The current state of American healthcare


#1

Originally published at: http://boingboing.net/2016/10/24/the-current-state-of-american.html


#2

Are you saying that French drugs are cheaper because the French government are forcing Americans to pay for the research? Are you voting for Trump this election? Because that makes just as much sense as this drivel.

Also, there were five beaches landed on at Normandy, of which the US forces landed on two. And at that they lost more soldiers than they should have because of their generals’ insistence that they didn’t need any specialised beach-clearing equipment like the British and Canadians did, because they were Americans.


#3

The American pharma industry is adept at producing drugs that don’t cure anything that needed curing; they find obscure conditions and work hard to get as many people as possible to buy a pill every day for the rest of their lives to ameliorate it.
Thank you, TV, for running ads for prescription pills!


#4

I’ve been told that their air support was two minutes late, as well, leading to massive initial casualties when the enemy fortifications were both intact and had unobstructed fields of fire.


#5

I don’t think that’s what he wrote.


#6

With Big Pharma spending 10-20 times more on advertising than on R&D, and the gods only know how much on political lobbying, I’m pretty confident in thinking that the USA is not subsidizing socialized medicine in other countries.


#7

This argument that the US subsidizes drug development with high drug prices makes sense at face value but when I took a look at the published data it does not support this thesis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
As compared to our GDP the US does not contribute significantly more to new drug discovery than other countries. We merely pay more because we don’t control the prices and as the author correctly points out choices around healthcare are rarely really choices at all.


#8

Ummm… that’s exactly what he wrote.

It’s hard to imagine a more ass-backwards analysis of the problems with the US pharma industry.


#9

Well that was paragraphs upon paragraphs of somebody impressing himself with his cleverness, but very little in the way of substance. Socialized medicine works, free market not so good for health care. But we’ve all known that for ages, except Republicans. The New York Times has probably written the same article monthly for ten years.

I want my five minutes back.


#10

There is an enormous amount of work being done by the pharmaceutical industry to develop new antibiotics. They don’t have much to show for it, but antibiotics are a blockbuster drug class. They’re an actual cure that everyone needs, likely multiple times in their life. Even the best antibiotic ever wouldn’t be a one-time cure.

This is a case where the profit incentive lines up with the public good.

Then again there’s examples like Sovaldi, which cures Hepatitis C with a 95% success rate and is much better tolerated than previous interventions. It costs $80,000 USD for a course of that stuff.

How much is your liver worth to you? Remember, you’ll die without it.


#11

Not sure… poor me another drink and I’ll think about it.


#12

America has opened a tab at the pharma bar and everyone else is drinking for free, but setting price controls isn’t entirely the answer. It works for other countries, because American consumers pick up the research tab. Consider, though, if we all had limited pricing: profits would decrease, but so too would the rate of new innovation. I like being alive. And I want those pharmaceutical companies to be as motivated as possible to keep coming up with better ways to keep me and my friends going.

I hate this line of argument, in discussions about new drugs or about any other kind of innovation. People have more incentives to create things that will help other people than greed. And for those who do have greed as their primary motivation, setting limits on what they can earn from it won’t slow them down. They’ll still greedily chase that amount of money instead. Also, this argument does not acknowledge how corporations are structured. Those seeking maximum profit (executives, shareholders) are not the same people as researchers.


#14

I agree with the idea of researchers seeking the good, but we no longer live in a time when materials are “cheap”. Labs cost money, big money and realistically the only other entity that has that kind of capital is a government. He kind of laid it out on the table there toward the end, but like most people just fell flat with it. It’s not about curbing corporate greed or imposing monetary limits, it’s about a fundamental societal shift in how we allocate resources. Example: NASA. Yes there was a lot of patent stuff and other areas where the government was sort of throwing the baby out with the bath water, but all in all NASA did a lot of good for everyone. I’m all for my taxes going toward research that might not yield results for decades, I’m all for allowing companies to write of the money they spend on serious R&D - I’m all for pouring money and resources into our future.

As far as free market healthcare…I think it’s a double edge sword. If you had a theoretical 100% socialized medical system why would you allocate resources to someone who only had a 10% chance of living? In the 100% open/free market system you would only be limited by how much you could spend, but there in lies the problem. At some point all the easy problems are solved, but people are now dying of things that cost much much more to fix…


#15

Basic human decency?

Why argue hypotheticals when actual socialized healthcare systems exist?

You could just read up on how things like NICE work.

And the rich could still buy their expensive healthcare if they wanted.


#16

Since I’ve been brought it up so often, I feel like I owe people here an update.

My mother finally qualified for a free course of the new hep c meds which she just finished. She had been trying to gain access to them since the last round of trials.

She was literally told that she was “lucky” to have no income.


#17

It’s also complete bullshit. Big Pharma like most industries have been buying out small labs who barely scraped by to fund their research who did all the innovation, and then takes the investment through drug trials. The innovation happens no matter what, it’s just the large scale trials that are privatized because of the US politics around medicine that Big Pharma coughs money up for in the name of “innovation.”


#18

Because they exist in parallel with privatized healthcare as well. That entire Wikipedia entry makes the point that once you cross a specific monetary threshold there is only X treatment. The only way to obtain more is through private insurance or to do with a lower, more cost effective, level of treatment. That’s why I stated it in theoreticals, because there would be no private insurance for you to fall back to, you would be at the mercy of the system. The same as you would be at the mercy of corporations in an entirely capitalistic/free market one.

Both have limitations and very rarely do I see those put forth in non-argumentative ways.


#19

You’re using a different definition of greed, then. The definition I generally use is “a desire to obtain and hold resources beyond what is reasonable or healthy”.

I have never once, in a long career in high tech, seen corporate greed “propel” invention. Corporations variously inhibit, exploit, and distribute the works of inventors, who are almost never driven by greed. Note only one of those three activities is desirable.

Which is necessary because political corruption of the FDA has prevented the regulation of antibiotics in animal feed. Seriously, this has been documented since the 1970s - and there’s exactly one political candidate talking about it* since Sanders got out of the race.

The golden nugget from this essay. The exploiters know exactly what they are doing when they convert taxpayer-subsidized research and development into privately controlled economic restrictions on the availability of healing.

It’s nice to have new voices inside the bubble, even when I don’t share their viewpoint. Or even especially then - look at the great, informative replies sprinkling this thread!

* talking about it in terms other than simply abolishing the FDA, that is.


#20

Agreed. Innovation isn’t happening at the big companies; acquisition is.


#21

If the great, informative writing is all in the comments, then you have a problem. Giving the megaphone to the least well informed writer is an uncommonly prevalent problem in online journalism (Case in point, the Grauniad. So many of their opinion writers get immediate refutation below the line)