't smoke or use recreational drugs, worked as a nurse on her feet constantly for 40 years, yet she acquired both MS and rheumatoid arthritis. She is on 11 prescription drugs, including drugs for high blood pressure and cholesterol that many associate with an unhealthy lifestyle.

Those are genetic disorders.

Some are, some aren't. For example, they don't know what causes MS or how to prevent it. It seems to afflict those living in northern latitudes, like Norway and Sweden, more often that people living in the tropics, leading researchers to speculate that it could be environmental, yet there are potential genetic markers that could identify a person that's at a higher risk of acquiring the disease. Same goes with high cholesterol and high blood pressure. It can be caused both by eating an unhealthy diet and/or a trait passed down through ancestry.

I am getting the sense that you are assigning too much importance to controllable attributes like smoking and over eating, which is why I gave you my personal example. My wife doesn't smoke, doesn't drink, and doesn't over eat, yet she's on 11 prescription drugs including many to treat conditions of unknown origin. Even things we assume are controllable, like obesity, you can't draw a line and decide that one case is environmental while another is genetic and others might be some unknown combination of the two. It's not an exact science.

My main concern is what I've already stated: that our government will not do what is necessary to force people to better nutrition and fitness or at least make those unwilling to take the steps to improved health and fitness pay the price. If I were in charge, I would take those steps including weighing people for their tax rate like a yearly tab, taxing the hell out of fast food and junk food companies, and implementing nutrition education in school as well as having a PE system that requires children to exercise daily, not play a handful of games in class. The fact we don't teach humans how to properly care for their bodies as part of our education system shows how far we have to go to have a truly useful and effective education system in America.

So you're going to "force" people to live a healthy lifestyle? In other words, if I want to order a steak and baked potato, you're going to make me produce a card showing what my body mass index and that the government will allow me to eat a high fat, high calorie meal? And even if a person's health problems are due 100% to an unhealthy lifestyle, are you going to deny them one of life's basic pleasures by being able to eat whatever and whenever they feel like? And do you seriously advocate making people that don't fit your perception of good health pay more taxes? So in other words, you're telling me that only the rich that can afford the higher taxes can eat or drink what they please?

Same goes with your proposed taxation policy on fast food and junk food. If it's that bad for us, then make it illegal, but don't use the power of taxation to influence what the government thinks is bad behavior. Those types of taxes tend to shake out by class. For example, 21% of adults with incomes below $35,000 are smokers while just 7% of those with income of $100,000+ smoke, so in reality, sin taxes like those you are proposing are likely to hit the poor much harder than they would the rich.

I'm not sure if I want to live in this "government knows best" world of yours. It sounds too much like communism.

[I-5]

Interesting thread. I don’t have any hard statistics to add, but wanted to share a post from today from my good friend Laura here in Vancouver about a recent experience (she is in her 60’s):

“ On Sunday I had the opportunity to visit Vancouver's new Urgent Care clinic and I cannot say enough good things. My hand had suddenly become swollen and extremely painful and while I didn't think it was an actual emergency, (as it turned out, it easily could have become one) I didn't want to wait until I could see my GP, (which probably would have been sometime later in the week, and then only if I phoned first thing Monday). Initially I misread the operating hours, so it wasn't until 2:30 PM that I discovered City Centre Urgent Primary Care Centre IS open on Sundays and presented myself to them. Ten people were ahead of me—a take-a-number system of waiting, so I wasn't in the dark about how long it would take. In the hour and a half before I was seen by an doctor, I read my book and observed people in the waiting room. Everyone was treated well by the staff, who actually smiled a lot and didn't seem the least bit jaded or unhappy to be working the weekend between Christmas and New Year's. When the doc examined my hand, we chatted about the possible causes. They thought it was an arthritis fare-up, I thought it might be gout. "That's a good guess", they said and ordered blood tests, x-rays and, to my surprise, an ultrasound. I underwent those procedures immediately and waited in a reclining chair in a curtained-off area. A nurse brought by a blanket and tucked it around me. I wasn't cold, but the care they took nearly made me weep. I am super emotional when in pain. An hour later my doc told me my elevated white blood cell count made them think I might have cellulitis and offered a prescription for antibiotics. After discussing whether it would be prudent to wait until there was an actual confirmation of the diagnosis before beginning antibiotics, I decided to start them. It was clear to me I had an infection of some kind that was only getting worse. I left with prescription in hand and within 12 hours of beginning the meds, my pain was gone and my hand almost looked normal.

