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The US spends more on healthcare for no gain says new report from Johns Hopkins

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Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#61

Post by Alex3917 »

refurb wrote: post #28
paulie_a wrote: post #21

Earlier quoted context omitted.

I don't know if it still the case but advertising costs were previously considered r&d so grossly inflating those numbers.

Do you a source? As far as I know, R&D never included advertising.

R&D includes a lot of (most?) but not all advertising. It probably doesn't include things like running DTC ads on TV. But it does include things like:

- Paying doctors to prescribe the drug to patients for "research purposes."

- Paying doctors for their "valuable opinions" about the drug.

- Paying for advertising to recruit patients into clinical trials.

And so on.

I don't think there are any industry-wide statistics, so you'd have to look at the break down for each individual drug (where available). If you read pretty much any book on the pharma industry it will go into this, there are no shortage that you can find on Amazon.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#62

Post by cpncrunch »

airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

But R&D isn't included in the OECD health spending database as far as I can tell.

http://www.oecd.org/els/health-systems/health-data.htm

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#63

Post by zzleeper »

dragontamer wrote: post #41
zzleeper wrote: post #32

Earlier quoted context omitted.

That's not how it works. You invest if it's worth investing, not if you just have the money laying around. Paying a few billion dollars to a big pharma company is not going to make them invest more in research. They will instead pay the money out as dividends. The goal of patents is to create incentives for future research, but if you change the rules by increasing the extent of EpiPen patents after the drug was crea…

> Paying a few billion dollars to a big pharma company is not going to make them invest more in research. They will instead pay the money out as dividends. This is a misconception. No investor wants their money back. Investors want a promise of MORE money back in the future. If investors wanted their money back immediately, they wouldn't have bought stock in the first place! The vast majority of investors prefer (ex:…

You don't have to pay dividends, you can just do a stock repurchase.

Regarding investor preferences, they only want the money spent if it gives them a positive NPV. Pharma companies are already paying dividends, which means they have funds in excess of their NPV>0 projects, which is why they return them to shareholders.

Hell, half of the shareholder activism literature and the policy payout literature is about CEOs overinvesting and doing empire-building instead of returning the money to shareholders..

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#64

Post by kps »

MichaelApproved wrote: post #49
bluetwo wrote: post #22

Like the article says, previous research has come to the same conclusion. We pay much more, and are ranked nowhere near the top for lifespan, childhood mortality, and other measures. Obamacare was a great first step. Define what basic healthcare is and form markets that encourage apples-to-apples comparison. Let the free market work. Sucks that one party used this as a weapon to wrestle power. Oh well. Not going to a…

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

A free market would have patients and physicians reaching a supply/demand equilibrium, with facilitating brokers taking a small cut.

In the US, patients go bankrupt and physicians go bankrupt — money flows to the parasites who set prices: administrators and insurers.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#65

Post by rayiner »

cameronh90 wrote: post #44
airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

It does appear to be the case that the US funds most pharma R&D due to Americans overpaying relative to the rest of the word. In some cases (China, India) this is due to weak IP protection, but in other cases (Canada, UK, Europe) it's more to do with our governments having a stronger negotiating position and setting hard limits on what they'll spend for a given benefit to patients. Some characterise this as freeloadi…

> The pharma industry seems to run at a very healthy profit margin compared to most other industries.

But not compared to other high risk, capital intensive industries, i.e. tech.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#66

Post by Gibbon1 »

MichaelApproved wrote: post #49
bluetwo wrote: post #22

Like the article says, previous research has come to the same conclusion. We pay much more, and are ranked nowhere near the top for lifespan, childhood mortality, and other measures. Obamacare was a great first step. Define what basic healthcare is and form markets that encourage apples-to-apples comparison. Let the free market work. Sucks that one party used this as a weapon to wrestle power. Oh well. Not going to a…

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

> Respectfully, enough with this free market garbage.

Kenneth Arrow pretty much proved in 1963 that 'the free market' doesn't work for healthcare. Nothing since has produced a shred of evidence that he was wrong.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#67

Post by the_cat_kittles »

MichaelApproved wrote: post #49
bluetwo wrote: post #22

Like the article says, previous research has come to the same conclusion. We pay much more, and are ranked nowhere near the top for lifespan, childhood mortality, and other measures. Obamacare was a great first step. Define what basic healthcare is and form markets that encourage apples-to-apples comparison. Let the free market work. Sucks that one party used this as a weapon to wrestle power. Oh well. Not going to a…

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

this is such an underemphasized point, and it completely undermines dumb "free market" solutions. a lot of people in america have been fooled, plain and simple.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#68

Post by Gibbon1 »

kps wrote: post #64
MichaelApproved wrote: post #49

Earlier quoted context omitted.

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

A free market would have patients and physicians reaching a supply/demand equilibrium, with facilitating brokers taking a small cut. In the US, patients go bankrupt and physicians go bankrupt — money flows to the parasites who set prices: administrators and insurers.

Respectfully; you believe in magic.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#70

Post by hacknat »

MichaelApproved wrote: post #49
bluetwo wrote: post #22

Like the article says, previous research has come to the same conclusion. We pay much more, and are ranked nowhere near the top for lifespan, childhood mortality, and other measures. Obamacare was a great first step. Define what basic healthcare is and form markets that encourage apples-to-apples comparison. Let the free market work. Sucks that one party used this as a weapon to wrestle power. Oh well. Not going to a…

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

Some providers actually have policies that prohibit giving out any pricing information.

There are so many reasons why healthcare isn’t close to a free market. Here are a few:

1. All medical residents receive their salaries from Medicare.

2. It is illegal not to treat people who go to the emergency room. This actually makes the whole system socialized in some ways in that there is a guaranteed way to get healthcare without having to pay for it. It’s literally the worst way to socialize medicine though (what with preventive medicine being cheaper).

3. Within the industry itself their are drug pricing cartels, lab monopolies and facility provider splits that even some hospital administrators don’t understand. You mentioned shopping around for lab results, but I think there is only one option in a lot of states.

Forget single payer socialize the whole thing (it already is in the most expensive, stupid way).

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