Author Topic: This is why we need single payer health care  (Read 3863 times)

Johnez

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This is why we need single payer health care
« on: April 13, 2018, 04:38:10 PM »
https://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-say/

Quote
“Is curing patients a sustainable business model?” Goldman Sachs analysts ask

"The potential to deliver “one shot cures” is one of the most attractive aspects of gene therapy, genetically engineered cell therapy, and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies... While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow."

The fact that investment bankers have a say in what gets cured and who gets to be milked for money disgusts me to the core. I realize companies need to make a profit, but if profits get in the way of curing disease, is it worth keeping the model?

lost_in_the_endless_aisle

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Re: This is why we need single payer health care
« Reply #1 on: April 13, 2018, 09:41:26 PM »
Isn't there a parallel argument that no one should want to make self-driving cars? If cars drive themselves, ownership levels can plunge since they will be more of a utility that is hired on demand than an asset that is owned and kept in a garage. And yet, companies are developing self-driving cars.

Even if gene therapy/editing destroys the profitability of incumbents, there is still an incentive to develop those technologies (because if you don't, some other guy will and will end up owning the market in the future).

Johnez

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Re: This is why we need single payer health care
« Reply #2 on: April 14, 2018, 03:25:58 AM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?
« Last Edit: April 14, 2018, 03:28:41 AM by Johnez »

marty998

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Re: This is why we need single payer health care
« Reply #3 on: April 14, 2018, 05:04:48 AM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Ahh the old "cancer has been cured but will never see the light of day" conspiracy.

Most scientists are of the variety of helping humanity. I doubt they would be ok with it, and everything leaks eventually.

cloudo

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Re: This is why we need single payer health care
« Reply #4 on: April 14, 2018, 01:16:26 PM »
The fact that big pharma CEOs still get diseases like the rest of us and would prefer not to. 
 

scottish

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Re: This is why we need single payer health care
« Reply #5 on: April 14, 2018, 03:13:38 PM »
Pharmaceutical companies will work on drugs that treat diseases as opposed to curing them.

For example, there's a drug called Entyvio that works well for Crohn's disease.   However it costs around $25K per year, and once you start, you don't stop unless it stops working or you have an adverse reaction.    There are about 1.5 million people who may be able to take advantage of this drug in North America.    1% of this market is about 400M per year in sales.

BudgetSlasher

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Re: This is why we need single payer health care
« Reply #6 on: April 14, 2018, 03:55:17 PM »
Perhaps I have misunderstood, but as I understand it a single-payer system only means that medical expenses are paid (and rate somewhat set by) a single entity, usually the government (similar Taiwan's national health insurance); or it can be a system where the services are provided directly by the single-payer (closer to the UK NHS).

However, I am not aware of a single payer system where drug/treatment/equipment production and R&D decisions have also been centralized to the single payer.

In fact, the company that article references as the kind that might not be profitable/investable long term (Gilead Sciences) has 3 locations in the UK, 2 in Canada, and 1 in Taiwan. Likely indicating that they either do business or hope to do business in those single pay systems.

Thus even a single payer system would not prevent the companies controlling R&D from declining to bring such treatments to market for a single payer system to purchase. No if the means of R&D, production, and distribution were also controlled by the single payer . . . but that begins to look an awful lot like socialism of communism.

Even today CRISPR is out there and when the patents expire someone will produce treatments using it (if they are viable). Maybe it will be a rival, perhaps it will be a biotech startup, or perhaps it will be a state university medical school using grant money from NIH, heck maybe Amazon/Apple/Musk-himself will further back a play in healthcare. If your are a major drug company maybe you can sit on a treatment for disorder A so that you can sell medication for it, but if your rivals start curing disorders B/C/D which you also sell drugs to manage you are eventually going to have to join in.

Of course an established investment firm used to investing in drug companies would worry about a paradigm change. So perhaps this should be in the same file as clickbait articles, no one has a use for personal computers/the internet, or online retail will destroy the economy in its entirety.

As an alternative, albeit all too rosy for capitalism, CRISPR gene editing becomes a common place mechanism for treating genetic conditions. The patents, if any, that limit the use of CRISPR expire and every Tom/Dick/Harry biotech startup, medical school research program, or individual who can read ATGC AUGC can choose to focus on ID'ing the genes associated with various illnesses and the versions of the gene not associated. All treatable by swapping in the non-illness gene into the same delivery mechanism. The FDA develops more expertise, if not expedience, in approving these treatment. Reusing the same mechanism and simpler approval result in greatly lowered development of approval costs, allowing profitability at lower and lower levels of sales. This allows more and more obscure disorders to be treated, while prices fall from the $1,000 a pill ($84,000 for a course of treatment) for hepatitis C today. Investments, the market, and large firms adapt to this shifting model and money flows into companies that not only develop that will have customers for long periods of time, but those that demonstrate their R&D can consistently develop new approvable gene treatments.

 

GrayGhost

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Re: This is why we need single payer health care
« Reply #7 on: April 14, 2018, 08:48:41 PM »
Couldn't a slightly generalized version of the argument be used to advocate for a nationalization of almost any industry?

"Investment bankers get to decide where people get to live and how much money they can be milked for and this disgusts me to the core"
"Investment bankers get to decide what people get to eat and how much money they can be milked for and this disgusts me to the core"
"Investment bankers get to decide where and how people get to shop and how much money they can be milked for and this disgusts me to the core"
"Investment bankers get to decide what media people get to consume and how much money they can be milked for and this disgusts me to the core"

I'm not saying that the current US healthcare model is wise, sustainable, or even moral; however I am skeptical of an absolute government takeover of everything health related.

Leisured

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Re: This is why we need single payer health care
« Reply #8 on: April 15, 2018, 01:59:47 AM »

I'm not saying that the current US healthcare model is wise, sustainable, or even moral; however I am skeptical of an absolute government takeover of everything health related.

I am Australian, and we have both state hospitals and private hospitals, The State pays for public hospitals and pays all general practitioners a basic fee per visit. Some GPs charge extra, some do not. Private health insurance is available, and there are private hospitals. My wife and I have private health insurance, and pay about A$2K in premiums a year. Our GP sometimes charges A$18 extra per visit, sometimes not. I do not know what happens in other countries with national health schemes.

