Cost of medicine

[medstu2006]

Why is the cost of medicine so high in the US more than anywhere else in the world? Any views, ideas or facts as to why is that?

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[aubieRx]

have you seen public housing?

your answer is there.

 

[ZpackSux]

Why is the cost of medicine so high in the US more than anywhere else in the world? Any views, ideas or facts as to why is that?

It costs a lot to develop a new drug, get FDA approval, and market it. A new drug has a lifespan called patent. Once the patent runs out and enters the generic market, the developer of the drug won't make as much money.

So, the pharmaceutical companies need to make as much profit in a given period. Rightfully so.. I guess.

That being said, why is it more expensive in the US? Because we subsidize the rest of the world... because pharmaceutical companies can get away with it. Is it fair? I don't know.. is it fair that we live in the best country in the world when others can't? Perhaps it's a little price to pay for the ownership of the US Citizenship.

But what would I like to see? I want the pharmaceutical companies produce quality drugs and let the drug market itself. Sure.. young 25 y/o blonde drug rep with miniskirt and high heels bringing lunch for your staff is pleasant to look at.. but how much money are we spending on this frivolous practice?

 

[aubieRx]

oh i thought he meant healthcare in general.

 

[ZpackSux]

oh i thought he meant healthcare in general.

Must have been a deduced percetion.

 

[medstu2006]

oh i thought he meant healthcare in general.

And that too. Basically, what I was getting to is that healthcare in general is very expensive in the US. Who is at fault? I think everyone involved is- from doctors to insurance companies to patients. Insurance companies charge you based on your age and other x amt of diseases that you have or dont have, and after a certain age, when you need it the most, the companies desert you. Many doctors have exhuberent fees since insurance pays most of it. As a result, insurance costs are high. Prescription drugs are expensive. 2 yrs ago my school nurse prescribed me an anibiotic for my cold. It cost me $80. Quite expensive and I did not buy it. I bought NyQuil and was fine the next day.
Even many hospitals perform unnecessary tests on their patients to gain more money. Patients are at fault as well because there are some who want to sue their doctor for malpractice. It is all a cycle. There must be a solution somewhere for all this. Grrrr.. What do you guys think?

 

[aubieRx]

well in socialist countries you have to be on a waiting list to get treatment. Some people who get on waiting lists for cancer diagnosis end up dying of cancer before they get to go in for a visit (in canada for example)

its worse than what is going on in the USA

 

[Oneday_9]

And that too. Basically, what I was getting to is that healthcare in general is very expensive in the US. Who is at fault? I think everyone involved is- from doctors to insurance companies to patients. Insurance companies charge you based on your age and other x amt of diseases that you have or dont have, and after a certain age, when you need it the most, the companies desert you. Many doctors have exhuberent fees since insurance pays most of it. As a result, insurance costs are high. Prescription drugs are expensive. 2 yrs ago my school nurse prescribed me an anibiotic for my cold. It cost me $80. Quite expensive and I did not buy it. I bought NyQuil and was fine the next day.
Even many hospitals perform unnecessary tests on their patients to gain more money. Patients are at fault as well because there are some who want to sue their doctor for malpractice. It is all a cycle. There must be a solution somewhere for all this. Grrrr.. What do you guys think?

You are very right on in this analysis, the reason for the high cost of healthcare in the united states encompasses all those things. Patients are also at fault alot of times bc they do not want to take a generic medication, insist on a brand medication, and have their own superstitions or inaccuarte information about generics and brands. So int he scheme of things, from a prescriber to the pharmacist to the patient to the pharma company and especially the insurance company, this is driving up the cost.

I think the insurance here is key as well, and the unnecessary, expensive testing that goes on in hospitals, etc. Also, the population of the US is living longer, meaning more utilization of health care than ever before and we see the trend of companies pushing the health care cost back on the employee. Smaller companies are suffering from health care costs, large companies too. We can expect with the baby boomers that this will probably get worse.

It's such a mind bending situation. I can recommend an excellent, excellent book examining these issues and it is from the point of view from a physician/epidemiologist from Harvard Medical School:

Powerful Medicines : The Benefits, Risks, and Costs of Prescription Drugs
by Jerry Avorn

As a student pharmacist and someone interested in public health and policy this was a very important reading. I would recommend it for anyone interested in this issue as we should all be anyways. It is now in paperback so it's probably pretty cheap on amazon.

Thanks for bringing this issue up, very important discussions.

I guess we know there is a problem, but what is the solution to all of this? With all these contributing variables, how much of each variable do we need to rework? How long will it take? How much will that cost? Would politicians back it if it means cutting costs or hinderances to the insurance and pharmaceutical companies? What types of policies or programs can we install to combat poor prescribing habits?

Let's talk about it.

 

[ZpackSux]

This topic is too indepth for most of us to understand. But what is the problem and what outcome do you seek?

"Healthcare is too expensive" is a broad statement. Healthcare is too expensive for whom? Medicare, Medicaid, and insured people?

Or is it too expensive for uninsured who ends up not paying?

Why are employers providing healthcare benefits for employees? When did it become a god given right for employees to receive healthcare from being employed? Where is the connection.

The problem and the solutions lie within us. Healthcare insurance for a family of 4 can range anywhere from $300 to $800 per month. Of course if you're a smoker, obese, and have HTN, Diabetes, it will be expensive...whose fault is that?

Then again, if you're employed, health benefits aren't very expensive.

