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Fed Up with Drug Companies, Hospitals Decide to Start Their Own

nytimes.com

81–90 of 244 posts

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#81
post #55

Earlier quoted context omitted.

Country-owned means of production have usually not fared well vs competitive forces in the past. And it could be considered as unfair competition: a state-owned manufacturer could basically have a blank check from the government for any kind of investment and would not have to worry at all about profitability. It sounds very nice as a thought exercise, but economical incentives are very tightly linked with productivi…

Thinking of it as “unfair competition” implies that companies have some sort of entitlement to a market. They don’t. If my town wants to have its own fire department, it’s not “unfair” to privately owned fire departments anymore than working on my own car is “unfair” to professional mechanics.

Nationalized producers are generally considered "unfair" because they're usually (always??) tax subsidized in some way. As such, they're not competing on a level playing field with the other players. In fact, the other players are being taxed... to pay for subsidizing their direct competitor!

Now if you wanted to setup a nationalized producer, put a "chinese wall" between it and the State and force it to compete without subsidies or special (favourable) regulations, sure, go for it. But then what's the advantage of it being nationalized to begin with? Anybody could start a non-profit corporation and do the same thing.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#82
post #72

I always assumed it would be CVS that got into the game. There are are probably a dozen or so drugs that account for the majority of consumption. Flu vaccines, blood pressure, cholesterol, thyroid, insulin, asthma, progesterone, beta-blockers, gerd, etc. Providing these at minimum cost, as well as community public health services. Could be enormously cost effective. And extend general wellness and productivity many t…

I they seem to be explicitly targeting generics, so R&D doesn't come into play. It's really just find someone who can build a known compound and press it into a pill. This has the potential to be massively disruptive.

Even generics need FDA approval. Manufacturers must demonstrate therapeutic equivalence.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#83

I always assumed it would be CVS that got into the game. There are are probably a dozen or so drugs that account for the majority of consumption. Flu vaccines, blood pressure, cholesterol, thyroid, insulin, asthma, progesterone, beta-blockers, gerd, etc. Providing these at minimum cost, as well as community public health services. Could be enormously cost effective. And extend general wellness and productivity many t…

Yeah, I wonder why not CVS and other chains.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#84

I always assumed it would be CVS that got into the game. There are are probably a dozen or so drugs that account for the majority of consumption. Flu vaccines, blood pressure, cholesterol, thyroid, insulin, asthma, progesterone, beta-blockers, gerd, etc. Providing these at minimum cost, as well as community public health services. Could be enormously cost effective. And extend general wellness and productivity many t…

i was thinking the same thing, but i was thinking that it was going to be Walmart who got into the game first, especially since they were starting to get into the clinic gig already.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#85

Earlier quoted context omitted.

Some, if not most, of this is a result of the insurance system. The insurance companies only pay x% of any given item, therefore the hospitals have to jack prices through the roof to collect enough to survive. The problem with our healthcare system is that too much money goes to drug companies, medical device makers, and insurance companies and not enough makes it to the people actually providing the care. Its a bit…

Oh please. Doctors in the US get huge amounts of money, to the point they're the actual 1%. You don't see anything like this in OCDE countries. Doctor associations all across the country create enormous barriers to the opening of new medical schools to avoid competition. Don't get me wrong, medical doctors are generally good hard working people. But we need to acknowledge they're part of the problem.

> Doctor associations all across the country create enormous barriers to the opening of new medical schools to avoid competition.

similar to how nursing unions band together and squash efforts for community paramedicine (many of the same services at a way lower cost) to expand. "they'll be taking our jobs!" is what it boils down to.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#86
This article makes it seem like drug companies alone are responsible for predatory pricing in US healthcare, with hospitals being somehow on the consumer's side of the issue. In reality US hospitals are just as guilty of predatory behavior. If they do achieve lower costs through a new generics company, I do not trust them one bit to pass on the savings to patients. Why would they?

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#87
post #56
post #46

Earlier quoted context omitted.

All you are saying is correct but you can't excuse their billing practices.

I work for a hospital and I agree with you that the billing practices are shitty, but I couldn't tell you what a procedure will cost you even if ordered to. At best I could give you an average for a procedure but if you're in for a few days you may see dozens of doctors and have hundreds of procedures including an operating room procedure or two and a whole lot of blood tests, imaging, poking and prodding (e.g. asses…

That's the thing. They don't even give averages. In my view they should have to publish all costs for procedures they have done. The current system is totally opaque and as patient you are often forced to do something hoping it won't ruin you but you have no way get something concrete upfront.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#88
post #71

When there's lack of competition, one needs to look for artificial barriers. Ah, found it: "Intermountain executives said that they would seek approval to manufacture the products from the Food and Drug Administration, which has vowed to give priority to companies that want to make generics in markets for which there is little competition."

I certainly hope you're not suggesting that we dispense with FDA approval for drug manufacturers just for the sake of increasing competition.

I don't need government approval to start manufacturing cars. Why for generic drugs?

Note that you're paying plenty for having the FDA as gatekeeper.

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#89

Earlier quoted context omitted.

This is all nice and cynical sounding like HN loves when it comes to big companies, but even then: is that such a bad thing? You have ten years of a lot of people getting cheaper and better access to drugs, and you have a bunch of hospitals getting much-needed capacity increases with state-of-the-art facilities, and you have a proven business model for someone else to come in and take their turn at the money-making w…

Concur with maj maj maj maj... additionally, the the cynisism ignores the introduction of new competitive forces with a different moral vector in a largley unchecked market, the repurcussions of which are certainly uncertain, for certain.

I agree with you that more competition is a good thing, but I don't think you can say that hospitals have a different moral vector than drug companies. Hospitals are as much huge corporations trying to please stockholders as big pharma is, they just happen to have people working for them who have a different moral vector. But I wouldn't put much hope in hospitals making a huge investment like this for the good of their patients

Re: Fed Up with Drug Companies, Hospitals Decide to Start Their Own

#90
post #71

Earlier quoted context omitted.

I certainly hope you're not suggesting that we dispense with FDA approval for drug manufacturers just for the sake of increasing competition.

I don't need government approval to start manufacturing cars. Why for generic drugs? Note that you're paying plenty for having the FDA as gatekeeper.

There are numerous federal regulations concerning the manufacturing of cars.
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