Our system is a safety net for the poor, which also benefits everyone else. The US could consider a similar arrangement.

Hula Hoop

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Re: This is why we need single payer health care
« Reply #9 on: April 15, 2018, 07:27:37 AM »
Here in Italy, there is a public health care system which is used by most people.  For example, we're a middle class family and don't have private insurance and use the public system as much as possible.  There is also a parallel private system which you can either buy private insurance to pay for or just pay a la carte.  Even though we don't have private insurance, we sometimes use private doctors out of convenience - so I guess we use the private system a la carte.  For example, my private gynaecologist is right next to my work so I go to her and pay around 80 euro for my annual exam.  Going private sometimes like we do is still cheaper than paying an annual private health insurance premium. 

For any kind of major surgery the public hospitals are meant to be much better and everything is free or very cheap.  My daughter has had three surgeries in the public hospital and I've one one surgery and two babies and it was all good.  For pharmaceuticals, the government often subsidizes them and if you pay out of pocket it is still generally cheaper than in the US.  For example, my husband takes statins and they are either free (if he takes the generic version) or around 1-2 euro if he wants to name brand.

Anyway I always thought a system like what we have here in Italy is "single payer" ie. the government is the main provider of health care and subsidizes most pharmaceuticals. 

GrayGhost

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Re: This is why we need single payer health care
« Reply #10 on: April 15, 2018, 08:22:46 PM »

I'm not saying that the current US healthcare model is wise, sustainable, or even moral; however I am skeptical of an absolute government takeover of everything health related.

I am Australian, and we have both state hospitals and private hospitals, The State pays for public hospitals and pays all general practitioners a basic fee per visit. Some GPs charge extra, some do not. Private health insurance is available, and there are private hospitals. My wife and I have private health insurance, and pay about A$2K in premiums a year. Our GP sometimes charges A$18 extra per visit, sometimes not. I do not know what happens in other countries with national health schemes.

Our system is a safety net for the poor, which also benefits everyone else. The US could consider a similar arrangement.

Right. There seems to be this misunderstanding that there are two possible healthcare systems; one is the US's free market system (which isn't even a free market system) and the other is single payer. Many countries which have what is called universal healthcare do not have single payer.

NoStacheOhio

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Re: This is why we need single payer health care
« Reply #11 on: April 16, 2018, 09:54:09 AM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

JLee

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Re: This is why we need single payer health care
« Reply #12 on: April 16, 2018, 03:05:57 PM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

BudgetSlasher

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Re: This is why we need single payer health care
« Reply #13 on: April 16, 2018, 03:38:46 PM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

JLee

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Re: This is why we need single payer health care
« Reply #14 on: April 16, 2018, 03:39:58 PM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

Drug companies run up to a 42% profit margin, with average being nearly 20%. They also spend more on marketing than they do on R&D.

Needless to say, I don't cry for them.
« Last Edit: April 16, 2018, 03:41:54 PM by JLee »

ncornilsen

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Re: This is why we need single payer health care
« Reply #15 on: April 16, 2018, 03:57:08 PM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

Drug companies run up to a 42% profit margin, with average being nearly 20%. They also spend more on marketing than they do on R&D.

Needless to say, I don't cry for them.

:rolleyes:
Quote
"Stripping out the one-off $10bn (£6.2bn) the company made from spinning off its animal health business leaves a margin of 24%, still pretty spectacular by any standard." 

Last year, five pharmaceutical companies made a profit margin of 20% or more - Pfizer, Hoffmann-La Roche, AbbVie, GlaxoSmithKline (GSK) and Eli Lilly.

24% margin is nothing. We make 50, 60, 70% margin on our products, restaurants make 90% margins. Margin is meaningless in an industry where marginal costs are nil, but the fixed R&D costs are massive.

Net profit is meaningful - Pfiezer (2016) made less than 14% which isn't outlandish.


While it may be more profitable short term to warehouse a cure to collect on the treatment revenue... long term... patents expire, competitors come up with alternatives, and the public backlash if when it became known they were sitting on the cure for a disease.... long term it would NOT be worth it.

Also, the "they spend more on marketing that R&D" is a lie, or at best, a misrepresentation of the facts:
http://blogs.sciencemag.org/pipeline/archives/2013/05/23/another_look_at_marketing_vs_rd_in_pharma

NoStacheOhio

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Re: This is why we need single payer health care
« Reply #16 on: April 16, 2018, 04:41:24 PM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

This is key. Getting ten years in the market on patent is doing extremely well. They patent the molecules/chemistry basically as soon as they come up with them.

v8rx7guy

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Re: This is why we need single payer health care
« Reply #17 on: April 16, 2018, 05:03:04 PM »
Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

Drug companies run up to a 42% profit margin, with average being nearly 20%. They also spend more on marketing than they do on R&D.

Needless to say, I don't cry for them.

WOW!  A whole 42% margin?!  How dare they.

Abe

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Re: This is why we need single payer health care
« Reply #18 on: April 17, 2018, 01:15:19 AM »
I'll go out on a limb here and say that most of the drugs that will have a significant benefit at a low cost have been developed in the last 100+ years of modern drug development. Clearly there are some new classes of antibodies and targeted therapies for cancer and other chronic diseases (like Hepatitis C) that are going to be "blockbusters", but that's on the backs of tens of billions of dollars of spending in failed or low-benefit drugs. Most chronic diseases can be treated by a combination of diet/exercise and low-priced generic medications. That's what the big drug companies don't want everyone to realize, and why all of their marketing is to the next antibody that costs $50-100k/year. The US is the only developed country that hasn't figured this out (or more accurately has a system that isn't incentivized to care), and thus has no centralized decision-making body that determines whether or not to pay for a massively expensive medication or procedure.

krustyburger

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Re: This is why we need single payer health care
« Reply #19 on: April 17, 2018, 04:59:59 AM »
^this
One of my old supervisors worked in 'big pharma' for a decade or two, he used to say this all the time. The number of new drug candidates (focusing on antibiotics) has massively decreased as we have already found and developed the easier ones (there are many natural antibiotic fungi in the environment but no one has successfully cultured them in the lab), it takes on average 10 or so years to get a drug to market, this is after the years spent trying to find and isolate or make the molecules, literally hundreds of university labs around the world focus on just finding new active molecules.