You say we run unnecessary lab tests? For inpatient with DRG payment, hospiatls lose out..since no matter how many tests a hospital runs..and how much drug is provided, the hospital will only get paid the set DRG payment.

Our healthcare system is not perfect. Then again, I wouldn't go anywhere else in the world to receive healthcare. It's time we demand accountability to everyone and be responsible for their health and healthcare. When you set providing healthcare as a priority for your family, then there are ways and means to meet it. You say it's expensive? So is Lexus .. but it's all over the place.

 

[medstu2006]

This topic is too indepth for most of us to understand. But what is the problem and what outcome do you seek?

"Healthcare is too expensive" is a broad statement. Healthcare is too expensive for whom? Medicare, Medicaid, and insured people?

Or is it too expensive for uninsured who ends up not paying?

Why are employers providing healthcare benefits for employees? When did it become a god given right for employees to receive healthcare from being employed? Where is the connection.

The problem and the solutions lie within us. Healthcare insurance for a family of 4 can range anywhere from $300 to $800 per month. Of course if you're a smoker, obese, and have HTN, Diabetes, it will be expensive...whose fault is that?

Then again, if you're employed, health benefits aren't very expensive.

You say we run unnecessary lab tests? For inpatient with DRG payment, hospiatls lose out..since no matter how many tests a hospital runs..and how much drug is provided, the hospital will only get paid the set DRG payment.

Our healthcare system is not perfect. Then again, I wouldn't go anywhere else in the world to receive healthcare. It's time we demand accountability to everyone and be responsible for their health and healthcare. When you set providing healthcare as a priority for your family, then there are ways and means to meet it. You say it's expensive? So is Lexus .. but it's all over the place.

Disclaimer: 98% of what I say is useless, senseless, and meaningless. The other 2% probably doesn't apply to you. For your sanity, put me on ignore

 

[Oneday_9]

This topic is too indepth for most of us to understand. But what is the problem and what outcome do you seek?

"Healthcare is too expensive" is a broad statement. Healthcare is too expensive for whom? Medicare, Medicaid, and insured people?

Or is it too expensive for uninsured who ends up not paying?

Why are employers providing healthcare benefits for employees? When did it become a god given right for employees to receive healthcare from being employed? Where is the connection.

The problem and the solutions lie within us. Healthcare insurance for a family of 4 can range anywhere from $300 to $800 per month. Of course if you're a smoker, obese, and have HTN, Diabetes, it will be expensive...whose fault is that?

Then again, if you're employed, health benefits aren't very expensive.

You say we run unnecessary lab tests? For inpatient with DRG payment, hospiatls lose out..since no matter how many tests a hospital runs..and how much drug is provided, the hospital will only get paid the set DRG payment.

Our healthcare system is not perfect. Then again, I wouldn't go anywhere else in the world to receive healthcare. It's time we demand accountability to everyone and be responsible for their health and healthcare. When you set providing healthcare as a priority for your family, then there are ways and means to meet it. You say it's expensive? So is Lexus .. but it's all over the place.

I don't think it's unreasonable to classify this dire situation as expensive. I guess, what I am getting at is this . . .let me be careful...cumulatively, these costs add up, prescription, lab etc. and thus, although respective to one individual it is a $0 copay, it is still paid for by someone and that in itself drives up costs. So what I am getting at is that we need to rework the system to take care of these problems, use technologies, information, PHARMACISTS effectively to decrease the unecessary use of medications and carelessly taking tests etc. It's more about setting parameters to balance out things to reduce costs. So what types of policies can we come up with to tackle these issues? That's what I am getting at.

I'm not trying to be inflammatory or bitch and moan and be a bleeding heart but honestly people are struggling to make payments for healthcare, it's a truth and I won't paint some corporate picture rationalizing the costs and hear the sob story of of pharma, ins companies, and other corporations.

It is going to be my mission to do something about it, however miniscule. I am not saying our system is terrible, I know it's the best, but that doesn't mean it's perfect or we need to simplify it such that we compare the Lexus with other healthcare expenses and write them off.

So I'll try to be a bit more specific and careful before speaking about the flaws of our American healthcare system.

 

[ZpackSux]

don't be apologetic..

Lexus too is not perfect... They need to work the somewhat soft suspension a bit for it to handle like the mcpherson struts in 3 series

 

[aubieRx]

Is healthcare a right?

This was our admissions essay and i said no because you cannot have a right that requires the work of other people with rights of their own. They havea right not to perform their work for free/cheap.

Healthcare is a good. Like food, books, and even a lexus. It is a product of people who spend countless hours in school and then long hours in a job.

If we are going to say everyone should have government healthcare so everyone is equal we might as also say everyone can only eat government food so everyone is equal and everyone has a government car so everyone is equal and pretty soon that would really suck

 

[Oneday_9]

See, I don't think healthcare is a right but an inherent responsibility of society. Not everything is meant to be privatized, because these companies main focus is making money, and compassion and humanistic qualities are not part of such a system. This is not to say that is necessarily bad, it works, but we need to re-think what healthcare is about. It's not a right, it's the opportunity to have some means to benefit from our amazing health care system. The current trends are not working and I am skeptical when the new Medicare bill takes effect in 2006. But it's a start, it's at least going somewhere, and the MTM portion has the potential to drasticly change our profession and lend us more credibility with the general public.

