Effects of Reducing The US's expenditure on Medicine

[Toastedlightly]

I was doing some thinking (always a dangerous thing). We hear talk of how much the US spends as a % of GPD. We hear about other nations having at least the same quality of care as the US while spending so much less. Many people propose reducing our spending down to the levels of other nation by mandate or by free market.

Now, what would that do to the medical technology market? What would this do to other nation's healthcare costs?

I ask this because the amount of money in the healthcare system is rather fixed and removing large chunks of funding from the system may cause mayhem within the global health system.

Thoughts?

 

[sandorski]

The talking point about US Expenditures "subsidizing" everyone else is FUD.

 

[Toastedlightly]

The talking point about US Expenditures "subsidizing" everyone else is FUD.

And why is that? I am honestly wondering how the healthcare market would take a large plunge in revenues caused by a decrease in income from one of the largest consumer bases. Honest business question.

 

[JohnOfSheffield]

I was doing some thinking (always a dangerous thing). We hear talk of how much the US spends as a % of GPD. We hear about other nations having at least the same quality of care as the US while spending so much less. Many people propose reducing our spending down to the levels of other nation by mandate or by free market.

Now, what would that do to the medical technology market? What would this do to other nation's healthcare costs?

I ask this because the amount of money in the healthcare system is rather fixed and removing large chunks of funding from the system may cause mayhem within the global health system.

Thoughts?

It's true that you do spend more tax payer money than say, the UK, on healthcare (this is per capita and only what your government spends) and about three times that through other means.

It's a lie that any of that extra cash is spent on any form of research, it's mostly just new formulations and 5x what it cost to develop them to market them and make sure doctors go with the most expensive medicine for every patient (something which is of course illegal in every other nation besides the US).

Don't think the world relies on the US for medical research, not in any way, the truth is that most new technology doesn't come from the US medical arena nor do most new drugs (that fill a need and are not just reformulations to get a new patent and sell them for 5x what the same older medication that is essentially the same thing costs).

Take Tramadol, an opium like substance, it has more side effects, works less well and is just as or probably more addictive than regular morphine but still, doctors prescribe it because morphine is bad for you.

 

[Patranus]

Well, Medicare only pays out 70 cents on the dollar so that remaining 30% must be made up by those with private insurance.

As more and more of the population goes on Medicare and there are fewer and fewer with private insurance (as the population gets older due to the baby boom) the burden per person with private insurance must also go up.

In 2007 total Medicare costs were 440 billion dollars.
The actual cost of Medicare was around 629 billion dollars.
The other 189 billion had to be made up by the private insurance carriers.

 

[Darwin333]

The talking point about US Expenditures "subsidizing" everyone else is FUD.

Could you perhaps go into a bit more depth on that? I recently read an article that sounded rather convincing that states the opposite. It used prescription drugs as an example basically saying the drug companies can afford to sell the drugs cheaper to other countries (who have legislated price control) because of the higher prices we pay. The fact that we can and do import damn near anything into the country but Grandma can't buy her lipitor from Canada gives it a little credibility, at least at face value.


Serious question, I know next to nothing about the topic besides what I have read in a few articles from various sources.

Digging a bit deeper, what about cutting edge medical technology? How do cutting edge, but initially ubber expensive, technologies get to the average consumer price point in a government run health care system? MRIs as an example. I am not talking about R&D as much as I am talking about actually bringing a product to the market and being able to make a profit until volume and scale bring prices down to reasonable levels. If country Y is just now purchasing and using MRIs they obviously played little or no role in helping "fund" its initial development without which it probably wouldn't exist (at least not at the level that it does).

 

[JohnOfSheffield]

Could you perhaps go into a bit more depth on that? I recently read an article that sounded rather convincing that states the opposite. It used prescription drugs as an example basically saying the drug companies can afford to sell the drugs cheaper to other countries (who have legislated price control) because of the higher prices we pay. The fact that we can and do import damn near anything into the country but Grandma can't buy her lipitor from Canada gives it a little credibility, at least at face value.


Serious question, I know next to nothing about the topic besides what I have read in a few articles from various sources.