We are almost certainly facing severe antibiotic resistance in the near-mid future, he was worried therefore I am scared.

Also, enough of the 'big pharma' bashing, they're not charities and scientists are not evil ffs. Personally I am alive because of antibiotics and ventolin/corticosteroids and have a vastly improved quality of life thanks to painkillers to say the least.

Also worth mentioning that cholera, diptheria, polio, bubonic plague, rabies etc is a horrible way to die.
(I read The Plague by Albert Camus over the easter break, I now realise that I may be a little bit sensitive to this topic)

JLee

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Re: This is why we need single payer health care
« Reply #20 on: April 17, 2018, 08:54:12 AM »
^this
One of my old supervisors worked in 'big pharma' for a decade or two, he used to say this all the time. The number of new drug candidates (focusing on antibiotics) has massively decreased as we have already found and developed the easier ones (there are many natural antibiotic fungi in the environment but no one has successfully cultured them in the lab), it takes on average 10 or so years to get a drug to market, this is after the years spent trying to find and isolate or make the molecules, literally hundreds of university labs around the world focus on just finding new active molecules.

We are almost certainly facing severe antibiotic resistance in the near-mid future, he was worried therefore I am scared.

Also, enough of the 'big pharma' bashing, they're not charities and scientists are not evil ffs. Personally I am alive because of antibiotics and ventolin/corticosteroids and have a vastly improved quality of life thanks to painkillers to say the least.

Also worth mentioning that cholera, diptheria, polio, bubonic plague, rabies etc is a horrible way to die.
(I read The Plague by Albert Camus over the easter break, I now realise that I may be a little bit sensitive to this topic)

Who the fuck said scientists are evil?  Are we just making things up now?

Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

Drug companies run up to a 42% profit margin, with average being nearly 20%. They also spend more on marketing than they do on R&D.

Needless to say, I don't cry for them.

:rolleyes:
Quote
"Stripping out the one-off $10bn (£6.2bn) the company made from spinning off its animal health business leaves a margin of 24%, still pretty spectacular by any standard." 

Last year, five pharmaceutical companies made a profit margin of 20% or more - Pfizer, Hoffmann-La Roche, AbbVie, GlaxoSmithKline (GSK) and Eli Lilly.

24% margin is nothing. We make 50, 60, 70% margin on our products, restaurants make 90% margins. Margin is meaningless in an industry where marginal costs are nil, but the fixed R&D costs are massive.

Net profit is meaningful - Pfiezer (2016) made less than 14% which isn't outlandish.


While it may be more profitable short term to warehouse a cure to collect on the treatment revenue... long term... patents expire, competitors come up with alternatives, and the public backlash if when it became known they were sitting on the cure for a disease.... long term it would NOT be worth it.

Also, the "they spend more on marketing that R&D" is a lie, or at best, a misrepresentation of the facts:
http://blogs.sciencemag.org/pipeline/archives/2013/05/23/another_look_at_marketing_vs_rd_in_pharma

Seems you can make numbers say whatever you want.  The internet says you're the liar now.

http://smallbusiness.chron.com/average-profit-margin-restaurant-13477.html

Quote
In 2017, full-service restaurants had average profit margins of 6.1 percent, essentially the same margin as fast-casual and casual restaurants.
« Last Edit: April 17, 2018, 08:55:57 AM by JLee »

Linda_Norway

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Re: This is why we need single payer health care
« Reply #21 on: April 17, 2018, 09:03:17 AM »

I'm not saying that the current US healthcare model is wise, sustainable, or even moral; however I am skeptical of an absolute government takeover of everything health related.

I am Australian, and we have both state hospitals and private hospitals, The State pays for public hospitals and pays all general practitioners a basic fee per visit. Some GPs charge extra, some do not. Private health insurance is available, and there are private hospitals. My wife and I have private health insurance, and pay about A$2K in premiums a year. Our GP sometimes charges A$18 extra per visit, sometimes not. I do not know what happens in other countries with national health schemes.

Our system is a safety net for the poor, which also benefits everyone else. The US could consider a similar arrangement.

In Norway we have a similar system. The state provides healthcare. You can take an additional private health insurance, which gives you faster treatment in a private hospital. Many companies offer this to their employees. If you go the public healthcare way, you often need to wait quite long for treatment.

We have to pay a private share for any public visit to a GP or a hospital, which is way below the market price.

JLee

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Re: This is why we need single payer health care
« Reply #22 on: April 17, 2018, 09:04:49 AM »

I'm not saying that the current US healthcare model is wise, sustainable, or even moral; however I am skeptical of an absolute government takeover of everything health related.

I am Australian, and we have both state hospitals and private hospitals, The State pays for public hospitals and pays all general practitioners a basic fee per visit. Some GPs charge extra, some do not. Private health insurance is available, and there are private hospitals. My wife and I have private health insurance, and pay about A$2K in premiums a year. Our GP sometimes charges A$18 extra per visit, sometimes not. I do not know what happens in other countries with national health schemes.

Our system is a safety net for the poor, which also benefits everyone else. The US could consider a similar arrangement.

In Norway we have a similar system. The state provides healthcare. You can take an additional private health insurance, which gives you faster treatment in a private hospital. Many companies offer this to their employees. If you go the public healthcare way, you often need to wait quite long for treatment.

We have to pay a private share for any public visit to a GP or a hospital, which is way below the market price.

Canada is that way as well (Alberta, at least).

It was cheaper for me to pay out of pocket in Alberta as a US resident than it was to go through my insurance in the US, lol.

Roland of Gilead

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Re: This is why we need single payer health care
« Reply #23 on: April 17, 2018, 09:24:01 AM »
If pharma companies are so massively profitable, then why does any investor bother investing in any other industry like tech or banking or energy?

ncornilsen

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Re: This is why we need single payer health care
« Reply #24 on: April 17, 2018, 02:14:10 PM »
^this
One of my old supervisors worked in 'big pharma' for a decade or two, he used to say this all the time. The number of new drug candidates (focusing on antibiotics) has massively decreased as we have already found and developed the easier ones (there are many natural antibiotic fungi in the environment but no one has successfully cultured them in the lab), it takes on average 10 or so years to get a drug to market, this is after the years spent trying to find and isolate or make the molecules, literally hundreds of university labs around the world focus on just finding new active molecules.