I don't really understand the logic of government food etc. etc. etc. I mean, I get the point, but I see healthcare as a staple part of simply participating in society. It may be classified as a good but that's all relative to who classifies it that way. Currently, yes, it is viewed as a good with stock holders, the whole mess, but how profound are the implications of such a good? This good, if utilize incorrectly with negligence can end people's lives? These are inevitable, but what I am getting at is, healthcare is more than simply a good, it is a responsibility to be taken on and handled with absolute precision.

I see where you all are coming from . . . but I don't buy such a cold, indifferent analysis.

 

[ZpackSux]

The current trends are not working and I am skeptical when the new Medicare bill takes effect in 2006.

I ask again. What's not working? What segment of healthcare and what segment of patient population does it affect?

 

[Oneday_9]

I ask again. What's not working? What segment of healthcare and what segment of patient population does it affect?

LOL
Man, if you had asked me that, I would have answered. Here is information from the National Coalition on Health Care. If our entire payment of health care relies upon insurance and we have so many Americans without it, this means paying out of pocket is likely and the norm, most are handling all the expenses themselves, thus making them more likely to avoid healthcare, increasing their risk for mortality or progression of otherwise preventable disease states, and thus more cost than needed initially to treat their condition


So essentially the system is great my friend, but more and more people are losing access to it.

Posted from: http://www.nchc.org/facts/coverage.shtml

So who are the uninsured?

* Approximately 45 million Americans, or 15.6 percent of the population, were without health insurance coverage in 2003. The number of uninsured rose 1.4 million between 2002 and 2003.(1)
* Nearly 82 million -- about one-third of the population below the age of 65 spent a portion of either 2002 or 2003 without health coverage.(1)
* The percentage of people with employment-based health insurance dropped from 70 percent in 1987 to 61 percent in 2004. This is the lowest level of employment-based insurance coverage in more than a decade.(2,3)
* In 2003, 27 million workers were uninsured because not all businesses offer health benefits, not all workers qualify for coverage and many employees cannot afford their share of the health insurance premium.(4)
* The number of uninsured children in 2003 was 8.4 million - or 11.4 percent of all children. (1)
* Young adults (18-to-24 years old) remained the least likely of any age group to have health insurance in 2003 - 30.2 percent of this group did not have health insurance. (1) Based on three year average (2001-2003), people of Hispanic origin were the least likely to have health insurance. An average of 32.8 percent of Hispanics were without health insurance during that time. (1)

Why is the number of uninsured people increasing?

* Millions of workers don't have the opportunity to get coverage. A third of firms in the U.S. did not offer coverage in 2003. Two-thirds of uninsured workers in 2001 worked for employers who did not offer health benefits. (2)
* Nearly two-fifths (38 percent) of all workers are employed in smaller businesses, where less than two-thirds of firms now offer health benefits to their employees. (4)
* Rapidly rising health insurance premiums is the main reason cited by all small firms for not offering coverage. Health insurance premiums are rising at extraordinary rates. Over the past five years the average annual increase in inflation has been 2.5 percent while health insurance premiums have escalated an average of 11.4 percent annually. (2)
* Even if employees are offered coverage on the job, they can't always afford their portion of the premium. Employee spending for health insurance coverage (employee's share of family coverage and deductibles) has increased 126 percent between 2000 and 2004. (5)
* Losing a job, or quitting voluntarily, can mean losing affordable coverage - not only for the worker but also for their entire family. Only seven (7) percent of the unemployed can afford to pay for COBRA health insurance, the continuation of group coverage offered by their former employees. Premiums for this coverage average almost $700 a month for family coverage and $250 for individual coverage, a very high price given the average $1,100 monthly unemployment check. (6)
* Coverage is unstable during life's transitions. A person's link to employer-sponsored coverage can also be cut by a change from full-time to part-time work, or self-employment, retirement or divorce. (7)
* About 58 percent of uninsured adults report having changed or lost jobs in 2003. "Job lock" keeps others in positions they might have left if not fear for losing coverage. Job mobility of husbands is 25 percent to 32 percent lower when their wives do not have employment-based health insurance. (7)

How does being uninsured harm individuals and families?

* Lack of insurance compromises the health of the uninsured because they receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than the insured. (8)
* Regardless of age, race, ethnicity, income or health status, uninsured children were much less likely to have received a well-child checkup within the past year. A recent study shows that nearly 50 percent of uninsured children did not receive a checkup in 2003, almost twice the rate (26 percent) for insured children. (9)
* Over one-third of uninsured adults say they did not fill a drug prescription in the 2003 and over a third went without a recommended medical test or treatment due to cost. (4)
* The uninsured are increasingly paying "up front" before services will be rendered. When they are unable to pay the full medical bill in cash at the time of service, they can be turned away. (3)
* About 20 percent of the uninsured (vs. 3 percent of those with coverage) say their usual source of care is the emergency room. (3)
* Studies estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 a year. This mortality figure is similar to the 17,500 deaths from diabetes within the same age group. (7)
* Over a third of the uninsured had problems paying medical bills in the past year. The unpaid bills were substantial enough that many of the uninsured had been turned over to collection agencies - and nearly a quarter of the uninsured adults said they had changed their way of life significantly to pay medical bills. (10)
* Increasingly, the uninsured are more likely to be hospitalized for an "avoidable condition" - problems that could have been prevented had a person received appropriate and timely outpatient care. (10)
* A study has found that insured households paid an average of $26,957 in total medical spending after the diagnosis of a serious new health condition; uninsured households paid $42,166. (11)

What costs are created by the uninsured population?

