So I made the case yesterday that medical expenses are skyrocketing and no end in sight. An easy case.
The government has had a hand in making sure costs go up, by creating a monopoly and price protection. Getting the government out of medicine and letting the free market control would be preferrable.
Insurance companies have a hand in making sure costs go up. They don't care if costs increase as long as they can tell their shareholders that premiums are going up even faster. I don't see many insurance companies that are actually working to reduce the costs of medical expenses for families.
Doctors and Medical Practioners are in on it too. They work darn hard to make cosmetic and optional medicine a "need" so that the insurance companies can pay. They are using only expensive drugs, and very rarely perscribe generics unless asked by the patient. They never suggest to the patient ways to save money
Attorneys, the ambulance chasing kind, have run the cost of practicing medicine up to draconian levels because doctors have to purchase millions in coverage in case they ever make a mistake.
So, what are the politicians suggesting? Let's see Hillary thinks the government should just take over all medical coverage. Tax everyone who makes money, to pay for the entire system. Does that sound a bit like social security, which we already know doesn't work. Republicans are so busy being scared of the "poverty" segment of society, they don't want to recommend anything expect "limiting" government largess. Socialists and Libertarians are suggesting even dumber things. I would include the labor unions for the most part with the former, and "think tank" talking heads with the latter.
This is shaping up as a pretty catastrophic battle. The average household in middle America will have to work to make $50,000 a year for all their expenses, and then a second or third job for the $20-30,000 it would take to pay for their ever-increasing medical coverage. Now that's the kind of country I can be proud of, that's the place I like to call the American Dream.
No one, not a single politician, seems to care about the sheer cost of the medicine. You'll hear some talk about quality of life, or quality of coverage, or cost of innovation, or need to limit the power of the attorneys. But, I say no one is saying "Medicine Costs Too Much!!!!!"
You know what comes next, right? Housing and the expense of a home for the average American is going through the same exact cycle, it's just a few years behind. No one is saying "Homes and the expense of keeping a home are too expensive!!!!!"
I'd like to be the first.
Sunday, December 18, 2005
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3 comments:
Okay, medical costs are crazy! But I need to stand up for pharmaceutical companies, we are supposedly the root of all evil (not according to your posts, but in general, Steve.)
I was in a doctors office waiting room (working) the same time the news was on declaring that the family of someone who (might) have died from taking Vioxx was awarded over $240 million. At that same moment a patient decided to approach me, yell at me and tell me because I have a (cheap ass Taurus with 80k miles) as a company car and my exorbatent salary (NOT!)is why his drugs are so expensive. As he stood there with a pack of cigarettes in his pocket, and I am sure on his way to McDonalds (well maybe) for lunch. The man was overweight to boot. He probably takes my drugs because of his lifestyle.
Okay, okay back on track. Pharma companies must research 100's maybe even thousands of drugs before ONE gets to market, the cost of research has to be absorbed somewhere. (Since many of the government grants are issued to study previous studies on the effect of chewing gum when you are tired on Tuesday afternoons, instead of practical things.)
PHarma guidelines don't allow us to entertain doctors at baseball games and such like they once did in the past, anything we do for them must be of educational value or benefit patients directly. The costs of my job, advertising, promos and education are a VERY small portion vs research.
The costs of our drugs are basically based on two things research (necessary) and Tort Lawyers.
ALL pharma companies offer free or reduced medications to those in need, and most of the income guidelines are quite liberal. We also provide boat loads of FREE samples.
You did mention generic drugs and the fact that doctors don't prescribe as much as they should. The generic version (due to patents) are usually the first in the class, second and 3rd generation drugs generally provide greater efficacy, less side effects, and greater tolerability than the 1st generation which are now generics. Generics are also given a larger window of "acceptability" for each component of the drug. (I am not by any means saying they are unsafe, but maybe just not as effective or consistent.) The doctors get no benefit of prescrbing a "name brand" over generic except the fact that they have the confidence in giving the patient the best product for them. The only people that benefit from generics are pharmacies and insurance companies. Pharmacies make a ton more money from generic drugs than they do brand name.
Please don't get me wrong, there are people out there who are on the "cusp" of qualifiy for help and and not qualifying. If they can tolerate a generic and it works for them, it makes more sense for them to buy the generic.
Then there is Canada...why are there drugs cheaper, do pharma companies sell them cheaper there? NO! The government subsidizes the cost. The Canadian government wants to stop allowing US Citizens to purchase drugs from there because it is costing them too much money.
Then there is Mexico. Well you get what you pay for, or maybe not. Just please stay the heck away from any medication from there, there is a huge black market, you could simply get a placebo, or something that is really, really bad for you!
When it comes to the cost of medications and health, people need to take a little self-responsibility. Take care of themselves, excercise, eat right, make good choices. Don't smoke 2 packs a day and live off fast food and you might just not need 5 different meds every day!
Wow, what a bunch of hub bub and senseless chatter, but that is what blogs are for. Right? I feel better that I got that off my chest!
Happy New Year!
Thanks for the cogent response
I feel quite certain that medicine has undergone the same "balkanization" that home building has.
Widely shot at and bad mouthed. Liberals convinced that if they could just make all the decisions (ala Canada) then things would cost less. Hyper conservatives convinced that the mantra "let them eat cake" was a good idea.
In medicine I think it will take some massive tort reform, followed by some insurance companies stepping up and offering a better way to insure for catastrophe, followed by the FDA agreeing to make fast track really fast track, followed by a government guarantee that a medicine company can't be sued for a medicine that has side-effects, followed by a cultural movement that starts to budget and self-restrain.
Think any of that is possible?
Maybe just maybe, I believe in American ingenuity.
Unfortunately most probably won't happen. As to fast-tracking, in light of the Vioxx debacle, every med will now cost more as each med will require additional studies and testing, for longer periods of times. Fact...
Once again people and tort lawyers have this belief that if one drug saves 10's of thousands of lives and kills one, it is better it not be out at all. (It doesn't matter that those 10's of thousands may die without appropriate meds.) Even if it makes a better quality of life for a person. I mean people with bad reflux or arthritis rate their quality of life about a 3 on a scale of 10 (10 being best) while people with heart disease rate their lives about a 7, so it is not just about saving lives.
I think of reports I saw last spring on DDT, banned in the US, but could save hundreds of thousands in 3rd world contries, but the liberal bleeding hearts won't allow us to even fund spraying it in other countries. Heck, I remember running through the fog from the mosquito trucks in the summer evenings. I seem to be okay, as do all the other kids I ran around with!
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