The bipartisan war on drugs… what to do about pharmaceutical prices?

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There are many issues where Obama and McCain supporters live on opposite ends of the spectrum. But there is at least one where most of the populus… and if you read their campaign promises, the DNC and GOP candidate themselves… were on the same page. And that is on the price of prescription drugs in the US.

For the young and healthy, prices of medications seem low priority. For a nation of boomers, coming into their golden years, this is a looming… if not already omnipresent…. reality already.

The top three profit industries in America are pharmaceuticals, investment banking and oil/energy. Contrary to popular belief, the pharma industry held the #1 position thru most years historically, with oil coming in third. Needless to say investment banking will be losing that lofty status in the wake of our current economic status.

Even the most sensible citizen should be able to acknowledge that profit is integral to expansion of the business. And in the case of pharmas, that would mean the R&D/patent/development process necessary for new product… not an inexpensive path in itself.

So the argument seems simple on the surface… why is it so expensive to buy pharmas in the US compared to the rest of the world? And can we achieve competitive prices without risking R&D and development of new and better product?

I’ve been taking a crash course in pharmaceuticals, research, and drug manufacturers… and our recent Congressional history affecting the prices to the end consumer. What I found was surprising… and should turn out to be perhaps the second issue (the bailout being the first…) uniting the nation’s population, regardless of party affiliation…. provided they are well informed on the history of reform, and the nuances between each party’s suggested “cure”.

What I’ll also expect to hear is the typical blaming of the other party. Unfortunately, from what I can see … both in financial support, and deliberate thwarting of legislation… there is ample culpability to be borne by both sides. So allow me to pass on what I’ve learned… and then let ‘er rip in the comments.

SOME HISTORICAL BACKGROUND ON LEGISLATION

In 2003, Bush championed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, sponsored by Dennis Hastert and 20 GOP co-sponsors. The bill passed the House, mostly along party lines. It was subsequently sent to the Senate, where it was approved by unanimous consent.

Then came reconciling the differences between the Senate and House versions: resulting in a Dec 8th, 2003 enactment of the bill, with final House votes as the Yeas and Nays: 220 – 215, and a Senate vote of 54 Ayes, 44 Nays, 2 Present/Not Voting.

I only found two floor speeches involving the dissention at that time. Sen. Akaka (HI-D) wanted to make sure that generic drugs could be brought to the market in a timely fashion, stated the bill’s language prevented Hawaii from obtaining its DSH allotment as long as the QUEST program remains in place.. Sen. Daschle (SD-D) focused on drugs used to create meth were a danger in his rural state.

What I see missing from the debates then is what our commenter, Larry Weisenthal, and founder of the Weisenthal Cancer Group in Southern California, speaks of today… and that is the ability of the DHS Secy to negotiate the price of drugs directly with the pharmas.

A huge component of the runaway health care costs are prescription drug costs. And it’s getting worse. The average new cancer drug costs between $5,000 and $11,000 PER MONTH!

The greatest special interest buy off in history was when Big Pharma got inserted into the Medicare Prescription Drug law a PROHIBITION against Medicare negotiating with the drug companies regarding drug costs. In one fell swoop, government (1) gave Big Pharma a pricing monopoly and (2) guaranteed payment from the government. This was a sweetheart deal worth hundreds of billions of dollars. No other sell out to non-military special interests in history ever came close.

What Larry refers to here is referenced as Part D of title XVIII of the Social Security Act.

The reason Part D is absent from the debate is because of dualing partisan legislative attempts to address it separately in the same time period.

Sen. Arlen Specter (PA-R) has made multiple attempts to introduce clean bills addressing the DHS Secy’s power of negotiation, including S2766 in July 2004, S.813 in April 2005, and in Jan 2007 as S. 273. All appear to have met with the same results… read twice, and sent to the Committee on Finance.

SUMMARY: Amends title XVIII (Medicare) of the Social Security Act with respect to prescription drug plans to repeal the prohibition against: (1) interference by the Secretary of Health and Human Services with negotiations between drug manufacturers and pharmacies and prescription drug plan sponsors; and (2) the Secretary’s requiring a particular formulary or instituting a price structure for the reimbursement of covered Medicare part D (Voluntary Prescription Drug Benefit Program) drugs. Grants the Secretary authority similar to that of other Federal entities that purchase prescription drugs in bulk to negotiate contracts with manufacturers of covered part D drugs.

Meanwhile, the DNC were busy working on their own cures. Rep. John Larson (CT-D) introduced HR 3299 in Oct 2003 with 19 of his peers. This bill also died in the subcommittee.

Medicare Prescription Drug Price Negotiation Act – Requires each participating manufacturer of a covered outpatient drug to make such drugs available for purchase by any qualified Federal health care provider, by each pharmacy, and by each provider of services, physician, practitioner, and supplier under the Medicare program at a price that the Secretary of Health and Human Services, in conjunction with the Secretary of Defense and the Secretary of Veterans Affairs, negotiates with the manufacturer. Provides that the amount of a covered outpatient drug that a participating manufacturer shall make available for purchase is equal to the sum of the aggregate amounts of the covered outpatient drug dispensed by pharmacies to Medicare beneficiaries plus those dispensed through qualified Federal health care providers.

Requires that, in conducting negotiations with participating manufacturers, the Secretary take into account the goal of promoting the development of breakthrough drugs.

Requires the United States to exclude from Government contracting and subcontracting, for a period of time, a manufacturer of drugs or biologicals that does not comply with this Act.

Directs the Secretary to establish a mechanism (such as an ombudsman) for the resolution of disputes between Medicare beneficiaries and prescription drug resellers and drug manufacturers in order to protect such beneficiaries and to ensure that: (1) prescription drug resellers are not artifically increasing prices charged to Medicare beneficiaries (above those negotiated under this Act) in places (such as rural areas) where there is less competition; and (2) such resellers are not colluding on prices in areas with more potential significant competition.

The DNC version carries more legislative caveats than the more direct Specter versions: determining a formula as to how the price is set, creating a financial blacklist for some drug manufacturers that are not seen as cooperative, and increasing departmental personnel to act as dispute mediators and investigate what they may see as price fixing within the industry.

Larson tried again in May 2005 with HR 2685, … this time with only three DNC co-sponsors.

The 2007 battle over HR 4 and S3

These previous attempts garnished little media fanfare in their day since neither got out of committees. Mid-terms ushered in a more substantial majority for the DNC. In Jan 2007, Rep. John Dingell’s bill, HR 4, with it’s 198 all Democrat co-sponsors, pushed thru committees and to the floor for a vote on the Part D negotiation issues.

The Summary reads virtually identical to Larson’s previously introduced bills mentioned above, carrying the same caveats, and expansion of government departments.

HR 4 passed with 100% DNC support, and 88% GOP opposing.

Almost simultaneously, Sen. Harry Reid (NV-D) was introducing S.3, with 17 peer co-sponsors. Tho the summary reads “clean”, the bill text (the hotlink provided) shows similar caveats as the House bill INRE subsidies, aggregate price negotiation, plus added caveats about privacy of disclosure of such with some exemptions.

This bill failed a cloture motion, preventing consideration of the bill, in the Senate by roll call vote. The totals were 55 Ayes, 42 Nays, 3 Present/Not Voting

Or, put more simply, the GOP led a filibuster, and the DNC Senate majority – along with GOP Senators Sens. Norm Coleman (MN), Susan Collins (ME), Chuck Hagel (NE), Gordon Smith (OR), Arlen Specter (PA) and Olympia Snowe (ME) – could not muster the required 60 votes needed.