* United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis. (12)
* Hospitals provide about $34 billion worth of uncompensated care a year. Over 30 percent of emergency department visits by the uninsured are considered non-urgent. (12)
* Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage. (12)
* The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stayed estimated to be about $3,300. (12)
* The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices. (8)

Conclusion

The impacts of uninsurance are clear and severe. There exists a significant sense of vulnerability to the potential loss of health insurance which is shared by tens of millions of other Americans, who have managed to retain coverage in recent years. Every American should have health care coverage, participation should be mandatory, and care should be comprehensive.

Notes

1. DeNavas-Walt, C., B. Proctor, and R. J. Mills. Income, Poverty, and Health Insurance Coverage in the United States: 2003. U.S. Census Bureau., August 2004.

2. The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2004 Annual Survey. 9 September 2004. http://www.kff.org/insurance/7148/index.cfm

3. Center on Budget and Policy Priorities. Number of Americans Without Health Insurance Reaches Highest Level on Record. 26 August 2004 .

4. The Henry J. Kaiser Family Foundation. The Uninsured: A Primer, Key Facts About Americans without Health Insurance. 10 November 2004 .

5. Hewitt Associates LLC. Health Care Expectations: Future Strategy and Direction 2005. 17 November 2004.

6. Dalrymple, M., "Senators Seek Tax Credit for Unemployed." Associated Press, 9 October 2003.

7. Institute of Medicine. Insuring America's Health - Principles and Recommendations. The National Academies Press, 2004.

8. Institute of Medicine. Care Without Coverage - Too Little, Too Late. The National Academies Press, 2002.

9. The Urban Institute. Key Findings from the 2002 National Health Interview Survey. 9 August 2004.

10. The Henry J. Kaiser Family Foundation. Access to Care for the Uninsured: An Update. 29 September 2003 .

11. Smith, J. "Healthy Bodies and Thick Wallets: The Dual Relation Between Health And Economic Status." Journal of Economic Perspectives 13(2): 145-166.

12. Institute of Medicine. Hidden Costs, Values Lost: Uninsurance in America. The National Academies Press. 17 June 2003 .

 

[aubieRx]

This is not to say that is necessarily bad, it works, but we need to re-think what healthcare is about. It's not a right, it's the opportunity to have some means to benefit from our amazing health care system. The current trends are not working

And why is our healthcare system amazing? Because when medical workers put an input of effort into it they get rewarded with cash. The vast majority of them would not do their jobs for free and I am sure that if financial rewards were cut back the "amazing" quality would quickly reflect this. The healthcare systems in socialist countries do not come close to matching the quality of the USA because their rich fly to america to get surgery done!

You cannot demand "the opportunity to have some means to benefit" (which btw is pretty much the same thing as saying healthcare is a right) because you cannot demand someone treat you for free. Its a job; its work; its a service just like hiring someone to come fix your computer.

I don't really understand the logic of government food etc. etc. etc. I mean, I get the point, but I see healthcare as a staple part of simply participating in society. It may be classified as a good but that's all relative to who classifies it that way. Currently, yes, it is viewed as a good with stock holders, the whole mess, but how profound are the implications of such a good? This good, if utilize incorrectly with negligence can end people's lives? These are inevitable, but what I am getting at is, healthcare is more than simply a good, it is a responsibility to be taken on and handled with absolute precision.

I see where you all are coming from . . . but I don't buy such a cold, indifferent analysis.

Is not eating a staple part of participating in a society? Doesn't eating affect one's health? Yet we do not think people have a right to receive food for free. Also, the more affluent get better food than the less affluent. If we were going to start giving everyone free healthcare we might as well start giving them free food, clothing , shelter....

There are a lot of jobs that require responsibility and can end lives. Airline pilots..... the people who design automobiles ...etc etc. Even the people who cook your food at a restaurant could end your life if not careful.

they are all goods and services to be bought and sold.

as far as my coldness it is logic. If the majority of people in america (which btw is the case) have access to great healthcare why should we ruin this system for a minority of people? Why should everyone have poor healthcare instead of a minority? to me that is colder

 

[ZpackSux]

It seems like 85% of the population has health coverage.

Out of the 15% without coverage in 2003, what % do you feel that if they had "health coverage" as a priority, they could've had it.

I guess we should tax the 85% to take care of 15%..while the 15% goes out to eat at Outback.. take vacations.. drive nice cars.. then when they have to pay for healtchare.. the scream.."I can't..cuz I lost my job and I can't afford health insurance.. because I have $800 per month car payment."

If you're willing to pay for it, healthcare is readily available. I would prefer that over having money but not able to receive healthcare due to the system. So what do those Canadians do? They come across the border to receive valuable diagnostic and treatments.

 

[aubieRx]

i agree with zpacksux (big surprise there)

Why do we need to change a whole system that works fine for 85 percent of the people and has the potential to work fine with a bit of elbow grease for some percentage of the 15% wihtout insurance.

That would be giving everyone crummy healthcare when before it was only 15 percent who had crummy healthcare.

I thought liberals were of the philosophy "greatest good for the greatest number"

 

[ZpackSux]

Ok,

I thought long and hard about it. I have the perfect solution to
make sure we have 100% coverage for all and still keep our current system
of Healtchare.

1. Poll, Do you believe govt or an organization should provide healthcare to all non-insured and we need to change our current system?

Yes/No If Yes proceed to 2.

2. If you said "Yes" to #1 are you willing to pay additional 10% - 30% mandatory income tax to assure the change in our system?

