THIS is the problem with healthcare

[fskimospy]

Yes other countries have different answers. But theres more to it than simply adopting. No other countries have a constitution. Thats a huge factor.

Many, many other countries have constitutions.

 

[blackangst1]

Just a wee bit ignorant there bunky

https://en.wikipedia.org/wiki/List_of_national_constitutions

Thanks for the correction. I guess what I was thinking is no other country is based on a free market. And yes, I understand there are various degrees of "free".

 

[blackangst1]

If it's like Medicare or the VA, the government would pay for it (possibly minus a small copay). I get most of my medicine/supplies through the VA, and I guarantee they pay far less than I would have to.

Thats a reasonable point.

 

[dank69]

Havent you already decided?

Under certain circumstances, yes. Under other circumstances, no.

Oh circumstances. Let me narrow it down for you a bit. Let's say you'd pay enough extra that it would be very inconvenient but it wouldn't wreck your finances. Not knowing your budget or situation, let's start the bidding at $1000 more per year.

 

[fskimospy]

Thanks for the correction. I guess what I was thinking is no other country is based on a free market. And yes, I understand there are various degrees of "free".

Many, many other countries are based on a free market. If you think there is a meaningful distinction between the freedom of US markets and the freedom of other developed nations' markets that is relevant to the distribution of health care you will have to describe it.

 

[dank69]

Thanks for the correction. I guess what I was thinking is no other country is based on a free market. And yes, I understand there are various degrees of "free".

lol

 

[Cozarkian]

The issue is cost. Drug cost. Care cost. Treatment cost. I know for instance in Japan they have price controlls, so although providers can charge whatever they want, they cant go above certain price for any given proceedure or drug. Although that sounds great, I dont know that such controls could be implemented constitutionally.

Simple, tie cost controls to patents. If you don't like the cost control, you don't get a government backed Monopoly.

 

[blackangst1]

Oh circumstances. Let me narrow it down for you a bit. Let's say you'd pay enough extra that it would be very inconvenient but it wouldn't wreck your finances. Not knowing your budget or situation, let's start the bidding at $1000 more per year.

Sure. Depending.

 

[blackangst1]

Many, many other countries are based on a free market. If you think there is a meaningful distinction between the freedom of US markets and the freedom of other developed nations' markets that is relevant to the distribution of health care you will have to describe it.

Yes, there are. But there are significant differences between the US's version of free market, and others. This paper is, IMHO, a pretty good overview of the differences.

 

[fskimospy]

Yes, there are. But there are significant differences between the US's version of free market, and others. This paper is, IMHO, a pretty good overview of the differences.

Which of those differences fundamentally alter how we must structure our health care insurance markets?

 

[blackangst1]

Which of those differences fundamentally alter how we must structure our health care insurance markets?

I guess the two glaring things *I see* are 1. The elimination of the private health insurance market, and 2. how exactly price controls would pass constitutional muster. For the latter point, Ive already acknowledged we have price controls in the banking market, so theres that. On the former, to address a point made by another poster, Im sure some people wouldnt mind working for the federal government, but I suspect many wouldnt. Admittedly, this opinion is biased on my own discussions with coworkers through he decades of discussions with others in my profession (due to the fact private jobs in general pay much more than public positions).

Im not completely against a single payer idea. I guess I just havent seen anything other generalitites. And I, nor no one on this forum, can have an educated plan to do this.

As generalities go, I found THIS article;e pretty good.

 

[spacejamz]

Regarding the cost of drugs, which countries do most of the research and development (I honestly don't know if the US, Asia or Europe does the most)? how is the price of a successful drug calculated to recoup cost as well as profit (that is probably another topic altogether)? If a drug is successfully patented in country 'X', should all of the countries (at least those who are able) in the world help 'pay' for it (probably falls under the same discussion as profit)...

 

[fskimospy]

I guess the two glaring things *I see* are 1. The elimination of the private health insurance market, and 2. how exactly price controls would pass constitutional muster. For the latter point, Ive already acknowledged we have price controls in the banking market, so theres that. On the former, to address a point made by another poster, Im sure some people wouldnt mind working for the federal government, but I suspect many wouldnt. Admittedly, this opinion is biased on my own discussions with coworkers through he decades of discussions with others in my profession (due to the fact private jobs in general pay much more than public positions).

Im not completely against a single payer idea. I guess I just havent seen anything other generalitites. And I, nor no one on this forum, can have an educated plan to do this.

As generalities go, I found THIS article;e pretty good.

I suspect we would do it the way most countries across the Atlantic do it, which is that the government runs a basic insurance program that covers everyone but you can buy supplemental, private insurance if you're well off. (this of course varies considerably by country). While the US has already constitutionally implemented price controls in the past, in this case the 'price controls' would simply be what the big government insurance company was willing to pay. Drug companies would be free to sell it to whoever else they wanted for whatever price.

As far as eliminating the private insurance market goes I'm fine with that. It's not very efficient and it's giving us bad outcomes. Like I said before protecting it is like protecting the buggy whip factories of a century ago. If you don't work you get left behind.

 

[fskimospy]

Regarding the cost of drugs, which countries do most of the research and development (I honestly don't know if the US, Asia or Europe does the most)? how is the price of a successful drug calculated to recoup cost as well as profit (that is probably another topic altogether)? If a drug is successfully patented in country 'X', should all of the countries (at least those who are able) in the world help 'pay' for it (probably falls under the same discussion as profit)...

The US does more R&D than anyone, last time I checked. The cost of a drug for each country is based on individual negotiations for the most part. Countries shouldn't help 'pay' for drugs through the prices their insurance companies pay any more than any other customer should help pay for any product. The manufacturer decides what price they are willing to sell it for and the customer decides what price they are willing to buy it for. If they overlap, great. If they don't, such is life.

