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Old 02-26-2013, 12:20 PM   #141
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............
Well, no, not really. The issue is that we all probably agree about the causes, or at least easily could agree... the problem is with regard to the solutions............
The issue is your condescending and abrasive manner of posting.

Generally people with this style don't last long here, but I've found it useful to put them on my ignore list until they burn out and go away.
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Old 02-26-2013, 12:34 PM   #142
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While the American lifestyle may have led to self created health problems and more need for health care. And life style changes and healthier living may reduce some of those health care cost. The at times rancorous arguments have not addressed the issue of the increasingly out of control cost of providing health care, together with a large aging population that will need a lot of health care in the next 20 to 30 years, that convergence will create such a financial tsunami that no one in the government or private sectors have any plan or solution for.
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Old 02-26-2013, 12:43 PM   #143
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I agree with Gaterdoc50. I believe that our unhealthy lifestyle is the major force driving high healthcare costs. This might change if the healthcare system also emphasized preventation through lifestyle changes, instead of just treating disease.
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Old 02-26-2013, 12:50 PM   #144
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The issue is your condescending and abrasive manner of posting.

Generally people with this style don't last long here, but I've found it useful to put them on my ignore list until they burn out and go away.
+1.....
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Old 02-26-2013, 12:52 PM   #145
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I agree with Gaterdoc50. I believe that our unhealthy lifestyle is the major force driving high healthcare costs. This might change if the healthcare system also emphasized preventation through lifestyle changes, instead of just treating disease.
I don't think so. The UK and Mexico obesity rates are only a few % points behind the USA but their healthcare costs are way lower

Obesity statistics - Countries Compared - NationMaster
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Old 02-26-2013, 12:52 PM   #146
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Actually, I heard it argued that it's better, from the standpoint of total spending on heath care, for obesity and other lifestyle-caused diseases, because people die earlier, rather than draw on health care resources for decades.

As for prescription drugs, what was that sedative that was common in the '60s and '70s?

We do have the mentality of the magic pill curing everything. And the drug companies charge Americans higher prices, subsidize the rest of the world for their "research" which often comes from NIH-funded work.
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Old 02-26-2013, 01:00 PM   #147
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Actually, I heard it argued that it's better, from the standpoint of total spending on heath care, for obesity and other lifestyle-caused diseases, because people die earlier, rather than draw on health care resources for decades.
Since you've introduced the thought, care to provide a link or any basis for same? And how smoking, cancer and other health issues lower lifetime costs while you're at it...
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Old 02-26-2013, 01:13 PM   #148
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Since you've introduced the thought, care to provide a link or any basis for same? And how smoking, cancer and other health issues lower lifetime costs while you're at it...
I'll help. You will love this one Midpack!

However, smokers die some 10 years earlier than nonsmokers, according to the CDC, and those premature deaths provide a savings to Medicare, Social Security, private pensions and other programs.

Vanderbilt University economist Kip Viscusi studied the net costs of smoking-related spending and savings and found that for every pack of cigarettes smoked, the country reaps a net cost savings of 32 cents.

http://usatoday30.usatoday.com/news/...co-costs_N.htm

It's all how you interpret the data, I guess. It is kind of humorous that the data could be interpreted different ways from what is traditionally believed. I would certainly guess the bean counters at Medicare and the Social Security Offices would probably prefer everyone over the age of 18 to light up.
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Old 02-26-2013, 01:17 PM   #149
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the drug companies charge Americans higher prices, subsidize the rest of the world for their "research" which often comes from NIH-funded work.
This is one of my pet peeves. Our current semi-free market system of providing health care drives this and opens the door for foreign govt's to negotiate and procure drugs cheaper than our own private distributors and retailers can in some instances.

While I have some reservations about Obamacare and the direction it's heading, I am all in favor of some change to our system that ensures that USA citizens pay no more for USA invented and patented drugs than anyone else in the world. I hope Obamacare helps get us there.

I also think we spend too much for drug research and wish it wasn't so easy for drug companies to pass on the cost of research to consumers, especially USA consumers.
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Old 02-26-2013, 01:30 PM   #150
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I also think we spend too much for drug research and wish it wasn't so easy for drug companies to pass on the cost of research to consumers.
Who should pay for the research? Consumers pay for product research in every other industry, right?
But if you mean that you wish there was some way to introduce more price competition when drugs are under patent--I'm with you. That's a tough problem. One partial answer does come from the market: When a company makes tons of money on a unique patented drug, there's usually another drug company in hot pursuit, so the original company seldom remains in a monopoly position for the full term of the patent.
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Old 02-26-2013, 01:37 PM   #151
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Who should pay for the research? .
I think there should be less research, especially along the lines of trying to find new wonder cures. Admittedly, it will be hard for the gov't to intervene. Perhaps eliminating tax incentives and reducing patent protection would help. That is, if a new wonder drug, developed without tax incentives and with limited patent protection, returns the cost of development to the developer, good. But if it doesn't and the developer loses money, then that will be incentive to hold our outrageous drug development costs down or spread them around the world more evenly.