Yes/No If Yes, proceed to 3, If No, then end of the discussion.

3. If you said "Yes" to #2, are you ok if people who don't believe in this systme are exempt from the mandatory taxation?

If you say Yes to it, then you're a trooper.

 

[Oneday_9]

i agree with zpacksux (big surprise there)

Why do we need to change a whole system that works fine for 85 percent of the people and has the potential to work fine with a bit of elbow grease for some percentage of the 15% wihtout insurance.

That would be giving everyone crummy healthcare when before it was only 15 percent who had crummy healthcare.

I thought liberals were of the philosophy "greatest good for the greatest number"

Haha and why is this a liberal vs conservative issue? I actually am registered with both parties

As far as I know, what I proposed or suggested isn't all that surprising with what I see on a daily basis in my pharmacy, with folks forgoing treatments based on price, affordability. I'm not looking for some radical change, there are simply ways we could curb the tide, so to speak, on access to healthcare. I haven't proposed socialized healthcare at all, wouldn't work, and in many ways, what we have now with our system is similar to what Winston Chruchill suggested about democracy, it's the best system we probably can use in the real world.

The percentage of uninsured is increasing so you say 15 but what do you say when it increases to 40 or 50? What is the threshold where you would believe there is some underlining problem?

We can go in circles here, so I may say to agree to disagree, because it is obvious yall aren't hearing me and lumping me with some liberal agenda to save the world and deny the reality of the situation, which I clearly am not doing.

Again, I never said we needed to change the whole system, so if that's the case, can you address how people are going to pay for healthcare (i.e. it is now "expensive") when for years we relied on insurance and since ins is not AS available or affordable than in the past (notice the word "as")?

If reliance on insurance is the basis for payment in our system, than we may have a huge problem in the future, and what steps or miniscule alterations can we make to avoid it?

 

[aubieRx]

Haha and why is this a liberal vs conservative issue? I actually am registered with both parties

t?

I have yet to read the rest of your post but I can tell you I do not believe ^ the above statement

 

[ZpackSux]

I actually am registered with both parties

Aesop's tale.. the bat ..mammal with wings..

 

[Oneday_9]

And there are no republicans that see a problems with the state of healthcare?
I don't know why I find myself being labeled some crazy liberal for proposing some change to an imperfect healthcare system? Just because it is the best does not mean it is perfect or free from a facelift.

And as far as your scenario goes, I wouldn't mind paying extra taxes as it would afford me the chance to have healthcare in the future, especially when I am retired. Now if we enter the domain of being a senior citizen 50 years down the line, god only knows what the cost will be for us. With the state of social scecurity and the elimination of pensions, etc., it's going to become increasingly difficult.

I guess, my feelings are, why do you both seem so astronomically opposed to some sort of change with our system? Let me answer, because there isn't a problem you liberal fool! Am I right? haha

And I think 15% do matter, and the other 85% are having to pay more and I am sure if you surveyed them, they wouldn't all classify it as some paradise derserving of absolutely no change?

In my mind, health insurance companies and pharma and all these major corporations are running our health care system. It isn't ours anymore, as healthcare professionals, it is not ours, we merely have to deal with it, at least that's what you both seem to be inclined to do. I think there is a big white elephant in the room, no pun intended in regards to your respective party, and many seem inclined to deny it is there. Same thing with the war in Iraq and many other pressing issues in our political climate. But let's not go there...haha

off to work in the pharmacy! Thank you both for your arguments, as I find them compelling and pushing me to actually research more on this issue.
Good to have some republican friends, bad enough this girl I dating is a staunch republican. haha

Have a good day!

 

[aubieRx]

And there are no republicans that see a problems with the state of healthcare?
I don't know why I find myself being labeled some crazy liberal for proposing some change to an imperfect healthcare system? Just because it is the best does not mean it is perfect or free from a facelift.

well why change it to make it more lke other countries who do not have good healthcare systems in comparison with our own?

And as far as your scenario goes, I wouldn't mind paying extra taxes as it would afford me the chance to have healthcare in the future, especially when I am retired. Now if we enter the domain of being a senior citizen 50 years down the line, god only knows what the cost will be for us. With the state of social scecurity and the elimination of pensions, etc., it's going to become increasingly difficult.

you'll feel differently when you see a big chunk missing from your paycheck

I guess, my feelings are, why do you both seem so astronomically opposed to some sort of change with our system? Let me answer, because there isn't a problem you liberal fool! Am I right? haha

Because the system will never be perfect and overhaulng a good system to chase some impossible idea of perfection is a fool's errand

. I think there is a big white elephant in the room, no pun intended in regards to your respective party, and many seem inclined to deny it is there. Same thing with the war in Iraq and many other pressing issues in our political climate. But let's not go there...haha

don't blame me im a registered gp ralph naderite and voted for him in the last election. you know i am registered with 30 parties including the communist one.

off to work in the pharmacy! Thank you both for your arguments, as I find them compelling and pushing me to actually research more on this issue.
Good to have some republican friends, as it is bad enough this girl I dating is a staunch republican; I can escape you all! haha

Have a good day!

as a registered republican in san fran. i am sure you have a lot to talk about with your republican girlfriend

 

[ZpackSux]

My experience has taught me that people less conservative then I am tend to have idealistic do all good attitude and beliefs.. which usually involve more tax money. Hence I suggest to them add another 20 to 30% to the check they write to IRS every year. I will bet my next month's paycheck that no one that I suggested this to has done so. They tend to be very liberal with other people's money.

