"OK"..you retire. But what about Health Care if your under 65???

[Shaman97]

Yes, if you are a veteran it's definitely a good thing. I doubt many 18 year-olds are enlisting for the health care but those benefits are HUGE. 18 year-olds are thinking about college benefits but the medical is worth much more in the long run. As others have mentioned, you don't have to be disabled or injured in the war to claim healthcare benefits. There are some income requirements, but if I understand correctly any veteran can get services but may have to pay co-payments and facility fees, depending on their income. No matter, it's still way cheaper than outside insurance.

 

I work for the VA and we have seen an explosion of veterans in the age bracket and situation that you describe - guys 55-65 looking for health care coverage. I started 12 years ago and my department saw about 3200 patients that year. Last year we saw over 18,000. Outsiders often assume we are seeing so many more patients because of recent wars, but we honestly don't see many of those soldiers. Most of them are still young and healthy and not thinking about health care yet. They will someday. But now it's the the 55-65 group coming in droves, and they aren't leaving when they can get Medicare. The care at the VA is good (despite some understandable complaints) and once they start receiving care here most don't leave.

 

That explosion in demand has caused the the VA to be somewhat overwhelmed. Wait times for non-urgent appointments can be long. As you can imagine the government is reactive, not proactive so we don't get the extra employees to serve the veterans until we are already behind. That said I still think we provide an excellent option for healthcare.

 

I see the same thing. Few younger guys, but mostly older guys. I still have and use my civvie health insurance, keeping the VA for mess and if I lose my job and get a catastrophic (financially) situation.

 

I also see a lot of much older guys that are there instead of in nursing homes. I imagine they have more in common with other vets than if they were in a private or State run facility.

[RichEdwards]

Ken...I like your defense of the Canadian health care system and I'm embarrassed by the present US health care system. Here it's often based on luck. I was lucky enough to be a teacher who belonged to a strong union that fought for decent health care for its members. So I pay nothing for health insurance that covered me and my entire family since I started teaching in 1968. Now retired, I still pay nothing...and I am reimbursed for the cost of my Medicare supplemental insurance. My girlfriend, on the other hand, pays over $900 a month for health insurance that is inferior in coverage to mine.

The US is a third-world country when it comes to health care.

[BFish]

i know folks who'd be thrilled to only pay $900 month. unreal how expensive it is for some. as time goes on more and more of us are going to look into residency in another country to mooch off the health care and cost of living benefits.

 

 

[Lets_Play_Two]

You might find this interesting http://www.youtube.com/watch?v=bbOTnA1KHe4. Its about Camden NJ. I do not have the answer but it seems to me a problem is, in this country we don't really know what health care is. We just throw money at the problem and hope to fix it. When that doesn't work and we've busted the budget we limit what we will pay for care. The "right"to health care seems to mean in the US that I can get it whenever I want it for whatever I want, and being caring souls we agree that no one can be denied. But then we forget to fix the problem. I was on medicare for a short period and I had to make three trips to the doctor for my annual physical which was done in one trip under private insurance. Why? So the doctor could get paid more than the $35 he was otherwise going to get paid. We expect everything and don't want to pay for it. Government run health care won't solve this. I believe as a previous commenter said, we have to go back to the old system or completely redo it.

[moshe_levy]

All-

 

The is a good article in this week's Time magazine (June 11, 2012) - cover story by Joe Klein entitled "How To Die," which details his recent experiences as both his parents passed away. It focuses onthe Geisinger model of care - it's well worth a read from someone who has just been through the actual experience. Recommended!

 

-MKL

[Matts_12GS]

You might find this interesting http://www.youtube.com/watch?v=bbOTnA1KHe4. Its about Camden NJ. I do not have the answer but it seems to me a problem is, in this country we don't really know what health care is. We just throw money at the problem and hope to fix it. When that doesn't work and we've busted the budget we limit what we will pay for care. The "right"to health care seems to mean in the US that I can get it whenever I want it for whatever I want, and being caring souls we agree that no one can be denied. But then we forget to fix the problem. I was on medicare for a short period and I had to make three trips to the doctor for my annual physical which was done in one trip under private insurance. Why? So the doctor could get paid more than the $35 he was otherwise going to get paid. We expect everything and don't want to pay for it. Government run health care won't solve this. I believe as a previous commenter said, we have to go back to the old system or completely redo it.

Where's that like button!?

 

Well said Bill.

[Ken H.]

You might find this interesting http://www.youtube.com/watch?v=bbOTnA1KHe4.

Certainly use of ERs as a primary care facility (because many have no where else to turn) is a part of the problem and any effort to reduce that by the use of more effective methods is a good step. Albeit a small one.

 

But toward the end he hits the key point that stands in the way, “Brenner’s coordinated approach to reducing cost is essentially taking away patients and business from hospitals and doctors. That threatens the profits of most of the established players in health care. When we speak of reducing cost, remember that for many powerful interests, that translates into taking away my business.”

 

The discussion always comes back to the key flaw – as long as you have a society that persist in the notion that health care can or should be a for-profit enterprise; all efforts to 'fix' it will fail.

 

[Whip]

as long as you have a society that persist in the notion that health care can or should be a for-profit enterprise; all efforts to 'fix' it will fail.

 

Nothing could be further from the truth.

 

Without profit there is no incentive for advancement in healthcare. No reason to invest. No reason to do research.

