Health Care subsidies

[explanade]

Foreclosures from mortgages but not sure about bankruptcies.

I'm not sure about market forces in health care either. During the whole health care debate, there was talk about selling insurance across state lines. Turns out in many states, it's just one or two carriers which dominate the whole state market.

So deregulation could bring interstate competition in theory. Or the biggest insurers cherry-pick the most lucrative markets and bail on unprofitable ones, like they do with car insurance. Plus if applying real market forces means the insurers get to continue with preexisting conditions to deny or revoke coverage, then they may not get a market big enough -- young healthy people may not bother or have the money to get coverage on the individual market. Or simply redline those zip codes with older average populations.

The other part that wasn't really pursued are the providers and it's not clear that hospitals in a city would get into a price-war or anything like that.

 

[lets-retire]

One thing nobody ever seems to bring up is the "boomer effect". Since the boomers have been around anybody marketing anything to them has had the good fortune to become very wealthy. The same phenomenon is now occurring with health care and people are getting upset. Instead of implementing programs to expand supply as demand gradually increased everything has waited until it is essentially too late. I don't expect medical schools to expand their training, because the more demand there is for their product the more they can charge. The demand is a blip on the long term projections, so medical schools aren't really interested in spending millions or billions of dollars to expand when in 20-30 years they will be looking for ways to shrink. Not too mention most, if not all of the instructors are practicing doctors. If too many doctors are trained it has a dampening effect on their income. It is kind of like a cops job is to make their job obsolete.

 

[ziggy29]

If someone invented a cure for cancer, but it cost $50 million per person, would we offer it to everybody?

If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it. You'd need to take massively expensive Big Pharma drugs for life to prevent it from spreading.

Cures aren't profitable drugs. They are one-and-done. Notice how all the new medications don't cure anything, but merely manage symptoms and need to be taken for life?

 

[FinanceDude]

If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it. You'd need to take massively expensive Big Pharma drugs for life to prevent it from spreading.

Cures aren't profitable drugs. They are one-and-done. Notice how all the new medications don't cure anything, but merely manage symptoms and need to be taken for life?

+1

 

[samclem]

If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it.

"They'd" keep it in that secret warehouse where "they" have that 100 MPG carburetor and the car that runs on water.

I guess no one in "Big Pharma" or any of those medical researchers have a spouse or child dieing of cancer.

 

[GregLee]

Health care providers have pricing power because the average person isn't going up on WebMD and say that heart bypass isn't needed or should only cost 50%.

You're leaving out the insurance companies, which may perfectly well refuse to pay, or pay less, for that heart bypass. They have the motive and the power to make those decisions, which is why we've made them our gatekeepers for medical services.

I'll give you a small example. Three and a half years ago, I had a colonoscopy for which my insurance refused to pay. After a lot of back and forth with my doctor's office and the insurance people, I found out what had happened. The insurance company allows screening colonoscopies only every 3-5 years (depending on risk class), and I had had a colonoscopy just 2 years previous. Usually, the doctor's staff keeps track of such things, and will not offer a procedure or service unless the insurance company will pay for it, at least not without warning a patient about the problem. This time, the doctor's staff fouled up. Ordinarily, patients don't witness these behind the scenes negotiations between doctors and insurers.

(It turned out, in this example, that I didn't have to pay, after all, because the doctor's office had mistakenly characterized the procedure as "screening" when it should have been called "diagnostic".)

 

[ERD50]

If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it. You'd need to take massively expensive Big Pharma drugs for life to prevent it from spreading.

Cures aren't profitable drugs. They are one-and-done. Notice how all the new medications don't cure anything, but merely manage symptoms and need to be taken for life?

I'll agree that the profit and incentive is towards maintenance drugs versus a cure, but I think you overstate it by a large margin.

Let's see, off the top of my head:

Cheap generic aspirin is recc for some conditions, little profit there.

Vaccines that essentially 'cure' a disease - I bet those iron lungs were expensive and required, more money on that than a single shot.

CPR - I hear all the PSA's about using just your hands to save a life - would be far better for Big Pharma to have a sick person for years require massive care.

Seat belts, air bags, etc - I don't see Big Pharma waging a war against these things.

Laparoscopic surgery - look at how many procedures have become simpler and less expensive. Hey, wouldn't they prefer the more expensive options to make more profit?

I'm sure I could come with dozens of better examples if I took some time. Again, I agree that the profit motivation isn't as aligned with patient needs as well as we would like, but let's not condemn them with a broad brush.

Part of the blame may lie with the FDA - to the extent that they may be overly bureaucratic and ineffective (I don't expect perfection), they are adding to the cost of bringing drugs to market. So only highly profitable drugs can make their way to market.

I also believe the demand for a cancer cure would be so high, that competition for that product would bring it to market. It can be better to have a bigger slice of a smaller pie than a small slice of a big pie. Or to be left with no slice at all, because you didn't go to the party.

-ERD50

 

[FinanceDude]

"They'd" keep it in that secret warehouse where "they" have that 100 MPG carburetor and the car that runs on water.

I guess no one in "Big Pharma" or any of those medical researchers have a spouse or child dieing of cancer.

Maybe, but GM discovered ABS in the 1940's, and how long did that TAKE to become mainstream, the 1990's??