We are almost certainly facing severe antibiotic resistance in the near-mid future, he was worried therefore I am scared.

Also, enough of the 'big pharma' bashing, they're not charities and scientists are not evil ffs. Personally I am alive because of antibiotics and ventolin/corticosteroids and have a vastly improved quality of life thanks to painkillers to say the least.

Also worth mentioning that cholera, diptheria, polio, bubonic plague, rabies etc is a horrible way to die.
(I read The Plague by Albert Camus over the easter break, I now realise that I may be a little bit sensitive to this topic)

Who the fuck said scientists are evil?  Are we just making things up now?

Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

Drug companies run up to a 42% profit margin, with average being nearly 20%. They also spend more on marketing than they do on R&D.

Needless to say, I don't cry for them.

:rolleyes:
Quote
"Stripping out the one-off $10bn (£6.2bn) the company made from spinning off its animal health business leaves a margin of 24%, still pretty spectacular by any standard." 

Last year, five pharmaceutical companies made a profit margin of 20% or more - Pfizer, Hoffmann-La Roche, AbbVie, GlaxoSmithKline (GSK) and Eli Lilly.

24% margin is nothing. We make 50, 60, 70% margin on our products, restaurants make 90% margins. Margin is meaningless in an industry where marginal costs are nil, but the fixed R&D costs are massive.

Net profit is meaningful - Pfiezer (2016) made less than 14% which isn't outlandish.


While it may be more profitable short term to warehouse a cure to collect on the treatment revenue... long term... patents expire, competitors come up with alternatives, and the public backlash if when it became known they were sitting on the cure for a disease.... long term it would NOT be worth it.

Also, the "they spend more on marketing that R&D" is a lie, or at best, a misrepresentation of the facts:
http://blogs.sciencemag.org/pipeline/archives/2013/05/23/another_look_at_marketing_vs_rd_in_pharma

Seems you can make numbers say whatever you want.  The internet says you're the liar now.

http://smallbusiness.chron.com/average-profit-margin-restaurant-13477.html

Quote
In 2017, full-service restaurants had average profit margins of 6.1 percent, essentially the same margin as fast-casual and casual restaurants.

Not really. You can misrepresent what a number is, and conflate/be sloppy about the difference between gross and net profit margin... which is misusing numbers to say what you want. The numbers say what they are. They're just helpless numbers floating on the internet, ripe for someone huckster to misuse them/mislabel them for their own purposes.

In this case, you don't understand the difference between gross and net margin... or are deliberately being obtuse about it since doing so supports your premise. my 90%  figure is a bit overstated, sure...but the gross margin on the food, etc is high. 50-70%ish. https://yourbusiness.azcentral.com/gross-profit-margin-food-industry-26284.html

But restaurant margins are beside the point - a gross margin figure is an invalid method of determining if drug companies are price gouging, net profit or net margin IS valid...  net margin in those companies isn't outlandish.


JLee

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Re: This is why we need single payer health care
« Reply #25 on: April 17, 2018, 02:58:44 PM »
^this
One of my old supervisors worked in 'big pharma' for a decade or two, he used to say this all the time. The number of new drug candidates (focusing on antibiotics) has massively decreased as we have already found and developed the easier ones (there are many natural antibiotic fungi in the environment but no one has successfully cultured them in the lab), it takes on average 10 or so years to get a drug to market, this is after the years spent trying to find and isolate or make the molecules, literally hundreds of university labs around the world focus on just finding new active molecules.

We are almost certainly facing severe antibiotic resistance in the near-mid future, he was worried therefore I am scared.

Also, enough of the 'big pharma' bashing, they're not charities and scientists are not evil ffs. Personally I am alive because of antibiotics and ventolin/corticosteroids and have a vastly improved quality of life thanks to painkillers to say the least.

Also worth mentioning that cholera, diptheria, polio, bubonic plague, rabies etc is a horrible way to die.
(I read The Plague by Albert Camus over the easter break, I now realise that I may be a little bit sensitive to this topic)

Who the fuck said scientists are evil?  Are we just making things up now?

Incentive to develop-yes, of course. Buuuuuut, I know I'm going to sound like a conspiracy theorist-but what's to stop some big pharma company, or even a financial institution, from buying up a company on the front line of these new cures and burying the patents and discoveries? Is a company making billions off of treatment going to invest in a cure that will erase that source of revenue?

Patents expire, then become public (well, they're public before they expire, but nobody can use them). At best, that's a stalling tactic.

They take 20 years to expire. That's a really long time..

It seems like a long time if a company is sitting on the patent.

On the other hand it doesn't seem like a long time, when a company has spent millions apparently the number is billions of dollars developing a drug, they are going to patent is as soon as it is patentable. That is likely before the 8 plus years to get the drug approved by the FDA. That's not a terribly long time to recover R&D costs, and realize a profit sufficient to encourage future R&D by private investment.

Drug companies run up to a 42% profit margin, with average being nearly 20%. They also spend more on marketing than they do on R&D.

Needless to say, I don't cry for them.

:rolleyes:
Quote
"Stripping out the one-off $10bn (£6.2bn) the company made from spinning off its animal health business leaves a margin of 24%, still pretty spectacular by any standard." 

Last year, five pharmaceutical companies made a profit margin of 20% or more - Pfizer, Hoffmann-La Roche, AbbVie, GlaxoSmithKline (GSK) and Eli Lilly.

24% margin is nothing. We make 50, 60, 70% margin on our products, restaurants make 90% margins. Margin is meaningless in an industry where marginal costs are nil, but the fixed R&D costs are massive.

Net profit is meaningful - Pfiezer (2016) made less than 14% which isn't outlandish.


While it may be more profitable short term to warehouse a cure to collect on the treatment revenue... long term... patents expire, competitors come up with alternatives, and the public backlash if when it became known they were sitting on the cure for a disease.... long term it would NOT be worth it.

Also, the "they spend more on marketing that R&D" is a lie, or at best, a misrepresentation of the facts:
http://blogs.sciencemag.org/pipeline/archives/2013/05/23/another_look_at_marketing_vs_rd_in_pharma

Seems you can make numbers say whatever you want.  The internet says you're the liar now.

http://smallbusiness.chron.com/average-profit-margin-restaurant-13477.html

Quote
In 2017, full-service restaurants had average profit margins of 6.1 percent, essentially the same margin as fast-casual and casual restaurants.

