Conservative....on exactly what?

[Jim]

Maybe the Bushie types can help me with this dilemma. The "conservatives" are in control of both houses of Congress and the White House. So why are these items in the recent Medicare Bill:

 

1) Creation of a $11 Million slush fund for the private insurers (what happened to free markets)

 

2) Makes it illegal to buy mail order drugs from Canada, where they are significantly cheaper (markets again).

 

3) Includes a provision that the US government will not use its bulk buying capacity (drug benefit) to bargin with drug companies for discounts (WTF?).

 

So we have to pay more that what we could bargin for as a large group purchaser, can't buy the cheaper drugs from Canada, and their's a slush fund for the insurance industry. Helloooo - what is so conservative about this? It's blowing another hole in the budget and giving older Americans the shaft.

[lummox]

your answer

[Jim]

[JoshK]

That medicare bill is such a crap. It's basically a complete hookup for the drug companies, and nothing more.

[chelle]

I thinnk it all fits well. Bush and his cronies are all about helping big business.

[allthumbs]

ehmmic said:

I thinnk it all fits well. Bush and his cronies are all about helping big business.

no shit? what gave you that impression?

[Dr_Flash_Amazing]

trask said:

ehmmic said:

I thinnk it all fits well. Bush and his cronies are all about helping big business.

no shit? what gave you that impression?

 

It might've been that time when he said "give me your tired, your poor, your huddled masses, and I'll grind them up and use them to power Enron's generators, and make whatever's left into pate for Halliburton's executives to nosh at their next business lunch at the White House! This message brought to you by Pfizer Pharmaceuticals!"

[allthumbs]

bully for you, gov'na

[vegetablebelay]

Shit, if big business does well again, ehmmic might get work again. See how it works?

[chelle]

Not interested in working for big business Mr. Veggie. Already gave 11 years of blood sweat and tears to their causes. I'm holding out for a non-profit hospital system. Now if only our government would allocate some money to fund the special grants and loans for nursing education they promised all of us last year, I would be very appreciative.

[vegetablebelay]

You go girl.

[JayB]

As far as the pharmaceutical angle is concerned, Canada and all other companies that impose price caps are effectively being subsidized by Americans, for pay full price for drugs and in so doing pay for the R&D that ultimately generates the new drugs that benefit the rest of the world. In the end, if the world wants new drugs, the world is going to have to pay for them. Paying for them, in essence, means providing rewards for investors that are sufficent to compensate them for the enormous risk that investing capital in developing new therapeutics involves. There's no other industry where the time from investment to payoff is as high, or the number of false starts is as great - so cut off the return by placing price controls on the products that they produce and you'll have cheaper existing drugs, but no new ones. This would be great for people with diseases that we already have effective treatments for, but bad for those suffering from maladies for which there is no cure yet. If you are advocating price controls, this is a guaranteed outcome that you have to take into account. The rest of the world has been able to avoid such an outcome because of our effective subsidy of drug development on their behalf, and I hope that in developed countries we either end this by way of negotiation or that drug companies force them to face the consequences of their actions by refusing to sell new products in markets where price controls are in effect. Not sure why they ever did otherwise - so in some respects they are reaping the consequences of their own poor decisions when they allowed the Candian government to dictate the prices in the first place, as any rational consumer living within driving range of the border is going to buy their drugs where they are the least expensive.

[Billygoat]

I remember that Bush the Elder was on the board of Eli Lilly for some time. Probably has nothing to do with it...

[Ratboy]

vegetablebelay said:

Shit, if big business does well again, ehmmic might get work again. See how it works?

 

And when there's a slight downturn in the market, out the door she goes again. Continue the cycle until the job ultimately ends up in Asia somewhere for 1/10 the labor cost. All the while, the executive's salary and stock portfolio grows. See how it works?

[chelle]

JayB said:

As far as the pharmaceutical angle is concerned, Canada and all other companies that impose price caps are effectively being subsidized by Americans, for pay full price for drugs and in so doing pay for the R&D that ultimately generates the new drugs that benefit the rest of the world. In the end, if the world wants new drugs, the world is going to have to pay for them. Paying for them, in essence, means providing rewards for investors that are sufficent to compensate them for the enormous risk that investing capital in developing new therapeutics involves. There's no other industry where the time from investment to payoff is as high, or the number of false starts is as great - so cut off the return by placing price controls on the products that they produce and you'll have cheaper existing drugs, but no new ones. This would be great for people with diseases that we already have effective treatments for, but bad for those suffering from maladies for which there is no cure yet. If you are advocating price controls, this is a guaranteed outcome that you have to take into account. The rest of the world has been able to avoid such an outcome because of our effective subsidy of drug development on their behalf, and I hope that in developed countries we either end this by way of negotiation or that drug companies force them to face the consequences of their actions by refusing to sell new products in markets where price controls are in effect. Not sure why they ever did otherwise - so in some respects they are reaping the consequences of their own poor decisions when they allowed the Candian government to dictate the prices in the first place, as any rational consumer living within driving range of the border is going to buy their drugs where they are the least expensive.

 

So the american consumer ends up subsidizing the rest of the world's access to new drug therapies, and the elderly (and their families) under the new medicare program will likely foot a larger part of the bill than they do now. And the drug companies and their executives continue to get rich. Who benefits from this "free" enterprise and "improved benefit"? I agree that price controls might stifle R&D in the pharmaceutical industry, but it seems to me that the whole process needs some overhaul. The American public seems to be the one to repeatedly get screwed by our capitalistic free market, while the rest of the world benefits from different rules and pretty much equal access to the benefits of our contry's investment in R&D.