I'm particularly annoyed when a new "wonder drug" under patent protection sells for big bux here in the States but later is quietly introduced into other parts of the world for less money. If I recall correctly, bringing these drugs back into the USA is discouraged by FDA and other rules. A big scam IMHO.

Rearch into cost reducing current drugs is OK as long as the resulting reduced manufacturing costs more than offset the cost of the research.
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Old 02-26-2013, 02:03 PM   #152
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I think there should be less research, especially along the lines of trying to find new wonder cures.
I think we'll have to disagree on this one. I want the best and brightest looking for ways to halt cancers, to develop antibiotics to stay one step ahead of disease resistance, to treat debilitating illnesses that steal life from our years. I've got no problem if lots of folks make lots of money doing that, and if private investors are thereby encouraged to put their own money at risk to produce the next big thing. I would have had no objection if Jonas Salk had become wealthier than a Rockefeller.

The problem (IMO) is the drugs that are only marginally better (or even not better at all) but which are hyped to the extreme directly to patients. Doctors write prescriptions because patients ask for the drugs (responding to the ads)--why should the doctor say no? The patient is his customer and he's making a request, the new drug is safe (if also expensive and not any better than the available old alternative) and it doesn't cost the doctor or the patient anything extra. Now, if the patient is paying 10% out of pocket for the drug, then maybe he'll listen when the doc recommends the old standby. The patient is at least sure to give it a try.
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Old 02-26-2013, 02:16 PM   #153
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I think there should be less research, especially along the lines of trying to find new wonder cures. Admittedly, it will be hard for the gov't to intervene. Perhaps eliminating tax incentives and reducing patent protection would help. That is, if a new wonder drug, developed without tax incentives and with limited patent protection, returns the cost of development to the developer, good. But if it doesn't and the developer loses money, then that will be incentive to hold our outrageous drug development costs down or spread them around the world more evenly.

I'm particularly annoyed when a new "wonder drug" under patent protection sells for big bux here in the States but later is quietly introduced in other parts of the world for less money. If I recall correctly, bringing these drugs back into the USA is discouraged by FDA and other rules. A big scam IMHO.

Rearch into cost reducing current drugs is OK as long as the resulting reduced manufacturing costs more than offset the cost of the research.
I have to take exception to the concept of doing less research. I am a cancer survivor and have been involved in cancer support groups for 17 years. I've also been involved in other areas of consumer health care issues. I think it's our research priorities that are a large part the issue. We need a lot of basic science research. I don't know that it will cure heart disease or obesity or cancer (which is really many different diseases). It certainly will help develop targeted therapies for many diseases by offering a less systemic approach. Using cancer as an example, we need therapies that target the cancer cells and don't poison the whole person.

I agree, the "wonder drug" approach is awful. Lipitor is a prime example and there are many more. The prices charged here for medication are appalling. But this is a big issue and not one to be resolved easily. Some of those "wonder drugs" are being taken off the market when they go off-patent despite the fact that there are people who need them as therapy.

I'm on a lot of medications. I am not grossly obese or a smoker. I am glad there are some options available for me to help my health - but the costs are obscene.

As I said, I would like to see much more money used for basic scientific research.
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Old 02-26-2013, 02:17 PM   #154
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I think we'll have to disagree on this one. I want the best and brightest looking for ways to halt cancers, to develop antibiotics to stay one step ahead of disease resistance, to treat debilitating illnesses that steal life from our years. I've got no problem if lots of folks make lots of money doing that, and if private investors are thereby encouraged to put their own money at risk to produce the next big thing. I would have had no objection if Jonas Salk had become wealthier than a Rockefeller.

The problem (IMO) is the drugs that are only marginally better (or even not better at all) but which are hyped to the extreme directly to patients. Doctors write prescriptions because patients ask for the drugs (responding to the ads)--why should the doctor say no? The patient is his customer and he's making a request, the new drug is safe (if also expensive and not any better than the available old alternative) and it doesn't cost the doctor or the patient anything extra. Now, if the patient is paying 10% out of pocket for the drug, then maybe he'll listen when the doc recommends the old standby. The patient is at least sure to give it a try.
+1 (we cross-posted)
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Old 02-26-2013, 02:25 PM   #155
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I think we'll have to disagree on this one. I want the best and brightest looking for ways to halt cancers, to develop antibiotics to stay one step ahead of disease resistance, to treat debilitating illnesses that steal life from our years.
Yes, we will have to disagree on that one. Obviously, I too favor cures for cancer, etc. And I too want "the best and brightest looking for ways to halt cancers, to develop antibiotics to stay one step ahead of disease resistance, to treat debilitating illnesses that steal life from our years."

Our difference seems to be on focus. I think we can acheive most of what we both would like in drug developement without a 100% allocation of health care resources in that area. And I think the costs of the research can be spead around the world more equitably.