ENTER THE MEDIA, AND THE PARTISAN CAMPAIGN FINGER POINTING

Now in the heat of a ramping up, bitter partisan battle for control of the Oval Office, the finger pointing and accusations start flying…. with the GOP being portrayed as evil doers, bent on keeping prescription drugs unnaturally high. Yet, in reality, both parties want to address the problem, but see different ways of doing so.

What’s the bone of contention? According to Jeff Patch in an April 2007 Politico article, GOPer held among their concerns the appearance of price fixing, would would end up with an across the board price mark up for all companies. Also, since the thrust of the legislation is intended to lower federal costs for drugs, the GOP cited a Congressional Budget Office analysis of S.3 that concluded the legislation’s impact on federal spending would be “negligible”.

CBO estimates that developing the prioritized list of comparative effectiveness studies and preparing the reports would cost $2 million in fiscal year 2008 and less than $500,000 annually in subsequent years, assuming the appropriation of the necessary amounts. Other provisions would have a negligible effect on spending.

S. 3 contains no intergovernmental or private-sector mandates, as defined in the Unfunded Mandates Reform Act. Under the bill, states could request and receive prescription drug data from the Secretary, provided that they limit disclosure and implement plans to safeguard the data. Any costs of safeguarding that data would be incurred voluntarily.

More from the Politico report:

Republicans also discounted Democrats’ arguments that the Veterans Administration has successfully used similar tactics, because it has limited choices on many drugs and some veterans have subsequently opted for the Medicare program instead.

William Pierce, a vice president at APCO Worldwide and former HHS spokesman, said the bill gave no incentive to negotiate prices.

~~~

Sarah Berk, the executive director of Health Care America, said her advocacy organization pushes for a private-public solution to the health care system and that seniors’ choice of medication would be limited if the bill became law and the secretary swayed prices.

“Seniors are saving more money than anticipated, and it’s costing taxpayers billions less,” she said.

Another Berk quote from a Miami Herald opine piece, (excerpted from the Kaiser Network organization:

Sarah Berk, Miami Herald: “Medicare Part D is a success, yet for its own political gain the new Democratic leadership in Congress seems intent on risking seniors’ access to prescription drugs and expanded medical benefits” by promising to remove restrictions on government drug price negotiations, Berk, executive director of Health Care America, writes in a Herald opinion piece. Supporters of these efforts “contend their bill prohibits the government from limiting drug choices … but there are only two ways the government can achieve the lower prices they envision: dictate exact prices or limit choices,” Berk writes (Berk, Miami Herald, 2/2).

So again, the consumer and health care providers find themselves on the short end of the stick as an embattled Congress – tho in agreement on the problem – cannot find a conclusion that actually will achieve the desired results.

WHAT ABOUT THOSE PROFITS? R&D vs advertising realities

While Americans in need, and health care providers wait out what we can only hope will be a sensible solution to prescription drug providers… and not adding fuel to an already blazing fire… what should be addressed is the pharma industry’s profit structure. Will any attempt to negotiate drug prices inhibit future development?

All indication I find is that Larry Weisenthal comment (linked above) has some merit:

Now, what about pharmaceutical R&D if drug prices go down? This is the big scare tactic bogeyman. That’s all it is. Pharma spends a tiny fraction of its budget on R&D, relative to marketing. It’s like those Apple commercials about Microsoft and VISTA. Big amount of money for advertising. Tiny amount for “fixing VISTA.”

The USA single handedly supports the global pharmaceutical industry (much of which is headquartered in Europe, by the way, e.g. Roche, Novartis, Astra-Zeneca, Bayer, etc.). With true competition, Americans will pay less and Europeans will pay more. And probably, we’ll see a little less advertising. But pharma has to do R&D, or it will die.

There is no doubt that the R&D and patent process is expensive. But of the profits, how big is that expense, and how much is genuinely borne by the pharma company, unsubsidized? Oddly enough, I found an interesting perspective in their defense from the blog, Patent Baristas, by patent attorney, Barista Stephen Albainy-Jenei.

Barista points out that US consumers pay 2-3 times the cost as those in other nations. And while specifically critiquing an April 2007 article in the New Standard, he says:

The article points out that Genentech reported total product sales for the first quarter of 2006 increased 39 percent, to $1.64 billion, while sales of their colon-cancer drug Avastin increased 96 percent, raking in $398 million. Currently, colorectal cancer patients pay about $46,640 for a ten-month treatment regimen of Avastin.

The article tries to make a connection that drug prices are maintained at high levels due to the political leverage of pharmaceutical companies in Washington. Admittedly, a 2005 study found that the pharmaceutical and health-product industries spent $87 million on campaign contributions to federal candidates between 1998 and 2005. Probably not just as a goodwill gesture.

It seems, though, that it is more than just a lack of political will in Congress to stand up to the drug companies and enforce rules that require the drugs to be priced fairly. Clearly, it’s difficult for the government to argue fair prices after a drug is proven to be beneficial and establishes its value on the market. You end up asking how much is it worth to keep a person alive?

It is true that about half the biomedical research in the US is supported by government, or non profits, but the bulk of the research involved in actually carrying drugs through the clinical testing process needed to gain FDA approval is carried on by the pharmaceutical industry and financed through patent protection. As he points out, altho the costs of R&D may represent a small percentage of the pharma industry’s budget, the advertising and marketing of their products – plus their administration costs – is a huge chunk.

Which then brings us to not only Larry’s statement above that there will be “less advertising”, but to the basic argument looming in America about the legitimacy of “windfall profits”… a charge the DNC has not yet applied to the pharma industry, and reserved only for “big oil” thus far. Or put more simply, does the government have the right to dictate profits for the private sector?

Barista offers a logical, and free market solution.

How can the pharmaceutical industry respond to the building wave of support for government intervention? Drug companies need to decide to make some changes by trimming their prices, or at least make them more equitable, and put more of their money into R&D. That would go a long way in smoothing over the unrest among consumers.

As a free market consequence, as drugs come off patent protection, the competition hits and costs are eased.

As the “con” to Barista above, we have a conversation on the MotherJones blog news site with excerpts of an interview with Dr. Marcia Angell, author of the book, The Truth About Drug Companies: How They Deceive Us and What to Do About It.

Dr. Angell says much the same as Barista… that the majority of expenditures is not the R&D, but the marketing and advertising. The difference between the two opinions is Barista asks the quintessential question always applied to “big oil”…. should the government dictate profits? Ms. Angell approaches it from the progressive/socialist angle… yes, those profits should be dictated.

~~~

What to do about pharmaceutical prices? It turns out it will be the same as the oil industry… government intervention to attempt to control prices for honest intents… and possibly disasterous outcomes.

BTW… I doubt you’ll want to go the “follow the money” route… Tho most surface analysis showed heavier support for the GOP overall, the devil is actually in the details. i.e. in the House, the bigger financial support went to Dems, and GOP in the Senate. And with the change of power in mid terms came the flip flop on where most of the money goes now….

And truthfully, after pouring thru OpenSecrets records of pharma PACs and lobbying, it is less party oriented, and more targeted to specific Congressional members. That should be sufficient warning to the partisans and Obama faithful… you may not want to see the numbers.