There are billions of dollars/Euros being invested in research the world over to cure everything from AIDS to cancer because of the great market that is the USA. If we take away that market we are all doomed. The entire world(especially Canada) benefits from the US market. So even though you don't live here any more we still pay part of your healthcare.

 

 

 

[Peter Parts]

as long as you have a society that persist in the notion that health care can or should be a for-profit enterprise; all efforts to 'fix' it will fail.

 

Nothing could be further from the truth.

 

Without profit there is no incentive for advancement in healthcare. No reason to invest. No reason to do research.

There are billions of dollars/Euros being invested in research the world over to cure everything from AIDS to cancer because of the great market that is the USA. If we take away that market we are all doomed. The entire world(especially Canada) benefits from the US market. So even though you don't live here any more we still pay part of your healthcare.

 

 

 

I hate to give a +1 to a rabid free-market rant but I agree the US carries some of the burden for the rest of the world. Another question - for another day - is how much the rest of the world supports US prosperity?

 

But you can't have it both ways: you can't say (1) free-market is God's own way for US health care and at the same time say that (2) free-market is robbing US to (not quite willingly) to subsidize Canada and others.

 

I've lived 29 yrs in US (and winters now) and 42 yrs in Canada. So I have some perspective on the issues.

 

Ben

can't remember ever hearing a Canadian say they didn't overall like the one-payer method here - the only time I hear it is from US lobbyists

[Quinn]

To add to Whip's reply.

 

I doubt that very many doctors got into the business to break even on their tuition.

 

Of course there is a profit motive. Only question is: who should skim the biggest share of it? Insurance company, lawyers, doctors, pharma and supply company, hospital and administration, nurses?

 

----

 

 

[Ken H.]

as long as you have a society that persist in the notion that health care can or should be a for-profit enterprise; all efforts to 'fix' it will fail.

 

Nothing could be further from the truth.

 

Without profit there is no incentive for advancement in healthcare. No reason to invest. No reason to do research.

There are billions of dollars/Euros being invested in research the world over to cure everything from AIDS to cancer because of the great market that is the USA. If we take away that market we are all doomed. The entire world(especially Canada) benefits from the US market. So even though you don't live here any more we still pay part of your healthcare.

There are all kinds of reasons to do things beyond profit. Even if we move beyond the ‘because it’s the morally right thing to do’ ideology to the pragmatic ones.

 

We as a group / society / governments build roads and bridges because people need to get around. We build sanitary sewer systems and pick up garbage because people need to not be exposed to excrement and filth. We create defense systems to protect one another. We fight fires because it is important to protect lives and property. The list goes on.

 

What you have to do, what most countries of the world have done, is make that mindset jump. That health care is necessary and important regardless of profit. That the reasons to invest, do research are for the good of the population, not for the good of investors.

 

(Oh, and BTW, per-capita Canada spends more on healthcare research than the USA.)

[Ken H.]

Of course there is a profit motive.

No, no, 1000 times no!

 

One would never say “of course there’s a profit motive” when talking about fighting fires. Or providing police protection. Or setting food inspection rules. Or the myriad of other services a collective society joins together to do.

 

But for some reason the USA singly and unexplainably makes a exception for health care. That it has to have a profit motive to be successful. But it doesn’t. You’ve got to start thinking of health care as integral part of what your society must do to succeed.

 

 

[MT Wallet]

Of course there is a profit motive.

No, no, 1000 times no!

 

One would never say of course theres a profit motive when talking about fighting fires. Or providing police protection. Or setting food inspection rules. Or the myriad of other services a collective society joins together to do.

 

But for some reason the USA singly and unexplainably makes a exception for health care. That it has to have a profit motive to be successful. But it doesnt. Youve got to start thinking of health care as integral part of what your society must do to succeed.

 

 

How are doctors in Canada compensated?

[marcopolo]

Of course there is a profit motive.

No, no, 1000 times no!

 

One would never say of course theres a profit motive when talking about fighting fires. Or providing police protection. Or setting food inspection rules. Or the myriad of other services a collective society joins together to do.

 

But for some reason the USA singly and unexplainably makes a exception for health care. That it has to have a profit motive to be successful. But it doesnt. Youve got to start thinking of health care as integral part of what your society must do to succeed.

 

 

How are doctors in Canada compensated?

 

Using a general practitioner (family doctor) as an example, it's on a fee for service basis. The fee schedule is determined by the provincial government (generally in consultation with the province's College of Physicians and Surgeons). I visit my family doctor, present my provincial health card (looks like a driver's licence), my doctor performs service then he/she submits the bill to the provincial Health Department, which then reviews the bill and pays the doctor. I, as the patient, see no billing paperwork whatsoever, either from the doctor, or the Health Department. A typical doctor is like a small business. They are not employees of the Government, but they do submit their invoices to the provincial Health Department. From the fees they receive, they must pay their office expenses, including their staff, and pay themselves out of what's left.

