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

nytimes.com

151–160 of 244 posts

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

#151
post #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?

Drug prices is an increasing problem everywhere.

Now I’m European so bare with me and my “Stalinist” ways, but I don’t see why something so essential to society is in the hands of corporations rather than the public.

Research? You could buy a lot of research for the amount of money we’re currently spending on medicine in healthcare and right now we’re really just paying a corporate tax to save lives so that some 1%’et can get even richer.

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

#152

Earlier quoted context omitted.

> Are they for-profit in the US? Yes, with few exceptions. Here's how this goes: "But if they weren't for-profit, then it would be more like Canada's or England's health care, and I've heard you have to wait months for anything over there. Also it would mean they wouldn't have as much money for innovation, and, y'know, the US has the best health care technology in the world. Oh, sure, only the rich can afford it, but…

One issue with the above. > England You mean Britain. It wouldn’t be HN without a rant correction.

> You mean Britain.

At the moment.

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

#153

Earlier quoted context omitted.

The parent comment was correct when they said this: "The real root problems with the system are that a tiny minority of very sick patients account for an overwhelming majority of treatment costs" It's impossible to tell exactly what the parent comment meant any more precisely without clarification, whether they were talking about unnecessary over-consumption of resources (Americans have been over-healthcare'd for dec…

You can do the NHS way and forbid paying for unwarranted procedures for life extension. Can't find data right now, but a generally healthy person will spend most of it's lifetime healthcare expenses on its last 2 years. NHS adopts this measures in the so called death panels. So it can have money to fund preventive care and promote healthy lifestyles.

> You can do the NHS way and forbid paying for unwarranted procedures for life extension.

Please cite which of these procedures are forbidden.

> NHS adopts this measures in the so called death panels

The US has these too, in the form of insurance companies.

I think if you're going to have them it's better to ahve them be publically owned not for profit organisations under intense government regulation, rather than profit making companies.

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

#154
post #111

Earlier quoted context omitted.

Even if they do not directly pass this on to patients, cheaper generics will benefit patients in terms of their availability. I recently was involved in a case where a flucytosine (an old, generic anti-fungal) was considered for a patient, but the cost of treatment was $7,000 (as an outpatient) and therefore not considered (despite this being the best option). For an interesting analysis of this, see [1]. [1] https:/…

"Due to generic drug manufacturer monopolization, flucytosine currently costs approximately $2000 per day in the United States, with a 2-week flucytosine treatment course costing approximately $28 000. The daily flucytosine treatment cost in the United Kingdom is approximately $22." Would it be permitted to travel to the UK (or somewhere closer) and buy the medicine, then bring it back? Or even order online, there's…

Why not just go on a 2 week holiday :)

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

#155

Earlier quoted context omitted.

> Are they for-profit in the US? Yes, with few exceptions. Here's how this goes: "But if they weren't for-profit, then it would be more like Canada's or England's health care, and I've heard you have to wait months for anything over there. Also it would mean they wouldn't have as much money for innovation, and, y'know, the US has the best health care technology in the world. Oh, sure, only the rich can afford it, but…

One issue with the above. > England You mean Britain. It wouldn’t be HN without a rant correction.

Not to get excessively meta-pedantic, but the constituent countries of the UK each run their own independent health services. The difference in wait times is currently quite a hot topic of discussion!

If anything, a comparison with England is probably more appropriate :)

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

#156

Earlier quoted context omitted.

> Are they for-profit in the US? Yes, with few exceptions. Here's how this goes: "But if they weren't for-profit, then it would be more like Canada's or England's health care, and I've heard you have to wait months for anything over there. Also it would mean they wouldn't have as much money for innovation, and, y'know, the US has the best health care technology in the world. Oh, sure, only the rich can afford it, but…

One issue with the above. > England You mean Britain. It wouldn’t be HN without a rant correction.

If you want to go down that road, probably you mean the United Kingdom.

And you may not be aware but “Each of the UK's health service systems operates independently, and is politically accountable to the relevant government: the Scottish Government; Welsh Government; Northern Ireland Executive; and the UK Government, responsible for England's NHS.”

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

#157

Earlier quoted context omitted.

> Why are hospitals doing the opposite to offering the best care possible to all citizens? Are they for-profit in the US? Contrary to sibling comments, no, they generally are not. Most (58.5%) US hospitals are private nonprofits, and another 20.2% are public. Only 21.3% are private, for-profit. [0] [0] https://www.beckershospitalreview.com/hospital-management-ad...

Contrary to your comment, yes, they generally are; they're just using Hollywood accounting and referring to their profits as "excess earnings". "A study published in the May issue of Health Affairs revealed that in 2013, seven of the top ten most profitable hospitals in the United States were nonprofit hospitals, with each earning over $163 million in profits from patient care." https://www.forbes.com/sites/brucelee/…

> Contrary to your comment, yes, they generally are;

No, they're not.

> they're just using Hollywood accounting and referring to their profits as "excess earnings".

No, they aren't. Excess earnings are the correct technical term. Non-profit status, even in theory, has nothing to do with whether you earn more in revenue than you expend in costs, it has to do with whether there are stockholders or others who have a claim on accumulated returns.

More specifically, charitable nonprofits (which non-profit hospitals are) have a wide variety of additional requirements and restrictions (both in general, and specific additional requirements for hospitals, including several added by the ACA.)

> read that one, it's a good breakdown of the accounting that hospitals use to maintain their nonprofit status while behaving in every other way like any other for-profit business.

No, it's just a bunch of dishonest, or perhaps merely clueless, mischaracterizing; the most obvious example being considering money expended in providing Medicaid services but not covered by Medicaid reimbursement as money the hospital “paid to itself” rather than an external benefit. This isn't money the hospital paid to itself, it's money the hospital paid out to provide services under a public program providing healthcare to the medically indigent but which was not reimbursed by that public program (in general, Medicaid is a money-losing program for providers, as—while there are some exceptions—reimbursement is generally at the lowest of three things: a state set rate, the actual cost of providong the service, or the provider's usual and customary charge for the same or substantially similar service. This is at best break even, but over all, across all providers, it's always going to be, in practice, below actual cost.

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

#159
post #150

Earlier quoted context omitted.

Aside from generics, Boots in the UK used their patent on ibuprofen to dominate their market. I’m always surprised there isn’t more pharmacy-driven research or investment into exclusive over-the-counter medicines to mimic that strategy, or bidding wars to get exclusive pharmacy rights to new drug patents so that firms can get halo effect shopping. (Not that I endorse this sort of corporate lechery, I’m just surprised…

Why would a pharmacy care? They typically make a margin on each drug they fill. The more expensive the drug, the more money they make.

I think you misread that comment. He wasn't talking about the pharmacy making anything cheaper. Quite the contrary.

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

#160
post #111

Earlier quoted context omitted.

Even if they do not directly pass this on to patients, cheaper generics will benefit patients in terms of their availability. I recently was involved in a case where a flucytosine (an old, generic anti-fungal) was considered for a patient, but the cost of treatment was $7,000 (as an outpatient) and therefore not considered (despite this being the best option). For an interesting analysis of this, see [1]. [1] https:/…

"Due to generic drug manufacturer monopolization, flucytosine currently costs approximately $2000 per day in the United States, with a 2-week flucytosine treatment course costing approximately $28 000. The daily flucytosine treatment cost in the United Kingdom is approximately $22." Would it be permitted to travel to the UK (or somewhere closer) and buy the medicine, then bring it back? Or even order online, there's…

There are multiple south american and european generic manufacturers, but I guess is not thay simple to ship drugs.
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