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re: Lets talk Yangs HC Plan
Posted on 12/17/19 at 10:01 am to Sneaky__Sally
Posted on 12/17/19 at 10:01 am to Sneaky__Sally
quote:
That is why we look at what other countries are paying - the worldwide market and pay in line with the market price.
You didn't address what I said though. If other countries are paying less, and the drug provider decides that they don't want to sell to the U.S. market because they aren't getting paid a fair price do you think the government just lets it go?
We would have to have a global standard for drugs so the FDA would allow international generics to be "worthy" for the U.S. consumer. I doubt that happens. It all leads to price fixing and cost shifting. That drug won't get made in the future if the company can't charge what they deem as a fair price for it.
1
Posted on 12/17/19 at 10:02 am to TOKEN
How about this:
Open up medicaid to whoever want it. If you are too cheap or poor that is for you. Who knows, maybe government will finally run something well. I doubt it. It will be on par with the DMV and US postal service. --No thanks.
Leave everything else alone. Consumers decide what plan they want to pay for. Zero government requirements. It could be a simple or one that covers everything.
You buy what you are willing to pay for.
Open up medicaid to whoever want it. If you are too cheap or poor that is for you. Who knows, maybe government will finally run something well. I doubt it. It will be on par with the DMV and US postal service. --No thanks.
Leave everything else alone. Consumers decide what plan they want to pay for. Zero government requirements. It could be a simple or one that covers everything.
You buy what you are willing to pay for.
Posted on 12/17/19 at 10:04 am to Sneaky__Sally
quote:
If everyone else is paying $100 for a drug is there a reason the US should pay $200?
After discounts/ preferred pricing/copays, is there pretty much anyone who pays the $200? Or is that the retail price that you'd pay absent insurance which, as we all know, everyone is legally required to have?
Posted on 12/17/19 at 10:07 am to nugget
quote:
I wasn't solely talking about drug prices. You also want the government to control what doctors can be paid. Do you not see how that will limit innovation.
I want to explore changes in the way that doctors are reimbursed to create better systems. I don't think it will impact innovation to the level you are indicating.
quote:
disagree. You are wanting the means of production to be taken over by the government
No that isn't what I want - I want the gov't to have checks on the free market system in healthcare - just like anti-trust laws - which are a "socialist" practice but are necessary in certain cases to help protect our free market / capitalist system as a whole.
I am not a proponent of national / socialized healthcare and that isn't the HC plan that Yang supports.
Posted on 12/17/19 at 10:09 am to SSpaniel
quote:
quote:
If everyone else is paying $100 for a drug is there a reason the US should pay $200?
After discounts/ preferred pricing/copays, is there pretty much anyone who pays the $200? Or is that the retail price that you'd pay absent insurance which, as we all know, everyone is legally required to have?
Regardless of when you pay it / who pays it, it is coming out of our pockets either as a cash payment, copay + portions of insurance premiums, etc. The cost always is passed on to the customer in some fashion, i just want to decrease the unnecessary bloat in the healthcare system.
Posted on 12/17/19 at 10:11 am to Tiger Roux
quote:All we need is a populace that cares about not being obese and the vast majority of costs disappear within a year
It would take a dictator to make the necessary changes to make even a modest reduction in health care cost.
Posted on 12/17/19 at 10:12 am to wutangfinancial
quote:
We would have to have a global standard for drugs so the FDA would allow international generics to be "worthy" for the U.S. consumer. I doubt that happens. It all leads to price fixing and cost shifting. That drug won't get made in the future if the company can't charge what they deem as a fair price for it.
You think that a drug company would bail on the US market if the US offered to purchase at the same rate seen in other highly developed Western European countries?
Posted on 12/17/19 at 10:12 am to Sneaky__Sally
quote:
I want to explore changes in the way that doctors are reimbursed to create better systems.
Why do you think the government could better determine the value added to society by a doctor than the free market could? When has that ever worked well for anyone?
quote:
just like anti-trust laws
The best way to keep the price down is to allow for competition in the healthcare field. I don't really see the correlation to antitrust laws.
Posted on 12/17/19 at 10:14 am to TOKEN
Like Yang's UBI plan, a whole lot has to be perfect for it to work and even then there's no guarantee.
A few problems I see from a technical perspective:
Telehealth - First there are clinics that already do this to a degree and yes, it has helped bring down costs. Forcing people to do so inters more technology costs, not just initial capital costs but operational costs. Healthcare has some of the worst cyber security out there unfortunately. For instance Our Lady of the Lake just pays the ransom for ransomware attacks (don't ask me how I know, I have on good authority they just do)
This needs to be addressed as well before we start forcing people to have doctor sessions over the internet that could be secretly recorded by a man-in-the-middle attack.
