The Buffett Rule

[justplugit]

Originally Posted by spence

All that R&D funding to create the next category killer drug is being subsidized by US consumers because drugs are sold at lower costs (often via price controls) in pretty much every other nation.

-spence

So as per my first question you are for price control ?

[spence]

Originally Posted by justplugit

So as per my first question you are for price control ?

I don't think the government should set prices arbitrarily but can see scenarios where regulations impacting price could be justified.

Take Canada for instance, they have price controls and as a result cheaper drugs. They also have a government system that provides healthcare for everyone, which creates almost a guaranteed customer base. So in this case the price control is balanced (to some degree) with a sure customer. Without price controls they'd risk having to ration some drugs if the manufactures decided to price them above value.

The drug companies don't have to sell to Canada, but they do anyway because the incremental production cost of the drugs is usually small compared to the development, approval and tooling processes...not to mention the tens of billions of dollars it takes to scare us all into demanding drugs for ailments we didn't even know we had.

So price controls in Canada seem to be a win/win for both the consumer and industry, but if you applied the same policy here you'd kill (or perhaps injure) the golden goose.

There is government regulation that helps pharmaceutical companies maintain higher prices across a very large market as well as regulation to ensure quality and safety which adds cost.

I don't think the pharma companies are bad, but when you do hear stories about Americans unable to afford some drugs here that are available across the border 10X cheaper it raises some questions. The pharmaceutical industry is one of the most profitable in the world. Regardless of what happens I'm sure they'll find a way to make a buck.

-spence

[justplugit]

[QUOTE=spence;889454]I don't think the government should set prices arbitrarily but can see scenarios where regulations impacting price could be justified.

Take Canada for instance, they have price controls and as a result cheaper drugs. They also have a government system that provides healthcare for everyone, which creates almost a guaranteed customer base. So in this case the price control is balanced (to some degree) with a sure customer. Without price controls they'd risk having to ration some drugs if the manufactures decided to price them above value.
_[QUOTE]

Spence, I would love to see Canada's national formulary. Guarantee it is limited
to one drug per class which means you won't have a choice when it comes
to efficacy or side effect profile. For instance there are many statin drugs
on the market for lowering cholesterol. They are all variations of statins
but each works a little differently. When there is only one,that will be based on the cheapest, and you can't tolerate it or it's not efficacious for you, too bad.
That is One of the biggest problems with government health care, no choice AND
mediocore medicine.

Rationing drugs based on age becomes another problem as expensive chemo
drugs etc. will be too costly to add another 5 years to say maybe a 75 yr old.

Good point on killing the Golden Goose. It is already happening. Companies
will not go out on a limb in R+D if they find a compound that has a limited
use. For instance, Amphotericin B was developed years ago to treat fatal
San Juakien (sp?) Valley ,a disease limited to the valley. They won't
be willing to spend millions and years of development when there will be
no return on investment. They will stay with the large markets for cardiovasculars
and anti effectives.

Same old story, you get what you pay for.

[spence]

[

Originally Posted by justplugit

Spence, I would love to see Canada's national formulary. Guarantee it is limited to one drug per class which means you won't have a choice when it comes to efficacy or side effect profile. For instance there are many statin drugs on the market for lowering cholesterol. They are all variations of statins
but each works a little differently. When there is only one,that will be based on the cheapest, and you can't tolerate it or it's not efficacious for you, too bad. That is One of the biggest problems with government health care, no choice AND mediocore medicine.

Well, Canadians would beg to differ...they love their health care. I think polls are usually 85-90% in favor.

As for prescription drugs, you can still get private insurance to cover prescriptions there...though as was mentioned above, the governments will negotiate costs which Medicare/Medicaid here isn't allowed to do by law.

I'm not sure the claim that only one drug per class is allowed is accurate. For instance, I found one report that listed % market share of the various statin drugs there.

Rationing drugs based on age becomes another problem as expensive chemo drugs etc. will be too costly to add another 5 years to say maybe a 75 yr old.

No different than in the USA.

Good point on killing the Golden Goose. It is already happening. Companies will not go out on a limb in R+D if they find a compound that has a limited use. For instance, Amphotericin B was developed years ago to treat fatal San Juakien (sp?) Valley ,a disease limited to the valley. They won't be willing to spend millions and years of development when there will be no return on investment. They will stay with the large markets for cardiovasculars and anti effectives.

I think a bigger issue is simply that the big companies are making more profit based decisions than just counting how much money is going into R&D. R&D spending is going down as they focus on better returns.

For a large organization it's probably just not practical to go after niche drugs unless you have a business model built around it. This should encourage growth in small companies to meet low volume needs.

There are a TON of companies like this in the Boston area alone.

-spence

[justplugit]

Originally Posted by spence

[
Well, Canadians would beg to differ...they love their health care. I think polls are usually 85-90% in favor.



I'm not sure the claim that only one drug per class is allowed is accurate. For instance, I found one report that listed % market share of the various statin drugs there.


No different than in the USA.


I think a bigger issue is simply that the big companies are making more profit based decisions than just counting how much money is going into R&D. R&D spending is going down as they focus on better returns.

For a large organization it's probably just not practical to go after niche drugs unless you have a business model built around it. This should encourage growth in small companies to meet low volume needs.