I was so impressed with the experience, but nothing prepared me to receive a phone call at 9:30 PM last night, from the very same doc, asking how I was doing. I nearly dropped my phone. They were also calling to give me the radiologist report on the x-rays and ultrasound, which was that I have a great deal of calcification and arthritis in my hand. This was not news to me, but I found their concern very touching.

Thank you so much, City Center Urgent Primary Care Centre, Vancouver Coastal Health, BC Ministry of Health, Government of Canada. Thank you to all the people who fought so hard to get socialized medicine. And to all the people who continue the fight against privatizing medicine, thank you, thank you.”

[RiverDog]

Interesting story. Just to add some balance to what I assume is the point you're trying to make, ie singing the praises of socialized health care, here's another:

Mountain-bike enthusiast Suzanne Aucoin had to fight more than her Stage IV colon cancer. Her doctor suggested Erbitux—a proven cancer drug that targets cancer cells exclusively, unlike conventional chemotherapies that more crudely kill all fast-growing cells in the body—and Aucoin went to a clinic to begin treatment. But if Erbitux offered hope, Aucoin’s insurance didn’t: she received one inscrutable form letter after another, rejecting her claim for reimbursement. Yet another example of the callous hand of managed care, depriving someone of needed medical help, right? Guess again. Erbitux is standard treatment, covered by insurance companies—in the United States. Aucoin lives in Ontario, Canada.

When Aucoin appealed to an official ombudsman, the Ontario government claimed that her treatment was unproven and that she had gone to an unaccredited clinic. But the FDA in the U.S. had approved Erbitux, and her clinic was a cancer center affiliated with a prominent Catholic hospital in Buffalo. This January, the ombudsman ruled in Aucoin’s favor, awarding her the cost of treatment. She represents a dramatic new trend in Canadian health-care advocacy: finding the treatment you need in another country, and then fighting Canadian bureaucrats (and often suing) to get them to pick up the tab.

[I-5]

Not one person claims that any healthcare in the world is perfect, so my post was simply to share something firsthand from a good friend that goes against the 'can't trust the gov't to provide healthcare' narrative. Secondly, the story you referred to is specifically about Ontario's policy with 'out of the country' healthcare provided by an unaccredited foreign practitioner using a drug that wasn't recognized or sanctioned yet in Canada. And yet, the Ontario Ombudsman (technically part of the government) ruled in favor of the citizen. That story, although it does show frustration with the Ontario Healthcare System's out of country policy, also shows the government caring about its citizens to fix a problem. What are the chances that would happen in the US?

[Aseahawkfan]

That's true. My point was that you're inevitably going to change the research funding equation by going on an attack on companies.

I do not see why you consider the pursuit of profit at the expense of human life and well being as necessary for advancing medicine. Many of our medical advancements have been done absent a strong profit motivation.

Some are, some aren't. For example, they don't know what causes MS or how to prevent it. It seems to afflict those living in northern latitudes, like Norway and Sweden, more often that people living in the tropics, leading researchers to speculate that it could be environmental, yet there are potential genetic markers that could identify a person that's at a higher risk of acquiring the disease. Same goes with high cholesterol and high blood pressure. It can be caused both by eating an unhealthy diet and/or a trait passed down through ancestry.

