The US spends more on healthcare for no gain says new report from Johns Hopkins • Hacker News Board

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

#111

Post by jellicle » Tue, Jan 08, 2019, 2:14 AM UTC

DennisP wrote: post #104

mikeg8 wrote: post #81

The book The Healing of America by T.R. Reid, 2010 was a phenomenal look at this subject and the conclusion was this: we are the only developed nation whose government allows for-profit health insurance companies to exist with ZERO regulation to cap healthcare prices. Because of this, we spend 20% of every dollar on "administrative" costs compared to 3%-7% in the European and Asian countries. The goal for American he…

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

Sufficiently advanced regulation is indistinguishable from single-payer - insurance is completely reliable, covers everything, and is completely fungible. Who cares what name is on the card? The easiest way to accomplish that is just to have a single government insurer. But you can finagle your way in the back door by regulating the shit out of insurance companies too.

One-third of the US population is on a US single-payer system right now.

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

#112

Post by awinder » Tue, Jan 08, 2019, 2:15 AM UTC

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…

NIH has also kicked in vast sums of capital to help fund that research, though. And actually considering the scale of healthcare spending (3.5T in 2017), you could probably publicly fund drug development outright within the savings window of something like full public funding of healthcare. Total drug R&D expenditure was like 70B in 2017, it's not some giant gift (though appreciated, temper the enthusiasm, so to speak).

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

#113

Post by rfinney » Tue, Jan 08, 2019, 2:16 AM UTC

rpedela wrote: post #95

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 is true that the US pays for a significant portion of drug R&D for the world. However the vast majority of that R&D is funded by the NIH which in turn is funded by U.S. taxpayers. It is a myth that it is the pharma companies who fund much of R&D even though they do spend some money on it. They set the prices so high because they can. The patents give them a monopoly, and they do everything in their power to "everg…

Check:

https://www.thebalance.com/who-funds-biomedical-research-266...

"In a Journal of the American Medical Association (JAMA) study published in January 2010, the largest study to date to attempt to quantify U.S. funding of biomedical research by the pharmaceutical industry, government, and private sources, researchers estimate that U.S. biomedical research currently stands at about over $100 billion annually.

The pharmaceutical industry is the largest contributor towards funding research, funding over 60 percent. The government contributes to about a third of the costs, with foundations, advocacy organizations and individual donors responsible for the remaining investments."

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

#114

Post by DennisP » Tue, Jan 08, 2019, 2:16 AM UTC

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…

Yes, but there are better ways to do it.

A natural group to pay R&D for patent-free drugs is health insurance companies, who would benefit from the lower costs, and perhaps even come out ahead. But its hard for those companies to organize such an effort, because they can get the same benefit even if they don't contribute. It's a classic public goods problem.

Usually we solve public goods problems with taxes, and we could do that here, taxing the insurers and spending the money on R&D for patent-free drugs. Bernie Sanders introduced a bill to this effect several years ago. Iirc it involved "xprizes" for successful treatments, so bureaucrats wouldn't be steering all the research.

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

#115

Post by jellicle » Tue, Jan 08, 2019, 2:19 AM UTC

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…

Most drug research is paid by the US taxpayer through research grants, not by private companies. Pharma company marketing budgets much exceed their drug research budgets.

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

#116

Post by refurb » Tue, Jan 08, 2019, 2:20 AM UTC

Alex3917 wrote: post #61

refurb wrote: post #28

Earlier quoted context omitted.

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…

For the first point you mean clinical trials? I wouldn’t call that advertising.

The 2nd point sounds like consulting fees, not advertising.

And the 3rd point is required to recruit for clinical trials. And the drug doesn’t even have a brand name at the point. Doesn’t seem like what the general public would call advertising.

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

#117

Post by autokad » Tue, Jan 08, 2019, 2:20 AM UTC

rpedela wrote: post #95

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 is true that the US pays for a significant portion of drug R&D for the world. However the vast majority of that R&D is funded by the NIH which in turn is funded by U.S. taxpayers. It is a myth that it is the pharma companies who fund much of R&D even though they do spend some money on it. They set the prices so high because they can. The patents give them a monopoly, and they do everything in their power to "everg…

> "It is a myth that it is the pharma companies who fund much of R&D"

I dont think that statement is incorrect. They spend a ton on r&d (20%), which is more than pretty much any other industry

https://www.investopedia.com/ask/answers/060115/how-much-dru...

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

#118

Post by refurb » Tue, Jan 08, 2019, 2:21 AM UTC

mikeg8 wrote: post #81

The book The Healing of America by T.R. Reid, 2010 was a phenomenal look at this subject and the conclusion was this: we are the only developed nation whose government allows for-profit health insurance companies to exist with ZERO regulation to cap healthcare prices. Because of this, we spend 20% of every dollar on "administrative" costs compared to 3%-7% in the European and Asian countries. The goal for American he…

Why would you cap healthcare prices for insurers, they don’t set prices. You mean providers?

Half of US healthcare spending is public payers - Medicare and Medicaid. They do set prices for providers and still spend far more than other countries.

And if you’ve been involved in US healthcare you’d realize it’s drowning in regulations already. It’s not a free market by a stretch.

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

#119

Post by pytyper2 » Tue, Jan 08, 2019, 2:24 AM UTC

They spend more on healthcare because a corporation presented a bill with a larger total at the bottom. NO human goes to the hospital and says, "...please charge me 37 dollars more than last visit for that generic aspirin..." All you international geniuses, help us out, stop investing in the for profit US healthcare system. Sell your holdings today, don't invest your retirement in funds that invest in for profit healthcare companies. That would get the ball rolling. Same goes for for profit prison management.

Trivia: What percentage of for profit healthcare corporations are directly or beneficially controlled by foreign investors who reside in countries that do not have our healthcare cost problems?

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

#120

Post by friedman23 » Tue, Jan 08, 2019, 2:25 AM UTC

grecy wrote: post #33

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…

Except that every company involved in the healthcare industry in America (drug companies, insurance companies, hospitals, etc.) make hundreds of billions (or trillions) in profit each and every year. The reason for the high prices is because healthcare in the US is an extremely, extremely lucrative for-profit industry.

> hundreds of billions (or trillions) in profit each and every year.

No company makes trillions of dollars in profit.