Not really. You can misrepresent what a number is, and conflate/be sloppy about the difference between gross and net profit margin... which is misusing numbers to say what you want. The numbers say what they are. They're just helpless numbers floating on the internet, ripe for someone huckster to misuse them/mislabel them for their own purposes.

In this case, you don't understand the difference between gross and net margin... or are deliberately being obtuse about it since doing so supports your premise. my 90%  figure is a bit overstated, sure...but the gross margin on the food, etc is high. 50-70%ish. https://yourbusiness.azcentral.com/gross-profit-margin-food-industry-26284.html

But restaurant margins are beside the point - a gross margin figure is an invalid method of determining if drug companies are price gouging, net profit or net margin IS valid...  net margin in those companies isn't outlandish.

Which is exactly what you did when you brought up the restaurant industry, yes?

Net margin: https://www.statista.com/statistics/314648/leading-global-pharmaceutical-companies-by-net-margin/

Gross margin: https://www.statista.com/statistics/473429/top-global-pharmaceutical-companies-gross-margin-values/

I'm sure you'll find something to complain about those numbers too.
« Last Edit: April 17, 2018, 03:00:56 PM by JLee »

JLee

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Re: This is why we need single payer health care
« Reply #26 on: April 17, 2018, 03:04:17 PM »
If you don't think drug companies gouge, you're in for a rude awakening.

http://www.latimes.com/business/la-fi-senate-drug-price-study-20161221-story.html
Quote
Turing, headed by executive Martin Shkreli, bought Daraprim, a 62-year-old medicine for a deadly parasitic disease, on Aug. 7, 2015, and raised the price overnight from $13.50 to $750 a pill.

When asked by investors about the expected revenues from the drug, Shkreli wrote, "I think it will be huge…. So 5,000 paying bottles at the new price is $375,000,000 – almost all of it is profit, and I think we will get 3 years of that or more. Should be a very handsome investment for all of us."

https://www.reuters.com/article/us-health-epipen-costs/another-look-at-the-surge-in-epipen-costs-idUSKBN16Y24O
Quote
Generic drugmaker Mylan obtained the rights to sell EpiPen in 2007. Since then, Mylan has increased the list price from $94 to $609, researchers report in JAMA Internal Medicine.

https://www.cbsnews.com/news/martin-shkreli-style-drug-price-hikes-are-everywhere/
Quote
About 20 brand-name prescription drugs have at least quadrupled since December 2014, while another 60 medications have seen their prices more than double in the same time period, Bloomberg News reports, citing a report from price-comparison software company DRX.

sol

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Re: This is why we need single payer health care
« Reply #27 on: April 17, 2018, 03:45:13 PM »
Cure it.  Use taxes of you have to, and let Goldman Sachs rot.

I think gene therapies are a transformative technology, like agriculture and electricity, the consequences of which we have largely failed to grasp.  There will be new sources of profit, after pharma companies go the way of buggy whip manufacturers.

Roland of Gilead

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Re: This is why we need single payer health care
« Reply #28 on: April 17, 2018, 04:36:23 PM »
If you don't think drug companies gouge, you're in for a rude awakening.

It is a few examples out of a vast amount of drug companies who act normal and produce cures and improve quality of life.

Might as well point out that all priests are child molesters because I can point out a few high profile cases of those.

And don't get me started on athletic coaches!

Drugs are expensive but it costs a ton to bring them to market and then turn a profit that will entice new investors for your next round of *wait 8 years for this to go through trials* drug.

But really there is a simple solution here.  Invest solely in drug companies and then use your massive profits to start a charity.   Can't fail if drug companies are just making buck hand over fist with no risk, right?

JLee

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Re: This is why we need single payer health care
« Reply #29 on: April 17, 2018, 05:38:39 PM »
If you don't think drug companies gouge, you're in for a rude awakening.

It is a few examples out of a vast amount of drug companies who act normal and produce cures and improve quality of life.

Might as well point out that all priests are child molesters because I can point out a few high profile cases of those.

And don't get me started on athletic coaches!

Drugs are expensive but it costs a ton to bring them to market and then turn a profit that will entice new investors for your next round of *wait 8 years for this to go through trials* drug.

But really there is a simple solution here.  Invest solely in drug companies and then use your massive profits to start a charity.   Can't fail if drug companies are just making buck hand over fist with no risk, right?

I don't think Martin Shkreli would agree with your little strawman of "no risk" - though to be fair, he's in jail for unrelated stuff, not for jacking drug pricing by 5500%, so maybe he would.

Last I checked, nobody died because they couldn't afford an athletic coach.

You know that diversification is important, but since you want to be all snide and whatnot, here you go:
https://www.andruswagstaff.com/blog/big-pharma-has-higher-profit-margins-than-any-other-industry/

I'll wait for you to get #notallpharma trending. That seems to be your calling in life.
« Last Edit: April 17, 2018, 05:44:47 PM by JLee »

BudgetSlasher

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Re: This is why we need single payer health care
« Reply #30 on: April 17, 2018, 06:32:36 PM »
Cure it.  Use taxes of you have to, and let Goldman Sachs rot.

I think gene therapies are a transformative technology, like agriculture and electricity, the consequences of which we have largely failed to grasp.  There will be new sources of profit, after pharma companies go the way of buggy whip manufacturers.

I agree gene therapy could be a transformative field and that new field could provide new profit sources and likely a pattern for those profits (a new therapy is developed, a huge spike in revenue/profits is seen as people currently suffering from the disorder/disease are cured, and a much smaller tail of revenue/profits going forward.)

I doubt that pharma companies will go the way of buggy whip manufacturers. It is likely that  a sizable market for antibiotics, pain killers, anesthetic drugs, and vaccines will remain. Plus, they are likely the best positioned (as a group) to develop gene therapies.


Roland of Gilead

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Re: This is why we need single payer health care
« Reply #31 on: April 17, 2018, 08:03:05 PM »
If you don't think drug companies gouge, you're in for a rude awakening.