I am getting the sense that you are assigning too much importance to controllable attributes like smoking and over eating, which is why I gave you my personal example. My wife doesn't smoke, doesn't drink, and doesn't over eat, yet she's on 11 prescription drugs including many to treat conditions of unknown origin. Even things we assume are controllable, like obesity, you can't draw a line and decide that one case is environmental while another is genetic and others might be some unknown combination of the two. It's not an exact science.

It is quite well known that smoking is extraordinarily bad for your health. That is not even in question at all. It is terrible for you.

I am not assigning too much importance to controllable factors. You are taking a single individual and extrapolating that to large populations when the data already proves quite succinctly that obesity and related illnesses and smoking are terrible for your health and cause huge numbers of health problems.

MS is a disorder they check for when you are a child. And rheumatoid arthritis is a genetic disorder with the immune system causing inflammation of the joints. Neither one associated with obesity or smoking. Does she have any disorders associated with smoking or obesity like so many Americans?

Sure, some components are genetic. The vast majority of health problems are due to lifestyle choices. The vast majority. As far as personal anecdote goes, my grandmother died at 95 of old age. She never smoke, wasn't overweight, and didn't have any serious medical conditions and took no medications until her 90s. Then she died of old age and the body shutting down. That anecdotal evidence of a single individual has very little to do with the mass evidence of obesity and terrible life-style choices of smoking, drug abuse, alcohol abuse, or the like ruining health.

Even playing professional sports is highly dangerous and causes health to suffer.

My main point for this is people should pay for the lifestyle choices they make in a socialized system. The one advantage of private healthcare other than increase premiums for all is that people who make bad lifestyle choices end up paying for them with increased health costs. That would be difficult to get people onboard with in a socialized system where we have to feel bad for little fat Jimmy's parents abusing him and we can't hurt little fat Darla's feelings and heroin-addicted Jack had a bad upbringing so we have take care of him because we feel bad. That's the part of it we need to hammer down on to reduce costs.

Controllable factors are largely the highest medical costs we deal with. I'm not sure why you are downplaying it given the sheer volume of evidence to the contrary. People are terrible at taking care of their health. And it costs a lot of money to insurers because of it.

They don't exercise much. They eat like crap. They sit around watching TV or playing on the computer. Smoke and do drugs, then wonder why they're taking ten medications by the age of 60 or earlier. They believe everything the doctor tells them like gospel taking no time to learn about their health. That is my biggest fear with socialized healthcare. I'll be paying huge taxes to support an obese, lazy, vice-addicted group of humans that are getting money from stupid liberals that don't want to make people get in shape and give too much money to placate whining crybabies who don't want to put work in.

So you're going to "force" people to live a healthy lifestyle? In other words, if I want to order a steak and baked potato, you're going to make me produce a card showing what my body mass index and that the government will allow me to eat a high fat, high calorie meal? And even if a person's health problems are due 100% to an unhealthy lifestyle, are you going to deny them one of life's basic pleasures by being able to eat whatever and whenever they feel like? And do you seriously advocate making people that don't fit your perception of good health pay more taxes? So in other words, you're telling me that only the rich that can afford the higher taxes can eat or drink what they please?

Same goes with your proposed taxation policy on fast food and junk food. If it's that bad for us, then make it illegal, but don't use the power of taxation to influence what the government thinks is bad behavior. Those types of taxes tend to shake out by class. For example, 21% of adults with incomes below $35,000 are smokers while just 7% of those with income of $100,000+ smoke, so in reality, sin taxes like those you are proposing are likely to hit the poor much harder than they would the rich.

I'm not sure if I want to live in this "government knows best" world of yours. It sounds too much like communism.

