Healthcare going forward

[vulgar_newcomer]

We've been through all that claptrap before and gave you more-than-ample proof that your argument is a lie. They spend far more on advertising than on R&D, and their profits are far more than their R&D and advertising budgets combined. Your argument just doesn't cut it, and nobody here except you and your friends believe that the ridiculously-high cost of drugs is because of R&D. Nobody.

You can repeat the well known and easy to search facts a billion times to a rock head. They will continue to ignore them and repeat the agenda as programmed to do by their greasy slime bag asswipe leaders. The GOP knows how to control their moron base.

 

[Kulindahr]

One the other hand, they are confiscating the earnings of other people to help you. Why should you keep the house while others lose their earnings for you?

Rubbish -- they're not confiscating anything.

You have no loyalty to this country at all, do you? You don't understand what it is to be a country, or a people. You have no grasp of what this republic is supposed to be about -- you just see it as a set-up for enabling you and others to plunder so you can look down on others.

 

[Kulindahr]

It sounds great for the drug companies to pay huge amounts for research, development and testing new drugs, only to have the government limit the price, but it will end or impair development. If people can't afford the new drugs, they are not any worse off. We should not end the development just because some people cannot afford the drugs.

I'm not even going to try to guess how many times you've been shown that this is empty rhetoric, falsehood held out as talking points.

The real irony here is that you're relying not on the free market, but on law forbidding the free market from working!

 

[Kulindahr]

If the US government controls prices, development of new drugs will be unfeasible.

Do you enjoy attacking your straw men?

All anyone is asking is to allow the government to participate in the free market on a level field with insurance companies.

 

[Kulindahr]

So you think the drug companies are throwing away and wasting money on advertising. It is amazing that liberals think they know more about making a profit that the businesspeople who spend their lives learning and concentrating on how to do it, knowing that they may lose their jobs if they do not make a profit. More importantly, the rectitude of business men is measured by an objective criterion;profits or not. Liberals can espouse the same notions year after year with no profit discipline to answer to.
Advertising performs two critical function not readily apparent. Any patents are limited to a certain number of years after disclosure of the patent info BUT the company still cannot sell until FDA approval, which takes years. So there is a narrow window of time for the company to recover costs, before the patent expires and other companies can sell for a lower proce, having no R and D costs. Second even after Doctors prescribe the drugs, if side effects occur, lawyers will sue, saying the company should pay enormous punitive damages for not advising the patient personally of the side effects. The advertisements then are necessary to inform patients of the potential effects.
The companies are not wasting the advertising money. They are spending it because they have to.

You skipped the biggest function of advertising: being able to bamboozle people because they don't have the expertise to catch outrageous claims.

Pharmaceutical companies don't want to have to advertise to just doctors, because they know doctors are educated and able to evaluate claims.

 

[Kulindahr]

Personally, I think a far more effective approach is to just let the government agencies that procure drugs such as Medicare, Medicaid, Tricare, VA, DoD, etc. be able to use their purchasing powers to negotiate prices. That alone would have a tremendous effect.

Yep -- free the market.

 

[Kulindahr]

Eliminate the advertising and the drugs will be significantly cheaper, the unforeseen complications fewer and the overall cost of health insurance will be lower. Reform the patent system and the FDA rules for generic medications and you will see costs decrease immensely.

Anyone with a smattering of basic economics will see something here that shows the game for what it is: if they used half their advertising spending to reduce the price of their drugs, they'd sell more pills. So the whole point is to keep prices artificially high and move product by playing on people's emotions.

 

[ballcaphair]

There's three pieces of legislation under discussion:

1. The ACA- current law known as "Obamacare"
2. The AHCA - the House bill that passed
3. The BCRA - the Senate bill that hasn't been voted on.

There's a couple of sites that do a very good, impartial analysis. The most detailed is Kaiser Family Foundation's site. They've broken down all three bills into a table with categories for the various changes.

A less detailed analysis is on Modern Healthcare's site.

Incidentally, with all the focus on the individual market, there's a section in the ACA that requires disclosure of "payments" by pharmaceutical companies and device manufacturers make to providers and teaching hospitals. That goes away as part of the repeal, if it passes. Want to know why your doctor recommends certain medications or treatments, look them up.

