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Consumer Ignorance Sustains Spiraling Drug Costs?


Jeff Matthews

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18 minutes ago, babadono said:

Sounds great Canada. We're racing to catch up with your perfect, free system.

Definitely a model to look at but it's not free.

35 minutes ago, RT FAN said:

While I have no love of Big Pharma, as the developers of life saving drugs they are entitled to earn royalties from their products.

I agree but put a cap on it like they do the Insurance companies.

 

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Some of these drugs cost billions of dollars to develop and see through to a viable and safe drug. These trials often take years. After a certain period of time, generic drugs are allowed to enter the market cutting into their profit margin  

 I follow generic drug maker Mylan and they have competed with "Big Pharma" for sales for decades.

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To legislate or cap the amount of money these firms can earn from their efforts will lead to a stifling of research and less innovation in the marketplace.

I don't believe this to be true.

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You can believe what you wish Zen, but people are motivated by reward in whatever form it takes, be it monetary, personal glory or sexual gratification etc. Limit the reward and the lack of effort is sure to follow.

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12 minutes ago, RT FAN said:

You can believe what you wish Zen, but people are motivated by reward in whatever form it takes, be it monetary, personal glory or sexual gratification etc. Limit the reward and the lack of effort is sure to follow.

I will admit it's a balancing act and as of now I am still arguing that companies can make a profit. There is a HUGE gray area which is the middle ground between the ACA (and fixes) and Single Payer.

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That gray area is indeed rather large and must be addressed by politicians at some point. Those that are advocating the elimination of private insurance are either not cognizant of how the economy works, ill informed or delusional. Perhaps a combination of all three.

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7 minutes ago, RT FAN said:

Those that are advocating the elimination of private insurance are either not cognizant of how the economy works, ill informed or delusional. Perhaps a combination of all three.

I put the blame on the folks that didn't want to address how to fix the ACA...There was no repeal and/or replace and now the argument has gone back to where it was when Joe Lieberman reneged on being the 60th vote for a Medicare buy-in...Stay tuned.

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1 hour ago, Jeff Matthews said:

True, but there is a flip-side.  Big Rx continues to market to other nations that impose price constraints.  So, we know they are willing to sell to foreigners for less, provided the free market in American continues to subsidize the foreigners.

 

Keep in mind that not all medications are developed in the US, or by US companies.  If a Swiss or English or Canadian company is bringing out a new drug, they know what price will give them a workable profit margin.  It would be hard to believe that their discussions will go something like “Wow, it’s lucky we can charge the American patients so much.  It keeps down our prices in the rest of the world.”

 

Greed is a big part of why healthcare is so expensive.  Drugs are often overpriced, and doctors in some countries are very highly paid.  Here in Canada, doctors do quite well, but few of them are wealthy, unlike quite a few doctors in the US.  Still, in spite of not being rich, Canadian doctors in nearly all cases are very dedicated and skilled professionals, and so are the nurses and other healthcare workers.

 

Luckily, generic versions of many drugs are available, but the generic manufacturers have to wait something like 17 years before a drug patent expires and they can start production of their equally effective version of a drug.  When the rules were made, that was deemed to be long enough for the drug developers to recoup their costs and make a healthy profit as well.

 

However, this means that newer and often more effective drugs can remain very expensive until their patents expire.

 

BTW, in Canada, like in most countries other than the US, it’s illegal to advertise prescription medications on TV or radio.  There’s a good reason for this.  If a patient sees a convincing ad for a drug, he may decide that’s just what he needs for his condition, and ask or even demand that his doc prescribe it for him.  The doctor, not the patient, is the one who has the training and experience to know what meds are most helpful and effective, but if he doesn’t want to chance losing that patient, he may go ahead with prescribing a medication that is less than ideal for the patient’s condition.

 

Finally, government-funded healthcare produces a different mindset on the part of hospitals.  In Canada, a patient is an expense, so it makes sense to help the patient recover as quickly and completely as possible, in order to limit costs to the system.  In the US, a patient is a profit source, so in some cases, the patient is kept in the hospital until his money runs out, and then sent away.  I saw this happen with my own father when he was living in Florida.  He fell ill, but was well enough to walk into the hospital.  For three days, he was subjected to repeated, redundant, and expensive tests, but no treatment, then discharged to palliative care, where he died two hours later.  I’m pretty sure things would have gone very differently in Canada.  He might still be alive, and he and his wife would not have been hit with a bill for many tens of thousands of dollars.

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14 hours ago, Islander said:

 and they can start production of their equally effective version of a drug. 

All generics are not equally effective.

