Poll

8 votes (33.33%)
11 votes (45.83%)
1 vote (4.16%)
1 vote (4.16%)
1 vote (4.16%)
2 votes (8.33%)

24 members have voted

SanchoPanza
SanchoPanza
Joined: May 10, 2010
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January 15th, 2017 at 11:06:24 PM permalink
Quote: MathExtremist

Who do you think supports a 3x increase in premiums? That's just asinine, nobody is out there cheering for costs to go up.
Here's another showing that even after accounting for increased demand (that is, more people going to the doctor), the US could save $40B by switching to a national healthcare program:
http://decisiondata.org/news/how-much-single-payer-uhc-would-cost-usa/
Look at the cost share of healthcare in the US vs. everywhere else. Our public/government spending is mostly in line with other wealthy nations, but our private spending -- what comes out of your pocket -- is completely out of whack:

Is there really public opinion against saving money and having better access to healthcare? Why?

The lamentable aspect of this charade is that much of Affordable Care insurance was predicated on lower health care costs. Yet no one in power in Washington raised even a pinky to foster that. That is a major reason why premiums go up and the key umsubsidzed enrollment goes down.

The overwhelming majority of the 22 million Obamacare enrollees, according to Table 4 of this CBO report, are
*People who either receive large tax credits or now qualify for Medicare because of the expanded eligibility under Obamacare.
*Only two million of the total Obamacare exchange enrollees are paying the full product cost – not getting tax credits or Medicare.
*People with pre-existing conditions.
*People who lost their plans because of Obamacare and signed up for Obamacare. For these customers, Obamacare is a last resort. All other options had been removed. They had no choice but to buy an Obamacare replacement plan – often at higher costs and worse benefits.

One provision requires insurers to spend 80 percent of premiums on medical costs. It was supposed to help control insurance costs. The only way insurers can increase profits is by paying more for medical bills. A doubling of underlying medical bills permits a doubling of premiums and, therefore, a doubling of the 20% amount that can go toward insurer profits.

Obamacare does nothing to lower physician, hospital, lab and pharmacy costs while providing insurance with much higher deductibles and premiums than pre-Obamacare policies.

One way to help all the problems dragging down the Affordable Care Act in addition to those proposed in the 54 Republican efforts to repair it would be if all recipients of health care could search any medical procedure online and see pricing for all providers within X miles. Disclosing provider’s prices will create the free market forces and true price transparency necessary to force competition among providers.
RS
RS
Joined: Feb 11, 2014
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January 16th, 2017 at 6:20:11 AM permalink
Quote: SanchoPanza

One way to help all the problems dragging down the Affordable Care Act in addition to those proposed in the 54 Republican efforts to repair it would be if all recipients of health care could search any medical procedure online and see pricing for all providers within X miles. Disclosing provider’s prices will create the free market forces and true price transparency necessary to force competition among providers.



Indeed. Well, I'm not sure if this is what you meant, but I agree. It seems like with medical stuff, for the most part, people go to their doctor that they always use....without shopping around. Not that some people don't, but, it seems like many do not. Hell, many people will drive seemingly across town to save 10c/gallon on gas (coincidentally, probably spending more on gas getting there than they save on the 10c/gallon).



Pardon my ignorance -- but I heard (and did a quick google search to semi-confirm?) that it costs a few billion dollars to get a drug approved by the FDA. I'm not sure if this is actual research costs...or just the cost to get it approved (ie: whatever the company pays to FDA to get it approved). Are these immense costs actually necessary (or is it a "greed" thing where they can charge that much because no other way to get it on the market)?