Thank you for the links and input. KaraBulut you're a resource.

 

[frankfrank]

I should add that the more units are sold, the less R&D expense that must be recovered for each unit.

How does this address people like Martin Shrkeli from Mylan who bought up a LIFE-SAVING drug for AIDS/HIV (which certainly had already been priced to cover R&D under the previous company)...then raised its price 53-fold? And what ever happened with that, in the end? (I've heard nothing in about a year now.) The same thing happened with the Epi-Pen which saves lives (and which has a short shelf life, so replacement "standby doses" must continually be bought), and I don't even think it was sold to a new company, nor was anything changed.

It's unconscionable and CRUEL (a word which I use sparingly, as I consider it possibly the most intense word in English) that any of this should be allowed.

Personally, I think a far more effective approach is to just let the government agencies that procure drugs such as Medicare, Medicaid, Tricare, VA, DoD, etc. be able to use their purchasing powers to negotiate prices. That alone would have a tremendous effect.

B-b-b-but...that is ILLEGAL currently!! One of the Republican poison pills that got put into something (not sure if ACA, or something else). Stupid...and wasn't even Cory Booker on board with this continuing to be illegal? Either this, or something else that would have helped the system be more responsive and was obviously a "Democrat thing to do" and he's supposed to be one of the quintessential Democrats.

Citizens United speaks VERY loudly and clearly.

Republicans will NEVER allow this illegality to be repealed...period.

 

[Benvolio]

Personally, I think a far more effective approach is to just let the government agencies that procure drugs such as Medicare, Medicaid, Tricare, VA, DoD, etc. be able to use their purchasing powers to negotiate prices. That alone would have a tremendous effect.

The agencies have so much power that the will not be negotiating, they are dictating, and the drug companies have no bargaining power. Please, please Comrad let us make a little bit of our investment back, please let us have a tiny profit. A few years ago, the government, which buys lot of the vaccines for children, "negotiated" the price so effectively that US companies went out of the business.

 

[Benvolio]

I could not find a link to the vaccine shortage caused by government negotiation a decade ago, but see this: https://www.google.com/url?sa=t&rct...ba655/&usg=AFQjCNH44guul2CuVfGqKOYnzJ1l-Iq3Qg
As we know, all agencies tend to be single minded or even fanatical. Negotiated drug prices by such an agency is not a good idea.

 

[Benvolio]

Anyone with a smattering of basic economics will see something here that shows the game for what it is: if they used half their advertising spending to reduce the price of their drugs, they'd sell more pills. So the whole point is to keep prices artificially high and move product by playing on people's emotions.

That is obviously false. Even with the smattering of basic economics you are so proud of having, you should be able to see from the advertisements that they spend half their time telling the public some of the horrible side effects which may result from the drug. If they were playing on the emotions, they would not be doing so in such a negative way. I am sure even you, watching some of the adds, have wondered why anyone would take the risk of such a drug. The drug companies hope to sell more during the limited patent window by informing the public that a new drug is available if their doctor advises it, AND, the companies hope to avoid punitive damages by informing the public of the side effects.

 

[Benvolio]

Do you enjoy attacking your straw men?

All anyone is asking is to allow the government to participate in the free market on a level field with insurance companies.

The government has far too much buying power through medicare and medicaid for it to be a level field. The Companies are left with no bargaining power, only begging and pleading. https://www.google.com/url?sa=t&rct...pinion&usg=AFQjCNFflcldT3_l-yKdmzm-vRk3kVy_Qw

 

[rareboy]

 

[KaraBulut]

Personally, I think a far more effective approach is to just let the government agencies that procure drugs such as Medicare, Medicaid, Tricare, VA, DoD, etc....

...B-b-b-but...that is ILLEGAL currently!!

I didn't catch this earlier.

The VA is allowed to negotiate pricing. Recently, when a new treatment regime for Hepatitis C was listed at a price of $1000 per dose by Gilead, the VA used it's power to negotiate a much better price for veterans. The public pays Gilead about $84,000 for a 2-3 month treatment. The VA pays about $25,000. According to the company that originally developed the drug, it costs about $1,400 to make the drug- a 5900% markup.

