Our Healthcare System

[cheesehead]

Re: Our healthcare System

Eh, the co-pay for drugs shouldn't be some simple "20 bucks" it should be a percentage of the total cost of the drug and then maybe the patients and docs would become more sensitive to this issue. The area many ways to treat heartburn besides the newest fanciest drugs. The cheapest ways aren't always fully investigated if a $176 dollar a month drug is available for 20 bucks.

Canadian/European systems work, kinda, if you don't get sick and then good luck getting anything done. Here you get a head CT if you have a headache, in Europe, you get an "emergency head CT" in 2-3 weeks.

We do spend too much money on the last remaining years of life, but that's what the consumer demands. If the doc says "no", then he can get sued. We have 3/4 of the worlds lawyers in the US and they like to keep busy.

Overall it's a good system, just needs a little socialization.

 

[James S]

Re: Our healthcare System

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We do spend too much money on the last remaining years of life, but that's what the consumer demands. If the doc says "no", then he can get sued. We have 3/4 of the worlds lawyers in the US and they like to keep busy.

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There is some movement in america at the moment towards more hospice care for end of life care. However, it requires a lot of paperwork and the doctor has to spend literally hours trying to talk the patients family into first admitting that their loved one is dying and that while yes, there are many things we could continue to do it's not going to help, except that it might help, but probably not. Which is the truth in 90% of cases that reach that point. Manage their pain and let them go is what that is about. Or you can continue to perform CPR every other afternoon and put an unconscious person on a vent and dialyze them through a femoral artery catheter and they will still die but after a lot more pain and suffering. But how can you be sure that is the right thing to do? You want to save the world and your family a lot of money and yourself a lot of pain write yourself a living will and make sure that you're family understands your wishes or they will override your paperwork at the last minute. In my case I'd ask that you get a second and a third opinion on my condition just to make sure that the doctor in charge wasn't dropping the ball, and then do what they suggest.

A living will is something that you can all do right now to help alleviate this particular problem. it doesn't matter so much when you're younger. The doctors in the hospital will always do everything for a young or otherwise healthy person. Even an older healthy person who has been in an accident or something. Don't worry about them suggesting that they switch you off if you're actually going to recover. But after a certain point, you're not going to recover. Families in this situation are NEVER prepared to make this decision, even when they KNOW the condition of their loved one.

 

[MichiganMan]

Re: Our healthcare System

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cheesehead said:
Eh, the co-pay for drugs shouldn't be some simple "20 bucks" it should be a percentage of the total cost of the drug and


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No doubt, that would get us closer to where we need to be, but at a rate faster than would be healthy for maintaining the public's tolerance for reform. IOW, we're already inundated with stories about how expensive drugs are for the minority of people that don't have drug benefits. Imagine the media cacophony once the whole population finds themselves in the space of a few years seeing, say, a 500% increase in their out of pocket expense. Sure, the cost of the drug will not have changed a cent, but the perception of the consumer will be that our system is spiraling out of control and "something needs to be done" Which is equivalent to pouring gasoline on a fire to politicians with legislatively itchy fingers.

No, like I said, it took us decades to get into this mess. Any solution that doesn't break the country, or the reform istself, is going to take nearly as long.


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Overall it's a good system, just needs a little socialization.

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Just clarifying, you're talking about conditioning the participants, right, not introducing more socialism into the system?

 

[cheesehead]

Re: Our healthcare System

MM,

Copays seem to be slowly increasing, but since they are of a constant amount, that doesn't change anyones attitude. Copays that I was thinking of would be a small % of the total with a set upper limit (no reason to crush anyone financially). Eh, drug companies certainly wouldn't want that.

Socialization, er, yes, I was getting a little sleepy, but I agree, if patients aren't properly socialized then they are more likely to get sick, etc. Also, more square dances for the elderly, etc. all part of the preventative health care. Socialism, what the hell was I thinking?

 

[cy]

Re: Our healthcare System

Great thread..

Wonderful getting opinions from all walks of life. Would like to hear from drug mfg side. Would agreed with most of what's been posted.

Profits is what drives America and the rest of the world. The difference is, the rest of the world limits what the profits are when it comes to health care.

1. Drug companies grossly overcharge in US because they can. look what the rest of the world is paying for the exact same thing. For the public good, there needs to be limits on profits.

2. Lawyers squeeze the max amount from med tort claims because they can. adding to everyone's overall costs. there needs to be reasonable limits. high enough to compensate but not allow jackpotting.

3. doctors order full batteries of tests probably not needed just to cover their ***. all adding on costs. Doctors should have limits of liablities in place.

4. Insurance companies are paperwork nightmares. As was pointed out, insurance companies touche lots of dollars, but net out little.

5. There are wide veriety of drugs doing simular things. incentives are needed to use the cheapest drug that will do the job. contrary to drug companies' interests

That's all for now, could go on forever with this list.

Seems for the public good, limits on profits needs to be inserted. Don't know if that is politically possible. Would like to think it is.

