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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

#41

Post by dragontamer »

zzleeper wrote: post #32
shawnz wrote: post #26

Earlier quoted context omitted.

I don't understand your point. Obviously it's going toward R&D of new drugs unrelated to the EpiPen. What does the price of an EpiPen have to do with how the money is spent?

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: Tesla) a company to spend all their money asap on infrastructure, research, development, etc. etc.

Dividends are a last resort, only to be used if a company doesn't know what to do with its cash. Once a company starts paying dividends, it means that it has run out of ideas for how to invest into the future.

Besides: its more tax efficient to grow the stock price rather than to pay the profits back in cash.

---------

Even a big company will want to at least appear that it is growing even bigger, through R&D funds and what-not. If you start to give out a lot of dividends, investors will probably take it as a bad sign and flee.

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

#43

Post by conductr »

trophycase wrote: post #24

Everyone wants to blame drug prices but let's not ignore the problems of obesity, diabetes, etc. Much of which is a result of urban sprawl, poor diet (both in food culture, and in crop subsidies), and poor work culture.

While I agree with you’re sentiment, wouldn’t the article be titled “Americans use more healthcare” if this was a driving force of high cost?

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

#44

Post by cameronh90 »

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 freeloading, but looking at the NHS for example, they set relatively clear limits for how much they will pay per quality-adjusted life year that a drug provides. If a drug costs more than this limit, financially more people will lose out if our healthcare system purchases this drug over something else (more doctors, hospital beds, etc.).

Does this make us immoral for "freeloading", because we prefer putting our limited money into cost effective treatments?

Also, is it not worth looking at why pharma R&D costs so much? The pharma industry seems to run at a very healthy profit margin compared to most other industries. Maybe the lack of market pressure is allowing the pharma industry to remain fatty? Obviously there's a fear that cutting US pharma revenue would hurt global medical R&D, but I don't see this as being a foregone conclusion. It could just as possibly be market failure and regulatory capture keeping pharma R&D expensive.

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

#45

Post by d--b »

These studies serve no purpose. Everybody knows this.

The usual debate follows: yes but US funds research - yes but doctors, insurance and pharmaceutical companies get paid a lot more than anywhere else - yes but that’s the market, I want to pay more to have a top notch doctor / insurance - blah blah blah.

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

#46

Post by d--b »

airstrike wrote: post #27
trophycase wrote: post #24

Everyone wants to blame drug prices but let's not ignore the problems of obesity, diabetes, etc. Much of which is a result of urban sprawl, poor diet (both in food culture, and in crop subsidies), and poor work culture.

As a U.S. immigrant who struggles to find truly healthy food choices in Manhattan of all places, I couldn't agree more.

Whole Foods is pretty healthy. Fresh direct is not bad at all. Fairway market...

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

#47

Post by AngryData »

airstrike wrote: post #16
brohoolio wrote: post #8

Earlier quoted context omitted.

I’m not sure what kind of R&D the $800 or whatever it costs now Epipen is paying for. R&D for lobbyists? Or profits because the company gamed the market.

The EpiPen is one of the "hard to manufacture" drugs I mentioned. Although it is top of mind to many, it is not representative of the market. EDIT: "hard to manufacture" is in quotes because it's what I said in my parent comment (though to be fair I said "costly to manufacture"), but I meant it as an umbrella term for everything that can't be substituted by generics

There are cheap generics all over. The only patent EpiPen has is the applicator. Generics require you to take a syringe and inject it by hand because the patent prevents competitors from using a similar style spring loaded applicator.

The epinephrine used in epipens is extremely cheap to produce.

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

#48

Post by harimau777 »

Are there any measures of how America does compared to Europe if you only count Americans that have good health insurance?

It seems to me that many people who are opposed to socialized medicine don't necessarily disagree that it would give the poor better care; rather they fear that it will result in them receiving worse care.

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

#49

Post by MichaelApproved »

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 physician how much a service cost. I asked my physician and they had no clue. They finally gave me an estimate of "it'll be nominal", so I accepted the procedure. Turned out to be ~$200. I'm currently disputing it and refuse to pay based on their original quote of "nominal".

Imagine your at the doctor and need to get a blood test. What do you do? Start calling around local labs to ask which one has the best price? Maybe check Groupon for a discount? All this while your doctor waits to see if the price is within your budget, so they could continue the test.

Pricing in the medical industry is not even opaque. It's solid black.

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

#50

Post by fzeroracer »

api wrote: post #3
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…

If this is in fact true it means the rest of the world is freeloading off the US system. Not saying I'm convinced it is true. I'd like to see a deeper unbiased analysis.

I would say it's more likely that the rest of the world has realized that collective bargaining allows them to set prices far lower than countries like say, America where they're free to gouge the money right out of your wallet.

If you don't play ball with a government, you're denying yourself a lot of potential customers. A single person? A fraction of a fraction of a drop in a bucket.

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