Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 06-21-2009, 12:38 PM   #81
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Gone4Good's Avatar
 
Join Date: Sep 2005
Posts: 5,381
Quote:
Originally Posted by DblDoc View Post
The New York Times also picked this up (their story has some additional details about the poll results) http://www.nytimes.com/2009/06/21/he...%20care&st=cse

What I found really surprising was this . . .

Quote:
Nearly 6 in 10 said they would be willing to pay higher taxes to make sure that all were insured.
Normally poll results reflect a certain amount of cognitive dissonance in the populace where people want the government to fix something but don't want to pay for it in any way.

Another noteworthy finding for those who are afraid that any change in the status quo will result in health care rationing . . .

Quote:
One in four said that in the last 12 months they or someone in their household had cut back on medications because of the expense, and one in five said someone had skipped a recommended test or treatment.
The status quo already rations care, and it will only get worse.
__________________

__________________
Gone4Good is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 06-21-2009, 01:19 PM   #82
Thinks s/he gets paid by the post
DblDoc's Avatar
 
Join Date: Aug 2007
Posts: 1,224
Rationing is a given if you truly want to control costs. The challenge will be in finding a way to do it that is acceptable to us. As pointed out earlier if it costs us $150,000 per year of life saved to prescribe statins for those with elevated cholesterol is this worthwhile? Would we want to be footing the bill for even more expensive statins that drug companies want to develope?

DD
__________________

__________________
DblDoc is offline   Reply With Quote
Old 06-21-2009, 01:47 PM   #83
Thinks s/he gets paid by the post
 
Join Date: Jul 2004
Posts: 1,072
"That is why I think Obama and others clearly state they will not get rid of existing plans as part of the restructuring as that would not be palatable."

I believe the problem is if the government becomes one of the larger players in the market, the others will go by the wayside with the end state being only a government plan - if one looks at Medicaid/Medicare, the private options are limited where they play. Why should an employer administer or deal with a private healthcare mechanism or healthcare choices if the government will do it? If they could get rid of yet another program to manage, they will. Now some might argue that's great for 'portability,' but the possible unintended (and I don't know if it is unintended or not) consequence is one plan for all Americans....oh except for our congresscritters - don't they use a private plan?
__________________
Deserat aka Bridget
“We sleep soundly in our beds because rough men stand ready in the night to visit violence on those who would do us harm.” - George Orwell/Winston Churchill
deserat is offline   Reply With Quote
Old 06-21-2009, 02:22 PM   #84
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
dex's Avatar
 
Join Date: Oct 2003
Posts: 5,105
Quote:
Originally Posted by DblDoc View Post
Rationing is a given if you truly want to control costs. The challenge will be in finding a way to do it that is acceptable to us. As pointed out earlier if it costs us $150,000 per year of life saved to prescribe statins for those with elevated cholesterol is this worthwhile? Would we want to be footing the bill for even more expensive statins that drug companies want to develope?

DD
You bring up a good point.

Will companies want to pay for research and development if the return on investment does not justify it?
__________________
Sometimes death is not as tragic as not knowing how to live. This man knew how to live--and how to make others glad they were living. - Jack Benny at Nat King Cole's funeral
dex is offline   Reply With Quote
Old 06-21-2009, 05:06 PM   #85
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Feb 2007
Posts: 5,072
I believe inflation of health care cost will eventually drive us to a government controlled system. If it doesn't happen now, it will in the next 5-10 years.

Here is an interesting slide show that provides and overview of the problem from McKinsey & Company.

Accounting for the Cost of Health Care in the United States

I have read similar reports. We spend more per capita, die sooner, have higher infant mortality than the average of other developed nations.

The report indicates that the US has a higher volume of surgical procedures.

It appears Americans are often advised for unnecessary surgical procedures.

Many Stent Procedures Unnecessary

The average cost of having an angioplasty was $38,000 in 2003, according to the American Heart Association.

Drug costs appear to be 50% to 70% higher than other developed nations.
__________________
chinaco is offline   Reply With Quote
Old 06-21-2009, 07:26 PM   #86
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
I know high costs and savings involve many things. One helpful thing to look at is different parts of the US and different medical centers that have a lower cost with better outcomes. This all goes to the evidence based medicine that Rich and Meadbh talk about. For example, the Mayo Clinic, which is often cited as an example of excellent medical care and attracts people from other countries, does this a far lower cost than many other medical clinics. for example, clinics in Texas. Obama is pushing using best practices to save money. When making the calculation for the costs of health care reform the GAO does not count any savings from these types of practices.