Seems like a way to lower health insurance and health care costs overall would be to lower the cost of getting a drug on the market. If that's feasible or in the works, I do not know. Just found it a bit interesting.
billryan
billryan
Joined: Nov 2, 2009
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January 16th, 2017 at 9:22:07 AM permalink
If you are unaware of Thalimide, you might change your mind about the cost of drug testing after you Google it.
This one hits home for me, as a Dr in Japan recommended it to my mother if she experienced morning sickness while she was pregnant. He supposedly told her not to worry that it wasn't approved in the U.S... politics or money or something
Face
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Face
Joined: Dec 27, 2010
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January 16th, 2017 at 9:35:26 AM permalink
Before addressing ME, just wanted to give a big +1 to Paradigm. Having just gone through an attempt to take control of my health care, I remain completely staggered. There is no info, at least not easily obtained, that has idiot-level info to allow for any shopping whatsoever. I may find a snippet that says I have "$1,500" in benefits available per year, but nothing that I could find that stated how that $1,500 is divvied up between different procedures and processes. So even after a sincere attempt to be an educated consumer, I found that I didn't have a sort of "flat" $1,500 with which to use, but instead got ~$330 reimbursed for a $900 procedure, then $20 reimbursed for an $840 one, all depending on the specific procedure mentioned. So for that $1,740 in goods and services, I had a surprise bill of $1,300+ due immediately, instead of the sub-$300 one I expected.

Perhaps this is the way it's always been and y'all already have it figured out. But when I, who is neither lawyer nor doctor, has tooth pain, I don't really have the time or ability to obtain the info I need. I may be savvy enough to know I need a cap, but ain't no way in hell I'd know that if that's what I need, I need to look for coverage for an "onlay of the occlusal surface". And even if I did know that, would I then aim my coverage towards orthodontics, periodontics, or endodontics?

Especially you entrepreneurs, do you just toss darts and hope? Did you take six months and a copy of Grey's Anatomy to familiarize yourself with terms and procedures? How in the hell did you shop for insurance? For the layman, I see no way to make anywhere near an educated decision. It's like sending my kid to the shop for oil. I'll get oil, surely. But when I finish a rebuild and he shows up with a gallon of 90W, you find the "assistance" you receive ain't worth the cost of admission.

Quote: MathExtremist

Like what? Give me an example.



Meh, a hasty, thoughtless comment. I suppose even if I were to solar panel and pig s#$% my way into self sustaining electricity, the argument would stand that I still need to engage in support of Big Electric due to all the products I receive that would not exist but for it. So forget I said it; I typed without thinking.

Quote: ME

No, you're not being forced to play the game, you're grudgingly accepting it because you don't like the alternative. One of the freedoms granted to Americans is the freedom to give up their freedoms. You can leave. Every day you don't leave, however, is another day where you wake up and implicitly accept the rights and responsibilities of being a citizen. You don't get to have one without the other, and you especially don't get to say "I demand my Constitutional rights" without acknowledging that that same Constitution directly called for a Congress to implement Laws for society that govern your conduct within that society. If you don't like those Laws, you can either agitate to change them or you can leave, but you don't get to break them. That's what I mean by acknowledging social debt. The ultimate example of a freeloader is someone who demands rights from a society but who does not acknowledge the responsibilities they owe to that society.

That's what disturbs me so much about this narrow-minded idea that people who are ruggedly individually successful got that way all by themselves, without any help from anyone else current or past. Nobody living in this country today built their existence from whole cloth. Every single one of us owes a debt to the society we live in, even if it's not immediately transparent why that's true. It's sometimes hard to see 3rd or 4th order effects, but they're there nonetheless. Give me an example of someone who doesn't owe a debt to society, and I'll show you someone who doesn't live in one.



I can understand that, but what similarly disturbs me about your critique is that you suggest I do something which is impossible. I could move, sure. But where exists a society more attuned with my personal stance on living? Where could one go where things are more anarchist, or in line with a self subsistent lifestyle? I ain't Ranulph Fiennes, I can't survive on the caps. I'd likely not be allowed, by either the tribes or the surrounding 1st world .gov, to enter some aboriginal lost society. Should I decide to put my money where my mouth is and cast off with a bunch of like minded individuals with no allegiance to any .gov, what is my option? If I'd prefer a sort of a la carte system as you proposed, which I'm quite interested in, where do I go?