There are a TON of companies like this in the Boston area alone.

-spence

Sources please.

If your insurance company won't cover chemo at age 75 for you, ya
betta get another company,you'll be there before ya know it.

BTW, Govt. announced today they want everyones medical records computerized
for Obamacare. Like they will remain private.
BIG BROTHER at it's best.
Whats next ?????

[RIROCKHOUND]

Originally Posted by justplugit

BTW, Govt. announced today they want everyones medical records computerized for Obamacare. Like they will remain private. BIG BROTHER at it's best.

Yeah, because when we tried to get my wifes records transfered from one doc to another, it was so effieicent with paper records it only too a few days/week...

[justplugit]

Originally Posted by RIROCKHOUND

Yeah, because when we tried to get my wifes records transfered from one doc to another, it was so effieicent with paper records it only too a few days/week...

That's not the point, your doctor controls your records now, paper or computerized.
Point being the Govt.wants control of everyone's records and hackers or bureacrats can get in.
Remember Wilkileaks.

[spence]

Originally Posted by justplugit

Sources please.

Not going to spend the time to Google, but I'll take the Wiki as good enough...

Canadians strongly support the health system's public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported "public solutions to make our public health care stronger."[6][7]

A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States, more than ten times as many as the 8% stating a preference for a US-style health care system for Canada[8] while a Strategic Counsel survey in 2008 found 91% of Canadians preferring their healthcare system to that of the U.S.[9][10] In the same poll, when asked "overall the Canadian health care system was performing very well, fairly well, not very well or not at all?" 70% of Canadians rated their system as working either "well" or "very well".[citation needed] A 2003 Gallup poll found only 25% of Americans are either "very" or "somewhat" satisfied with "the availability of affordable healthcare in the nation", versus 50% of those in the UK and 57% of Canadians. Those "very dissatisfied" made up 44% of Americans, 25% of respondents of Britons, and 17% of Canadians.[11]

In November 2004, Canadians voted Tommy Douglas, Canada's "father of Medicare", the Greatest Canadian of all time following a nationwide contest sponsored by the CBC.[12][13]

http://en.wikipedia.org/wiki/Canadian_health_care#Public_opinion

I'm not saying that the Canadian system is perfect, or even that I'd want it, but that Canadians seem to like it.

If your insurance company won't cover chemo at age 75 for you, ya betta get another company,you'll be there before ya know it.

The point was that a huge amount of money is spent keeping people alive those extra years regardless if it's government sponsored or through private insurance.

Rationing, already exists in both scenarios as neither private or public care will fun increasingly expensive treatment with little return. There's also indirect rationing where charging more for drugs here than other countries either forces them to travel or prices Americans out of the treatment.

BTW, Govt. announced today they want everyones medical records computerized for Obamacare. Like they will remain private.
BIG BROTHER at it's best.
Whats next ?????

Privacy is certainly a concern, but you also complained about 600B in fraud earlier. How do you think they're going to fight this without a clear grasp of what's really going on?

If implemented property, I'd think the benefits (reduced costs, quality of care) outweigh the risks.

-spence

[justplugit]

eQUOTE=spence;889719]
Not going to spend the time to Google, but I'll take the Wiki as good enough...
--__________________________________________________ ___________________
Spence,the info you gave was done between 2003-2009, hardly recent.

----------------------------------------------------------------------------------------------
__________________________________________________ ____________________
The point was that a huge amount of money is spent keeping people alive thoseimplemented property, I'd think the benefits (reduced costs, quality of care) outweigh the risks.
-spence[/QUOTE]

Spence, don't grow old.
__________________________________________________ ___________________
Don't know how cutting Medicare fraud increases quality of care?

BTW, without giving up your privacy,the medicare payment form sent
should be outlined in laymans terms. If the patient questions the procedure,
or what Doc performed it, just check it and send it back to Medicare to check
it's legitamacy with the provider
They can also check on their side which Docs over use of a code.

[scottw]

Originally Posted by spence

Not going to spend the time to Google, but I'll take the Wiki as good enough...

Canadians strongly support the health system's public rather than for-profit private basis, and a 2009 poll by Nanos Research found 86.2% of Canadians surveyed supported or strongly supported "public solutions to make our public health care stronger."[6][7]

A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States.

-spence

more from your WIKI




Health care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities.

I'm shocked that 82% prefer a system that is "mostly free" and when asked if they prefer it to one that they never use (American) and would have to pay for....... they chose the "mostly free" one...go figure?????

also wonder how enthusisatically they'd support their healthcare system if they were denied access to American made pharmaceuticals, American medical technology and advancements, or denied travel for American medical care when they cannot get it on their own side of the border and had to rely soley on what Canadians produced through their own "mostly free" price controlled system... ????

might still be 82% I suppose as it would still be the only thing that most of them have known since birth....and the alternative, particularly if you have to pay something...can be scary

http://www.reuters.com/article/2010/...64u3xo20100531

"We can't continually see health spending growing above and beyond the growth rate in the economy because, at some point, it means crowding out of all the other government services.

"At some stage we're going to hit a breaking point."


"It's an area that Canadians don't want to see touched," said TD's Burleton. "Essentially it boils down the wishes of the population. But I think, from an economist's standpoint, we point to the fact that sometimes Canadians in the short term may not realize the cost."