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Yes, this is something that we all agree on. This issue is exactly why I thought Hillary’s health care plan was better than Obama’s (a solution I’m sure we don’t all agree on, but progress is progress…)

Of course, I’ve only had time to quickly skim over your post, and hope to read it more thoroughly in the near future. I’m just glad we’re all pretty much on the same page with this major issue. If he’s as smart as those of us who supported him thinks he is, perhaps this is where he could start.

Wow, Mata. You sure did a very profound rechearch on that subject. Bravo!

I will repost my comment done on another thread before:

This VIDEO should interest you. It is on the abusive regulation of drugs. This is why the drugs in USA are so expensive. The title is in French, but the video is in English. Maybe Mata you could embed it.

RÉGLEMENTATION PERVERSE

Courtesy embed by mata


Réglementation perverse
Uploaded by TheEconomist

Réglementation perverseUploaded by TheEconomist

And I also found this:

HERE IS A PICTURE OF THE PHARMACEUTICAL INDUSTRY IN USA IN 2008:

– Time to develop a new drug: 10-15 years.
– Average cost to develop a new drug: 1,318 billion of dollars.
– Investment in R&D: 58, 8 billions of dollars.
– Numbers of drugs approved in 2007: 23.
– Average wear of a “patent” to protect a drug: 11 years.
– Percentage of commercial drugs revenues that equals or exceeds the cost of R&D: 20%.
– Percentage of generic drugs: 67%.

For each commercialized drug, the pharmaceutical industry has to do research on 5,000 to10, 000 compounds. But only 0, 01% to 0, 02% of those compound are commercialize.

AS YOU CAN SEE, whenever government puts his nose in the market, the prices go sky rocketing.

The Conservatives I know believe that government should be kept out of the health care system, and I believe they are justified in this point of view.

However, as someone struggling to make it in the entertainment industry (with a union which requires its members to find work about half the year to get on it health plan, while reporting a 90% unemployment rate), and makes a large portion of my earnings freelancing in the service industry, I find it troubling that if I get in trouble with the law, the government will provide me with a lawyer; yet if I get sick, I’m on my own for a doctor and medication, to be gauged. I work just as hard as any successful business person (for in a sense, I am running my own business), I pay my taxes, and never ask for a handout – and I know I’m not alone. So, while I understand the problem with “socializing” health care, I’m concerned as to what the solutions are for people like me. I’m glad you brought this up, and look forward to reading your post more thoroughly, when I get back from passing pretentious hour derves!

It would be cheaper to do it this way. Pharm companies will no longer do advertising and R&D. Their job would to make and deliver the drug.

The real medicine would be done through government R&D programs done through universities. This way the drugs would be better checked as the money and time would be there. Then when a drug is made, the bidder offering the lowest sales price on the goods get the bid. A tax is put on all the pills to help cover the cost of the R&D.

The customers would like the deal because drugs will probably be safer.

The pharms would like it because a large amount of expenses would be cut and they wouldn’t have to fight off genetics or patients, because the drug they would be selling would cost as much as the generic and if somebody did try and sell a generic, they would get hit with the R&D tax at least in the U.S.

Cary,

DOESN’T CANADA SPEND LESS THAN THE U.S. WHILE GETTING BETTER ACCESS TO HEALTH CARE?

Officially, Canada spends less on health care than the U.S. However, costs are controlled by arbitrarily limiting the number and availability of doctors, specialists, operating room hours, high-tech equipment, diagnostic tests, drugs and expensive treatments. In short, the government limits the supply of health care in order to hold costs down. The result: shortages, rationing, and long wait lists.

YES, BUT CANADIANS, ON AVERAGE, LIVE SLIGHTLY LONGER THAN AMERICANS. ISN’T THIS PROOF THAT THEIR HEALTH CARE SYSTEM IS BETTER?

No, it’s not. A nation’s average life expectancy is the result of a multitude of factors including the lifestyles, genetic makeup, environment and education of it’s citizens – and the U.S. is composed of large ethnic groups having differing life expectancies. For example, the average life expectancy of a black male in the U.S. is 68 years, while a man of asian descent has an average life expectancy of 81 years! The quality of a health care system has very little to do with the average life expectancy of an entire population – however, it has a lot to do with the the health outcomes of those who are already sick – and on that score, the U.S. does better than Canada. 25% of those diagnosed with breast cancer in the U.S. die from it – while the mortality ratio in Canada is 28%. Similarly, the U.S. prostate cancer mortality ratio is 19% while 25% of those diagnosed with prostate cancer in Canada die from it.

A CANADIAN FRIEND OF MINE BOASTS ABOUT THEIR HEALTH SYSTEM. HOW DOES THIS SQUARE WITH WHAT YOU ARE SAYING?

Many Canadians who have never been really sick are supportive of their system. In fact, the system caters to the healthy majority with free primary care doctor appointments, flu shots, etc. while depriving the truly sick – often the elderly – of timely medical treatment that is often more expensive. Political expediency dictates that health care dollars are spent where the votes are: the healthy majority – while across Canada, hundreds of thousands of sick and disabled people quietly languish in pain in their homes on long waiting lists for treatment while being told that to question the moral supremacy of their health care system is somehow “Un-Canadian”.

ARE YOU SAYING THAT ALL CANADIANS WAIT AND DON’T GET GOOD MEDICAL CARE?

No. Certainly there are pockets of excellence in the Canadian health care system – and not everyone waits. If a person is in the process of having a heart attack, they get immediate treatment. However, any treatment deemed ‘elective’ – meaning that possible death is not imminent – often entails a wait. Cancer biopsies, MRI scans, heart bypasses, cataract operations, and hip replacements all involve lengthy waits for many Canadians.

You guys have the best Health care system in the world and you don’t know it. Please read my comment # 7 and PLEASE watch that great video explaining the difference between the Canadian and American system:

DEAD MEAT

Courtesy embed by Mata

Well – I have to speak up. I am a Canadian, in my 70s. Our system isn’t perfect, but really very good. There are waits for elective surgery, but none for serious illnesses. Case in point: doctors thought I had a serious form of cancer and I was in for a high-tech biopsy operation within days. Luckily, the tests were negative. Another – I have relatives in the US. I was told to get a colonoscopy as was my US relative, who has very good insurance. I have to wait for mine, because there are no medical reasons to have it except for my age – when I get it, it will, of course, be completely free. My relative had hers soon after it was requested by the doctor, and at last count had received over $6000.00 in bills and they were still coming – this not being covered by the insurance. Many (most?) people in the US could not afford this and would not get it at all.
The writer above talked about older people not getting care. This is not my experience. My parents both had severe illnesses in their later years and had excellent care and services. I know of no one who has had long waits or problems. And free……
No one in Canada thinks twice before going to the doctor. No co-pays or paper work – just give your card anywhere in Canada for good service.

Boy, Marge I don’t know in which province you live, but this is not my experience. I’ve lost 3 friends of cancer because they couldn’t get operations in time. I live in Quebec and the Health care is really shitty. And remember all the cancer patients we were sending to the States to get their treatments 2 or 3 years ago?

Social medecine is only good for healthy people. Sick people dies from it. Social medecine is not working, never did, never will. Hopefully Quebec went to the Supreme Court in Canada contesting our Health system and the judge ruled our system as unconstitutional. Now in Quebec, you are getting some private clinics and it help a great deal. We are trying in Canada to go back to the private system and the States are trying to go for socialist medecine… how ironic!?

You want more videos to prove my points, I will give you more:

Here is one…
CANADIANS TO AMERICANS: DON’T MAKE YOUR HEALTHCARE LIKE OURS

I have more in reserve if you are not convinced.