 

[Westernskies]

If someone in Big Pharma invented a cure for cancer, they'd throw it away until they developed something that would keep cancer in check for life, but wouldn't cure it. You'd need to take massively expensive Big Pharma drugs for life to prevent it from spreading.

Cures aren't profitable drugs. They are one-and-done. Notice how all the new medications don't cure anything, but merely manage symptoms and need to be taken for life?

Hmmm.. let's see ... off the top of my head- Polio, Whooping Cough, Tuberculosis, Rubella, Smallpox, Scarlet Fever- all of these are almost "diseases of the past" What about Joint replacements, pacemakers, defibrillators, etc...


How did Viagra ever make it to market? Surely something that game-changing would be locked away in the "top-secret repository o' good stuff", access-restricted to only high-level corporate execs and corrupt government officals...

 

[Rich_by_the_Bay]

Hmmm.. let's see ... off the top of my head- Polio, Whooping Cough, Tuberculosis, Rubella, Smallpox, Scarlet Fever- all of these are almost "diseases of the past"

You are assuming that anything good in health care is a product of Roche? Lilly? Pfizer? if so, you might want to update your "facts."

• Polio - Salk was at the University of Pittsburgh where his major work was done
• Whooping Cough - Belgian scientists Jules Bordet and Octave Gengou discovered the bacillus that causes whooping cough in 1906. They developed a vaccine against the disease
• Tuberculosis - 1912 by a couple of chemistry Ph.D. students in Prague; Domagk, who was the first one who discovered the structure of sulfanilamide, made some compounds that were anti-tubercule and they were used to treat about 7,000 Germans for tuberculosis
• Smallpox - Jenner, not Roche
• Scarlet Fever- Fleming, penicillin
• etc...

But nice try.

Not saying big pharma hasn't contributed, but playing fast and loose with the facts may not be the ideal way to make your point or bolster its credibility.

Just sayin'.

 

[Texas Proud]

Which false dichotomy is that?

Health care providers have pricing power because the average person isn't going up on WebMD and say that heart bypass isn't needed or should only cost 50%.

That's why health care costs have been going above inflation for decades now.

Oh and yeah, people are forced to pay without insurance coverage, either because coverage is denied or the lifetime cap is exhausted.

Speaking of comparing to other markets, what other business causes the same rate of personal bankruptcies? I would guess nothing comes close but maybe you know of another, since you seem to think health care market is a market just like any other.

Been out of this one.... but I would say CC debt beats out health... even with the new laws...


OK... looked it up... health is #4...

http://www.bankruptcyhome.com/top10reasons.htm

 

[ziggy29]

Hmmm.. let's see ... off the top of my head- Polio, Whooping Cough, Tuberculosis, Rubella, Smallpox, Scarlet Fever- all of these are almost "diseases of the past" What about Joint replacements, pacemakers, defibrillators, etc...


How did Viagra ever make it to market? Surely something that game-changing would be locked away in the "top-secret repository o' good stuff", access-restricted to only high-level corporate execs and corrupt government officals...

For the most part, the eradicated diseases you mentioned were cured decades ago. How many serious conditions have had a *cure* developed in, say, the last 20-30 years?

As for Viagra, it doesn't cure anything, either. if it did, you'd take it once, for a short time, and the chronic condition would no longer be present.

My point is that I think this is a significant part of the rise in health care costs. Not only are many new boutique drugs expensive, but they often have to be taken for life. The drugmakers are in business to make money, and that's fine, but it also comes with the realization that they'd rather develop stuff that creates customers for life instead of one-timers.

 

[Westernskies]

You are assuming that anything good in health care is a product of Roche? Lilly? Pfizer?

Not sure where you made the jump to that assumption, Rich. I know that research occurs at both public and private facilities, but (fortunately, or unfortunately, depending on your perspective...) big pharma is best-positioned in terms of infrastructure, capital, and distribution networks to commercialize the discoveries and distribute them to the trade. I shudder to think what would happen if we put the gub'mint in charge of our prescription drugs.. Oh, wait, never mind...

 

[explanade]

Seems a big part of Big Pharma's business is in lifestyle drugs -- ED, allergies, managing hypertension, high cholesterol, etc.

You know, all the things they advertise heavily these days, instead of things like cancer.


I thought the AMA somehow tried to limit the number of med school students or in some way try to limit the number of new doctors entering the profession every year?

 

[ziggy29]

I thought the AMA somehow tried to limit the number of med school students or in some way try to limit the number of new doctors entering the profession every year?

I'm pretty sure they do. This is not unique to the medical profession; it's also found in other (mostly) lucrative occupations where the practitioners want to limit the "supply" of people in their trade to keep their labor rates high.

Meddling with the free market takes a lot of different forms.

 

[FinanceDude]

I thought the AMA somehow tried to limit the number of med school students or in some way try to limit the number of new doctors entering the profession every year?

They don;t have to anymore, Obamacare took care of that. Now, a newly minted resident simply gets a letter that says: "Congratulations on graduating from medical school, you are now $300,000 in debt, and the most you will ever make is $80,000. Now go see some patients"..........

 

[Westernskies]

They don;t have to anymore, Obamacare took care of that. Now, a newly minted resident simply gets a letter that says: "Congratulations on graduating from medical school, you are now $300,000 in debt, and the most you will ever make is $80,000. Now go see some patients"..........

You just had to use the "O-word"- the pig's engraved invitation.