That's why I (perhaps incorrectly) compared it to indentured servitude. You say I implicitly agree. I'd ask what choice do I have?

I see none, so I'm doing what you suggested. Educate and agitate. FWIW, I think this is helpful, the way we comport ourselves. Yelling that you implicitly agree by existing and countering with LMTFA is just two billies buttin' heads. When you describe a stance, you more often find common ground with the disagreement being simply the execution.

Perhaps, one day, the a$$holes in charge will figure that out.
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FleaStiff
FleaStiff
Joined: Oct 19, 2009
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January 16th, 2017 at 9:37:16 AM permalink
Drug companies and Catholics get a lot of mileage out of that Thalidomide scare. Its a great experimental drug now. Europe makes it easier to introduce drugs. Large scale side effect follow up exists elsewhere. Here we keep drugs off the market but have no real after market follow up.

High costs are a barrier to entry into the market and that protects existing members.
billryan
billryan
Joined: Nov 2, 2009
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January 16th, 2017 at 11:31:30 AM permalink
Quote: FleaStiff

Drug companies and Catholics get a lot of mileage out of that Thalidomide scare. Its a great experimental drug now. Europe makes it easier to introduce drugs. Large scale side effect follow up exists elsewhere. Here we keep drugs off the market but have no real after market follow up.

High costs are a barrier to entry into the market and that protects existing members.



The Thalidomide scare? That's what you call 10,000 dead or deformed babies?
RogerKint
RogerKint
Joined: Dec 5, 2011
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January 16th, 2017 at 11:59:19 AM permalink
Quote: monet0412

No reason to go too far into it but it is interesting that this same government forces its citizens to eat gmo food, poison drinks, dollar burgers, processed cheese but not raw milk or cheese. So let me get this straight. Basically the government forces its citizens to get ill and profit off of it with secret deals with big business food companies. Next they play the other side with all the pharmaceutical companies and health care providers and force its citizens to pay for that service. If they don't pay they fine them. These guys are good!

In the meantime let's tax these poor bastards at the same time. Last I seen we have over 300 taxes that most people don't even realize are implemented in your day to day activity.

Funny how you all think the problem or solution is some fair health care system! The truth is that the whole thing is too far gone. I'm not just talking about health care. It's over and you all just don't want to accept it.



Craigslist is a good source to get raw milk and all sorts of farm fresh deliciousness. In California, raw milk is sold only in special stores at $15+ per gallon because of all the government hoops they have to jump through. When I went to the same store in Las Vegas, and asked for raw milk, I was told by the manager that it is illegal in Nevada.
100% risk of ruin
beachbumbabs
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beachbumbabs
Joined: May 21, 2013
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January 16th, 2017 at 12:28:39 PM permalink
The thing about drugs costing billions to bring to US market is probably true, not a Big Pharma exaggeration. I am no fan of Big P, but they do have a point. There are 4 main issues, if I understand the process correctly.

1.Identifying something that a drug will help. A drug has to have some percentage of effectiveness for some particular application for it to be viable. The R&D costs of just matching substances to illnesses are formidable and can take years. Either isolating active ingredients from complex molecules or biological sources, or discovering combinations of ingredients that act together, then a series of tests on animal subjects afflicted with a variety of issues, generally working up the complexity ladder.

An ancient example would be salicylic acid. Beginning thousands of years ago (they think), tribes in the Americas used to chew the bark of a particular tree to help headaches, fever, body aches. Relatively modern processes isolated and identified the active component, and marketed it as aspirin, starting about 100 years ago. Common now, always available to anyone living, but still had to be identified back then. And understanding how aspirin works, countering overdose, side effects, and contraindications (some people can't take it) is still evolving. Only in the last 20-30 years have cardiologists prescribed a small daily dose for heart patients and those at cardiovascular risk. A new prophylactic application resulting in billions more in sales per year.