This is an audio that explain the Quebec new regulations that we have got from the Supreme Court who said our Health System was unconstitutional. The case is called the: Dr. Jacques Chaoulli versus Quebec. Please listen to it.

CANADIAN HEALTHCARE EXPOSED – PART 2 ( AUDIO)

And here is an article explaining it:

INTRODUCE MORE PRIVATE MEDICINE, SAYS DOCTOR WHO CHALLENGED QUEBEC BAN

The doctor who took the Quebec government to the Supreme Court of Canada, causing it to change its policy on wait times and private health insurance, wants to see more privatization.
In his Supreme Court case, Dr. Jacques Chaoulli argued “patients will continue to suffer and die” because of waiting lists.

Read the rest:
http://www.cbc.ca/canada/story/2006/03/21/private-healthcare060321.html

Craig,

Thanks for sharing your perspective and experience. I’m only online a very short time, but I can see there are lots of good points which you, Mata, and others have brought up. Now, quickly, I have a couple, which I hope you guys will address…

I’m sure we Americans have a great heath care system, possibly the best indeed, but that’s for those who have access. How do we provide access for everyone? As far as cost, let’s consider what it costs taxpayers to have our poor flooding hospital emergency rooms for basic care and then not being able to pay.

And while the Canadian system may favor the healthy, it seems to me that preventative care should go a long way into increasing the numbers of healthy citizens, while certainly not all inclusive either.

Personally, I’d like to see our access to doctors become something akin to that of lawyers. In that if you can afford a good plan with top doctors, you go ahead and get one. If you cannot afford such a plan, you are then entitled to SOMETHING. It may not be as good or as fast or as efficient, but it’s better than sitting to rot when something goes awry.

I have no idea how we’d go about such a thing logistically, but I do believe that health care should be a basic right. Stronger, healthier Americans make a stronger, healthier America. (I know that sounds cheesy, but I believe it.)

“I’m sure we Americans have a great heath care system, possibly the best indeed, but that’s for those who have access.” (Cary)

Indeed you have the best system of all.

McCain wanted to give a $5,000 tax cut so everyone could get a healthcare plan insurances. And he wanted people to be able to shop for their plan in any States to get a better deal.

This is how you could have done it. And I believe that you also have a semi-social Health Plan system in your country. Otherwise, you would see thousands of people dying in the streets… and you don’t. It would be in every front pages of Newspapers.

Craig, I live in BC. I can only tell you what my experience has been. I have always had great service, and have never paid a cent…. other than the taxes, of course!

A couple of days ago I read a page on Obama’s new post-election website about health care. His new plans were to give tax credits ‘up to’ $2500.00 – little more. This was the URL:

http://www.change.gov/agenda/healthcare

Obama wasn’t even going to negotiate lower drug costs with the companies, as Canada does, but it said that he would make it legal to order drugs from Canada – words to that effect. It was a total wash of any health care changes.

I went back today and the page has been wiped. I wish I had copied the page……

Good luck with Obama helping the uninsured in the US.

Oh, and Craig -we do have lots of private clinics. If I need an x-ray or blood test, I go to a private clinic. Private clinics provide lots of services that are covered under the health care plan. As far as health care being unconstitutional – don’t be silly. Health services should be a right for everyone.

Only a few rich right wing Canadians would trade what we have for the US model.

There is never worry. Canadians never worry about getting bills for necessary care. Nobody goes bankrupt for medical bills. Everyone I know feels happy and secure about our system. And if a few people complain about waiting for elective surgery – that is unfortunate, but doesn’t change the fact that our system works very well.

“As far as health care being unconstitutional – don’t be silly.” (Marge)

Go tells this to the Supreme Court. They are the ones who said it:

TOP COURT STRIKES DOWN QUEBEC PRIVATE HEALTH-CARE BAN
Last Updated: Thursday, June 9, 2005 | 9:33 PM ET

CBC News
The Supreme Court of Canada ruled Thursday that the Quebec government cannot prevent people from paying for private insurance for health-care procedures covered under medicare.
In a 4-3 decision, the panel of seven justices said banning private insurance for a list of services ranging from MRI tests to cataract surgery was UNCONSTITUTIONAL under the Quebec Charter of Rights, given that the public system has failed to guarantee patients access to those services in a timely way.

Read the rest:
http://www.cbc.ca/canada/story/2005/06/09/newscoc-health050609.html

Cary,

Believe me, never go on social medecine. It is the worst thing that a country can do. I have seen so many people suffer in vain for many years and finally die because of waiting lists. I wouldn’t take Marge’s opinion too seriously, she seems to be an Obama fan. There are many Canadians that got fooled by THE ONE… lol

Here is a suggestion for your Health care system, that you might like to watch:

HOW TO FIX AMERICA’S HEALTH INSURANCE CRISIS: GET SOME

Mata;
Great submission, thanks.

Craig:
Thanks for the videos. Though the first might be a little dated; I’ve been on Beta-blockers since my heart attack in 2002. Then again, I’m was in the military at the time and we do get some medications sooner than the general public. I’m guessing here, but perhaps our military is part of the FDC testing process. Fortunately, as retired military and on our system called Tricare, I don’t have to worry so much on my own future drug costs as I only get charged $3 per prescription refill. Although, military and VA hospital physicians typically try to avoid prescribing expensive drugs to us and go generic whenever possible.

IMO there are several factors we need to attend to in order to reduce our drug and medical costs:

– Tort reform; To reign in class action lawsuits (where only the lawyers ever see any “real” money anyway) & reduce sue-happy frivolous lawsuits that drive up drug costs and malpractice insurance costs.
– Caps on jury punitive damage awards.
– Price caps on new patented drugs
– Streamlining of the FDA process from 10-15 years to 5-7.
– Ban televised and radio drug commercials, particularly with various “designer drugs” and snake oil infomercials. Patients shouldn’t be self-diagnosing themselves and talking their doctors into prescribing certain brand name designer drugs based solely on a commercial they saw or tricked into spending their money on fly-by night fake remedies that are little more than placebo in a jar.
– Reduce drug patent expiration dates to enable competitive generic versions onto the market.
– Lower the annual Medicare prescription deductibles for seniors. $3600 a year is 4 months Social Security to many seniors I know.
– Legislation that requires Emergency Rooms to advise patients to seek outside clinics if they do not present with actual emergency medical conditions/symptoms. Illegal aliens in particular abuse our ER system to get free health-care. If they are illegally in this country, they should not be given a free pass to abuse our service industries. For every 1 medical supply item used on a paying patient, that consumer is charged for 20 more that go out free to people who do not pay.
– Allow consumers to procure their prescriptions from out of country sources. This gets rid of the 2/3 times cost our consumers have to pay for the same drug.
– Force HMO’s to allow consumers to compare provider prices and services to use whichever treatment facility they feel is more beneficial to them. I never liked the HMO system to begin with. HMOs was a big business step towards socialized medicine, only the HMO got to choose who to award their contracts to. They also used this against the patients by making deals with the heath-care providers not to offer certain procedures the patient may need, yet would require more money from them. Another big problem with the HMO system is, if the consumer got sick outside of their coverage area, they were out-of-pocket.