 

Just as an aside, even in our single-payor system financed by public funds, there are some service providers who are private entities. A good example is labs and diagnostic imaging centres. If my doctor orders blood tests, I typically go to a private lab, present my same health card and get my tests done. Once again, the lab submits the bill to the provincial Health Department. The same goes for an X-Ray, etc., unless it's performed in a hospital (hospitals are public institutions, not private). And obviously, drug companies sell their wares at a profit, whether to hospitals, or individuals (unless you're in the hospital, prescription drugs are not covered by provincial health care plans. Many people have supplementary insurance for things like drugs, eyeglasses, private hospital rooms etc., often through their employers. I'm covered under my wife's plan. If I were not, it would cost me $65/month for that supplementary insurance). Often prescription drugs in Canada are cheaper than in the U.S, even though the same companies supply us, as supply you (and they're still making a profit). What you won't see up here are those never-ending TV commercials for drugs that you're subjected to.

[MT Wallet]

Mark, with some exceptions and variations this sounds like it's about the same as here. We present an insurance card from PI, medicaid or medicare to our docs and hospitals. We then get an explanation of benefits telling us what is paid out on our behalf.

 

Is it the forums main consensus that the Insurance companies and the cost they charge is the real issue?

 

I am aware we started out wondering what people do for coverage between private insurance and medicare.

[Whip]

Of course there is a profit motive.

 

No, no, 1000 times no!

 

 

 

Sorry(IMHO)....profit is the most noble of all motives. Without the private investors incentive of profit healthcare research will end up like NASA or the Post Office. There must be a market driven place to recoup investment or we will be headed for the dark ages. There may be people willing to do the research for "The good of man", but there will not be enough investors nor will there be the research facilities. The US market is the biggest reason we live longer and better lives. The worlds quality of life will diminish without the great Satan known as US Capitalism.

 

Utopia does not exist and nothing is really free, someone has to pay just because it may not be you or me doesn't mean it is free.

 

 

 

 

 

 

[Whip]

Back to the original question.

 

I am a 50 year old monogamous male.

 

I have the best plan Blue Cross has.

 

My cell phone bill and cable TV cost more than my Health Insurance. Not to mention keeping my bikes maintained, licensed and insured.

 

 

If I could not afford these items I would make a choice.

 

Life is full of choices....choose wisely.

 

 

 

[moshe_levy]

The US market is the biggest reason we live longer and better lives.

 

Well, now you've gone and stepped in it, because although we lead "longer and better lives," we do not rank anywhere near the top in any measure of health care. Not in life expectancy, not in infant mortality, not in any measure of sickness per capita, including what we spend vs. what we receive. You can't wave the "USA #1" banner here, Larry. We're just not #1 here.

 

Keep in mind: I am not arguing against the market. I am arguing that you cannot claim a market solution is best when in fact we don't rank anywhere near the best in health care. We spend more, and we get less. There are a myriad of reasons why and maybe we can agree on some of them.

 

Second, Ken, you brought up firefighting as an example where profit should not be the prime motive. Naturally, I agree and see the parallels with health care. In this country however, sometimes the "market is the ONLY solution" mindset is tested. And since you brought up firefighting, perhaps we should recall the Cranick case from TN 2 years ago. For those who don't remember, see http://thelede.blogs.nytimes.com/2010/10/06/tennessee-firefighters-watch-home-burn/ The short story is, in this area, you pay a $75 fee for fire service, or you don't get any fire service. Mr. Cranick didn't pay, and as his home was burning down, the firefighters showed up, and watched it burn down. They only lifted their hoses in the event that Cranick's neighbor's house was endangered, because said neighbor paid the $75 fee.

 

And you might say, "Serves him right. He didn't pay, so he don't get no help." But that is NEVER the real American story. The REAL American story is the mindset that everyone is a moocher and welcher until it's YOUR time on the rack. When it's YOUR house on the line, YOUR job that's been lost, YOUR kid that's terribly sick - well, then it's justified help you seek from the rest of us taxpayers, and all of a sudden, market solutions aren't all they're cracked up to be. Cranick himself wound up making this same case.

 

Back full circle, Ken, another proud independent American who detests any government involvement in health care is Mrs. Mary Brown, a 56 year old woman who was a lead plaintiff in the case against our own national health care mandate that just went before the Supreme Court. Leading up to the case, Karen Harned, a lawyer for the National Federation of Independent Business which brought the case, said Brown "doesn't have insurance. She doesn't want to pay for it. And she doesn't want the government to tell her she has to have it."

 

BUT - there's always that but - court records revealed that Brown and her husband filed for bankruptcy last fall with $4,500 in unpaid medical bills. And once that came out, Brown went from symbol of proud independence into an example of exactly the problem we need to address.

 

So you see, we've heard all these speeches before, but we've also seen these same speechmakers grovel at the public trough over and over again - when THEIR time comes.

 

-MKL

[Whip]

I stepped in nothing. When I said we live longer and better lives I mean all of humanity owes their lives to the market place and the biggest market/profit place is the USA. Sorry I did not make that clear.

 

 

[Harry_Wilshusen]

Of course there is a profit motive.

No, no, 1000 times no!

 

One would never say of course theres a profit motive when talking about fighting fires. Or providing police protection. Or setting food inspection rules. Or the myriad of other services a collective society joins together to do.

 

But for some reason the USA singly and unexplainably makes a exception for health care. That it has to have a profit motive to be successful. But it doesnt. Youve got to start thinking of health care as integral part of what your society must do to succeed.

 

 

How are doctors in Canada compensated?