Is using best practices rationing? Is sayig that you should not have a stent denying you choice? Maybe, but maybe the choice is reasonable.
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 06-21-2009, 09:28 PM   #87
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
clifp's Avatar
 
Join Date: Oct 2006
Posts: 7,450
Quote:
Originally Posted by ziggy29 View Post
It's pretty clear there's increasingly a "war" on fat people going on today, and increased public funding exposure to health issues will only make that worse. I think fat people and smokers are the only two classes of people against whom bigotry and discrimination are still socially acceptable.

Probably true actually old people also are still acceptable discrimination class. Especially by our fellow old folks.

Still looking at those charts and the US ranking on smoking and obesity can you imagine what our health situation would be if we didn't have a such a strong (and ultimately effective) anti-smoking campaigns.
__________________
clifp is offline   Reply With Quote
Old 06-21-2009, 09:47 PM   #88
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
clifp's Avatar
 
Join Date: Oct 2006
Posts: 7,450
In Nords and my Angel investing group we often get presentation by startup companies in the medical industry.

Almost invariably the presentation goes like this.
Here at AppleADay we were working on device/procedure that revolutionize the treatment of this disease. Currently we spend X billion on the US for treatment and 3x billion for the rest of the world.
Our widget provides better care and speeds up treatment and will save the need to do these tests and procedures.
An Angel member will ask to do you authorization from Medicare and Insurance companies. The see will generally say yes we are very close yada yada.
After the entrepreneur leaves one of the Doctors in the group will comment on the technology which is often encouragin. He then will throw a ice bucket of water on investing in the company, as explains while all of the ways that new widget will cost the doctor and the hospital money and how hard it would be to get doctors to accept the new procedure.

Unless we redesign the system to encourage paying for results and not for activity, we are in continued trouble.
__________________
clifp is offline   Reply With Quote
Old 06-22-2009, 07:51 AM   #89
Moderator Emeritus
Nords's Avatar
 
Join Date: Dec 2002
Location: Oahu
Posts: 26,618
Quote:
Originally Posted by clifp View Post
After the entrepreneur leaves one of the Doctors in the group will comment on the technology which is often encouragin. He then will throw a ice bucket of water on investing in the company, as explains while all of the ways that new widget will cost the doctor and the hospital money and how hard it would be to get doctors to accept the new procedure.
Unless we redesign the system to encourage paying for results and not for activity, we are in continued trouble.
There's a reason they do all those human trials using a subcontractor in the Philippines...
__________________
*
*

The book written on E-R.org, "The Military Guide to Financial Independence and Retirement", on sale now! For more info see "About Me" in my profile.
I don't spend much time here anymore, so please send me a PM. Thanks.
Nords is online now   Reply With Quote
Old 06-22-2009, 08:31 AM   #90
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
HFWR's Avatar
 
Join Date: May 2005
Location: Lawn chair in Texas
Posts: 12,964
Quote:
Originally Posted by Rustic23 View Post
I guess a way to look at it is there is some very expensive equipment siting idle and not making money.
__________________
Have Funds, Will Retire

...not doing anything of true substance...
HFWR is offline   Reply With Quote
Old 06-22-2009, 01:59 PM   #91
Thinks s/he gets paid by the post
 
Join Date: Oct 2006
Posts: 3,820
Quote:
Originally Posted by dex View Post
You bring up a good point.

Will companies want to pay for research and development if the return on investment does not justify it?
No, they won't do the R&D.

But, if the best they can do is a maintenance drug that costs $150,000 per year of life extension, I don't think that I want them doing that R&D.
__________________
Independent is offline   Reply With Quote
Old 06-22-2009, 02:06 PM   #92
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,612
Quote:
Originally Posted by Independent View Post
No, they won't do the R&D.

But, if the best they can do is a maintenance drug that costs $150,000 per year of life extension, I don't think that I want them doing that R&D.
This, I think, is part of the reason why all the new "blockbuster" drugs for chronic conditions are medications that only "maintain" rather than cure.