If you thought health-care was a pain in the butt under HMOs, where you can only be treated by certain parties under the program, socialized medicine is much worst. It is more expensive to the government than what the consumer or insurance companies would pay for the same results. That’s because it removes capitalist competition. And due to higher set treatment costs and government contracts for services, competitive businesses are forced to close their doors. We will have the medical equivalent of $500 toilet seats and $400 hammers as corrupt politicians award the contracts to whoever can give them the bigger kickbacks. The cost increases to the government is why it takes so long to get treated in socialized medicine. The polit-bureaucracies wastes even more money and time in red tape looking through stacks of case files to decide who will get treatment and who will not (Why do you think they call bureaucracy “Red tape” to begin with?).

The Canadian system is crap. It one of the reason I left the country when I could. There are deniers, and always have been. They are either ignorant and defaulting to nationalistic pride to claim its great, they are aware but their nationalistic pride prevents them from conceding something is wrong (especially to Americans), or they are socialists defending a socialistic practice.

One of the reasons drugs cost so much in the US is because drugs are so cheap in the rest of the world. Canada will actually deny their citizens an effective drug if drug makers don’t sell it nominally above cost. Other countries will allow local generic makers to actually steal the formula if they don’t comply. That leave the US to be the only market in which to recoup R&D costs as well as to get new drugs and drug information to the public.

And although in the above we got a lot put under the label of ‘advertising’ of which there is too much, part of that is genuine education. You can have an improved cancer treatment, but you have to let people know about it.

The idea of relying on Universities to do research is utterly absurd. They play an important role, but the lion share of new treatments come from the private sector. They are the well spring of innovation in the World and always have been.

Are the Republican morons in congress about to “Me Too” on socialized medicine or something?

The best point in this thread is how we’ve ignored addressing the lawsuits. That is what drive a lot of unnecessary testings and flat out costs. Last I heard doctors pay over 50% of their income in malpractice insurance. The irony of embracing the Canadian system is that Trial Lawyers are dreaming about accessing the Tax Payer’s pockets for their lawsuits now. Ummm…. No. Successful malpractice lawsuits in socialized medicine countries are very few and have very low payouts. Those systems simply can’t afford it. They can’t afford to admit doctors screw up either.

-Rocky B

Tort reform; To reign in class action lawsuits (where only the lawyers ever see any “real” money anyway) & reduce sue-happy frivolous lawsuits that drive up drug costs and malpractice insurance costs.
– Caps on jury punitive damage awards.
Good luck with both of those. Trial lawyers are the dems biggest donors and cronies. They are not going to cross them.

– Price caps on new patented drugs

Government interference which is what has got us in the trouble we are in now. Pharmaceuticals spend billions on research and developement. After 10-15 years in FDA they have only 10 years to recoup their costs. That is the reason drugs costs so much in the USA. They sell drugs in bulk to other countries not other foreign companies. Most of these drugs are out of date. They are still as potent as new but government regulations say they can’t be sold in the US. If we put a cap on price pharmaceuticals will find it not worth their while to invent new drugs. After all, pharmaceuticals are in the business for profit. No profit no new drugss.

– Streamlining of the FDA process from 10-15 years to 5-7.

Good luck with that also. Government bureaucracy moves slowly.

– Ban televised and radio drug commercials, particularly with various “designer drugs” and snake oil infomercials. Patients shouldn’t be self-diagnosing themselves and talking their doctors into prescribing certain brand name designer drugs based solely on a commercial they saw or tricked into spending their money on fly-by night fake remedies that are little more than placebo in a jar.

Inhibit competition. But it would certainly lower costs. This goes back to the ten year limit. Pharmaceuticals are trying to sell all the drugs they can before the patent runs out.

– Reduce drug patent expiration dates to enable competitive generic versions onto the market.

On the contrrary. It is short enough already. Again why would phamaceuticals be in the business under these circumstances?

– Lower the annual Medicare prescription deductibles for seniors. $3600 a year is 4 months Social Security to many seniors I know.

I don’t pay deductibles for my part D plan. The $3600 is what the insurance companies agreed to if you are talking about the gap. The government pays the premiums under Part D. So how could that help. I will say that before most of my drugs went generic I was paying about $600.00 per month for my drugs. That took a whack out of my SS.

– Legislation that requires Emergency Rooms to advise patients to seek outside clinics if they do not present with actual emergency medical conditions/symptoms.

That I agree with.

Illegal aliens in particular abuse our ER system to get free health-care. If they are illegally in this country, they should not be given a free pass to abuse our service industries. For every 1 medical supply item used on a paying patient, that consumer is charged for 20 more that go out free to people who do not pay.

I also agree with that except for life threatening occasions. Let them go back to their own countries to get treatment.

– Allow consumers to procure their prescriptions from out of country sources. This gets rid of the 2/3 times cost our consumers have to pay for the same drug.

If they want to take a chance with out of date drugs.

– Force HMO’s to allow consumers to compare provider prices and services to use whichever treatment facility they feel is more beneficial to them. I never liked the HMO system to begin with. HMOs was a big business step towards socialized medicine, only the HMO got to choose who to award their contracts to. They also used this against the patients by making deals with the heath-care providers not to offer certain procedures the patient may need, yet would require more money from them. Another big problem with the HMO system is, if the consumer got sick outside of their coverage area, they were out-of-pocket.

The biggest problem with that is doctors won’t accept some HMOs. Are you saying force the doctors to do so. And if the HMOs are forced to do that their premiums will go up. That is the name of the game.

If you thought health-care was a pain in the butt under HMOs, where you can only be treated by certain parties under the program, socialized medicine is much worst. It is more expensive to the government than what the consumer or insurance companies would pay for the same results. That’s because it removes capitalist competition. And due to higher set treatment costs and government contracts for services, competitive businesses are forced to close their doors. We will have the medical equivalent of $500 toilet seats and $400 hammers as corrupt politicians award the contracts to whoever can give them the bigger kickbacks. The cost increases to the government is why it takes so long to get treated in socialized medicine. The polit-bureaucracies wastes even more money and time in red tape looking through stacks of case files to decide who will get treatment and who will not (Why do you think they call bureaucracy “Red tape” to begin with?).

I agree whole heartedly. Not to mention putting multiple insurance companies out of business along with their stockholders. Or were they considering making the government pay the premiums for everybody and allowing the insurance companies to stay in business? Dems just don’t get the repercussions of their actions. Their whole mantra is if it feels good or sounds good do it. If the government is so gung ho to insure the uninsured then pay the premiums of people who cannot get it. BTW, whatever happened to SCHIP? I thought they insured anyone making less than $42,000.00. Or is that only for dems and minorities. The dems sure kept that program quiet until the wanted to increase the wage limit to $84,000.00.

The dems are talking now about taking away our 401Ks to pay for this schlick as if they are entitled to these funds. Here we all are, hoping that our retirement accounts will start building up again and the dems try to pull this.

THE PROBLEMS WITH SOCIAL MEDECINE ARE NUMEROUS.

Here are a few of them:

1- THE COST OF GOVERNMENT IS SO HIGH that they cut in areas they shouldn’t cut. Like on HYGIENE for instance. They cut on the cleaning staff. You leave the hospital sicker than when you came in, catching all sort of rare bacterias.

“Quebec’s epidemic of C. difficile (Clostridium difficile)shows all hospitals need to be vigilant about hygiene to prevent the dangerous strain from spreading across Canada, public health experts said Thursday. There is already a number of big outbreaks in Canada.”
http://www.cbc.ca/health/story/2004/10/21/c_difficile041021.html

2- THE COST OF GOVERNMENT IS SO HIGH that they do not pay their medical staff proper salaries. So the nurses and doctors leave the country to go to work in countries where the get a better salary and that creates a shortage of medical staff.