 

Using a general practitioner (family doctor) as an example, it's on a fee for service basis. The fee schedule is determined by the provincial government (generally in consultation with the province's College of Physicians and Surgeons). I visit my family doctor, present my provincial health card (looks like a driver's licence), my doctor performs service then he/she submits the bill to the provincial Health Department, which then reviews the bill and pays the doctor. I, as the patient, see no billing paperwork whatsoever, either from the doctor, or the Health Department. A typical doctor is like a small business. They are not employees of the Government, but they do submit their invoices to the provincial Health Department. From the fees they receive, they must pay their office expenses, including their staff, and pay themselves out of what's left.

 

Just as an aside, even in our single-payor system financed by public funds, there are some service providers who are private entities. A good example is labs and diagnostic imaging centres. If my doctor orders blood tests, I typically go to a private lab, present my same health card and get my tests done. Once again, the lab submits the bill to the provincial Health Department. The same goes for an X-Ray, etc., unless it's performed in a hospital (hospitals are public institutions, not private). And obviously, drug companies sell their wares at a profit, whether to hospitals, or individuals (unless you're in the hospital, prescription drugs are not covered by provincial health care plans. Many people have supplementary insurance for things like drugs, eyeglasses, private hospital rooms etc., often through their employers. I'm covered under my wife's plan. If I were not, it would cost me $65/month for that supplementary insurance). Often prescription drugs in Canada are cheaper than in the U.S, even though the same companies supply us, as supply you (and they're still making a profit). What you won't see up here are those never-ending TV commercials for drugs that you're subjected to.

 

So you have no idea what your health care costs.

[Ken H.]

I hate to give a +1 to a rabid free-market rant but I agree the US carries some of the burden for the rest of the world.

I disagree with that too. Certainly Canadians, through our single payer UHC system, pay dearly for drugs, medical technology and all aspects of health care imported from the USA. Including paying the profit margin that is part of that system. I doubt one single medical thing is sold to Canada at a loss.

 

The argument is a red herring one anyway. Just because something is created in one country doesn’t mean it’s subsidizing, carrying the load of the rest of the world. One could just as easily make the same argument that Canada has been carrying the burned of the US housing industry for decades because most of the USA’s lumber to build them comes from Canada. Or for decades (less so now) on smart phones (Blackberry). Or China carries the weight for the USA on electronics manufacturing, or Japan and Germany carries (nearly) all the burden for the USA in R&D of motorcycles. It’s a nonsense argument from all perspectives.

 

[Ken H.]

And since you brought up firefighting, perhaps we should recall the Cranick case from TN 2 years ago.

Yes I remember the story well. I thought it was deplorable. A new low in moral bankruptcy.

[Ken H.]

Sorry(IMHO)....profit is the most noble of all motives.

Well we’ll just have to agree to disagree because (IMHO)....caring for your fellow man is the most noble of all motives.

 

BTW, I have never said our UHC system was free. Only a fool, or a very very ill-informed person, would say that. I just said it’s a better system. We’re all paying for it ever single moment of our working days. We just get better for less, and it’s more morally just.

 

[Ken H.]

So you have no idea what your health care costs.

Of course we do. Health care cost per capita in the USA - $7960 per person per year. In Canada - $4363 per person per year. (US dollars, 2009 statistics.)

 

Now if you’re asking about specific itemized items, all that info is available too as it is all a matter of public record as part of the single-payer system. Far more transparency that I suspect the myriad of private and public insurance companies, PPOs, etc. have. Try getting your hands on a actuary table from within Blue Cross Blue Shield some time!

 

At the provincial level there are statistics out the wazoo about health care and health care cost. As a matter of fact some of the software the company I work for writes is just that.

[Ken H.]

My cell phone bill and cable TV cost more than my Health Insurance.

 

Life is full of choices....choose wisely.

I’m happy for you. I can think of 4.9 million other US Americans that I’d bet wish they could say the same thing.

[Whip]

My cell phone bill and cable TV cost more than my Health Insurance.

 

Life is full of choices....choose wisely.

I’m happy for you. I can think of 4.9 million other US Americans that I’d bet wish they could say the same thing.

 

 

If those 4.9 mil were allowed to buy my plan everyone's costs would go down.

[Ken H.]

 

How are doctors in Canada compensated?

Additional points…

 

It should also be pointed out that doctors are still paid well in Canada. Nobody is being asked to live on a pauper’s wages just because they are in health care. There is an article this morning about comparing the “1%ers” in the USA vs. in Canada. In the USA the majority by far are in finance and law. In Canada finance is well represented too, but doctors and dentist make up a good percentage.

 

In some providences (but not Alberta) people have to direct pay a small premium into the healthcare system. Just before Alberta did away with theirs in 2008 it was about $33 per person per month. And in Alberta anyway, some prescription drug cost are covered. But there is a co-pay.

 

Also, one of the reasons prescription drugs are cheaper in Canada is because of the bulk buying power of the single-payer system. Canada can and does shop the world over for the best prices.

 

Donna and I pay $0 for our prescription drugs, but it’s because I have two jobs and my small employer buys a group drug coverage plan for his employees as a perk. It cost him $10,000 a year for eight employees and pays the employee back their co-pay.

 

 

[Ken H.]

My cell phone bill and cable TV cost more than my Health Insurance.

 

Life is full of choices....choose wisely.

I’m happy for you. I can think of 4.9 million other US Americans that I’d bet wish they could say the same thing.

 

 

If those 4.9 mil were allowed to buy my plan everyone's costs would go down.