Finding a cure means you take it once for some time period, and never need it again. Where's the profit in that? I mean, I respect that the profit motive might lead to medications that substantially help the quality of life for many people suffering some pretty bad conditions. But I think that same profit motive means few (if any) curative medicines are being developed.

Had antibiotics only been a recent development, would the drug makers actually bother researching something like penicillin which only has to be taken for a very short time? Or would they need to invest to find drugs that only prevent infections from getting worse, but not actually cure them?

I hate that I'm this cynical, but I'm not convinced it's a coincidence that almost nothing developed today *cures* anything. When it comes to developing medicines, the profit motive is both a blessing and a curse.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote
Old 06-22-2009, 02:25 PM   #93
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
That is why I like having the NIH provide grants for research. But that has its own problems. Lot of wasted money went into one of its centers, the center for alternative and complementary medicine, for research on stuff that does not have any good theoretical foundation and is just psuedoscience. All due to lobbying from a senator that thought he was cured by bee pollen.
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 06-22-2009, 02:34 PM   #94
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
REWahoo's Avatar
 
Join Date: Jun 2002
Location: Texas Hill Country
Posts: 42,124
Quote:
Originally Posted by Martha View Post
All due to lobbying from a senator that thought he was cured by bee pollen.
The taxpayer's get stung once again...
__________________
Numbers is hard

When I hit 70, it hit back

Retired in 2005 at age 58, no pension
REWahoo is offline   Reply With Quote
Old 06-22-2009, 02:48 PM   #95
Moderator Emeritus
Rich_by_the_Bay's Avatar
 
Join Date: Feb 2006
Location: San Francisco
Posts: 8,827
Pharmaceutical companies always trot out the "blockbuster drug" that their R&D has discovered and, indeed, it does happen once in a great while. But more common is the introduction of a "me, too" drug to compete against a competitor's version of a simiilar drug; motrin v. naprosyn; nexium v prilosec; ambien v. lorazepam; lovenox v. fragmin, etc.

Our fantastic federal research resources (NIH et al) combined with grants to universities if properly funded can be a world leader in drug discovery, and intellectual property can be handled appropriately.

Private companies should feel free to do all the R&D they wish but I don't think we do or should depend on their view of what is important to research. Those decisions are profit-motivated.
__________________
Rich
San Francisco Area
ESR'd March 2010. FIRE'd January 2011.

As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
Rich_by_the_Bay is offline   Reply With Quote
Old 06-23-2009, 03:04 PM   #96
Thinks s/he gets paid by the post
 
Join Date: Oct 2006
Posts: 3,820
Quote:
Originally Posted by ziggy29 View Post

The thing is, the bean counters who rip into smokers and the overweight for "costing them more" in health care almost never account for the fact that on average, they live several years less -- and therefore collect several years less from Social Security and Medicare. So from a pure bean-counter standpoint, it would be intellectually dishonest to only look at the added public health care costs of smoking and obesity while ignoring the cost savings in Social Security (and perhaps Medicare in the long run).

Smokers and the obese could just as easily say they are subsidizing Social Security for the physically fit.
I've always wondered if anyone has done a study. I saw this today (via Mankiw's blog). It seems to support your point, but I have to admit that I haven't read the whole thing.

Quote:
Governments save on the costs of old-age medical care, social security, and nursing
home care due to the earlier death of smokers. (This result does not mean that it is
desirable that people die early; it means that in determining financial cost, if that is the
justification for a payment, a correct measure of the loss will only be calculated if these
effects are included.) Smoking has apparently brought financial gain to both the federal
and state governments, especially when tobacco taxes are taken into account. In general,
smokers do not appear to currently impose net financial costs on the rest of society. The
tobacco settlement will increase the transfer of resources from the smoking to the
nonsmoking public.
http://www.law.umaryland.edu/marshal.../97-1053_E.pdf
__________________

__________________
Independent is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Health Care Reform Rich_by_the_Bay Health and Early Retirement 121 06-22-2009 03:57 PM
Health Care Reform --- Will it happen after the election? chinaco Health and Early Retirement 20 02-19-2008 08:42 AM

 

 
All times are GMT -6. The time now is 01:00 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.