Luckily my doctor was aware of this after the generic drug was not performing and he suggested I pony up and pay the cost for the real drug.

The results speak for itself.

That is why there is a do not substitute check box on the prescription form.

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On 7/10/2019 at 7:14 AM, Davis said:

All generics are not equally effective.

Gen 1 version of the generic may not be the answer for you. Gen 2 may be a better more effective drug. Point is, even generics continue to improve and may end up being just the ticket for most people eventually.

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2 hours ago, JL Sargent said:

Gen 1 version of the generic may not be the answer for you. Gen 2 may be a better more effective drug. Point is, even generics continue to improve and may end up being just the ticket for most people eventually.

Normally the end user does the majority of the testing though.

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On ‎7‎/‎9‎/‎2019 at 3:59 PM, RT FAN said:

You can believe what you wish Zen, but people are motivated by reward in whatever form it takes, be it monetary, personal glory or sexual gratification etc. Limit the reward and the lack of effort is sure to follow.

I think we have come full circle that the lack of effort can be blamed on the Insurance companies with our current ACA. One of my friends was interviewed for this Time article and we had a good discussion on Facebook--One of the few on political matters. Today if you are paying too much for your drugs or forced to go genetic it's between you and your insurance company. https://time.com/5608386/cgrp-migraine-drugs-insurance/?fbclid=IwAR09jeGkw5s3TmT2YxOWv_XuLTATuc4dEs96OkTJX5kxuP_Zd3Uij3VoGW8

A Year After Approval, Migraine Drugs Are Changing Lives. But Insurance Battles Are Creating a Whole New Headache

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Freedom to choose is America’s mantra. Too often citizens choose the easy road. They opt for the easy decisions or the simple work or lifestyle. They do not apply themselves in school nor excel at their work. They are happy to settle for a mediocre existence...... or even less. On the other hand citizens often choose to excel. Whether they excel professionally or in business they achieve significant lifestyles. They work hard or they think hard. They earn the rewards due to their efforts. Choices. Foreigners want to come to America because they realize their own industry will gain them much more than their own country.

 

So - why should any government take funds from the working group and hand the most expensive benefits to those who opted to work lessor in life? 

 

I have 2 adopted sons. They were both raised in the same home with the same advantages/disadvantages. One is a ‘dolt’, the other isn’t. One worked insanely hard to get a good career, the other is a street urchin. One gets free healthcare and the other one pays through nose for nominal healthcare.

 

Freedom to choose is America’s mantra. IMHO if you choose lazy then that is what you deserve.

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Hard working people go bankrupt from medical bills.  It is not as simple as what you portray.  We are already paying for healthcare, for the hard working and the indigent.  Why allow the wealthy corporations to create indigence out of the hard working?  Why not have a better system, one that combines the best of other systems which would lead the world?

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34 minutes ago, Bosco-d-gama said:

Freedom to choose is America’s mantra. IMHO if you choose lazy then that is what you deserve.

Sometimes it may be a choice but usually that is for the most well off among us...Paying for Healthcare is a multifaceted aspect of life where some people take gambles and others don't have a clue what they will end up needing--Now or later.

31 minutes ago, oldtimer said:

Hard working people go bankrupt from medical bills.  It is not as simple as what you portray.  We are already paying for healthcare, for the hard working and the indigent.  Why allow the wealthy corporations to create indigence out of the hard working? 

Yep.

31 minutes ago, oldtimer said:

 

Why not have a better system, one that combines the best of other systems which would lead the world? 

The ACA had a pretty good framework until no one in charge wanted to fix it...Now the debate seems to be starting from where we left off right before it passed. Now it appears there is more momentum for going towards a Single Payer System than trying to clean up what we have. I gotta admit I am sorta torn about which way to go but Congress and the Administration need to start talking to each other on this and several fronts.

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7 minutes ago, oldtimer said:

Hard working people go bankrupt from medical bills.  It is not as simple as what you portray.  We are already paying for healthcare, for the hard working and the indigent.  Why allow the wealthy corporations to create indigence out of the hard working?  Why not have a better system, one that combines the best of other systems which would lead the world?

 

From an outsider's perspective, it would be difficult to immediately introduce a tax-funded healthcare system in the US that's very similar to the ones currently in operation in Canada and Europe.  The US healthcare system is based on profit, making doctors and hospitals both rich.  I don't know the situation in Europe, but in Canada, while doctors earn a good living, most of them are not millionaires.  Even so, they are not lacking in skill or dedication.