And then you would have... ta-da! Single-Payer Universal Health Care!

 

Oh but wait, that's a BAD thing, right? Confused...

[Whip]

My cell phone bill and cable TV cost more than my Health Insurance.

 

Life is full of choices....choose wisely.

I’m happy for you. I can think of 4.9 million other US Americans that I’d bet wish they could say the same thing.

 

 

If those 4.9 mil were allowed to buy my plan everyone's costs would go down.

And then you would have... ta-da! Single-Payer Universal Health Care!

 

Oh but wait, that's a BAD thing, right? Confused...

 

You are right.

 

You are confused.

 

[marcopolo]

 

So you have no idea what your health care costs.

 

In specific terms, like a visit I make to my family doctor for a physical, for example? No, I do not know what he bills, nor do I know what the province pays him. I see no paperwork. I'll give you a bigger example. My son received a kidney transplant a few years ago. There were umpteen visits to the transplant clinic for him and the donor in the workups to the surgeries (his and the donor's). Then there were the attendant hospital stays, followed by regular post-op visits to the transplant clinic. Nether he, nor the donor, ever saw a piece of paper. Cost was never mentioned at any time, but you know it was not cheap. That said, the provincial Health department does monitor for fraud, like a doctor billing for a certain number of procedures in a certain time frame where it would be impossible to accomplish etc.

 

In grosso modo terms, yes I know what health care costs. I just need to look at what my province's health care budget is for the year and also look at what the federal government contributes to each province for health care. Ken has pointed out above some per capita numbers for Canadians generally. Each province is slightly different in terms of what's covered and in terms of what they pay doctors. Now I suppose I could try and get my hands on the fee schedule and see what my doctor gets for a routine visit, or what the surgeons got for a kidney transplant, but why would I bother? I know what I pay each year in income taxes to the federal and provincial coffers. I could always figure out what percentages of the provincial and federal expenditures go to health care each year, but there are lots of people doing that on a regular basis. It ain't cheap, that's for sure.

[Harry_Wilshusen]

So you have no idea what your health care costs.

Of course we do. Health care cost per capita in the USA - $7960 per person per year. In Canada - $4363 per person per year. (US dollars, 2009 statistics.)

 

Now if you’re asking about specific itemized items, all that info is available too as it is all a matter of public record as part of the single-payer system. Far more transparency that I suspect the myriad of private and public insurance companies, PPOs, etc. have. Try getting your hands on a actuary table from within Blue Cross Blue Shield some time!

 

At the provincial level there are statistics out the wazoo about health care and health care cost. As a matter of fact some of the software the company I work for writes is just that.

 

So the last time you went to the doctor what was the cost? Do you know? Do you care?

[Antimatter]

as long as you have a society that persist in the notion that health care can or should be a for-profit enterprise; all efforts to 'fix' it will fail.

 

Nothing could be further from the truth.

 

Without profit there is no incentive for advancement in healthcare. No reason to invest. No reason to do research.

There are billions of dollars/Euros being invested in research the world over to cure everything from AIDS to cancer because of the great market that is the USA. If we take away that market we are all doomed. The entire world(especially Canada) benefits from the US market. So even though you don't live here any more we still pay part of your healthcare.

 

 

 

Whip, I'm afraid you're wrong on that one. My wife is a medical researcher for a public institution who's observed the process first hand. The majority of medical research in this country is done by public institutions, usually in form of block grants provided by the National Institutes of Health (NIH)to public universities, who then provide the foundation research to private companies. Those entities then go on to manufacture the drugs or treatments, and make the profits from selling them. The counter argument is that private companies spend $millions on research, but the majority of that money is actually spent on marketing. For years, drug companies have spent the lion's share of their money on advertising, and have always refused to give an actual accounting of how much they spend.

 

So, actually, the innovation that the US is famous for comes not from our free enterprise system, but from the large public subsidies we give to education. Our ability to innovate has always been based on the US being able to attract the best and the brightest to come here for education, and to work in research and development.

 

Free enterprise does come into play in marketing drugs, but it tends to encourage drug makers to concentrate on substances that fulfill broad diagnosis for emotional ailments (or sexual ones), and that don't generally qualify for insurance reimbursement; i.e. they can charge top dollar for a pill that might make your feel better, but that you won't want to stop taking. This is why we, the taxpayers, have to either subsidize manufactures to produce drugs like vaccines at low cost, or buy them from foreign companies. You may have heard about the shortage of cancer drugs that the US is currently experiencing - this is a result of the profit margin being very low on these treatments, most of which are older but still effective. Maximizing the profit margin has led the drug manufactures to concentrate on producing products with the highest prices, not necessarily those we currently need.

 

The reason the industry operates this way is a result of two big factors - first, during WWII the US government needed a way to provide large quantities of the drugs to help the war effort, and it developed the model of having the government do the research, and then turn that research over to the private sector for manufacturing. Second - the pharmaceutical industry has one of the largest lobbying groups in Washington DC; two lobbyists for every member of congress.

 

Finally, my own personal view is that any private enterprise that has the ability to hold life or death power over a person based on that person's ability to pay shouldn't be in a position to dictate terms. I see it as being as bad as the mob threatening to burn down your house if you don't pay. It's despicable and should be illegal.

 

Here's a good article describing the way pharmaceuticals are developed and marketed in this country.