 

[soulcougher73]

Id probably model ours system after German's from what info i currently have. They have single payer but you can also get your own private doctor/insurance if you choose to at your own additional costs. Taiwans story is pretty interesting as well, in how they sent out experts to study all the big countries that had a form of UHC and then pick and chose the parts that worked the best for their system. But as in any big change like that youll have growing pains and things to work out over time.

But to act like America is somehow the only 1st world country that cant pull UHC off is just retarded thinking.

 

[soulcougher73]

The US does more R&D than anyone, last time I checked. The cost of a drug for each country is based on individual negotiations for the most part. Countries shouldn't help 'pay' for drugs through the prices their insurance companies pay any more than any other customer should help pay for any product. The manufacturer decides what price they are willing to sell it for and the customer decides what price they are willing to buy it for. If they overlap, great. If they don't, such is life.

And when a country puts in an order. You know your buying bulk. Alternator size even.

 

[blackangst1]

Regarding the cost of drugs, which countries do most of the research and development (I honestly don't know if the US, Asia or Europe does the most)? how is the price of a successful drug calculated to recoup cost as well as profit (that is probably another topic altogether)? If a drug is successfully patented in country 'X', should all of the countries (at least those who are able) in the world help 'pay' for it (probably falls under the same discussion as profit)...

One example I can speak to is insulin. Insulin is one of the top 10 most expensive liquids in the world. One example is Novolog, made by Novo Nordisk out of Denmark. Its pricing is mentioned in THIS article-

Novolog (3 ml Flexpen, 100 units/ml) — $60.68 vs. $15.98 from Canada — 74% savings

Same product, same formulary. My needs for my insulin pump would run me just under $1000/mo without insurance.

 

[woolfe9998]

I guess the two glaring things *I see* are 1. The elimination of the private health insurance market, and 2. how exactly price controls would pass constitutional muster. For the latter point, Ive already acknowledged we have price controls in the banking market, so theres that. On the former, to address a point made by another poster, Im sure some people wouldnt mind working for the federal government, but I suspect many wouldnt. Admittedly, this opinion is biased on my own discussions with coworkers through he decades of discussions with others in my profession (due to the fact private jobs in general pay much more than public positions).

Im not completely against a single payer idea. I guess I just havent seen anything other generalitites. And I, nor no one on this forum, can have an educated plan to do this.

As generalities go, I found THIS article;e pretty good.

You should consider the bureaucratic cost savings in the single payer system. In our system, it is necessary for medical providers to generate itemized patient billing because we have multiple possible payers (private and government insurance carriers). If I'm not mistaken, a typical hospital employs about 40 people doing just that. Then, there is a roughly equivalent number of people who are paid to review those bills by the insurers.

In Canada, I believe they generate no itemized billings. The single government payer pays the provider's expenses - and everyone's salaries - allowing for a small, fixed profit margin. This is done based on a cost accounting which every business must prepare anyway.

If I'm not mistaken, this bureaucratic cost is close to 20% of the our total healthcare cost. That is just the savings from eliminating paperwork.

 

[sdifox]

Somehow Americans want to spend more and get worse outcomes that the reat of the OECD countries. When will you guys realise there has always been only one payer, the taxpayer.

 

[blackangst1]

You should consider the bureaucratic cost savings in the single payer system. In our system, it is necessary for medical providers to generate itemized patient billing because we have multiple possible payers (private and government insurance carriers). If I'm not mistaken, a typical hospital employs about 40 people doing just that. Then, there is a roughly equivalent number of people who are paid to review those bills by the insurers.

In Canada, I believe they generate no itemized billings. The single government payer pays the provider's expenses - and everyone's salaries - allowing for a small, fixed profit margin. This is done based on a cost accounting which every business must prepare anyway.

If I'm not mistaken, this bureaucratic cost is close to 20% of the our total healthcare cost. That is just the savings from eliminating paperwork.

Yes Im aware of this.

 

[MomentsofSanity]

Regarding the cost of drugs, which countries do most of the research and development (I honestly don't know if the US, Asia or Europe does the most)? how is the price of a successful drug calculated to recoup cost as well as profit (that is probably another topic altogether)? If a drug is successfully patented in country 'X', should all of the countries (at least those who are able) in the world help 'pay' for it (probably falls under the same discussion as profit)...

What you should be asking is why do drug companies spend so much more on advertising than they do on research? I’m talking about all those commercials telling you to hound your doctors for specific medications instead of letting them do their jobs based on what is in the patients best interest.

Imagine the impact dropping that would have in the price of drugs.

 

[blackangst1]

Somehow Americans want to spend more and get worse outcomes that the reat of the OECD countries. When will you guys realise there has always been only one payer, the taxpayer.

And I hope when you say "Americans" you mean those we elect to make laws addressing such issues? That would be more accurate.

 

[MomentsofSanity]

And I hope when you say "Americans" you mean those we elect to make laws addressing such issues? That would be more accurate.

No I think he means Americans including those on the right who scream socialism at the tops of their lungs as they kick and scream anytime the topic comes up.

Most on the right are incapable of just having an honest conversation about health care based on facts.

 

[sdifox]

And I hope when you say "Americans" you mean those we elect to make laws addressing such issues? That would be more accurate.

Elections have consequences. You decide who represents you.

 

[dank69]

Somehow Americans want to spend more and get worse outcomes that the reat of the OECD countries. When will you guys realise there has always been only one payer, the taxpayer.

Remember it isn't us guys. It's retarded conservatives that would rather twist themselves in knots rationalizing why the liberals are wrong and continue being fleeced instead of admitting liberals are right.