 

I imagine that they sell the drugs cheaper elsewhere because they are still sold at a profit, and some profit to offset R&D and increase share prices is better than standing on principle with viable product and few markets to sell it into.

[JayB]

I am sick of the US subsizing the rest of the world's health care too - but I would rather change that through means other than bringing the development of new drugs to a standstill - like trade negotiations. You put price caps on drugs manufactured by companies headquartered in the US, we throw punitive tarriffs on a wide range of products that your most important industries export to the US. This is not the right time to pursue this project, but at some point the rest of the world will either have to start paying up for the new drugs they enjoy or go without - either as a result of pressure from the government and big pharma or the US consumer getting fed up and refusing to subsidize their health care any longer and demanding the price controls that will ultimately bring about a drastic reduction in the number and frequency of new drugs coming to market. I'd personally much rather go through a trade war than see people with potentially treatable diseases go without new medications that might help them.

 

As far as the new prescription drug benefit is concerned, I don't understand how adding a massive infusion of government cash to fund drug purchases for the elderly is going to make sick old people any worse off. It may not be the best plan, and there may be some sops to industry in there - but it's hard to see how more funding would make the seniors any worse off. There's also the matter of paying for the benefit - which seems to be where the restrictions come in. We can have two of the three following things in this country, but not all of them: universal coverage, unlimited care, and sustainable cost containment. Pick any two you like - but one of them has to go. That's not being cruel and conservative - that's being sober and rational. Even if you eliminated defense spending entirely there wouldn't be close to enough money to pay for the whole package. This is true now, and it will only be more so as the ratio of retirees to workers declines further in the very near future.

 

[Jim]

JayB said:

We can have two of the three following things in this country, but not all of them: universal coverage, unlimited care, and sustainable cost containment.

 

Though I disagree with some of your other comments - this one hits the nail on the head. But I would take it a step further. Why not increase the efficency of the system with single-payer? The we would not have the massive duplication of effort (and profit) of the current insurance system. The current Medicare system is one of the most efficient deliverers of health care - it's administrative costs are less than a third of the insurance industry. But if we ever went to a univeral system cost controls would be needed. Hell, they're needed now - and we just ration health care in this country differently - you can't pay for it - you don't get it.

[chelle]

JayB said:

I don't understand how adding a massive infusion of government cash to fund drug purchases for the elderly is going to make sick old people any worse off.

 

Jay - from what I have read the people who benefit the most are seniors who are very poor, which is a very good thing. Those in the middle will get some coverage. And wealthy seniors get very little. The tiering is a good approach.

 

Unfortunately those seniors that have some level of perscription coverage through their company pensions will likely see that disappear because the companies willl want to save money where there is potential duplication, which would mean that they will pay much more under the new system. I understant the benefit to be about $600 per medicare participant. That's not a lot given the meds many seniors pay for, but yes it is better than nothing.

 

What I wish congress had delivered was a real benefit rather than a confusing sandwhich benefit where they get some coverage after a high deductible, then no coverage for a period then some coverage again after a maximum outlay. And the whole thing doesn't even start for 2 more years.

 

On the trade war thing...when is the last time the US has effectively used this strategy? (An honest question)

[dryad]

Something like 60% of total big pharma costs go to marketing/advertising, not R&D, much to the dismay of drug discovery scientists. So the statement that drug prices have to be so high to support development is largely crap. At some point pharmas decided that it would be more profitable to push drugs with the biggest possible market (ie. antidepressants, Viagra, "the purple pill", cholesterol meds, etc.), than to develop cures for serious but obscure maladies with a limited market.

[E-rock]

Sticking up for the pharmaceutical industry is like sticking up for the mafia. D U M B. Poor wittwe guys. How will they ever survive?

[Jim]

dryad said:

Something like 60% of total big pharma costs go to marketing/advertising, not R&D, much to the dismay of drug discovery scientists. So the statement that drug prices have to be so high to support development is largely crap. At some point pharmas decided that it would be more profitable to push drugs with the biggest possible market (ie. antidepressants, Viagra, "the purple pill", cholesterol meds, etc.), than to develop cures for serious but obscure maladies with a limited market.

 

Word!! Gotta look for the latest designer malady.

[Al_Pine]

ehmmic said:

Unfortunately those seniors that have some level of perscription coverage through their company pensions will likely see that disappear because the companies willl want to save money where there is potential duplication, which would mean that they will pay much more under the new system.

 

The new medicare bill makes it illegal to have extra prescription benefits via private insurance. That is, it forbids supplemental insurance specifically meant to help cover the medicare deductible.

[Al_Pine]

JoshK said:

That medicare bill is such a crap. It's basically a complete hookup for the drug companies, and nothing more.

 

And insurance companies.

[E-rock]

Jim said:

dryad said:

Something like 60% of total big pharma costs go to marketing/advertising, not R&D, much to the dismay of drug discovery scientists. So the statement that drug prices have to be so high to support development is largely crap. At some point pharmas decided that it would be more profitable to push drugs with the biggest possible market (ie. antidepressants, Viagra, "the purple pill", cholesterol meds, etc.), than to develop cures for serious but obscure maladies with a limited market.

 

Word!! Gotta look for the latest designer malady.

 

Or create one! Ever heard of "acid reflux disease" before prilosec hit the market? Incidentally it is VERY similar to its predecessor, however the patent ran out for the company who makes and now prilosec's predecessor is going generic.

[Ratboy]

E-rock said:

Ever heard of "acid reflux disease" before prilosec hit the market?

 

Unfortunately, yes. I've had it off and on since I was 12. Seems to run in my family. Although until Prilosec hit the market it was called "heartburn".