Medicaid programs are allowed to negotiate pricing. Several states produce their own standard formulary for their Medicaid program which allows them to also get better prices.

Under the Medicare D legislation passed in 2003, Medicare was barred from negotiating drug prices. An unfortunate side-effect of the 2003 change was that Medicare recipients were allowed to use Medicaid pricing discounts before 2003. The Medicare D legislation outsourced Medicare drug benefits to privately-owned prescription drug plans (PDPs) and Medicare Advantage (MA) plans (i.e. the US government does not "own" the Medicare D drug insurers); after 2003, Medicare recipients must obtain their drugs through these privately-owned pharmacy benefit managers which means they cannot use Medicaid discount pricing and Medicare is prevented from negotiating to get them better pricing.

Several bills have been proposed to allow Medicare to negotiate discounts (e.g. The Medicare Prescription Drug Price Negotiation Act of 2013 (S. 117, H.R. 1102), The Medicare Prescription Drug Savings and Choice Act of 2013 (S. 408, H.R. 928), The Medicare Drug Savings Act (S. 740, H.R. 1588), et al.) however these bills have either not made it out of committee or were unable to muster enough votes to advance.

 

[KaraBulut]

Thank you for the links and input. KaraBulut you're a resource.

This is all very confusing and it's very important that the word gets out to the public about what is happening in these two bills.

Most Americans have no idea that there are consumer protections in the ACA that are being repealed. They also aren't being told that this is a tax cut for people who make over $250K per year that is being financed by eliminating healthcare coverage for millions of Americans.

Most Americans have no idea that Medicaid is being gutted in the ACHA and the BCRA. Most Americans don't realize that Medicaid covers a portion of their mother's nursing home bills or their grandchildren's immunizations or their neighbor's pap smears/mammograms.

The BCRA is timing the Medicaid phase-out so that it happens after the next election. This gives you an idea of who it affects, how bad the effects will be and how the Republicans are hoping that most people don't notice it until after 2020.

People who are watching Fox News are being told that the ACA is in a death spiral and that the AHCA/BCRA are fixing a broken system. They're seeing commercials with pretty blonde women talking about how Obamacare messed up their insurance and that the Republicans are going to fix it. They're seeing Trump on a loop telling them that the BCRA is going to be a great healthcare plan with "lots of heart".

It's important that the truth gets out there and that the American public really understand what is being done and that this is damaging healthcare that 24 million people rely upon. They need to understand that the small community hospitals- the largest employer in many small towns- will lose the money that keeps those hospitals in business.

 

[ballcaphair]

Being on the front-line in rural New Mexico with a budget and staffing as Spartan as can be, I do not see how we can even keep up if funding is cut. We self-funded our rehab rooms with local support because the ACA was surly not perfect. But this is terrifying to us. How in the world do we face this?

 

[gsdx]

a 5900% markup.

That is not 'free enterprise'. That is price gouging, and they have the people who need the medication 'by the balls' so to speak. That cannot be justified by a minimal amount of R&D and a more-than-minimal amount of advertising.

No justification. None. Zip. Zilcho. (Except for pure greed.)

 

[KaraBulut]

That is not 'free enterprise'...

Gilead (the same company that produces Truvada, the PrEP medication) said in interviews that it randomly chose $1,000 per pill, in effect, to see if insurers would pay it. Most insurers would because a) it was an FDA-approved treatment and b) because the drug results in cure in about 90% of the cases, the 12 weeks of treatment at $84,000 still ended up being less than the cost of a lifetime of managing the disease process of Hep C.

It wasn't until later that the cost of $1,400 for the 12 week supply was disclosed in an interview with one of the physicians involved in the development of the drug. That physician now works for the VA, so Gilead's retail price of the drug shocked him since he knew how much the drug actually cost to make.

Gilead plays another game that is increasingly common in the market: they provide "discount cards" that help cover copays or in some cases, result in a lowered price for some patients. They also provide the initial doses of the medication free to physicians so that the patient can get the first couple of days free before they discover the actual cost of the full 12 week treatment. This is the same strategy that they're using with PrEP which costs about $1300 per month and is partially covered by insurance.

 

[gsdx]

^ Wow. Just wow.

I'm waiting to read about the justification. I doubt if it will ever come.