“One in nine trained-in-Canada doctors is practising medicine in the United States, says a study published in Tuesday’s issue of the Canadian Medical Association Journal. The study suggests that luring back some of these Canadian physicians would go a long way toward solving the country’s doctor shortage. There were 8,162 Canadian-educated doctors providing direct patient care in the U.S. in 2006, the study said.”
http://www.cbc.ca/news/yourview/2007/04/canada_a_training_ground_for_u.html

3- THE COST OF GOVERNMENT IS SO HIGH that they have quotas for doctors in Canada. Surgeons are given a very limited number of surgical “block times” in which to do their work. Younger surgeons get less time, and senior surgeons get the prime slots, just as in Britain. Each surgeon has a waiting list or “queue.” When a surgeon does an emergency case, the patients on his waiting list are pushed back by one slot for each emergency he does.

“According to no less a source than the World Health Organization, Canadians, for the price they pay, now have the WORST HEALTH CARE SYSTEM IN THE WORLD. WHO ranks Canada’s health system as the third-most expensive system in the world, and rates it 30th in efficiency and 18th in access to care.”
http://theglitteringeye.com/?cat=89

Here is the best VIDEO of all:

JOHN STOSSEL- SICKLY IN AMERICA
http://www.youtube.com/watch?v=refrYKq9tZQ&NR=1

Craig, it sounds like you’re stuck in this USA vs. Canadian health care system trap that a lot of Canadians get their thought process into. Try watching something like Michael Moore’s Sicko, for an almost entertaining example that the world is a bigger place than two countries with two systems. The fact is Canada and the US both have to improve our health care systems significantly to better serve everyone.

@jpm100:
“That leave the US to be the only market in which to recoup R&D costs as well as to get new drugs and drug information to the public.”

AKA drug propaganda. The amount drug companies spend on marketing is absurd, and should be criminal especially when they are caught marketing a drug that causes harm. Celebrex… mmmm yummy. You only have to turn on cable TV to see how messed up the American health care system is, with countless drug ads with tiresome symptom and side effect lists droning on, and on, and on. If the drugs are so great, and everyone needs them, why do they spend so much on advertising if doctors will prescribe them when required?

Quite simply, drug companies would rather market a symptom suppressing drug, than do the research to cure the ailment for good. Where’s their money going to come from if a few doses fix a problem that don”t come back? That’s why we need independent researches, paid by private and public grants, to solve problems the market will not try to.

“Try watching something like Michael Moore’s Sicko” (Saskboy)

You gotta be kidding, right? Michael Moore’s crap? That guy is a pure idiot!

The socialize Canadian system stinks. The American system is the best in the world.

What else could possibly happen under the leadership of the left-wing illuminati? It’s sad that drugs are being legalized, what else is next?

@Craig:
” That guy is a pure idiot!

The socialize Canadian system stinks. The American system is the best in the world.”

I think your comment there reveals who looks at the world with idiot eyes. What exactly makes the American system better than Canada? That it serves millions fewer poor people each year, leaving (per capita too) fewer people with quality medical treatment?

Mata,

After reading the article that you have linked in your last comment, it reminded me of a video I had once seen before. I looked for it and I found it.

Do you want to watch a very funny discussion between a Congress leftist democrat and a conservative President on Education, Health and Environment?

PRIME MINISTER – THE NATIONAL EDUCATION SERVICE
http://www.youtube.com/watch?v=LLDb2V86Ei0&eurl=http://www.antagoniste.net/?m=200808&paged=2

Huge thanks to Mata for some incredible scholarship; thanks also to Craig for a number of salient observations, statistics, and video links.

I’d like to offer my perspective as both a provider and consumer of medical services, as well as one who has medical colleagues/good friends in Sweden and who has visited Swedish hospitals.

Where to begin?

The problem with turning medicine into a capitalistic market commodity is that, at the basic level of life versus death, the laws of supply and demand are no longer in operation. The demand increases exponentially. The number one cause of bankruptcy is health care expenses. People will bankrupt themselves and their families in search of health; they don’t generally do this in search of consumer electronics or entertainment or transportation.

It is true that Americans have greater access to health care than Canadians. But this isn’t an unqualified blessing. More health care isn’t always better. Boston has as many neurosurgeons as in all of England. With more neurosurgeons, there is more neurosurgery. Supply creates demand. There are literally scores of equally efficacious drug regimens for the treatment of breast, lung, colon, and ovarian cancers. Studies show that the choice of drug regimen is strongly correlated with the profit to the oncologist. Survivals for diseases like prostate cancer between countries is misleading. There is much more screening for prostate cancer in the USA. More urologists who wish to do prostatectomies in the USA, in a disease in which the effectiveness of prostatectomy is still questionable. So earlier diagnosis means longer survival from time of diagnosis, but it’s not clear that overall survivals are better, to say nothing of quality of life.

It’s been estimated that iatrogenic deaths (those caused by medical errors and mismanagement) in the USA total between 75,000 and 150,000. These medical errors are estimated to shorten life expectancy by between 6 to 12 months. In comparison, a total cure for all cancer would only increase life expectancy by 24 months.

http://ije.oxfordjournals.org/cgi/content/full/30/6/1260

Supply creates demand. Here’s another example: In the 1970s, the number one money making operation for general surgeons was the vagotomy (cutting of the vagus nerve, to reduce acid secretion) and antrectomy (partial stomach resection), for the treatment of ulcer disease. By the late 1970s, the first billion dollar drug emerged (Tagamet, for the reduction of stomach acidity in ulcer disease). Gastroenterologists made a fortune in performing gastroscopies to follow the course of ulcer treatment.

In the 1980s, an Australian pathologist proved that ulcers were not caused by too much acid but were instead caused by a bacterium (H pylori). The treatment switched from antacids and Tagamet and surgery to a two week course of antibiotics, which permanently cured most cases. The problem was, however, the pharmaceutical industry had developed a new class of anti-acid drugs (so-called “proton pump inhibitors, e.g. Prilosec/omeprazole) to treat ulcer disease. But now the disease (ulcer disease) had gone away. What to do? Hype a previously obscure disorder (gastroesophageal reflux disease or GERD) and promote the new “proton pump inhibitors” for treatment of this disease. Funny (actually, not so) thing has happened. We are now facing an epidemic of gastroesophageal cancer. Is this because of overuse of drugs like Prilosec? We don’t know. Stay tuned. But it does illustrate the point that more treatment is not always better, for drugs or for surgery.

American health care is much more expensive than health care anywhere else and there is no evidence at all that overall health care outcomes are better in the USA than in Europe, Canada, Japan, South Korea, etc. Health care causes numerous bankruptcies in the USA, but not elsewhere. So health care reform is a legitimate issue.

I actually favor a hybrid of the health care plans of Bush, McCain, and Obama. I personally pay $12,000 per year out of pocket for health insurance which has a $20,000 annual deductible, but which pays for 100% of everything beyond $20,000. I don’t need health insurance to pay for a few thousand dollars per year in medical expenses, anymore than I need auto repair insurance to pay for the odd catastrophic transmission failure. Were I to get a catastrophic illness or injury, that $20,000 deductible would be a major hit, but I won’t go bankrupt. I’d love to get a little government help paying my insurance premiums. I’d bank the savings (ideally in a tax deductible health savings account) as a reserve fund to pay that first $20,000 when I finally have my catastrophic medical problem.

