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The Club takes on Healthcare - Free Market Style
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Truth is, there is no such thing as completely private R&D in medicine or biotech. NSF is almost always somewhere in the funding tree. And, yes, that includes Harvard and its $31 billion endowment. You'd think they wouldn't need the Fed's money. But that's in part why they have $31 billion. They know the power of spending other people's money.Doog_de_Jour said:
I was going to mention this but you beat me to the punch.BuffBuffPass said:Unfortunately none of that deals with the cost of the actual drugs, which is a huge driver in increased costs. One easy, quick solution to that: state that we will pay no more than the average cost of a drug across a basket of similar countries: let's say Canada, the UK and Germany. If you want to charge more for the drug than the average cost across those countries, you can do so but you lose your patent exclusivity. We currently subsidize the rest of the world by paying outrageously high prices compared to similar economies to the point that states are now looking at importing drugs from Canada that were manufactured in the US in the first place.
There's a lot of other waste in the pharmacy/PBM/drug space that could be fixed, but the above is the lowest hanging of fruit.
I am going to skirt dangerously to Tug talk here, but the fact that the US is not only footing the in pharma but in things like biomedical devices is definitely problematic. We might not have the best standard of care, but we’re still the best in scientific/medical research. That research ain’t cheap and the cost has to be passed on to somebody.
That’s why when people start comparing the US healthcare system to other countries, I get a little upset. There are some very unique problems that the US has to deal with that other countries do not. It’s fine to look to these places for ideas, but trying to replicate Canada or anyone else probably won’t work. -
We’re all having big belly (YSWIDT) laffs in the press room about the fatty shit Americans eat, but this another example of what I’m talking about with challenges that the US faces and other nations don’t (well, until recently as we?ve gotten very good at exporting fast food), is obesity and diet.creepycoug said:
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.hardhat said:
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.creepycoug said:
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.hardhat said:
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.1to392831weretaken said:
https://www.youtube.com/watch?v=h4rg-DJBd34
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
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Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
I know it’s fashionable on this bored to make fun of overweight people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue. -
Good point about obesity. No easy solutions, and I want to enjoy my food and my god given right to mock fatties, but there are some better approaches:Doog_de_Jour said:
We’re all having big belly (YSWIDT) laffs in the press room about diet, but this another example of what I’m talking about with challenges that the US faces that, until recently (because we?ve exported American fast food), is obesity and diet.creepycoug said:
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.hardhat said:
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.creepycoug said:
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.hardhat said:
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.1to392831weretaken said:https://www.youtube.com/watch?v=h4rg-DJBd34
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
I know it’s fashionable on this bored to make fun of fat people, but it is a very real problem for many that leads to other serious conditions and ultimately drives up the cost of healthcare.
Again, I have no clue how to solve it. But that’s another layer of complexity to the issue.
...only about 3.5% of the population is classified as obese, compared to rates as high as 30% or greater in countries like the U.S. And it's not just a generally healthier diet and lifestyle that's kept the Japanese trim.
Citizens must adhere to government-mandated waistline limits or face consequences. The government has established waistline limits for adults ages 40 to 74. Men must maintain a waistline at or below 33.5 inches; for women, the limit is 35.4 inches. The "metabo law" went into effect in 2008, with the goal of reducing the country's overweight population by 25% by 2015. The government's anti-obesity campaign aims to keep "metabolic syndrome" — a number of factors that heighten the risk of developing diabetes and vascular diseases, such as obesity and high blood pressure, glucose and cholesterol levels — in check, thus minimizing the ballooning health care costs of Japan's massive aging population.
https://www.mic.com/articles/84521/japan-has-cut-obesity-to-3-5-in-a-controversial-way-that-wouldn-t-fly-in-america -
My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
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My two cents: The cost of the progression of technology and the embedded return on investment for facilities has created the higher cost of care in the US.
When I was younger we had a charming show on early TV ~ Marcus Welby MD with two actors that would focus on one malady after another in the various episodes. The humorous part was that there was no technology in the day so really the doctors were largely flying blind.. the testing was elemental and rudimentary and as a result the solutions were often country doctor approaches which amounted to try this because it has been helpful to similar cases that I have seen over time. Many surgeries were exploratory in nature which amounted to lets take a look and go from there.