Thinks is bad behavior? I don't care about the government thinks. I care about what they prove. Obesity is costly to our private medical system. There is clear evidence certain things are terrible for your body. That junk food is terrible is not in question. That smoking is terrible is not in question. You already know making things illegal is pointless. It's better to tax them and make them spend more money to cover the increased costs of the harm they do to themselves and society. It is almost always smarter to use taxation which is voluntary than to criminalize something and crowd your jails with unproductive people trapped in cells. If you don't want to pay the extra tax, then don't eat the crap food or smoke or do the crap activity. That is far superior to encouraging a black market for junk food that would cause more of what we see with the useless and expensive War on Drugs.

Yep. I would probably have you get an health inspection every year. You would get a tax break for keeping yourself in shape and having good biomarkers with additional passes given to those with genetic disorders that cause their biomarkers to read off.

That is if I had control. People shouldn't be able to do whatever they want and make others pay for it. They should have to pay for it with increased costs for their terrible behavior. The best way the government can do that is the following:

1. Stay completely out of it and let people suffer the full consequences of their stupid behavior. I'm ok with this option, but the government does not seem ok with it.

2. Make sure any system they implement taxes the people engaged in the rotten behavior so that people not engaged in said rotten behavior can avoid the tax by simply not engaging in the behavior. I can live with this option given the government and bleeding hearts seem incapable of allowing option 1 to happen.

I'll leave it at that as we're both fairly entrenched in how we see things.

[RiverDog]

It is quite well known that smoking is extraordinarily bad for your health. That is not even in question at all. It is terrible for you.

Then the FDA should ban it (smoking), and if they did, they would enjoy my full support. But so long as it's a legal product, the government has no business foisting their view of healthy behavior by abusing the power of taxation granted to them by the citizens to punish those that don't conform to their edicts. The sole purpose for taxation should be for needed operating revenue, not to promote their idea of clean living.

I am not assigning too much importance to controllable factors. You are taking a single individual and extrapolating that to large populations when the data already proves quite succinctly that obesity and related illnesses and smoking are terrible for your health and cause huge numbers of health problems.

I'll give you your take on smoking. As I said above, there's enough evidence that it should be banned. It seems silly that they're banning vaping but smoking is still legal. But obesity is a different monster. How many times do you see families with 3 or 4 generations that are all obese? Are all of them due to controllable factors or is there a gene that's passed down that makes it more difficult to control one's appetite?

Besides, as far as health care costs go, if you live an unhealthy life and die 10-20 years earlier than had you lived your maximum age, you're doing the taxpayer a favor by not drawing on Social Security and not being a financial burden to Medicare. My dad was a lifelong smoker and died of lung cancer when he was 59, never saw a SS check and was never on Medicare. Mom lived to be 88 and had heart valve replacement surgery when she was 81. I don't know how much her surgery cost, but they can approach half a million dollars. It goes without saying that my dad did the taxpayer one helluva favor by smoking and dying young while mom made them pay for her healthy lifestyle choices.
.

MS is a disorder they check for when you are a child. And rheumatoid arthritis is a genetic disorder with the immune system causing inflammation of the joints. Neither one associated with obesity or smoking. Does she have any disorders associated with smoking or obesity like so many Americans?

I never said either was affected by obesity or smoking. What I said was that they aren't sure if MS is environmental or genetic. By environmental, I mean the conditions a person lives in or is exposed to vs. what they are born with. Is there something about living in equatorial regions that makes you more immune to MS? Or is it a genetic trait that's passed down from northern European decedents? They don't know.

My wife never has had a problem with weight control, nor has any of her family members, at least not to the point where they'd be considered obese. She did smoke early in her adulthood but hasn't smoked for over 30 years. She's also a very light drinker. We've been together for 20 years and I've never seen her drunk. Neither of her current conditions are believed to be as a result of a poor lifestyle choice, but that doesn't mean they're genetic.

Sure, some components are genetic. The vast majority of health problems are due to lifestyle choices. The vast majority. As far as personal anecdote goes, my grandmother died at 95 of old age. She never smoke, wasn't overweight, and didn't have any serious medical conditions and took no medications until her 90s. Then she died of old age and the body shutting down. That anecdotal evidence of a single individual has very little to do with the mass evidence of obesity and terrible life-style choices of smoking, drug abuse, alcohol abuse, or the like ruining health.