Digging a bit deeper, what about cutting edge medical technology? How do cutting edge, but initially ubber expensive, technologies get to the average consumer price point in a government run health care system? MRIs as an example. I am not talking about R&D as much as I am talking about actually bringing a product to the market and being able to make a profit until volume and scale bring prices down to reasonable levels. If country Y is just now purchasing and using MRIs they obviously played little or no role in helping "fund" its initial development without which it probably wouldn't exist (at least not at the level that it does).

So you're saying you should pay France more?

Oh, and while MRI's are so cool that everyone just NEEEEEEEDS one at every appointment, ultrasound is usually a better option for most things.

 

[nonameo]

The thing is, we're all living fine with the medical technology we have now, we just need to redirect resources towards making that same technology cheaper rather than trying to come up with the next $$$ 1 million dollar cure for 0.0001% of the population.

 

[nonameo]

ahh.... crap double post

 

[CaptainGoodnight]

I think this is a legitimate question. How would US Healthcare reform effect medical spending in the US? Currently 80% of all the money spent on medical research is spent in the United States. Would it move elsewhere?

 

[ElFenix]

It's true that you do spend more tax payer money than say, the UK, on healthcare (this is per capita and only what your government spends) and about three times that through other means.

which is why we're fscked. our medicare/aid/schip/VA systems in total already spend as much per capita (not per covered person) as the NHS or france's system or germany's.

 

[JohnOfSheffield]

I think this is a legitimate question. How would US Healthcare reform effect medical spending in the US? Currently 80% of all the money spent on medical research is spent in the United States. Would it move elsewhere?

And yet you only have less than 20% of the actual research?

Does that tell you something? Spend a fraction of what you spend now abroad and get MORE research is what it SHOULD tell you.

 

[JohnOfSheffield]

which is why we're fscked. our medicare/aid/schip/VA systems in total already spend as much per capita (not per covered person) as the NHS or france's system or germany's.

I'm afraid that that can only be solved by a single payer system or some form of oligopoly that is allowed to work together to bring prices down.

It's pretty fair to say that the competition does not work as intended in your "free" market of today though.

Basically, your government ends up with the bill while others get the dollars paid by the citisens.

 

[Patranus]

And yet you only have less than 20% of the actual research?

Does that tell you something? Spend a fraction of what you spend now abroad and get MORE research is what it SHOULD tell you.

Is the USA going to get the same quality research from England as we saw from the CRU?

 

[Toastedlightly]

It's true that you do spend more tax payer money than say, the UK, on healthcare (this is per capita and only what your government spends) and about three times that through other means.

It's a lie that any of that extra cash is spent on any form of research, it's mostly just new formulations and 5x what it cost to develop them to market them and make sure doctors go with the most expensive medicine for every patient (something which is of course illegal in every other nation besides the US).

Don't think the world relies on the US for medical research, not in any way, the truth is that most new technology doesn't come from the US medical arena nor do most new drugs (that fill a need and are not just reformulations to get a new patent and sell them for 5x what the same older medication that is essentially the same thing costs).

Take Tramadol, an opium like substance, it has more side effects, works less well and is just as or probably more addictive than regular morphine but still, doctors prescribe it because morphine is bad for you.

I am asking what would happen to the industry itself.

Interestingly:

Tramadol was developed by the German pharmaceutical company Grünenthal GmbH in the late 1970s.[1][2]

So are you saying that ALL the world's industry is like this, or just our's?

 

[CaptainGoodnight]

And yet you only have less than 20% of the actual research?

Does that tell you something? Spend a fraction of what you spend now abroad and get MORE research is what it SHOULD tell you.

Where do you get your 20%?

I get 80% from here: http://en.wikipedia.org/wiki/Health...#Medical_products.2C_research_and_development

I can't really say how much of that money spent yields actual results. One indication is look at the number of Nobel prize winners in the last 30 years. Most of them are from the United States.

edit: Also, it really doesn't matter where the research is done. The fact remains that the US is bankrolling most of the medical research in the world. That might dry up if healthcare reforms are passed.

 

[JohnOfSheffield]

Is the USA going to get the same quality research from England as we saw from the CRU?

Yes, no, maybe?

How do you expect me to be able to answer that?

Unlike you i don't live in the land of make believe.

 

[ElFenix]

I'm afraid that that can only be solved by a single payer system or some form of oligopoly that is allowed to work together to bring prices down.