It is a few examples out of a vast amount of drug companies who act normal and produce cures and improve quality of life.

Might as well point out that all priests are child molesters because I can point out a few high profile cases of those.

And don't get me started on athletic coaches!

Drugs are expensive but it costs a ton to bring them to market and then turn a profit that will entice new investors for your next round of *wait 8 years for this to go through trials* drug.

But really there is a simple solution here.  Invest solely in drug companies and then use your massive profits to start a charity.   Can't fail if drug companies are just making buck hand over fist with no risk, right?

I don't think Martin Shkreli would agree with your little strawman of "no risk" - though to be fair, he's in jail for unrelated stuff, not for jacking drug pricing by 5500%, so maybe he would.

Last I checked, nobody died because they couldn't afford an athletic coach.

You know that diversification is important, but since you want to be all snide and whatnot, here you go:
https://www.andruswagstaff.com/blog/big-pharma-has-higher-profit-margins-than-any-other-industry/

I'll wait for you to get #notallpharma trending. That seems to be your calling in life.

Strawman is so overused...it probably ranks just behind mentioning Hitler on the internet.

So you think drug companies just have the highest profit of any business....why then would someone invest in anything else?   Could it be that you are falling for survivor bias and not counting the many drug companies that have gone belly up and lost billions of dollars?  I can name you 20 drug companies that are trading for less than a buck which at one time had raised $20 a share for every one drug company you can show me who has jacked prices 100% or more.

pecunia

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Re: This is why we need single payer health care
« Reply #32 on: April 17, 2018, 09:18:00 PM »
The business model is not flawed.

In construction, we are always working our way out of a job.  Their construction is life.

Those folks will have other diseases to conquer.  Sometimes profit must take a back seat to doing the right thing.

It appears that all of the statistics point to government controlled medicine being better.  It costs less money and gives better results if done like some other countries.   Now - Isn't that a good business model?

lost_in_the_endless_aisle

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Re: This is why we need single payer health care
« Reply #33 on: April 17, 2018, 10:22:06 PM »
US pharmaceutical revenues are ~$450B, total US health care spending is ~$3.2T (wikipedia). If we assume an average net profit on pharmaceuticals of 20% (probably high because these are high-end estimates and, as mentioned, survivorship bias plays a role) then net profit on pharmaceuticals is ~$90B, which is 2.8% of total healthcare spending. Backing out marketing and advertising spend (assuming a single buyer would eliminate all of this entirely) at a rate of 20% of revenue would result in a reduction, potentially, of another $90B, for a total of $180B, or 5.6% of health care spend.

These are the first numbers I found googling so grain of salt, but pharma advertising and profits by themselves can't seem to explain the healthcare cost disease in the US. I never see health care costs fully categorized and quantified so that $3.2T figure is still a huge mystery to me in general and I don't really follow this topic that closely (#disclaimers).

JLee

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Re: This is why we need single payer health care
« Reply #34 on: April 18, 2018, 08:04:14 AM »
If you don't think drug companies gouge, you're in for a rude awakening.

It is a few examples out of a vast amount of drug companies who act normal and produce cures and improve quality of life.

Might as well point out that all priests are child molesters because I can point out a few high profile cases of those.

And don't get me started on athletic coaches!

Drugs are expensive but it costs a ton to bring them to market and then turn a profit that will entice new investors for your next round of *wait 8 years for this to go through trials* drug.

But really there is a simple solution here.  Invest solely in drug companies and then use your massive profits to start a charity.   Can't fail if drug companies are just making buck hand over fist with no risk, right?

I don't think Martin Shkreli would agree with your little strawman of "no risk" - though to be fair, he's in jail for unrelated stuff, not for jacking drug pricing by 5500%, so maybe he would.

Last I checked, nobody died because they couldn't afford an athletic coach.

You know that diversification is important, but since you want to be all snide and whatnot, here you go:
https://www.andruswagstaff.com/blog/big-pharma-has-higher-profit-margins-than-any-other-industry/

I'll wait for you to get #notallpharma trending. That seems to be your calling in life.

Strawman is so overused...it probably ranks just behind mentioning Hitler on the internet.

So you think drug companies just have the highest profit of any business....why then would someone invest in anything else?   Could it be that you are falling for survivor bias and not counting the many drug companies that have gone belly up and lost billions of dollars?  I can name you 20 drug companies that are trading for less than a buck which at one time had raised $20 a share for every one drug company you can show me who has jacked prices 100% or more.

It's not overused if it's relevant. When you stop twisting what I say to fit your argument, then perhaps I'll stop using it.

Roland of Gilead

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Re: This is why we need single payer health care
« Reply #35 on: April 18, 2018, 08:41:50 AM »
It's not overused if it's relevant. When you stop twisting what I say to fit your argument, then perhaps I'll stop using it.

Your initial statement was "If you don't think drug companies gouge, you're in for a rude awakening"

By not including the words "some drug companies", you imply there is massive price gouging across a majority of the drug companies.

In fact, there are over 58,000 drugs on the market and the article presenting excessive price gouging in less than 0.2% of those drugs.

This is why I tossed up the other cases where people will tend to lump an entire group into a stereotype because of the bad actions of a few.

I have no problem going after those 0.2% of drugs where pricing has been abused.   I don't think it will make a serious dent in healthcare costs in the USA but it might make people feel like they are doing something.

JLee

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Re: This is why we need single payer health care
« Reply #36 on: April 18, 2018, 09:36:46 AM »
It's not overused if it's relevant. When you stop twisting what I say to fit your argument, then perhaps I'll stop using it.

Your initial statement was "If you don't think drug companies gouge, you're in for a rude awakening"

By not including the words "some drug companies", you imply there is massive price gouging across a majority of the drug companies.

In fact, there are over 58,000 drugs on the market and the article presenting excessive price gouging in less than 0.2% of those drugs.

This is why I tossed up the other cases where people will tend to lump an entire group into a stereotype because of the bad actions of a few.

I have no problem going after those 0.2% of drugs where pricing has been abused.   I don't think it will make a serious dent in healthcare costs in the USA but it might make people feel like they are doing something.

I guess this Harvard study was all for naught, then. There's no problem here!