I don't doubt that living a healthy lifestyle is the largest component of overall life expectancy. But it's next to impossible to make that distinction on an individual case. Is over eating a completely controllable urge or does genetics play a role, and if so, to what degree? Diabetes is another condition that's cause both by genetics as well as over eating. All a doctor will tell you is that you lower your risk of acquiring it if you eat right.

My main point for this is people should pay for the lifestyle choices they make in a socialized system.

If you could prove that a condition, on a case by case basis, was caused by completely controllable causes and that genetics did not play a role, such as smoking, then I would agree with you. Additionally, if you can show that those that over eat will cost more for the government to maintain than a person that lives to their maximum age, then I would also agree with you. But neither of those conditions are present.

Controllable factors are largely the highest medical costs we deal with. I'm not sure why you are downplaying it given the sheer volume of evidence to the contrary. People are terrible at taking care of their health. And it costs a lot of money to insurers because of it.

I am agreeing with your underlined sentence. Our differences are what, if anything, should be done about it. I do not believe that taxation or other punitive measures are the answer as it's impossible to separate those cases where a person intentionally caused themselves harm, nor am I convinced that the rest of society is having to pay for their excesses.

[RiverDog]

Not one person claims that any healthcare in the world is perfect, so my post was simply to share something firsthand from a good friend that goes against the 'can't trust the gov't to provide healthcare' narrative. Secondly, the story you referred to is specifically about Ontario's policy with 'out of the country' healthcare provided by an unaccredited foreign practitioner using a drug that wasn't recognized or sanctioned yet in Canada. And yet, the Ontario Ombudsman (technically part of the government) ruled in favor of the citizen. That story, although it does show frustration with the Ontario Healthcare System's out of country policy, also shows the government caring about its citizens to fix a problem. What are the chances that would happen in the US?

I don't hear very often about people going out of the country for medical procedures unless it's due to cost issues. My cousin traveled to SE Asia (Malaysia, I think) to have heart surgery because he was a small businessman and didn't have group insurance. The cost was way lower than it is here, and the surgery was performed by American-trained doctors. I have not heard of people going out of the country for reasons due to the story I quoted.

Let's assume that the roles in the story I quoted were reversed, and Canada had our health care system and we had Canada's. Given the difference in population and the amount of distance to travel to get to the border (what percentage of the Canadian population lives within 200 miles of the US border?), would it be a viable option for me to travel to Canada for a procedure I couldn't get in the US? If there were months long waits to get an MRI in the US, how many people would be traveling to Canada to get one and would they be able to handle the demand?

It must be nice for Canadians to have good ole Uncle Sam to count on as a backup if their system fails them.

[I-5]

Once more, not one person is claiming that the Canadian system is perfect. Yes, Canadians who can’t wait or don’t want to wait can and do go to the US treatment, but the costs are ridiculous (hence the story above). Also, not all cancer treatments are approved or readily available in Canada. For the huge majority of healthcare needs, however, the single payer system works EXTREMELY well, and administered by competent and caring professionals in my experience and every other Canadian I’ve spoken with about (even the ones who have some frustration with it). All it takes is to bring up the US system, and no one would want to trade.

[RiverDog]

Once more, not one person is claiming that the Canadian system is perfect. Yes, Canadians who can’t wait or don’t want to wait can and do go to the US treatment, but the costs are ridiculous (hence the story above). Also, not all cancer treatments are approved or readily available in Canada. For the huge majority of healthcare needs, however, the single payer system works EXTREMELY well, and administered by competent and caring professionals in my experience and every other Canadian I’ve spoken with about (even the ones who have some frustration with it). All it takes is to bring up the US system, and no one would want to trade.