 

[chotty]

Quote:
I guess, my feelings are, why do you both seem so astronomically opposed to some sort of change with our system? Let me answer, because there isn't a problem you liberal fool! Am I right? haha -Oneday_9

Quote:
Because the system will never be perfect and overhaulng a good system to chase some impossible idea of perfection is a fool's errand -aubieRx

I don't see why is so liberal to think about some variables and parameters to improve our health care system. As you both agree, our system is not perfect. And it cannot be perfect! But obviously, it's getting more expensive and the % of uninsured population is increasing. Don't we need to find some solution to relieve this upcoming problematic issues and to maintain the good quailty of health care? (Btw I don't care about the people who ruin their option to get health care by buying Lexus or getting tatoo...etc.) I know you guys agree that we need to consider and do something about the cost of medicine in order to keep our patient healthy. I am glad to see Oneday_9's considerate opinion. And he didn't mention government-controlled system is better than our current free market health care system. I don't want that, either.

 

[aubieRx]

I think there is a big white elephant in the room, no pun intended in regards to your respective party, and many seem inclined to deny it is there. Same thing with the war in Iraq and many other pressing issues in our political climate. But let's not go there...haha -aubieRx

.

I never said that!

but then again, it doesn't really matter that much

edit: thanks for fixing. If I am to be opinionated I should like to be that way with my own opinions

 

[chotty]

I never said that!

but then again, it doesn't really matter that much

edit: thanks for fixing. If I am to be opinionated I should like to be that way with my own opinions

mistake!!

 

[aubieRx]

And the only reason I consider major changes to the healthcare system a liberal agenda is that it is primarily liberal politicians and liberal voters who really want to push for it. I am sure that not all liberals feel that way about healthcare but the general trend is that liberals are for a more socialized healthcare and conservatives are not

Also, I don't think what we have in america is perfect because, yes , it is expensive. But I think the overall disadvantages of this expense are less negative than the overall disadvantages of government health care.

And even with govt care you still get taxed for it. So its not "free"

anyone who can afford it will fly into america to get major surgery done rather than do it in their own contry. To me that speaks volumes about us vs. them as far as health care quality.

 

[aubieRx]

And he didn't mention government-controlled system is better than our current free market health care system. I don't want that, either.

well if we don't give the govt. more control over healthcare then how do you suggest the problem be fixed?

Most people who feel like something needs to be done think that the government will need more control so I tried to oppose that stance in my posts.

 

[Jeddevil]

(Btw I don't care about the people who ruin their option to get health care by buying Lexus or getting tatoo...etc.)

Your tatoo quote cracks me up. You forgot one group. I don't care about those complaining about healthcare and at the same time are chainsmoking and drinking all the time. Those that complain about the cost of drugs but have plenty of money for smokes and booze get no sympathy from me.

Healthcare in America is not a given right. You need to work for it like we all do. If people choose to not priortize it and then complain when they need it, that is not the systems fault. I have never had health coverage for my family provided but we always have it because we make it a priorty and pay for it out of pocket, thus the crap 95 civic I still drive. Others can do the same.

 

[WVUPharm2007]

So many reasons. It would take a brilliant philosopher/economist/health scientist to even attempt to solve the conundrum.

When I begin thinking about the high price of healthcare I think of many things. The most prominent are:

1) pharmaceutical companies
2) the idiotic hierarchical system in place that places all of the decisions on few people



So let's begin with the bastards I hate the most, the big pharma companies.

The stock BS I hear from these folks is that it requires billions to put a drug through production, therefore they are justified to make billions off the drugs. The problem is that whenever you actually stop and look at the figures, it turns out that most pharmaceutical companies make net profits of 25%+. That's profit, not margin. That's how much they make, annually, AFTER R&D, trials, advertizing, etc. That has to be within the top 2% of all businesses in the US in return on investment. Why should they make so much? All they do is cherry-pick, anyway. What I mean by cherry-pick is that they just capitalize off of common scientific knowledge at the point where profit can be made and do no research unless it is profitable. Sure, you can make an agent that blocks some receptor, but why should only the pharmaceutical companies profit? Let's randomly use PPIs as an example. In order to know blocking said receptor is beneficial, the corporation has to know that receptor exists, what it does, and so on. How do they know all of this? Because some other guy, more than likely in academia or on a grant from the NIH, discovered the physiology of the H+/K+ ATPase pump. Why should only AstraZeneca profit off of his work and discovery? The reason, of course, is because the system is set up so that some discoveries are patentable and some others are not.

They do not make all that money because they need to, or are entirely responsible for the dicovery, it is because they can.


The second question I have is why isn't our drug discovery socialized? CEOs, stockholders, and advertizing agencies do not make a new drug, guys in labs with PhDs in medicinal chemistry working off of a body of science inclusive of 1000s of years of history and knowledge do. If, rather, they received funding from the collective society, drugs could be discovered, made generically from the getgo, and be sold at cost to the American people. You could even give big bonuses to scientists that make big discoveries. Imagine that - a system that rewards scientists, not people that do nothing but throw money around.

All corporations do is base the process off of profit rather than science. Anybody care to demonstrate to me why the world needs 6 proton pump inhibitors? Rather than investing completely in new science, the big pharma corporations copy each other (or repackage products like Xopenex, Nexium, Clarinex, etc.) and invest in propaganda games to garner maximum profit.