 

[Lurker]

Re: Our healthcare System

[ QUOTE ]
cy said:
1. Drug companies grossly overcharge in US because they can. look what the rest of the world is paying for the exact same thing. For the public good, there needs to be limits on profits.


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Drug companies are operating within the system of capatilism and should be expected to pursue profits. This is OK because capitalism is generally a very efficient system. I see no reason to change the basic rules of capitalism by trying to directly control profits or prices. That is an overly simplistic and dangerous approach to the problem.

Capitalism will work well in health care if we can remove the things that are distorting it. Right now, it is the healthcare insurance system that is distorting the market and leading to extremely high costs. As has been discussed earlier in the thread, one of the ways that insurance distorts the system is by taking away from the consumer almost all of the marginal cost of consuming healthcare, which leads to overconsumption. Many other distortions have also been discussed, such as the malpractice problem, etc., and it is these distortions that should be addressed. But undermining the basic system of capitalism by trying to directly control profits or prices might well make the problem worse rather than better.

 

[James S]

Re: Our healthcare System

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1. Drug companies grossly overcharge in US because they can. look what the rest of the world is paying for the exact same thing. For the public good, there needs to be limits on profits.

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We don't honestly have any way to gage if it's true that we are being overcharged or not. One could argue that the canadian government legislating lower prices force the companies to charge more in other places that do not have such artificial limitations like here in America. The drug companies are so careful to hide every bit of expenditure that it is not possible for the government to find out how much it really cost them to develop and test a drug and therefore to try to determine a reasonable cost for it and enforce that in some way. The fight right now is on disclosure from these companies so that more information about just how far off the mark the prices are can be dug out of their morass of financial paperwork.

I'm not in ay way defending the drug companies stance in this situation, just suggesting that it sounds very simple to say that by limiting their profits we're limiting the cost of the drug, but this is not a simple situation at all.

I have to really disagree with limiting profits to keep costs down. The problem is not that they are charging all the market will bare, but that the other half of this big business scam, the insurance companies, are in collusion with them and allow them to charge considerably MORE than what the market will handle.

I do not want the government deciding how much research and development of new drugs to save my life is worth and telling people how much they can be paid to do this work. That is very scary because you as an individual don't mean anything at all to the government. For the exact same reason I don't want the government deciding that doctors should be on some socialist pay schedule.

Don't try to think that there is anything altruistic in the drug companies designing new drugs. They are in it for the money. (the individual researchers and doctors are mostly not, thats different and not what I'm talking about) I WANT them to make money and to continue to pour that back into research for the next drug that me or my family is going to need. The problem here is not the free market and making a profit. The problem is that drug companies plus insurance companies equals a kind of privatized socialism. We all pay into the insurance company bank account, so that they can turn around and pay out for what some of us are going to need. But the more money that moves through their system the more powerful and rich they become. So the more they spend on drugs for them the better. They will just keep raising your rates, they don't care.

A system where people had to pay a co-pay based on the actual cost of the drug would let the market decide better on a fair price for that drug. At the moment, since nobody is paying out of pocket for their drugs that has a plan like this they can charge anything they want and nobody cares. If you had to pay more for it they would sell less of it if they overpriced it. If you had to pay too much for a name brand then you'd buy the generic instead and you'd force those big companies to compete in the normal and very successful american market. It's only because they don't have to compete or even worry about it that they are able to get away with this.

But then there are all the other difficult questions that got us into this situation in the first place. Aren't I ENTITLED to any drug or service that I need in order to save my life? (or cure my headache or whatever) I'm sure that those problems can be solved without leaving people out in the cold without medical treatment. We already have grants and low incoming housing allotments and indeed even special medical care for people that can't afford to see a doctor without it. If I can afford it, then I don't get that help I'm expected to pay for it myself. (or at least a bigger portion of it) So thats already in place, it just needs to be expanded a bit.

The insurance companies have removed any market pressure from the drug companies at all, so of course they charge whatever they can get away with. The difference with other things mostly being that you can't get away with totally gouging your customers in any other market.

EDIT: In reading back through my post I can see other problems with just having the market decide. You have to offer some perks and some leeway to the drug companies. There are actually quite a few drugs that are vital if you have an uncommon problem, but there aren't enough people that are going to need them to make back the investment to create them before the generic rights become available. So they must be allowed to price other things in a way that allows them to use higher profit margins on 1 product to finance the other drugs. Otherwise they will stop any less profitable production lines and just make viagra and rogane /ubbthreads/images/graemlins/smile.gif And if there is a smaller market for a specific drug then it's going to be more expensive. If the government tries to tell them what they can charge more for reinvestment and the like, we won't have anything but the most common and readily used drugs. There will also be no reason for different companies to develop competing drugs for the same problem as the government will already be controlling their profits, so why bother with something where we don't own the entire market. And the heck with you as a consumer if the first drug doesn't work for you or if it causes you too many side effects to use.

No, we definitely don't want a socialist system of medicine, we need to reform insurance so that the companies can give us what we are willing to pay for (or subsidise) at a reasonable cost.