That's all fine and dandy, but you didn't really address my point: Canadians and their health care system have a distinct advantage over the United States in that a large majority of their citizens are just a few hours drive away from the border so if they do happen to fall through the cracks, as in the story I quoted, they have this huge, wealthy country right at their doorsteps that can provide them with their needs. That kind of safety net would almost certainly not exist for citizens of the US should we go to a similar system, at least not anywhere close to the same proportions as it does for Canadians.

[Hawktawk]

I've got a buddy from Vancouver BC and we've discussed the Canadian system. He said they pay roughly 50% of their gross income in taxes but he personally likes it because of all the things the government provides at no extra charge. He has no problem with the medical care at all, also in Canada maternity leave is 1 year paid by the government, etc. When it comes to our for profit system I think the care is rolls royce but the price is astronomical. Still, can you take a car doing 100 mph and put it in reverse?

[I-5]

Riv, you're right the Canadians have it good having the US as neighbors. Actually, I hear Asian countries like Thailand and India are a great resource for high quality healthcare options. I was simply making the point that the gov't can and does provide a quality healthcare provider experience everyday, even in spite of the story you shared.

Hawktalk, 50% does sound a bit high, so I'm not sure why. Here are the Canada tax brackets (they are not wildly different than the US):

2018 Canadian Federal income tax rates
$46,605 or less |15%
$46,605 to $93,208 | 20.5%
$93,208 to $144,489 | 26%
$144,489 to $205,842 |29%

https://www.canada.ca/en/financial-consumer-agency/services/financial-toolkit/taxes/taxes-2/5.html

[c_hawkbob]

Riv, you're right the Canadians have it good having the US as neighbors. Actually, I hear Asian countries like Thailand and India are a great resource for high quality healthcare options. I was simply making the point that the gov't can and does provide a quality healthcare provider experience everyday, even in spite of the story you shared.

Hawktalk, 50% does sound a bit high, so I'm not sure why. Here are the Canada tax brackets (they are not wildly different than the US):

2018 Canadian Federal income tax rates
$46,605 or less |15%
$46,605 to $93,208 | 20.5%
$93,208 to $144,489 | 26%
$144,489 to $205,842 |29%

https://www.canada.ca/en/financial-consumer-agency/services/financial-toolkit/taxes/taxes-2/5.html

I'd be dropping 2% off my tax bracket and getting a decent health care system? ... damn I wish my plant was in Canada.

[RiverDog]

Riv, you're right the Canadians have it good having the US as neighbors. Actually, I hear Asian countries like Thailand and India are a great resource for high quality healthcare options. I was simply making the point that the gov't can and does provide a quality healthcare provider experience everyday, even in spite of the story you shared.

I'm not disputing your claim. I was simply pointing out that there's a number of factors that makes Canada's situation different than that of the United States, and the safety net is one of them.

My point is that comparing us with Canada is apples and oranges. The United States is a very unique country, and it always gets my dander up when people start suggesting that we could easily adapt to Country X's system and expect the same results.

You're right about SE Asia, at least to some degree. I'm not sure if you read all of my comments, but a few years ago, my cousin opted for heart surgery in Malaysia at a hospital that attracts patients from around the world. It was a fraction of the cost as the same surgery is here. All of the surgeons are American trained.

[c_hawkbob]

The United States is a very unique country, and it always gets my dander up when people start suggesting that we could easily adapt to Country X's system and expect the same results

in deference to your dander, I think we could easily adopt the Canadian health care model and be better off for it. Unless you have stock in pharma.

[RiverDog]

The United States is a very unique country, and it always gets my dander up when people start suggesting that we could easily adapt to Country X's system and expect the same results

In deference to your dander, I think we could easily adopt the Canadian health care model and be better off for it. Unless you have stock in pharma.

Good luck paying for it. I doubt that all it would take to finance a Canadian-style health care system here in the US would be to adapt the tax structure noted by I-5.