So called Health Deserts - This is the same nonsense to justify government subsidizing grocery stores in urban areas nobody want's to invest in due to high crime. You only have to look to New Orleans to see how bad of an idea this has been. Yang's team assumes rural America has no access to healthcare. There are doctors and clinics in rural areas it's getting people to the doctor. You can't force someone to do preventive medicine even if they get it for free.
Rebuilding EHR - First off, electronic health record systems are complicated and add overhead due to federal and state regulations. Also to include many standards set forth by insurance companies for coding and billing. It's no different than Enterprise Resource Planning software that any other business uses to run their business. That's the nature of it. What I find funny is that we're going to streamline something that got bloated because of government with.....wait for it....more government.
How about EHR companies take feedback from customers to streamline workflow based on their customer's needs. Many already do this and the advances in EHR platforms have given patients more insight into their health records and to keep in constant contact with their primary care provider than ever before, without heavy handed government regulation.
Another issue I see is the whole thing about protecting doctors from malpractice suit abuses. Basically you're advocating for tort reform which has been talked about for ages. With a legislative body that's mostly lawyers and have a lot of friends that are lawyers, you really think that's going to happen?
A few problems I see from a technical perspective:
Telehealth - First there are clinics that already do this to a degree and yes, it has helped bring down costs. Forcing people to do so inters more technology costs, not just initial capital costs but operational costs. Healthcare has some of the worst cyber security out there unfortunately. For instance Our Lady of the Lake just pays the ransom for ransomware attacks (don't ask me how I know, I have on good authority they just do)
This needs to be addressed as well before we start forcing people to have doctor sessions over the internet that could be secretly recorded by a man-in-the-middle attack.
So called Health Deserts - This is the same nonsense to justify government subsidizing grocery stores in urban areas nobody want's to invest in due to high crime. You only have to look to New Orleans to see how bad of an idea this has been. Yang's team assumes rural America has no access to healthcare. There are doctors and clinics in rural areas it's getting people to the doctor. You can't force someone to do preventive medicine even if they get it for free.
Rebuilding EHR - First off, electronic health record systems are complicated and add overhead due to federal and state regulations. Also to include many standards set forth by insurance companies for coding and billing. It's no different than Enterprise Resource Planning software that any other business uses to run their business. That's the nature of it. What I find funny is that we're going to streamline something that got bloated because of government with.....wait for it....more government.
How about EHR companies take feedback from customers to streamline workflow based on their customer's needs. Many already do this and the advances in EHR platforms have given patients more insight into their health records and to keep in constant contact with their primary care provider than ever before, without heavy handed government regulation.
Another issue I see is the whole thing about protecting doctors from malpractice suit abuses. Basically you're advocating for tort reform which has been talked about for ages. With a legislative body that's mostly lawyers and have a lot of friends that are lawyers, you really think that's going to happen?
Posted on 12/17/19 at 10:15 am to Sneaky__Sally
quote:
You think that a drug company would bail on the US market if the US offered to purchase at the same rate seen in other highly developed Western European countries?
They should have the right to do so. The government shouldn't be negotiating heal prices on behalf of its citizens. Let the private insurance companies do that.
Posted on 12/17/19 at 10:24 am to nugget
quote:
The best way to keep the price down is to allow for competition in the healthcare field. I don't really see the correlation to antitrust laws.
anti trust is the easiest example to show where gov't intervention can be a necessary check on capitalism to preserve the integrity of the system as a whole.
And we are veering really far off the original course and I think its probably run its course.
I personally feel that the current system is not maximizing our return on investment at the national scale - something like 18% of GDP in healthcare costs I think - and I'd like to improve that.
You disagree and that is fine.
Posted on 12/17/19 at 10:28 am to Sneaky__Sally
quote:
Sneaky__Sally
I asked you to tell me which other countries have the equipment and the means to provide services like MRIs and CAT scans with a shorter waiting period than the U.S.
Posted on 12/17/19 at 10:32 am to Smeg
Yes, and ignored it because it wasn't pertinent to the discussion and is simply a misguided random internet argument got ya attempt which didn't do anything to further the discussion.
There were better posts with interesting and quality content that i chose to respond to instead.
There were better posts with interesting and quality content that i chose to respond to instead.
Posted on 12/17/19 at 10:37 am to Sneaky__Sally
quote:
You disagree and that is fine.
We both want a better ROI, we just disagree on how to get there. You want more government control to lower prices and I want less government control to lower prices, as a simplified form of this discussion. The innovation and great rates of disease survival are present not because the US is inherently smarter than the rest of the world, it's because of the lack of regulation we've had until Obamacare.
Posted on 12/17/19 at 10:37 am to Sneaky__Sally
quote:
because it wasn't pertinent to the discussion
It's extremely pertinent to the discussion and you reveal your ignorance by admitting you don't understand why.
These things cost a lot of money. Under our for profit model, they can be afforded. Patients benefit because they can get the scans done, same day, at clinics all over.
In Canada, they may have to wait weeks before being scheduled.
Is that a "benefit"?