[Whip]

Anti

 

I prolly was not clear. It is our consumer market that drives the worlds research for innovation as well as drugs. We are the source of profit for the worlds research. We are the golden goose. What will happen if there is no pot of gold under the rainbow? What will be the incentive for me to invest in the next technical advancement if there is no free market for the product? If you think the governments of the world will now be the supplier of money for the next great cure you need to go to the USPO or see what happen at NASA when it became the whippin boy for austerity. I would rather trust my healthcare to peeps trying to make a profit over peeps trying to get votes.

 

YMMV

 

 

 

[brennaman]

(Oh, and BTW, per-capita Canada spends more on healthcare research than the USA.)

 

Just curious, where do you get your source. This is what I found. This on the national psoriasis, and they state we spend $30 billion annually on biomedical research.

 

http://www.psoriasis-cure-now.org/medical-research-funding-level-by-country-world-psoriasis-day-challenge/

 

 

And here is a wiki link that breaks it down to actual #'s. Although they look like old #'s.

 

 

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

 

By this, Canada needs to pick it up a little bit. And by the way, no need to say thanks.

(this remark was not directed at the majority of Canadians, only the few that like to find fault with most everything about your southern neighbors )

[Antimatter]

Anti

 

I prolly was not clear. It is our consumer market that drives the worlds research for innovation as well as drugs. We are the source of profit for the worlds research. We are the golden goose. What will happen if there is no pot of gold under the rainbow? What will be the incentive for me to invest in the next technical advancement if there is no free market for the product? If you think the governments of the world will now be the supplier of money for the next great cure you need to go to the USPO or see what happen at NASA when it became the whippin boy for austerity. I would rather trust my healthcare to peeps trying to make a profit over peeps trying to get votes.

 

YMMV

 

 

 

And, as I pointed out, the profits in healthcare don't actually pay for research - grant money from the government does that. There's really no connection between the money drug companies make and the medical research that's done in the US. Changing the healthcare delivery system in this country to single payer wouldn't change the need for drug manufacturing and distribution, and might actually improve it for some companies who would be able to provide products for long-term care as opposed to having people die in the ER.

 

I tend to distrust for-profit motivations as they usually lead to grift and short-changing, except when a clear comparison between similar products exists. Put simply, capitalism works well when buying widgets, but not so great when there is too much informational asymmetry between the seller and the buyer. Medical care, drugs, and insurance are perfect examples of this. It's an industry predicated on barriers to entry (patents) and the ability to extract every last bit of money from someone who's trying not to die.

 

BTW, can anyone think of major industry in the US that didn't start or isn't maintained by some form of government subsidy?

 

Also, the USPO is getting killed by Congress. They've demanded the Post Office come up with 75 years of retirement money in the next 10 years, something no other corporation has been required to do. It's a deliberate attempt to kill the postal union, which incidentally, is the 2nd largest employer of US veterans in country (behind the Department of Defense).

 

I don't know much about NASA, but I suspect it's much like the Pentagon, only NASA contractors don't give as good of bribes to congress-critters. In a way, I think that will work out well - eventually when the Chinese beat us to Mars, we'll have a panic attack and get back on the ball.

[Whip]

I ain't getting through and it is prolly my fault so I give up.

 

Enjoy your day.

 

 

 

 

 

[MT Wallet]

as long as you have a society that persist in the notion that health care can or should be a for-profit enterprise; all efforts to 'fix' it will fail.

 

Nothing could be further from the truth.

 

Without profit there is no incentive for advancement in healthcare. No reason to invest. No reason to do research.

There are billions of dollars/Euros being invested in research the world over to cure everything from AIDS to cancer because of the great market that is the USA. If we take away that market we are all doomed. The entire world(especially Canada) benefits from the US market. So even though you don't live here any more we still pay part of your healthcare.

 

 

 

Whip, I'm afraid you're wrong on that one. My wife is a medical researcher for a public institution who's observed the process first hand. The majority of medical research in this country is done by public institutions, usually in form of block grants provided by the National Institutes of Health (NIH)to public universities, who then provide the foundation research to private companies. Those entities then go on to manufacture the drugs or treatments, and make the profits from selling them. The counter argument is that private companies spend $millions on research, but the majority of that money is actually spent on marketing. For years, drug companies have spent the lion's share of their money on advertising, and have always refused to give an actual accounting of how much they spend.

 

So, actually, the innovation that the US is famous for comes not from our free enterprise system, but from the large public subsidies we give to education. Our ability to innovate has always been based on the US being able to attract the best and the brightest to come here for education, and to work in research and development.

 

Free enterprise does come into play in marketing drugs, but it tends to encourage drug makers to concentrate on substances that fulfill broad diagnosis for emotional ailments (or sexual ones), and that don't generally qualify for insurance reimbursement; i.e. they can charge top dollar for a pill that might make your feel better, but that you won't want to stop taking. This is why we, the taxpayers, have to either subsidize manufactures to produce drugs like vaccines at low cost, or buy them from foreign companies. You may have heard about the shortage of cancer drugs that the US is currently experiencing - this is a result of the profit margin being very low on these treatments, most of which are older but still effective. Maximizing the profit margin has led the drug manufactures to concentrate on producing products with the highest prices, not necessarily those we currently need.