 

In the US, reducing doctor and hospital incomes would help make a taxpayer-funded healthcare system both affordable and sustainable, but would be a hard sell to those most affected financially.  I may be wrong, but I think it would have to be introduced in steps, in order to find widespread acceptance.

 

Another issue is racial resentment.  In his book Dying of Whiteness:  How the Politics of Racial Resentment is Killing America's Heartland, Jonathan M. Metzl argues that many poor people will vote against policy changes that will help them, because they will also help people they don't like, Blacks and immigrants, for example.  As a result, their lives are shorter, their children are more poorly educated, and their communities suffer more gun deaths.  This is partly due to the extreme polarization of US society these days.  The people the author spoke with see themselves as members of a (Republican) team, and are literally willing to die early for the team.  He bases this on interviews he conducted across Missouri, Tennessee, and Kansas, on topics like gun laws, the ACA, and school and social services policies.  I was able to hear the author in an extended interview on CBC Radio a month or so ago, so the topic is fresh in my mind.  He did seem to ruffle some feathers, since a group of white supremacists showed up at one of his book readings to protest him and his conclusions.

 

https://www.goodreads.com/en/book/show/40697553-dying-of-whiteness

 

https://www.mhpbooks.com/white-supremacists-storm-reading-of-dying-of-whiteness/

 

https://www.washingtonpost.com/local/public-safety/white-nationalists-interrupt-author-at-politics-and-prose/2019/04/27/d48012c6-692d-11e9-82ba-fcfeff232e8f_story.html?noredirect=on&utm_term=.b200e9b4aafc

 

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17 minutes ago, Islander said:

In the US, reducing doctor and hospital incomes would help make a taxpayer-funded healthcare system both affordable and sustainable, but would be a hard sell to those most affected financially.

We are already paying for it.  It's like a mortgage.  People think they are smart for taking advantage of the deduction from taxes, while paying a buttload to the banks in interest.  The smart money looks at total income versus total outflow.  It is better to own your home than carry a mortgage so you can save a relative little to taxes while paying much much more to the banks. 

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31 minutes ago, Islander said:

From an outsider's perspective, it would be difficult to immediately introduce a tax-funded healthcare system in the US that's very similar to the ones currently in operation in Canada and Europe.  The US healthcare system is based on profit, making doctors and hospitals both rich.  I don't know the situation in Europe, but in Canada, while doctors earn a good living, most of them are not millionaires.  Even so, they are not lacking in skill or dedication.

I agree it won't be easy, but in fact a hard sell to those entities as you say below. In the end though, their profession will still be marketable and the USA will be where they want to practice.

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In the US, reducing doctor and hospital incomes would help make a taxpayer-funded healthcare system both affordable and sustainable, but would be a hard sell to those most affected financially.  I may be wrong, but I think it would have to be introduced in steps, in order to find widespread acceptance.

This is a good observation and what I think trying to incorporate a buy-in to a "Medicare for all" system would be the starting point...Of course the Insurance companies would lose business and as the market changed for those opting for a lower cost/no frills plans their programs would be drastically more expensive...In this climate, regular corporations  would push the burden on their employees to find healthcare and they would no longer be responsible for providing it for their employees--Those big corporations along with smaller companies are being priced out of the market as it stands now.

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2 hours ago, oldtimer said:

The burden of cost has already been pushed to employees.

Yes it has and even more so given the already changing dynamic of the economy. 

 

4 hours ago, Bosco-d-gama said:

Freedom to choose is America’s mantra. Too often citizens choose the easy road. They opt for the easy decisions or the simple work or lifestyle. They do not apply themselves in school nor excel at their work. They are happy to settle for a mediocre existence...... or even less.

Yes. But this doesn't really pertain to the Healthcare discussion

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On the other hand citizens often choose to excel. Whether they excel professionally or in business they achieve significant lifestyles. They work hard or they think hard. They earn the rewards due to their efforts. Choices. Foreigners want to come to America because they realize their own industry will gain them much more than their own country.

Yes.

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So - why should any government take funds from the working group and hand the most expensive benefits to those who opted to work lessor in life? 

Because we are talking about the tremendous cost of actual HEALTHCARE through anyone of our lifetime's and while most expense occurs at the end , a lot of people are surprised with expense no one but the ultra-wealthy could be ready for.

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I have 2 adopted sons. They were both raised in the same home with the same advantages/disadvantages. One is a ‘dolt’, the other isn’t. One worked insanely hard to get a good career, the other is a street urchin. One gets free healthcare and the other one pays through nose for nominal healthcare.

Some folks you should be on the hook. I for one think we need a sensible Healthcare System that works for both as well as all other folks who live in the USA.

 

 

That's my take.

 

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