Fast forward to today and the picture is vastly different ~ visualization through MRI, Sonar, CaTSCAN ETC provides unheard of levels of advanced diagnosis, drugs platforms have widened as research has created sceismic breakthroughs, sophisticated levels of testing is geometrically better, hospital facilities are geometrically better and the level of sophistication has gone skyward as we approach levels of bionic healthcare solutions.
the issue is that all of this has been accomplished within the construct of Profit Based modeling which has caused pricing to go skyward as well. As an example, during the 80]s and 90's the growth rate of earnings revenue and cash flow for drug companies, hospital companies, medical supplies, surgical technology and the beginnings of biotech all grew 3x faster than the underlying economy.
The growth rate advanced just like clockwork. Since 2000, the growth rate of these groups has slowed as a result of the increased size and scale of the remaining companies, and the increased cost basis of operation has occurred as a result of the accumulated levels of increased pricing *** occurring over the last 30 years.
*** [During the 80's - 90's the accelerated growth rate also meant accelerated buyouts that reduced the number of competing companies in geometric fashion as furiously companies bought each other. Each buyout typically came at a premium to the publicly listed price through stock swaps and debt employed to close the deal. The importance is that the geometric buyout pattern reduced competition and increased the cost basis of the cost of care without providing additional benefit. ]
Summary: our health care provider network has the greatest access to technology available, and also the highest profit generating basis of operation on the planet ~ no wonder it doesn't profile like any other health care system ~ the entire basis of operation is fundamentally different. -
@CFetters_Nacho_Lover & @CfettersNachoLover ... you ok with this?BleachedAnusDawg said:My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
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THIS:
the issue is that all of this has been accomplished within the construct of Profit Based modeling which has caused pricing to go skyward as well. As an example, during the 80]s and 90's the growth rate of earnings revenue and cash flow for drug companies, hospital companies, medical supplies, surgical technology and the beginnings of biotech all grew 3x faster than the underlying economy.
Waiting for @Swaye to come in with tall tales about VA medical care.
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We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.BleachedAnusDawg said:My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work. -
This is a great point. What do I owe anybody who plays, or let's their kids play, football and 28 concussions later need life-tim care.Doog_de_Jour said:
We must not forget about people who use pot, have unprotected sex, drink alcohol, do extreme sports, don’t floss, etc.BleachedAnusDawg said:My plan is all people who have medical conditions due to being obese or smoking, etc get no help from taxpayers. Costs of everything go down for people who try to lead a decent lifestyle. Leave the fat people to the churches.
I get where you’re coming from, we do have to have some accountability in all of our own individual healthcare. But until there’s better access to preventative care and address some of things in America that contribute to a sedentary lifestyle (for example) I don’t think punishing people will work.
And, yeah, you nailed it: drugs and alcohol ... and smoking. We? are picking on fatty here ( @CFetters_Nacho_Lover and @CfettersNachoLover , still waiting for you to weigh (lolz) in), but the troof is we? put A LOT of bad shit into our bodies. -
creepycoug said:
I don't know about the fat content, which I'd guess is just as bad; but the fucking taste and the things they eat ... JFC those people can't cook.hardhat said:
Interesting point. I chortled at a brit mocking any other country for their diet. In the UK, I also think mr. pancreatitis would have had to wait his turn for his procedure. Or maybe if he was a bigwig he could have jumped the line.creepycoug said:
I'm watching the Crown on Netflix. I get most of my information from Netlfix and pendantically pass it off as my own knowledge.hardhat said:
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.1to392831weretaken said:https://www.youtube.com/watch?v=h4rg-DJBd34
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
Anyway, Churchill's Foreign Sec'y, Anthony Eden, is in the US meeting with someone, and he's having severe pancreas issues and needs surgery. Wants to do it in Boston because it's the best place in the word for that surgery. But not because of capitalism. He says to Churchill, he says, "because of the high fat diet in the US"; so we're good at fixing things caused by being like @CFetters_Nacho_Lover and @CfettersNachoLover . According to the pasty Brits.
So, I wonder, but don't necessarily know or believe, if we're good at some things and other countries are good at other things. Are we good at some medical technology because of the nature of our demographics and not because of the system? IDK. Maybe it doesn't matter.
Anyway, thought I'd throw some causation analysis in for fun.
The royal family apparently eschews garlic. Literally forbidden in the Buckingham palace kitchen. Hey Britty, try it sometime. It might make your disgusting food taste a bit better.
Anyway, I digress.