Do you not want people the have access to high quality care in the shortest period of time?
Posted on 12/17/19 at 10:42 am to Sneaky__Sally
Let me give you an example of what I am getting at:
Gilead cures Hep C effectively for the world. They were able to charge something like $64K in the U.S. In India, for example, they charged something like $4 for the treatment. Eventually the patent expired and the cost decreased dramatically because of competition from within the U.S. The real question is, without the monopolistic pricing powers, would we have a cure for Hep C at all? If the U.S. government can force the company to pin the price at $4 a pill there would be no profit incentive to create the treatment in the first place.
The government would be driving business out of the U.S. and would be sacraficing quality for cost more than likely. The U.S. consumer wants it both ways in this regard and it's not possible. If the government can retroactively choose which drugs they feel are overpriced, drug companies will move production to another market knowing when they have a blockbuster drug, they have no pricing power or profit incentive.
Yes, I think they would wait until the government was willing to pay a higher price due to pressures from consumers.
Gilead cures Hep C effectively for the world. They were able to charge something like $64K in the U.S. In India, for example, they charged something like $4 for the treatment. Eventually the patent expired and the cost decreased dramatically because of competition from within the U.S. The real question is, without the monopolistic pricing powers, would we have a cure for Hep C at all? If the U.S. government can force the company to pin the price at $4 a pill there would be no profit incentive to create the treatment in the first place.
The government would be driving business out of the U.S. and would be sacraficing quality for cost more than likely. The U.S. consumer wants it both ways in this regard and it's not possible. If the government can retroactively choose which drugs they feel are overpriced, drug companies will move production to another market knowing when they have a blockbuster drug, they have no pricing power or profit incentive.
quote:
You think that a drug company would bail on the US market if the US offered to purchase at the same rate seen in other highly developed Western European countries?
Yes, I think they would wait until the government was willing to pay a higher price due to pressures from consumers.
Posted on 12/17/19 at 10:43 am to nugget
quote:
We both want a better ROI, we just disagree on how to get there. You want more government control to lower prices and I want less government control to lower prices, as a simplified form of this discussion. The innovation and great rates of disease survival are present not because the US is inherently smarter than the rest of the world, it's because of the lack of regulation we've had until Obamacare.
Yes, I don't trust the healthcare industry to lower their prices / profits though, which is why I think some gov't checks are necessary. I don't want the gov't to own the means of production though and run the whole game or anything.
Obamacare is and was a failure - but there is no going back at this point and I personally have come around to the belief that everyone should have some form of affordable healthcare (I am an independent who typically leans conservative believe it or not, I just think Yang is best suited to help the gov't catch up to this century).
This post was edited on 12/17/19 at 10:44 am
Posted on 12/17/19 at 10:46 am to Sneaky__Sally
quote:
Yes, I don't trust the healthcare industry to lower their prices / profits though, which is why I think some gov't checks are necessary. I don't want the gov't to own the means of production though and run the whole game or anything.
Congrats on having the first civil discussion in Poliboard history
Posted on 12/17/19 at 10:53 am to wutangfinancial
I understand but the $4 is not what I want - which is why I am saying compare it to the mean pricing in developed western european countries with advanced economies.
But there is a middle ground, the drug companies are still going to be making tons of money and they aren't going to leave that money on the table IMO.
The advanced countries can still subsidize the cures, but it shouldn't just be the US citizens burden. The drug companies should charge the same or very similar rates in the US and UK for example - this is clearly going to be far higher than the rate in undeveloped / third world countries - as it should be.
I think that the drug companies are fleecing the US citizens because they can via the system, I don't think this would significantly impact innovation - it may result in higher prices in Western Europe if they feel the need to recoup that, but that is fine with me.
I really don't see the drug companies bailing on the US - way too much money to be had, even if we take steps to reduce these kind of costs and bloat, at least IMO.
But there is a middle ground, the drug companies are still going to be making tons of money and they aren't going to leave that money on the table IMO.
The advanced countries can still subsidize the cures, but it shouldn't just be the US citizens burden. The drug companies should charge the same or very similar rates in the US and UK for example - this is clearly going to be far higher than the rate in undeveloped / third world countries - as it should be.
I think that the drug companies are fleecing the US citizens because they can via the system, I don't think this would significantly impact innovation - it may result in higher prices in Western Europe if they feel the need to recoup that, but that is fine with me.
I really don't see the drug companies bailing on the US - way too much money to be had, even if we take steps to reduce these kind of costs and bloat, at least IMO.
Posted on 12/17/19 at 10:55 am to nugget
quote:
quote:
Yes, I don't trust the healthcare industry to lower their prices / profits though, which is why I think some gov't checks are necessary. I don't want the gov't to own the means of production though and run the whole game or anything.
Congrats on having the first civil discussion in Poliboard history
Haha, its good to have a little friction in a discussion but keep it civil, i've enjoyed it.
Need to get some work done now though.
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