There are some industries that I fundamentally believe should not be in the business of making as much profit as possible.  Health care and prisons are two of them.
« Last Edit: April 18, 2018, 09:42:10 AM by JLee »

Roland of Gilead

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Re: This is why we need single payer health care
« Reply #37 on: April 18, 2018, 10:17:32 AM »

I guess this Harvard study was all for naught, then. There's no problem here!

There are some industries that I fundamentally believe should not be in the business of making as much profit as possible.  Health care and prisons are two of them.

A quote from that study: "Conclusions and Relevance  High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. "

A government protected monopoly is just another name for a patent.   It is not a unique benefit to drug manufacturers although the extremely high research, development and regulation cost of bringing a drug to the market can make it seem like a monopoly.  An example of a drug which was/is expensive is Gilead's cure for HCV, which was a monopoly for all of about 2 years until two other companies developed similar drugs with a different patent and formulation.   Gilead's profit on this drug has fallen some 400% in just a couple of years.  They are curing people too, which makes the patient population dwindle rapidly.

This is a drug on which was spent $13B of private investor money, even before it was approved!   Now imagine if you are a private investor, and you risk that kind of money.   The return HAS to be outsized or you are not going to make the investment to begin with and we never see the drug developed.

We can certainly socialize the drug industry though and instead of private investors funding the drug trials and reaping the profits, we could have the government step in and provide all the money.   I imagine the taxpayer would end up much worse off as the USA would likely subsidize the rest of the world even more by paying for all of the development and reaping little of the profit.  It would be an interesting thing to see how it works.

pecunia

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Re: This is why we need single payer health care
« Reply #38 on: April 18, 2018, 10:26:24 AM »
Quote
We can certainly socialize the drug industry though and instead of private investors funding the drug trials and reaping the profits, we could have the government step in and provide all the money.   I imagine the taxpayer would end up much worse off as the USA would likely subsidize the rest of the world even more by paying for all of the development and reaping little of the profit.  It would be an interesting thing to see how it works.

Does it have to be all or none?  I believe an Australian post said they have both.  Perhaps, you can have the best of both worlds, public and private.  I do believe the government used to subsidize a lot of research into health.  Research by the government into many things has been slashed the past few decades.  As John Glenn once said, "We are eating our own seed corn."

JLee

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Re: This is why we need single payer health care
« Reply #39 on: April 18, 2018, 10:30:28 AM »

I guess this Harvard study was all for naught, then. There's no problem here!

There are some industries that I fundamentally believe should not be in the business of making as much profit as possible.  Health care and prisons are two of them.

A quote from that study: "Conclusions and Relevance  High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. "

A government protected monopoly is just another name for a patent.   It is not a unique benefit to drug manufacturers although the extremely high research, development and regulation cost of bringing a drug to the market can make it seem like a monopoly.  An example of a drug which was/is expensive is Gilead's cure for HCV, which was a monopoly for all of about 2 years until two other companies developed similar drugs with a different patent and formulation.   Gilead's profit on this drug has fallen some 400% in just a couple of years.  They are curing people too, which makes the patient population dwindle rapidly.

This is a drug on which was spent $13B of private investor money, even before it was approved!   Now imagine if you are a private investor, and you risk that kind of money.   The return HAS to be outsized or you are not going to make the investment to begin with and we never see the drug developed.

We can certainly socialize the drug industry though and instead of private investors funding the drug trials and reaping the profits, we could have the government step in and provide all the money.   I imagine the taxpayer would end up much worse off as the USA would likely subsidize the rest of the world even more by paying for all of the development and reaping little of the profit.  It would be an interesting thing to see how it works.

Cutting our per-capita health care expenditures to Canadian levels would free up over $1.6 trillion annually, so I expect that a solution is not outside the realm of possibility.

Roland of Gilead

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Re: This is why we need single payer health care
« Reply #40 on: April 18, 2018, 11:17:01 AM »
Does it have to be all or none?  I believe an Australian post said they have both.  Perhaps, you can have the best of both worlds, public and private.  I do believe the government used to subsidize a lot of research into health.  Research by the government into many things has been slashed the past few decades.  As John Glenn once said, "We are eating our own seed corn."


Investors could pay for simple drugs with a wide market and likely chance of success while the government could do the heavy lifting for drugs which cost tens of billions to develop (like cancer drugs).   I know the government already funds a lot of the initial development on these drugs but even after that funding it STILL costs a private company and investors many billions more to bring them through phase I to III trials and approval.  I do not directly see how this cost would drop significantly with the government taking on this task and cost.   The benefit would be reaped on the use of the drug since the government would own it and be able to set whatever cost it wanted.   The problem here is that other countries possibly would more likely be able to steal this government developed drug to use on their own population without having paid any of the costs of development.   I could easily see the situation where the USA continues to spend more than other countries because we would do the heavy government research and absorb the cost while other nations just reap the benefits.

I would like to see some examples of drugs that have been developed in this fashion by other governments and find out if they were able to recoup the costs from other nations or if they just bore the cost.

Don't we already see this in other areas?   The USA acts as world police, right or wrong, and other countries benefit without shouldering the costs.   It could be argued that we do all of this for our own interests but other countries do benefit from the protection (Japan, Taiwan, South Korea, etc.).   Perhaps   this would be extended if we went all out for socialized drug research and development.   We would be doing it for our own interests but in the end we would end up paying more as a country because the world would not reimburse our costs.   We should try it though and see if we go into more debt or maybe it works out peachy.
« Last Edit: April 18, 2018, 11:23:20 AM by Roland of Gilead »

acroy

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Re: This is why we need single payer health care
« Reply #41 on: April 18, 2018, 11:20:17 AM »
bah humbug.

If government is the answer, how dumb was the question? Government is good at taking your stuff & limiting your rights... for a weak promise of safety & security.

Bezos, Elon etc all want to live forever and will happily finance one-shot fix-it research to the detriment of the 'revenue stream' chronic illness industry. Creative disruption baby!

JLee

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Re: This is why we need single payer health care
« Reply #42 on: April 18, 2018, 11:59:06 AM »
bah humbug.

If government is the answer, how dumb was the question? Government is good at taking your stuff & limiting your rights... for a weak promise of safety & security.

Bezos, Elon etc all want to live forever and will happily finance one-shot fix-it research to the detriment of the 'revenue stream' chronic illness industry. Creative disruption baby!