And BTW, if you have a 401K, an IRA, or a mutual fund, you most likely have stock in pharma.

[Aseahawkfan]

Experts say the grim financial outlook for the few companies still committed to antibiotic research is driving away investors and threatening to strangle the development of new lifesaving drugs at a time when they are urgently needed.

One last comment. This statement is false and another example of a false media article.

As an investor in medical tech, there are hundreds of biotech companies. Too many too count. It is extremely difficult to sift the garbage of medtech there are so many producing useless items with money throwing at them by investors hoping to hype of a company, make a quick buck, and get out.

https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2014/antibiotics-currently-in-clinical-development

Total BS article. Biotech is well funded, over-funded if you ask me. It's hard to find good money in biotech because of how much useless money is thrown into the development of some cutting edge medical technology that may barely work, but gets enough hype to pump and dump a stock price. Do a search on the stock exchanges and you will find no shortage of biotech companies trying to find the next big thing or at least the illusion of the next big thing to pump and dump a stock with the barest of information.

[Aseahawkfan]

Good luck paying for it. I doubt that all it would take to finance a Canadian-style health care system here in the US would be to adapt the tax structure noted by I-5.

And BTW, if you have a 401K, an IRA, or a mutual fund, you most likely have stock in pharma.

We're paying for medicare. There are 44 million on medicare. That doesn't include state programs.

I still want to hear how competition drives biotech. All they do is drive up prices and hope insurance companies will be willing to pay for it. You still haven't explained to me how we're not already socialized through corporations. What are there? Five big insurers that insure the vast majority of people? Why is that better? What exactly do health insurance companies provide that is vastly superior to a socialized system? Driving up prices of insurance by adding a profit premium? I don't get what great part to insurance they are adding to the pool. They don't seem great.

Take some time to step away from the propaganda and assumptions and really look at how American health insurance works. That's why I did. It's why I changed my mind. For all intents and purposes, America is a socialized medical country save for we have a handful of huge insurance corporations that sell massive insurance policies to corporate America to ensure all their workers. Companies pay per employee to cover it getting a discount for the size of their policy. That insurance may or not cover what is wrong with you depending on the quality of the coverage. It's a very mixed bag.

Then you have the 44 million Americans on medicare, the public system. So far I've heard even government medicare is pretty good. Aren't you on medicare right now? How is it compared to your employee health coverage?

[RiverDog]

Then you have the 44 million Americans on medicare, the public system. So far I've heard even government medicare is pretty good. Aren't you on medicare right now? How is it compared to your employee health coverage?

As far as the quality of care goes, I haven't seen any difference at all. But then again, I'm relatively healthy.

However, 6 months before I reached age 65, my primary care physician's clinic went out of business. When I went to retrieve my records, I asked the staff if they had any recommendations for a new primary care provider, and they gave me the name of a couple of doctors. My response was that I was going to take my time before deciding, that I did not have any medical problems or prescriptions that had to be renewed for nearly 6 months. Their response was "Oh, don't wait too long! There are 2,000 patients that are going to be looking for a new primary care provider and not all doctors accept Medicare patients or they will only take X number of Medicare patients."

That incident leads me to believe that private insurance is essentially subsidizing Medicare, that many doctors are willing to treat Medicare patients so long as they have sufficient private care patients to offset the lower income Medicare provides, and that if we were to go to a "Medicare for All" proposal and take that 44 million out to 325 million, that it would cut off a lot of income for hospitals and clinics that are already in financial difficulty and force many out of business (we have a hospital here in the Tri Cities that just went through bankruptcy, not to mention my aforementioned primary care provider). Those providers that would be hit hardest would be in low volume areas, remote towns like Ritzville or Walla Walla, and force everyone into large, regional hospitals and clinics that have the volume to be able to pay the bills. That almost certainly will negatively affect the quality of care. Hospitals and clinics will need to process more patients per provider in order to financially break even.