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I would have had no objection if Jonas Salk had become wealthier than a Rockefeller.
Since the resources to make Salk wealthier than a Rockefeller would have come at the expense of other members of society, that might have been a tad on the painful. Those cheap innoculations at the clinic might have required a family's life savings just to save junior's life.
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Old 02-26-2013, 02:32 PM   #156
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As I said, I would like to see much more money used for basic scientific research.
Just curious, what areas of health care would you be willing to pull resources from in order to have more money used for basic scientific research?

Using today as a baseline, would you like 10%, 25%, 50% or XX% more spent on basic scientific research at the expense of other health care needs?

Isn't the issue of having finite resources a bitch?
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Old 02-26-2013, 02:39 PM   #157
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Just curious, what areas of health care would you be willing to pull resources from in order to have more money used for basic scientific research?

Using today as a baseline, would you like 10%, 25%, 50% or XX% more spent on basic scientific research at the expense of other health care needs?

Isn't the issue of having finite resources a bitch?
I don't think we have to pull resources from health care to do more basic research - just put more $ into doing research. Pull it from one of the many money-wasting and possibly redundant areas of the government budget. I don't know which one.

But it doesn't have to come out of the healthcare "pot", IMHO. In fact, had we gone to single payer insurance.... who knows, we might have saved money?

Of course if you want to discuss pot...
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Old 02-26-2013, 02:55 PM   #158
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just put more $ into doing research. Pull it from one of the many money-wasting and possibly redundant areas of the government budget. I don't know which one.

As I said, resource allocation is tough stuff. No one wants to recognize that resources are finite and no one wants to recognize that we can't allocate 100% of our resources to each of a zillion different projects and initiatives. The 100% has to be spread between ALL of them.

Regarding your idea of pulling the money from one of the many money wasting and possibly redundant areas of the government budget............ based on the discussions in Washington today, every penny the gov't planned on spending in 2013 is absolutely, positively critical. And you want to pull some for your projects? Not possible according to our politicians. Every penny they're spending, and more, is needed to be spent just as they've planned. Aren't they jerks?

Anyway, I'm delighted you had favorable results with your cancer. I recently had a friend go through chemo for NHL and he was told that the available drugs just a few years ago would have been harder on his body and less likely to have cured him. Still, my point is about resource allocation. Cures are good. But do we spend 100%, 99%, 98%, XX% of our total resources on developing them?

If we can't do everything we want, what do we do?
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Old 02-26-2013, 03:02 PM   #159
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I think there should be less research, especially along the lines of trying to find new wonder cures. Admittedly, it will be hard for the gov't to intervene. Perhaps eliminating tax incentives and reducing patent protection would help. That is, if a new wonder drug, developed without tax incentives and with limited patent protection, returns the cost of development to the developer, good. But if it doesn't and the developer loses money, then that will be incentive to hold our outrageous drug development costs down or spread them around the world more evenly.

I'm particularly annoyed when a new "wonder drug" under patent protection sells for big bux here in the States but later is quietly introduced into other parts of the world for less money. If I recall correctly, bringing these drugs back into the USA is discouraged by FDA and other rules. A big scam IMHO.

Rearch into cost reducing current drugs is OK as long as the resulting reduced manufacturing costs more than offset the cost of the research.

One of the big problems with this line of thinking is that nobody knows what will happen with the research....

IOW, research trying to find the unknown... sometimes you find it, most of the time you do not...

I do not see how we would be living as long as we do without this research... also, research is not limited to drugs... there are a lot of new machines and procedures that are better than previous ones because of research...


And you last stmt just makes no sense... how do you know BEFORE you do any research if it will be reduce mfg costs...
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Old 02-26-2013, 03:18 PM   #160
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One of the big problems with this line of thinking is that nobody knows what will happen with the research....

IOW, research trying to find the unknown... sometimes you find it, most of the time you do not...

I do not see how we would be living as long as we do without this research... also, research is not limited to drugs... there are a lot of new machines and procedures that are better than previous ones because of research...
I understand. But remember, we also don't know what the impact of shifting additional resources away from other endeavors and into drug research will have on society. As discussed above, perhaps the pirated resources would have just been wasted on, for example, dumb gov't projects. Or, maybe those resources would have been used to keep terrorists from getting poison into the Dallas drinking water supply. Or have payed for a doc to work in a impoverished area. We don't know. We're allocating some percentage of our resources to drug research today. How much more do you want to pull from other endeavors? When will we know we've hit the "sweet spot" and aren't spending money on diminishing returns?

Resource allocation is hard. And controversial.
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And you last stmt just makes no sense... how do you know BEFORE you do any research if it will be reduce mfg costs...
I can tell you didn't work in manufacturing process development. Before beginning a manufacturing process cost reduction project we'd identify what we would change and what the resulting savings would be. For example, we might note that adding a clean room environment to the process at a cost of $1MM would eliminate the $2MM of rejected lots we had last year. We'd base this on research that showed working in the clean room environment reduced the ppm level of contaminants by X%. And so on and so forth. Then we'd do the project, measure the outcome, and hopefully meet our goal. We weren't always successful but generally anticipated savings targets were met.
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