 

The reason the industry operates this way is a result of two big factors - first, during WWII the US government needed a way to provide large quantities of the drugs to help the war effort, and it developed the model of having the government do the research, and then turn that research over to the private sector for manufacturing. Second - the pharmaceutical industry has one of the largest lobbying groups in Washington DC; two lobbyists for every member of congress.

 

Finally, my own personal view is that any private enterprise that has the ability to hold life or death power over a person based on that person's ability to pay shouldn't be in a position to dictate terms. I see it as being as bad as the mob threatening to burn down your house if you don't pay. It's despicable and should be illegal.

 

Here's a good article describing the way pharmaceuticals are developed and marketed in this country.

 

Anti

Sorry to have to disagree to some extent with your contention that drug comapnies don't do research. True the vast majority of research is done in institutions. There are more colleges and universities than drug companies and therefore "more research" is done there. There is an old adage in academia "Publish or perish" Drug companies do troll publications for basic research and use it. Many findings/compounds that eventually become drugs are patented by the universities and aren't free. The rights to these compounds are SOLD to the drug companies for profit. If this didn't happen drugs would never make it to the marketplace. Drug companies have manufacturing know how and facilities which colleges and universities don't have. This ain't cheap! Even if a university licenses a product for production for manufacture by a drug company they get a rake off(cut). Doesn't sound so noble does it? Everything is money driven. Let's not fool ourselves.

 

Interestingly you referenced WWII and government subsidy of research. It was out of necessity. Manufacturing of the products was done by industry for a PROFIT. Remember the story of penicillin? The Brits discovered it and smuggled it out to the U.S to find a way to replicate and mass produce it secrectly. Discovered by academia and manufactured by drug companies for a profit!

 

WWII leads us to health care as we know it today. Back in the day industrialist Henry Kaiser had large profitable contracts with the government to build liberty ships, jeeps etc. he came to realize sick workers didn't work and jeopardized the war effort and his........yep, profits. What is now known as Kaiser Permanente was born to fill the need to keep workers healthy. The point is that money and profit isn't a bad thing. If not for profit what would the motivation be?

[MT Wallet]

 

And, as I pointed out, the profits in healthcare don't actually pay for research - grant money from the government does that. There's really no connection between the money drug companies make and the medical research that's done in the US. Changing the healthcare delivery system in this country to single payer wouldn't change the need for drug manufacturing and distribution, and might actually improve it for some companies who would be able to provide products for long-term care as opposed to having people die in the ER.-Anti

 

I'm just a contrarian today. Drug companies do in fact do big bucks research. Several years ago Pfizer had a big research and manufacture presenece in Ann Arbor Michigan. They drew talent from the University of Michigan system(see my previous post). They were a big dog in town. They were doing clinical trials on a drug (I think it was a diabetes drug) and they noted that too many patients were dying to be coincindence. They pulled the plug and said no one ought to ever take this drug. I don't know if they did the basic research or bought it but the financial consequences for them were devastating! They couldn't afford to maintain all of thier facilities and manufacturing capacity. In order to survive they sold off the Ann Arbor facility and have been looking for the next blockbuster drug. Now in the in the interest of staying solvent they aren't giving thier products away. A single payer probably would drive many companies who had this experience under.

 

Single payers like Medicare tend to dictate what they will pay and what you may charge if you are a provider or a drug company. If you (govenment) have budget issues the government tells doctors and hospital they are cutting the reimbursement. No appeal or recourse. This easily could happen to drug companies. You see the implications.

 

 

[Ken H.]

The rights to these compounds are SOLD to the drug companies for profit. If this didn't happen drugs would never make it to the marketplace. Drug companies have manufacturing know how and facilities which colleges and universities don't have. This ain't cheap! Even if a university licenses a product for production for manufacture by a drug company they get a rake off(cut).

I disagree. It’s not profit driven in research universities. There are no shareholders of research universities clamoring for an ever increasing share price gain. A dividend needs to be paid. A 6% year or year increase in revenues is demanded quarter after quarter.

 

Sure institutions generate an income for patents and their research, but that goes right back into more research that we all benefit from. The words “income” and “profit” are not synonyms.

 

If not for profit what would the motivation be?

The wellbeing of our fellow man. And all the benefits THAT brings to society and ourselves. I keep coming back to the fire fighting parallel because it’s an accurate one. We would never say, “If not for profit what would our motivation for fighting fires be?” Health care should be no different. As a matter of fact in most of the world it isn’t.

 

Everything is money driven. Let's not fool ourselves.

First off, that’s not true. Humans do lots of things for far more motivations than for money. But regarding this subject, where that is true, it shouldn't be that way. It’s morally wrong and ultimately damaging to all of us.

 

 

[MT Wallet]

Ken perhaps the term profit versus revenue was an inappropriate choice of words as it pertains to the Univ. research. The money goes to balance budgets etc.

 

In my ideal world of altrueism the wellbeing of by fellow humans would drive many endeavors. However, the world I live in doesn't work that way. Comparing firefighting to research and health care is like comparing apples to bowling balls. They are both round but much different. We pay for both.

 

If you don't believe things are money driven I suggest you write software for free! Yes, give it away for the betterment of society. No excuses just do it! Doesn't work in the real world. That was my point.

[Dave McReynolds]

I have to agree with Ken, in large part, on this one. Most researchers I have known who work in universities are primarily motivated by the interest they have in their research. Much the same type of interest that someone might have in learning how their motorcycle works. The researchers would like to be paid a reasonable salary for their efforts, but are not looking to get rich off it.