It's pretty fair to say that the competition does not work as intended in your "free" market of today though.

Basically, your government ends up with the bill while others get the dollars paid by the citisens.

frankly i like singapore's system if we're going the authoritarian route, though i'm certain much of their very highly ranked health outcome has to do with factors other than the medical system (such as diet, lower reliance on personal cars, lower violent crime rate, lower drug use, etc.).

 

[JohnOfSheffield]

I am asking what would happen to the industry itself.

Interestingly:

Tramadol was developed by the German pharmaceutical company Grünenthal GmbH in the late 1970s.[1][2]

So are you saying that ALL the world's industry is like this, or just our's?

Naturally it's the worlds industry, but just as an aside, check out the different brand names for Tramadol and the cost.

Unfortunantly i cannot use google myself but Tradolan and such should at least give you a head start.

 

[Toastedlightly]

And yet you only have less than 20% of the actual research?

Does that tell you something? Spend a fraction of what you spend now abroad and get MORE research is what it SHOULD tell you.

Outsourcing of jobs is a bitch, isn't it? However, I do doubt your 20% of actual research number. Have any sources?

 

[JohnOfSheffield]

frankly i like singapore's system if we're going the authoritarian route, though i'm certain much of their very highly ranked health outcome has to do with factors other than the medical system (such as diet, lower reliance on personal cars, lower violent crime rate, lower drug use, etc.).

I don't think it's fair to call it authoritarian, i mean, why don't you pay for your own security? Your own protection?

Why should the government subsidise police to protect those who won't pay for it themselves?

Not to mention fire departments, if you have no insurance, they will let your house burn down, if your neighbour does, they will protect his, unless they find that he's in error for having a pre-existing condition which someone might find, get a bonus while the house burns down.

You see, the US is probably the most authoritarian nation of all western nations. So please use another word because that one does not fit.

That said, i don't know much about Singapores solution, care to link me up?

 

[Toastedlightly]

Naturally it's the worlds industry, but just as an aside, check out the different brand names for Tramadol and the cost.

Unfortunantly i cannot use google myself but Tradolan and such should at least give you a head start.

So are your comments more directed towards the medical research community as a whole?

I heard there is a big push (from government?) to find better and cheaper solutions to diseases which have few choices for treatment.

 

[werepossum]

Outsourcing of jobs is a bitch, isn't it? However, I do doubt your 20% of actual research number. Have any sources?

What, are you questioning the voices inside his head?

 

[werepossum]

Right now the USA is by far the leading producer of new drugs, technologies, and medical equipment. Unlike medical insurance these industries are highly profitable. When we fully socialize our medical system, these industries will cease to to be so profitable. We will lose these industries just as Great Britain lost them, probably to Singapore and Red China, but they won't be as profitable because the USA is where most of the profits are made and because the more expensive new drugs, technologies, and medical equipment will have a market only for the ultra-rich. US companies will mostly be taken over by foreign companies, which is happening anyway due to our huge deficits.

I don't know that anyone can truly predict the effect on our health or on our health care system. A great deal of R&D is for competition for existing products. In theory, socialization will free up resources by eliminating this duplication of effort; one good anti-depression drug is in theory as good as seven. In practice, different people respond in different ways to different drugs, and profits will tend to be assigned according to political influence. Also, the cutting edge technologies and drugs tend to have marginal effects. The very expensive drugs and therapies tend to be last resorts anyway simply because they are so expensive. Expect to see drug resistance become a bigger problem and a near-end to new scanning technologies as the USA's profitability evaporates, but that's okay because it will all be free (not to mention served with free rainbow stew and a big Bubble-Up.)

 

[WhipperSnapper]

And why is that? I am honestly wondering how the healthcare market would take a large plunge in revenues caused by a decrease in income from one of the largest consumer bases. Honest business question.

It's a legitimate question. The only proper answer is, "If it turns out that we have been subsidizing other nations at our expense, then they'll need to pitch in and help support the costs of medical and pharmaceutical research." Why should we Americans suffer with an inferior system for the benefit of people in other countries?

Also, note that much of that revenue does not go towards medical research but rather is wasted on inefficiency--insurance companies, medical billing specialists, insurance brokers, company benefits plans managers--people and jobs that just push paper and have nothing to do with the actual provision of health care.