What I like about the Obama plan (and Massachussetts plan) is the compulsory nature of health insurance. We have so many uninsured because people too often make irresponsible choices in the way they spend money. Entertainment (cable TV, etc.) and nice automobiles are too often prioritized over health insurance. People without health insurance are like people without car insurance. They make health care more expensive for everyone. So the idea of no health insurance/no work makes as much sense as no car insurance/no car license.

Closing now with pharmaceuticals.

I disagree with the notion that it is government regulation which is the cause of out of control drug prices. The problem is not too much consumer protection, but too little. I could give many examples, but won’t, unless asked to do so. Yes, drug development is expensive and drug development takes a very long time. But the pharmaceutical industry is wildly profitable. So profitable that it can afford to throw away billions of dollars on television advertising, with little data to show that this has any effect on driving sales. Multiples of money on marketing and sales, compared to R&D. Anyone remember reading about the need for a government bail out plan for the pharmaceutical industry? What industry is most “recession proof?” Answer, Big Pharma.

Again, the problem with creating a true market economy for drugs is that there is an unlimited demand for products which improve health and which save lives, as compared to any other consumer commodity.

I think a terrific reform would be allowing Medicare to negotiate drug prices, as in the case of the Canadian government being able to negotiate drug prices. Also, allow for the free importation of pharmaceuticals from Canada, Europe, Asia. As I wrote before, the net effect would be a reduction in the price to Americans and an increase in the price to the rest of the world (which is a good thing, because right now we Americans are pretty much single handedly bearing the cost of global drug development. And, again, much of the international pharmaceutical industry is based overseas, e.g. Roche, Astra-Zeneca, Novartis, Bayer, etc.).

One last thing about health care systems. The Canadian system sucks, because it is a monopoly, which allows no competition. It would be like outlawing private schools and colleges in the USA. In contrast, in countries like Sweden and Norway and Australia, there are parallel public and private systems. Everyone can access the public system. For those wanting private health care, they can purchase insurance and obtain private health care from a co-existing private system.

– Larry Weisenthal/Huntington Beach, CA

“What I like about the Obama plan (and Massachussetts plan) is the compulsory nature of health insurance.” (Larry)

I don’t get it here. Obama wants a socialize Universal Health plan medicine… and of course it will be compulsory. What you like is exactly what I hate, the compulsory factor who gives you no other choices than to wait in line for medical attention. You are being taken care of. You have no more freedom and responsibilities for yourself.

“We have so many uninsured because people too often make irresponsible choices in the way they spend money. Entertainment (cable TV, etc.) and nice automobiles are too often prioritized over health insurance.” (Larry)

Here I agree 100% with you. Those idiots are brainless and ruin the medicals finances of your country. Americans sure can afford private Health insurance, they just have to cut a few beers, a few joints, a cellular phone and they will all be able to get insurances. Let them be responsible for a change. Irresponsibility is no virtue and doesn’t make a strong country. (see the video link in my comments #20)

“The Canadian system sucks, because it is a monopoly, which allows no competition.” (Larry)

Right on the dot! And it sucks also because everybody becomes irresponsible for their health. Why take care of it, government will pay for you if you are sick. So be happy, don’t worry, eat like pigs, drink like idiots, and get stone… no problems.

(In Sweden) “Everyone can access the public system. For those wanting private health care, they can purchase insurance and obtain private health care from a co-existing private system.” (Larry)

You have this system reversed in the States and I think it is a much better system. Almost every Americans can get private health care insurances, and for the ones who REALLY cannot afford it, the government takes care of them. You almost have the perfect system in the States, why ruin it? Make it compulsory for the idiots who can afford to get Health insurances. Go by their revenues… make it compulsory and make sure that they don’t get the free treatments reserved to the ones that cannot REALLY afford it. Then you will have the best system in the world. (Again watch the videos in my comments #20 and why not also in #9 and #25)

“I think a terrific reform would be allowing Medicare to negotiate drug prices, as in the case of the Canadian government being able to negotiate drug prices. Also, allow for the free importation of pharmaceuticals from Canada, Europe, Asia. ” (Larry)

I agree again 100%. Protectionism is an alienation for a country.

P.S.: I think that a Providence Government is the worst things that can happen to humans. It deprives them of their pride, their dignity and their responsabilities. A socialist country that takes care of the health of its people is only alienating people’s mind. Stand strong, be responsible and you will have a Great Country. Why do you think America is so great? This is why America is NUMBER ONE. But Obama will take all this away with his stupid obsession of socialism. By the way, watch my video link in comment #33… a funny but realistic conversation between a liberal Congressman and conservative Prime Minister on issues of Health, education and environment. It is really good.

I haven’t seen anything in Obama’s health plan proposals which would destroy the existing private health care system. His first priority is basically to extend Medicare to people under the age of 18. I think this is a good reform, for two reasons. Firstly, Medicare does a pretty good job of delivering cost effective health care. A lot of docs don’t like it, because Medicare doesn’t pay them what they’d like to be getting out of it. But very few opt out (full disclosure: I opted out). Physicians who want to participate in the Medicare system do so; those that don’t (e.g. me) don’t have to. Secondly, although one could make a case for allowing adults to be irresponsible, with regard to their own health, I do think that “society” (that socialist-sounding word) has a responsibility to protect its children. Parents should have the right to raise their children as they see fit, but they don’t have the right to commit child abuse and not having health insurance for children is child abuse, in my opinion.

So this is going to be the first health care priority: ensuring health care insurance, of some type, for children. The next priority will be an employer mandate. Somehow, between the employer and the employee, health insurance must be provided to everyone. That leaves, basically, the unemployed and the self-employed and employees of very small businesses. The self employed will get tax credits or expanded deductions; people who truly can’t afford it will get government purchased insurance.

All in all, it’s a much less “socialized” health care system than that existing in all the other western democracies.

This isn’t my ideal system, however. As I said, I do like elements of the Bush and McCain plans. I particulary like the concept of high deductible private insurance, with tax deductible health savings accounts. Making people personally responsible for the first 5,000 or 10,000 or (as in my case) 20,000 of health care costs actually does turn patients into consumers, with incentive to save on costs, not receive unnecessary MRIs, etc.

– Larry Weisenthal/Huntington Beach, CA

The pharmaceutical business is entirely globalized. I can’t think of a single industry more globalized. These companies are forever swallowing each other and merging with each other and doing all manner of deals with each other.

Here’s a list of the top 50 companies:

http://en.wikipedia.org/wiki/List_of_pharmaceutical_companies

Note that Genentech (#19) nominally based in the USA (South San Francisco) is, in fact, owned by Hoffman-LaRoche (“Roche”), based in Europe.

Additionally, countries nominally based in the USA may do their clinical trials abroad and companies based abroad may do their clinical trials in the USA.

So I don’t know how “protectionism” regarding pharmaceutical companies would ever work, from the standpoint of “protecting” US jobs. When one pharma buys another, typically there is consolidation of management, but they don’t typically pack up research labs, marketing departments, etc. and move them out of one country to another. And the vast network of sales reps (biggest part of the budget, remember, is sales and marketing) has to be maintained within the US health care system, no matter where corporate offices are located.

– Larry Weisenthal/Huntington Beach, CA

Larry,

I don’t know where you got your idea of Obama’s plan. But this is not his plan at all. His plan is STRICLY a socialize universal Health care system. And there is nothing, NOTHING good in it.

Like I said Americans have a real good Health care system, why ruin it? It would take just a few things to make it perfect:

1- Make it compulsory for all Americans that have revenue over an amount of XXX dollars to get a private health care insurance. By compulsory, I mean that if they don’t do it, they will not be able to get free treatments that will be reserved only for the ones who can not REALLY afford it.