 

Of course, there is a whole other group of researchers, many of whom started in universities, who have ventured out into business and definitely are looking to get rich from it. Different strokes for different folks

[Whip]

...and where do you think that money comes from for the research?

 

Let me help you out.

 

Google ... Pfizer University Donations.

 

 

Like I said.

 

The US Market is the single greatest cure for the worlds ailments.

 

 

Take it away at your own risk.

 

 

L

 

 

 

 

[brennaman]

(Oh, and BTW, per-capita Canada spends more on healthcare research than the USA.)

 

Still curious where you get those numbers.

 

I will agree with you that our health care is more expensive per capita. I wonder how those numbers would change if a few million US citizens decided to live in Canada, without your permision, and use your health care system without contributing to the expense?

 

We have some unusual circumstances in this country that Canada does not have to account for when it comes to health care.

 

In the US, for every 16 people, there is 1 uninvited guest. (approx. 20 million living with our 310 million population)

Canada has 1 uninvited guest for every 116 Canadian. (approx 300K living with your 34 million population)

 

Comparing the US with just about every other industrial nation is like comparing apples to oranges. There are a lot of dynamics in this country, other countries do not have to deal with. The US is a very generous country, that the world benefits from. Some people only look at the negative that goes along with all the positives we generate.

 

 

[Bob Palin]

If you don't believe things are money driven I suggest you write software for free! Yes, give it away for the betterment of society. No excuses just do it! Doesn't work in the real world. That was my point.

 

I have done that several times over the last few years for this very web site.

[Marty Hill]

Some people only look at the negative that goes along with all the positives we generate.

 

Truer words wer never spoken!

[Mike]

If you don't believe things are money driven I suggest you write software for free! Yes, give it away for the betterment of society. No excuses just do it! Doesn't work in the real world. That was my point.

 

I have done that several times over the last few years for this very web site.

 

[Whip]

(Oh, and BTW, per-capita Canada spends more on healthcare research than the USA.)

 

Still curious where you get those numbers.

 

I will agree with you that our health care is more expensive per capita. I wonder how those numbers would change if a few million US citizens decided to live in Canada, without your permision, and use your health care system without contributing to the expense?

 

We have some unusual circumstances in this country that Canada does not have to account for when it comes to health care.

 

In the US, for every 16 people, there is 1 uninvited guest. (approx. 20 million living with our 310 million population)

Canada has 1 uninvited guest for every 116 Canadian. (approx 300K living with your 34 million population)

 

Comparing the US with just about every other industrial nation is like comparing apples to oranges. There are a lot of dynamics in this country, other countries do not have to deal with. The US is a very generous country, that the world benefits from. Some people only look at the negative that goes along with all the positives we generate.

 

 

You left out how our military defends the world through treaties.

 

Canada and it's resources would be easy pickens if we did not defend her.

 

 

 

 

 

[moshe_levy]

...and where do you think that money comes from for the research?

 

Let me help you out.

 

Google ... Pfizer University Donations.

 

 

Like I said.

 

The US Market is the single greatest cure for the worlds ailments.

 

 

Take it away at your own risk.

 

 

L

 

 

 

 

Larry, I think here you find yourself in an ideological conundrum. On one hand you have the laissez faire orthodoxy which reflexively recoils whenever anything other than private captial and profit is part of an economy. On the other you have the (more valid) preference to better service at lower prices.

 

Our health care system is more "free market" than most if not all other industrial nations. It also costs more, and judging by basically every metric you can measure health care by, delivers less.

 

Times like this, I'd say, demand we consider all available solutions - especially those we see working better in practice - ideology aside. Because as you see above, it's real easy to trip over your own reasoning if everything is automatically dogmatic.

 

-MKL

 

[Whip]

...and where do you think that money comes from for the research?

 

Let me help you out.

 

Google ... Pfizer University Donations.

 

 

Like I said.

 

The US Market is the single greatest cure for the worlds ailments.

 

 

Take it away at your own risk.

 

 

L

 

 

 

 

Larry, I think here you find yourself in an ideological conundrum. On one hand you have the laissez faire orthodoxy which reflexively recoils whenever anything other than private captial and profit is part of an economy. On the other you have the (more valid) preference to better service at lower prices.

 

Our health care system is more "free market" than most if not all other industrial nations. It also costs more, and judging by basically every metric you can measure health care by, delivers less.

 

Times like this, I'd say, demand we consider all available solutions - especially those we see working better in practice - ideology aside. Because as you see above, it's real easy to trip over your own reasoning if everything is automatically dogmatic.

 

-MKL

 

 

Nice words that say very little. Attempting to belittle me by using words like dogmatic do nothing for whatever your point may be. Try something else next time please.

 

Keep in mind your opinions though valuable to this discussion are worth no more than anyone else's.

 

 

 

[moshe_levy]

Larry,

 

Listen, I'm NOT belittling you. I am saying you are defending the free market system here, and usually the primary defense of such a system in classical economics is "best product for lowest price." But here we are not getting the best product, or the lowest price. We are getting a worse product, for a higher price.

 

This isn't about you - it's about being ideological at a point where the ideology contradicts ITSELF, namely advocating a free market solution where it's proven to not live up to its promise of best product at lowest price. How do you reconcile that in your mind?

 

-MKL