I certainly agree that a free market should be the basis for the distribution of wants (i.e. cars, TVs, Coach purses, what have you), but if you use it to for the distribution of needs, it will lead to extortion.


Ok, so that's one thing. The other is the system. I'll keep this brief.

Basically, power, specifically prescribing authority, should be more widely distributed. I know physicians and their ilk (PAs, CNPs, etc.) think they should be the only ones that can prescribe medication, but the reality is that some control should be held at the point of sale. They don't know formularies or the intricacies of cost-benefit as pharmacists do. Sure, all physical diagnosis should be done by a diagnostician, but the choice of a specific drug within a class should be handled by the guys at Wags. I can literally think of about 30 situations within the last week where I work where a switch to a similar agent could have saved a ton of money for the patient without risking efficacy, but because I can't chose a specific agent, I'm useless.

I think the optimal situation would involve a switch to physicians doing a physical assessment, and, when pharmacotherapy is appropriate, giving a pharmacist a diagnosis and treatment recommendation, upon which the pharmacist would use the recommendation to select the optimal therapeutic agent based on factors such as cost, comparative efficacy, etc.

I know this is 'radical' and the med people will call me 'crazy', but, eh, so be it. Of course this also only reflects what I deal with only in my range of practice, I'm sure there are other situation I haven't even fathomed that other professionals have to deal with involving the 'system.'


I'd also love to have a further discussion of our 'perfect' healthcare system.

Now, I must admit, I'm a little biased because I'm a poor kid from the hills of West Virgnia. Where I grew up, finding a job with healthcare benefits was like hitting the lottery.

There seems to be confusion about skill and structure of the US healthcare system. While anybody would be crazy to deny calling the US medical community the most skilled in the world, I would have to call a person that calls the system the best in the world just as crazy (or ignorant of the facts.)

For instance, look at the infant mortality rates around the world:
http://www.geographyiq.com/ranking/ranking_Infant_Mortality_Rate_aall.htm

The US isn't even in the top 20. In fact, it's behind Cuba, that evil communist (even though it isn't really communist...) despot pit of the Caribbean. Not only that but the countries with the larger social safety nets seem to be setting the pace.

I would go on, but my attention span is going away...and The Fresh Prince of Bel-Air reruns are on. Somebody debate my points so I have something to do later......

 

[ZpackSux]

Healthcare in America is not a given right. You need to work for it like we all do. If people choose to not priortize it and then complain when they need it, that is not the systems fault. I have never had health coverage for my family provided but we always have it because we make it a priorty and pay for it out of pocket, thus the crap 95 civic I still drive. Others can do the same.

 

[ZpackSux]

And the only reason I consider major changes to the healthcare system a liberal agenda is that it is primarily liberal politicians and liberal voters who really want to push for it. I am sure that not all liberals feel that way about healthcare but the general trend is that liberals are for a more socialized healthcare and conservatives are not

Also, I don't think what we have in america is perfect because, yes , it is expensive. But I think the overall disadvantages of this expense are less negative than the overall disadvantages of government health care.

And even with govt care you still get taxed for it. So its not "free"

anyone who can afford it will fly into america to get major surgery done rather than do it in their own contry. To me that speaks volumes about us vs. them as far as health care quality.

Ann.. is that you??

 

[aubieRx]

I don't have the guts ann does...I do all my proding and poking anonymously

 

[WVUPharm2007]

I don't have the guts ann does...I do all my proding and poking anonymously

Ann...? Who?

I have never had health coverage for my family provided but we always have it because we make it a priorty and pay for it out of pocket, thus the crap 95 civic I still drive. Others can do the same.

Uh, oh, the patented 'life experience' thing. I can up the ante on that one. I had an uncle-in-law who contracted AIDS from his ex wife that cheated on him and couldn't afford the HIV medications because he had no health insurance and died within 3 years due to lack of quality treatment. He didn't have the opportunity to work for it.

 

[ZpackSux]

Is infant mortality the definining criteria of the "best" system in the world?

Do we know why US rate is higher than the other? Is it a system failure or is it a social consequence? Perhaps you can shed some light on it since you're using this stat to prove that US system isn't so good.

 

[ZpackSux]

Ann...? Who?



Uh, oh, the patented 'life experience' thing. I can up the ante on that one. I had an uncle-in-law who contracted AIDS from his ex wife that cheated on him and couldn't afford the HIV medications because he had no health insurance and died within 3 years due to lack of quality treatment. He didn't have the opportunity to work for it.

Sorry about your uncle. But why didn't he have insurance?

 

[Oneday_9]

well why change it to make it more lke other countries who do not have good healthcare systems in comparison with our own?



you'll feel differently when you see a big chunk missing from your paycheck



Because the system will never be perfect and overhaulng a good system to chase some impossible idea of perfection is a fool's errand



don't blame me im a registered gp ralph naderite and voted for him in the last election. you know i am registered with 30 parties including the communist one.



as a registered republican in san fran. i am sure you have a lot to talk about with your republican girlfriend

1) I never said alter it to be like other countries, nor anywhere in any post did I suggest making it socialized, but we need to figure out how to make it more efficient

2) I don't think at any point in anything I have said have you gotten what I mean by change. It's almost mind numbing how many arguments you attribute to me, that I have yet to actually write here.