2- Go with the McCain’s plan and let people have a tax cut of 5,000$ to be able to purchase an insurance plan.

3- Again, go with the McCain plan and make a new law that will enable people to shop for their insurance plan in every States of the USA to get a better price with that competition.

4- Every Americans that REALLY cannot afford insurance plan because their revenues are lower than XXX dollars; will automatically be treated free by the government.

That is much better than Socialist Universal care system. You are assured by this way of doing, that the free plan for the poor will never get crowed with waiting lists. The Sweden Plan, I don’t like. Sweden citizen have a tendency just like Canadians to brag about their system, but in reality, both stinks. In Canada, everybody is on waiting list. In Sweden, only the poor are on waiting lists. With the system that I propose for the U.S., nobody will be on waiting lists.

Larry, please watch this video. And Mata, it would be nice if you could embed it for me. Thanks.

SWEDISH MYTHS AND REALITIES
Johan Norberg discusses the “Scandinavian model”
http://www.reason.tv/video/show/508.html

~~~

[Mata Note: This one was battling the “embed” code, Craig. Tried a few times but their embed code results in nothing here. But gave it the ol’ rah rah effort. Sorry.]

REASON.TV’s

Nick Gillespie isn’t making a run for the White House, but he knows how to get coverage to at least half of the 45 million Americans who need it. And while Barack Obama and John McCain argue about who’s got the best health care plan, each ignores the simplest solution. Call it the Gillespie Plan: If you want health insurance, get some.

“Of people currently classified as uninsured, a conservative estimate says about 45 percent of them would be able to get health insurance right now if they wanted it,” says economist Glen Whitman. That estimate comes from a study headed by a Johns Hopkins University researcher, which separates those who could get insurance into one of two categories: Those who earn enough money to buy it, and those who qualify for existing government programs.

So how about some real straight talk for a change? If we separate those who can’t get coverage from those who can, we can focus more on helping the needy. “So if you can get coverage,” says Gillespie, “don’t wait for Washington. Go on out and get some.”

Previously linked in my comment #20:

HOW TO FIX AMERICA’S HEALTH INSURANCE CRISIS: GET SOME

So how about some real straight talk for a change? If we separate those who can’t get coverage from those who can, we can focus more on helping the needy. “So if you can get coverage,” says Gillespie, “don’t wait for Washington. Go on out and get some.”

Don’t want to miss out on a (perhaps rare) opportunity for agreement. Agree on the above point, entirely. The only thing that I’d add is that people who can afford insurance and don’t buy it aren’t guilty of a victimless “crime.” They add huge costs on those of us who are responsible. Hence the need for a mandate, in my opinion, similar to the mandate that car insurance must be obtained in order to license a car.

– Larry W/HB

The Obama plan isn’t a hyper-socialized plan. Here’s an executive summary (from Obama’s website: http://www.barackobama.com/issues/healthcare/ )

The Obama-Biden plan both builds on and improves our current insurance system, which most Americans continue to rely upon, and leaves Medicare intact for older and disabled Americans. Under the Obama-Biden plan, Americans will be able to maintain their current coverage, have access to new affordable options, and see the quality of their health care improve and their costs go down. The Obama-Biden plan provides new affordable health insurance options by: (1) guaranteeing eligibility for all health insurance plans; (2) creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance; (3) providing new tax credits to families who can’t afford health insurance and to small businesses with a new Small Business Health Tax Credit; (4) requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan; (5) requiring all children have health care coverage; (5) expanding eligibility for the Medicaid and SCHIP programs; and (6) allowing flexibility for state health reform plans.

The plan also allows importation of drugs from foreign countries and allows Medicare to negotiate for prescription drug prices. Obama has said they will first focus on getting all children insured.

– Larry Weisenthal/Huntington Beach, CA

Obama doesn’t know what the hell he is talking about. He flip-flopped on so many things. He said CLEARLY at the end of his campaign that he wanted a socialize Universal Health Care Program. What you just mentioned has nothing to do with a Socialize Universal Health Care Plan.
This guy is an idiot. He talks from both side of his fat ugly mouth, depending on who is listening to him. What you have just mentioned looks more like McCain’s plan. Gee I hate people like him… you never know what they think or what they will do. Ignorant flip-floppers. So he changed his mine one more time and he fooled all of the people by promising them that he wanted to create a Socialize Universal Health Care System. Boy, this guy is not going to stay Potus for long… delete by Mata What a lunatic!

I’m sorry Larry, but I do not understand how an intelligent guy like you voted for and ignorant idiot guy like him.

Larry;
First of all thank you for the link to Obama’s plan. To many of us that is the first time we’ve ever had any notion of what his proposal might be. It still bothers me, refused to reveal it or go into it on the campaign trail. I suspected it was because he had no real plan and considering how frequently, almost daily, he has edited other posts on that site, we just can’t trust what he presents until we actually see it in writing or in the form of a bill before Congress. You must admit, BHO has been less than transparent on almost all issues.

Long ago during the Clinton presidency I chanced to read the Clinton proposal for Universal Health-care and it was socialized medicine, plain and simple. Since Obama refused to divulge anything about his except, in name, and what seemed were empty campaign promises, there was nothing substantial for comparison. That’s what made us so nervous. I for one still cannot trust him until I actually see what is finally put on record. He has flip-flopped on us far too many times already. So I hope you can understand and appreciate our guarded skepticism. Were he a Republican or Independent, I’m sure you would feel the same.

As to the suggestion as to a form of limited free health-care (barring elective procedures) for those under a certain income level, I would have no problem with it, but it would require a screening process and I would want to see it offered only to U.S. citizens. I might bend to accept those on an approved working visa (and dependents who are here legally and residing with them here over one half of the year). After all they are active contributors to our society, just so long as they filed and pay their fair share of taxes here. Foreign exchange students may also be included since they are being hosted by a family here for that year. However, if you are a tourist or illegal, sorry but you have to pay full price. I would suggest setting it at something in the range of say $40-60,000 per year income with an additional, $15-25,000 for each additional dependent, with further adjustments for local costs of living expenses and increases as a start. Most making under that amount cannot afford to pay the cost for health insurance or are not offered it as part of their work package. This could also be used to transform our current medicare system so that the elderly do not risk loosing that which they would have willed to their children following their deaths to unscrupulous nursing home litigation under our current laws. For those making say $50-250,000 (With similar adjustments) then you could go with the higher steps for deductibles. Non-taxpayers such as the homeless would be required to show some form of ID such as state ID cards to be checked against the national databases to prove their identity and citizenship. Such security precautions would be required to screen for fake ID’s.

I would similarly include prescription drugs under that medical services umbrella so that no one could be denied the prescriptions or care they might desperately need for good health and survival. I would also tie in other medical procedures to include dental. So that incorporates pharma’s, services, and procedures. The greedy pharma’s, plastic surgeons, etceteras could still charge their outrageous prices to those who can afford it.

I would concede to expecting some minimal regulation to police substandard services and practices at a state level, much like Board of Health Departments. And perhaps a limited form of tort so that federal and state or even international government bodies might file suit individually or jointly against a company, charge them with anti-trust violations, and/or fine them (which may be appealed as high as the Supreme Court, the loser paying court costs) rather than the class action suits of the past. This would give the government an option to take legal action against malpractices such as we’ve seen with products from China.