2.Having a clear patent (finding a genuinely unique chemistry). Drug companies make their money out of the maybe 1 in 1000 process that comes out of R&D as a new molecule that does something. They went down all 1000 of those roads, losing money on the cost of finding 999 things that were ineffective, had lethal side effects, were not patentable, could not be replicated independently, a dozen other failure points. The one success has to pay for those as well as itself. The drug has to be patentable so that the company can recoup their losses over many years, not just a few months of lead time on marketing a product until other companies make a generic or branded equivalent.

3. Identifying possible side effects, including combinations with other drugs, their potency, frequency, and company exposure to liability. This takes years of testing, reporting, evaluation of long term effects, progressively more complex studies (maybe mice/rats to mammals to primates to humans), and evaluation of risk, both to the patients who will take them, and to the doctors who will prescribe them.

There are a lot of drugs that will kill you; for example, cumadin is rat poison. It's also a lifesaving drug for cancer patients and other illnesses that cause excessive clotting. But an overdose, or use by someone who doesn't have a clotting problem, can lead to uncontrolled hemorrhage and death (which is what it does to the rats, or family pets that ingest it, or even the toddler who finds where you put it out).

A lot of cancer - killing treatments have that kind of risk, where you have to acknowledge that the treatment has x% of a chance it will kill you instead of just killing the cancer. It's an enormous risk for a drug company to even put those things on the market (not just oncology); look at how often you see late-night commercials for class-action clients against a drug company for some side-effect or trying to prove the risk patients signed up to accept exceeded the known factors.

4. Complying with all testing/study/documentation requirements for FDA approval. Everything above, and a lot more, goes into proving to the FDA your drug is safe and effective. This is a good and necessary thing for the public. But it's expensive. And there's a fair chance that at least some of the hoops required/added over the years were meant as political or competitive blocks, not genuinely necessary requirements for safe and effective drugs to be approved. So I'm guessing there could be significant reform which would translate into lower costs, but I wouldn't know where to start in drugs.

(Saw overzealous requirements in aviation products when I worked on them in DC for a couple years; every requirement has a compliance component to .xxxxx tolerance, with every digit costing more. Every factor has a cost, and those are added up to evaluate risk, price, failure rates, a hundred other considerations. All this in advance of actually doing it, so mostly estimates. I'm sure there are many similarities in the FDA process to the FAA's process.)
If the House lost every hand, they wouldn't deal the game.
steeldco
steeldco
Joined: Nov 30, 2011
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Thanks for this post from:
Boz
January 16th, 2017 at 1:49:59 PM permalink
beachbumbabs,, the last documented average cost of getting a drug approved that I saw was $2.5 billion and I am sure that it is higher now. I own stock in a company that is 3D printing human organs. Assuming they succeed then I believe drug research costs may actually decrease. Until then however.......nothing but increases.

For those who constantly whine about paying for someone else's illnesses, stop using drugs to cure your own ills because doing so supports Big Pharma and allows them to cure heart disease, cancer, obesity issues, etc. Stop using drugs so that you don't pay for the illnesses that you don't have. You don't like to share the cost of health risk via insurance then don't share the cost of drug research by using drugs. K?
DO NOT blindly accept what has been spoken. DO NOT blindly accept what has been written. Think. Assess. Lead. DO NOT blindly follow.
steeldco
steeldco
Joined: Nov 30, 2011
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January 16th, 2017 at 1:54:54 PM permalink
Quote: steeldco

For those who constantly whine about paying for someone else's illnesses, stop using drugs to cure your own ills because doing so supports Big Pharma and allows them to cure heart disease, cancer, obesity issues, etc. Stop using drugs so that you don't pay for the illnesses that you don't have. You don't like to share the cost of health risk via insurance then don't share the cost of drug research by using drugs. K?



...and while I'm at it, if you're seriously ill, do not go to the hospital even if it means your death. Doing so would only support the people who go to the hospital and can't pay their bill. Hell.....stop any and all medical treatments so that we don't support those who can't afford it.
DO NOT blindly accept what has been spoken. DO NOT blindly accept what has been written. Think. Assess. Lead. DO NOT blindly follow.

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