Re-read some of the stuff I posted in my foreign doctors thread. We have a shortage of doctors. My nephew is studying to be a doctor, and it's costing him $50,000 a year. There are other fields with a much shorter payback and with much less time required. Could that be one of the reasons why 25% of all the doctors in the country did not get their MD's here and why we're having to import doctors to meet demand? And now you want to pay doctors less via a socialized health care system?

I don't pretend to have the answers. Perhaps some regulation or more oversight would help control the cost of health care. But I don't want to jump from the frying pan into the fire by gutting the entire system, disrupting our economic model (the health care industry represents 20% of our economy), and introduce a slew of new taxes to pay for it.

[RiverDog]

I still want to hear how competition drives biotech.

Here ya go!

The pharmaceutical industry is what economists call a high-fixed low-cost marginal cost industry. This means that the cost of bringing a new drug to market is very high and the process is risky, while the cost of producing an extra unit of a product that is on the market is frequently “pennies a pill”. There is energetic disagreement about the exact cost of bringing a new drug to market, but there is widespread recognition that the costs run into at least many hundreds of millions of dollars per new drug product.

In addition, for many drugs the costs of imitation are low. It is simple and low cost for a firm that did not develop the drug to produce a copy of a new drug. This means that if free competition were permitted, firms spending hundreds of millions of dollars to bring a new drug to market would be unlikely to recoup those investments, as competition would drive prices down to production costs (“pennies a pill”).

https://www.brookings.edu/blog/usc-broo ... velopment/

If you don't allow drug companies to make a handsome profit off the new drugs that they developed and we priced every drug produced at "pennies a pill", doesn't it reason that companies would not plow millions of dollars into R&D if they have no promise of recouping their costs let alone turn a profit? Or is it your position that the government will finance these types of adventures?

[RiverDog]

Aren't you on medicare right now? How is it compared to your employee health coverage?

My wife has been on Medicare for 2 years, and Part B is fine. Neither of us have been hospitalized so we have no experience with Part A But Part D, the prescription drug program, is a nightmare. The Medicare website has a very good tool that you enter your drugs/dosage into..my wife has 11 prescriptions drugs...and it will spit out the lowest cost provider. However, all you have to do is add or subtract one drug and the entire matrix changes, sometimes dramatically, so if you make your best choice in November during open enrollment for the next calendar year then on Jan 1 your doctor prescribes a new drug or takes you off of one, you can be stuck paying a higher amount for the entire year as you can only change providers during open enrollment once a year.

My wife has discovered that by calling around to different pharmacies that she at times can find drastically different prices for the same drug. She once had a drug that was going to cost over $100 at WalMart and called Costco and they had it for less than $10. The problem is that different pharmacies negotiate different prices at different times of the year and for different terms.

I could be talked into proposal that might yield a more even price structure by taking the "wow's" out of equation where the government, or some form of consolidated group of pharmacies, negotiates prices as a single entity and evened out the costs by raising the $10 drug and lowering the $100 drug. But I don't want to see the government over regulate these companies into being no more than low cost, mass producers of a bunch of Tylenol and Ibuprofen.

Up until last year, we did not have a Medicare Advantage plan in our area that we can enroll in, but I've heard a lot of horror stories about them and want nothing to do with it. It works like a HMO where there are only a certain number of doctors or specialists that they'll let you visit. In other words, they send you to the lowest cost provider with no regard to the quality of care, your doctor's referral, etc. Additionally, if you go with a Medicare Advantage plan and later decide you don't like it, traditional Medicare supplement insurance companies may not accept you.

Personally, I'm in a very good situation now as I was lucky enough to be grandfathered into a program sponsored by my former employer that contributes $6400/year in credits to a HRA account for me and my wife that can be used for any health care expense as defined by the IRS which includes Medicare premiums. If they blow up the current system and start taxing employers to help pay for their new system, my employer will undoubtedly respond by cutting off funding for this program.