3) see short term thinking, I am talking long term. If I contribute more money to my healthcare via taxes, then 50 years down the line the government will have a system set up for me. Is it so horrid to believe our government can and must have a role in taking care of its citizens? AND NO THIS DOES NOT IMPLY SOCIALIZED HEALTHCARE!!!! I am merely suggesting we need to work through the kinks to find means to limit the escalation of cost. This means responding more to research in such areas and trying to implement policy to better our system even more.

4) I'll not even waste any more space on politics, if ya don't mind! Not even worth my time, very disheartening that even here things become black and white, night and day when I thought we were ust talking about bettering our system and responding to escalating costs. We need to find means of change and they are not as drastic as both of you have gone in responding my posts, not reworking the wheel simply smoothing its edges. But I don't mind, so the tone here is not aggravated or anything else as first and foremost you are colleagues, so I respect you both, as I have seen Zpack's posts for awhile and you seem pretty cool.

Off to the movies, I'll try to respond to some other comments later.

Cheers!

 

[ZpackSux]

so I respect you both, as I have seen Zpack's posts for awhile and you seem pretty cool.

Don't you use Dale Carnegie on me Mr.

Ok.. talking about healthcare system is a daunting task. Unless we narrow it down to a particular topic.. I think I'll sign off on this thread..

 

[WVUPharm2007]

Sorry about your uncle. But why didn't he have insurance?

Mid-20s, disadvantaged childhood, no way to get into college, deadend job without health insurance. I never really knew him, this was back in the early 90s before the in-law part went into effect.

 

[WVUPharm2007]

Is infant mortality the definining criteria of the "best" system in the world?

Of course it isn't the absolute defining characteristic, access to healthcare, cost per capita, etc. would help define how good the system is. I would define the success of a healthcare system as how healthy a citizenry is.

Do we know why US rate is higher than the other? Is it a system failure or is it a social consequence? Perhaps you can shed some light on it since you're using this stat to prove that US system isn't so good.

I was just randomly throwing it out there because it's been implied that the system is ideal, or the best possible, or whatever. Give me some more time and if I can get more information, I'll be glad to tell you the answer.

And who is Ann?

 

[ForgetMeNot]

And who is Ann?

I'm gonna say they're referring to ann coulter, uber-conservative.

 

[museabuse]

And who is Ann?

Ann Coulter is a far as you can go right winger that hates liberals and can’t see past the word liberal and hates everything associated with the word liberal that even if a liberal came up with an idea that everyone in the whole world agreed with she would find a way to spin it and hate it. She basically takes everything Rush says and regurgitates it, just like Sean and all the other liberal haters. They all hate the New York times and anytime they can bash it they do. That’s where Aubie gets her hatred for the New York times, and CNN, and thinks fox news is the best thing since sliced bread. Why?, because Ann, Sean, and Rush say so. Many American that listen to these people will repeat their hatred speech without really deciding for themselves. There are Nascar fans out there regurgitating what these people say like, “The New York times is so biased, or damn liberal they want to take all our money, or they should impeach are president because he got a blow job and that is so immoral.” They say and believe everything these liberal haters say without even deciding for themselves. I love how Nascar and Bush stickers go hand and hand. Oh and John Deere and bush too. When it comes down to it the normal Nascar fans couldn’t even tell you who the governor of their state is… yet they can comment on highly involved political issues because they listen to the very moral vicodin/percocet Rush and regurgitate it.

I am not saying the New york times is not biased or liberals are great, just making a point that its unfortunate that these guys are out there because they are more biased than the New York times ever will be and people listen to them and think what they say is fact and truth without thinking for themselves and that is not good for democracy. I am just sad so many Nascar fans and brainwashed radio listeners voted in this election.

To get back on topic though... I don't think medication costs is a partisan issue... both parties get tons of cash from drug companies. I also don't think if a democrat gets into office all of a sudden we are going to have socialized health care... it doesn't work that way. I also don't think it is fair to say liberals are for lawyers and support law suits against health care... John Kerrys running mate was a lawyer and sued doctors but it doesn't mean all lawyers are democrats or all lawyers that sue health care are democrats. Don't make that generalization because I am sure there are a lot of conservative doctor suing lawyers in politics.

 

[WVUPharm2007]

Oooooooooooh, one of those hacks. I'd be offended if someone compared me to the likes of her or Michael Moore, personally.

 

[aubieRx]

That’s where Aubie gets her hatred for the New York times, and CNN, and thinks fox news is the best thing since sliced bread. Why?, because Ann, Sean, and Rush say so. Many American that listen to these people will repeat their hatred speech without really deciding for themselves. There are Nascar fans out there regurgitating what these people say like, “The .

First of all, I hate NASCAR. I was raised in massachusetts for 19 years. Second of all I don't religiously listen to coulter, sean or rush. I dont watch fox news unless bombs are going off in london or people are crashing planes into towers. Or if there is a hurricane i will turn it on to watch geraldo rivera blow around in the wind for fun.

So get a life! You dont know me. You don't know what I feel or think or listen to

life is too short to watch people argue about politics on TV. apparently you like to watch FOX news though cause you sure talk an awful lot about it

 

[ZpackSux]

Oooooooooooh, one of those hacks. I'd be offended if someone compared me to the likes of her or Michael Moore, personally.

Ann Coulter to Michael Moore.. a lot can fit inbetween..

thought Muse was a Moore fan. Just a guess.

 

[aubieRx]

muse doesn't have enough sense/politeness to be a michael moore fan

 

[ZpackSux]

Oh and John Deere and bush too

What's wrong with John Deere?