Must be why private fire departments and road systems are the norm?

...oh.

sol

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Re: This is why we need single payer health care
« Reply #43 on: April 18, 2018, 12:19:56 PM »
bah humbug.

If government is the answer, how dumb was the question? Government is good at taking your stuff & limiting your rights... for a weak promise of safety & security.

Must be why private fire departments and road systems are the norm?

...oh.

Also why we all use private power grids and water distribution systems.  Government would just "take your stuff and limit your rights" if it tried to provide these things.

MasterStache

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Re: This is why we need single payer health care
« Reply #44 on: April 18, 2018, 02:57:46 PM »
bah humbug.

If government is the answer, how dumb was the question? Government is good at taking your stuff & limiting your rights... for a weak promise of safety & security.

Must be why private fire departments and road systems are the norm?

...oh.

Also why we all use private power grids and water distribution systems.  Government would just "take your stuff and limit your rights" if it tried to provide these things.

They should be glad tin foil is cheap. Government mind control is a serious threat as well.

krustyburger

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Re: This is why we need single payer health care
« Reply #45 on: April 18, 2018, 03:52:13 PM »
Does it have to be all or none?  I believe an Australian post said they have both.  Perhaps, you can have the best of both worlds, public and private.  I do believe the government used to subsidize a lot of research into health.  Research by the government into many things has been slashed the past few decades.  As John Glenn once said, "We are eating our own seed corn."


Investors could pay for simple drugs with a wide market and likely chance of success while the government could do the heavy lifting for drugs which cost tens of billions to develop (like cancer drugs).   I know the government already funds a lot of the initial development on these drugs but even after that funding it STILL costs a private company and investors many billions more to bring them through phase I to III trials and approval.  I do not directly see how this cost would drop significantly with the government taking on this task and cost.   The benefit would be reaped on the use of the drug since the government would own it and be able to set whatever cost it wanted.   The problem here is that other countries possibly would more likely be able to steal this government developed drug to use on their own population without having paid any of the costs of development.   I could easily see the situation where the USA continues to spend more than other countries because we would do the heavy government research and absorb the cost while other nations just reap the benefits.

This might work in places outside of the US that have public healthcare, the idea being that any reduction in the treatment of long term expensive diseases such as cancer and alzheimers would massively reduce the health care budget, i.e. money that the government is already spending. Therefore not all costs have to be recouped through drug profits.
This is also why the government funds ads and education into lifestyle changes at the population level, even a small percentage of risk reduction can translate into millions of dollars saved in the long run.

Truly third world countries are not interested in cancer drugs (the 44 poorest also have an extension of the patent waiver). They need antimalarials, tuberculosis treatment, HIV drugs and antibiotics.

pecunia

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Re: This is why we need single payer health care
« Reply #46 on: April 19, 2018, 09:35:57 AM »
Quote
Also why we all use private power grids and water distribution systems.  Government would just "take your stuff and limit your rights" if it tried to provide these things.

It is truly amazing sometimes when a municipality provides electricity.  It is usually much cheaper than the private utility.  It is the same with cable TV.  I' ve always had my own pump so don't know about water.  I've never seen a private water company.

Roland of Gilead

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Re: This is why we need single payer health care
« Reply #47 on: April 19, 2018, 10:28:49 AM »
It is truly amazing sometimes when a municipality provides electricity.  It is usually much cheaper than the private utility.  It is the same with cable TV.  I' ve always had my own pump so don't know about water.  I've never seen a private water company.

The question though is if the costs are truly being reflected in the cheaper utility rates or if there is some shenanigans going on behind the scenes via underfunded city pensions, delayed upgrades, or a shifting of funds from other tax sources to cover costs.

It might just be though that since utilities are almost a complete localized monopoly, it is a great resource to exploit by private companies and thus is better run by the state.

Interesting to examine and theorize what industries would be cheaper and what would be more expensive if run by the government.   I imagine automobiles would end up more expensive as would a lot of tech products such as computers and cell phones.

zoltani

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Re: This is why we need single payer health care
« Reply #48 on: April 19, 2018, 01:05:37 PM »
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Also why we all use private power grids and water distribution systems.  Government would just "take your stuff and limit your rights" if it tried to provide these things.

It is truly amazing sometimes when a municipality provides electricity.  It is usually much cheaper than the private utility.  It is the same with cable TV.  I' ve always had my own pump so don't know about water.  I've never seen a private water company.

Public water is usually cheaper, but you know why? Their investment in maintaining and improving the system is actually much less than the private side. That's why it is cheaper, but generally they don't invest as much in capital improvements projects. They can be less proactive and more reactive about planning for drought as well, as was seen in californina.

I would like a better healthcare system, maybe not single payer, perhaps something like they have in france, a mix of public and private, but everyone is covered under the public system. I would be satisfied with more transparency and less shady tactics. In what other business can you walk in, have no idea of the price of the goods or service, purchase said goods and services, and have a third party negotiate the price for you. I have no idea why this is acceptable in the healthcare world and no where else.

pecunia

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Re: This is why we need single payer health care
« Reply #49 on: April 19, 2018, 03:03:04 PM »
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In what other business can you walk in, have no idea of the price of the goods or service, purchase said goods and services, and have a third party negotiate the price for you. I have no idea why this is acceptable in the healthcare world and no where else.

You struck a nerve there.  There have been many times I've had routine blood tests ordered by the doctor.  I show up and get it done.  Invariably, the people there have no idea what it costs.  In the past, I've had some of them say," You have insurance don't you?"  It is as if you should not even consider the cost if an insurer is paying for it. 

Although I am in favor of publicly funded medicine, this attitude is one of my fears that would ruin it.  I think people should bear some of the cost.  This would also help prevent people from running to the doctor for relatively insignificant problems.  I don't want my tax dollars to be paying for folks that leach from an otherwise good system.

I do not know about public water systems, but I am quite certain that FERC (now called the Federal Energy Regulatory Corporation) would make the municiipal electric works comply with the rules of ANSI C2, the National Electric Safety Code (NESC).    ((Not to be confused with the NEC))  FERC also has certain maintenance rules that must be complied with.  This is to ensure safety and reliability.  These facilities may, in fact, be better maintained since they operate in the public interest rather than the profit motive.