KSB and jerry

[penultimatestraw 473]

At this point all the reading comprehension in the world couldn't figure out your babbling. You didn't ask who had the best health coverage in the world in your original post.

 

Quantifying that would be pretty tough anyway, so your "question" can't be answered with 100% certainty anyway. Quality being the most important to me, I'll take ours over any other.

 

Keep acting like a ###### douche though.

 

 

Honestly, I think my point was very clear the first time I typed it. Did anyone else think I meant every country in the world has a better healthcare system than the US?

 

And it is difficult to quantify which country has the "best" care, but there are metrics like life expectancy, infant mortality, access to care, healthcare-related complications, and yes, affordability. You, RP and others want to think the US provides the best care based on little objective data. But why do you think it is best? Let me provide some food for thought:

 

The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. This report, which includes information from the most recent three Commonwealth Fund surveys of patients and primary care physicians about medical practices and views of their countries' health systems (2007–2009), confirms findings discussed in previous editions of Mirror, Mirror. It also includes information on health care outcomes that were featured in the most recent (2008) U.S. health system scorecard issued by the Commonwealth Fund Commission on a High Performance Health System.

 

Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, coordination, efficiency, and equity. The Netherlands ranks first, followed closely by the U.K. and Australia. The 2010 edition includes data from the seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on various dimensions of care.

The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage. Health reform legislation recently signed into law by President Barack Obama should begin to improve the affordability of insurance and access to care when fully implemented in 2014. Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term "medical homes." Without reform, it is not surprising that the U.S. currently underperforms relative to other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes.

But even when access and equity measures are not considered, the U.S. ranks behind most of the other countries on most measures. With the inclusion of primary care physician survey data in the analysis, it is apparent that the U.S. is lagging in adoption of national policies that promote primary care, quality improvement, and information technology. Health reform legislation addresses these deficiencies; for instance, the American Recovery and Reinvestment Act signed by President Obama in February 2009 included approximately $19 billion to expand the use of health information technology. The Patient Protection and Affordable Care Act of 2010 also will work toward realigning providers' financial incentives, encouraging more efficient organization and delivery of health care, and investing in preventive and population health.

For all countries, responses indicate room for improvement. Yet, the other six countries spend considerably less on health care per person and as a percent of gross domestic product than does the United States. These findings indicate that, from the perspectives of both physicians and patients, the U.S. health care system could do much better in achieving value for the nation's substantial investment in health.

Key Findings

• Quality: The indicators of quality were grouped into four categories: effective care, safe care, coordinated care, and patient-centered care. Compared with the other six countries, the U.S. fares best on provision and receipt of preventive and patient-centered care. However, its low scores on chronic care management and safe, coordinated care pull its overall quality score down. Other countries are further along than the U.S. in using information technology and managing chronic conditions. Information systems in countries like Australia, New Zealand, and the U.K. enhance the ability of physicians to identify and monitor patients with chronic conditions.
• Access: Not surprisingly—given the absence of universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans with health problems were the most likely to say they had access issues related to cost, but if insured, patients in the U.S. have rapid access to specialized health care services. In other countries, like the U.K. and Canada, patients have little to no financial burden, but experience wait times for such specialized services. There is a frequent misperception that such tradeoffs are inevitable; but patients in the Netherlands and Germany have quick access to specialty services and face little out-of-pocket costs. Canada, Australia, and the U.S. rank lowest on overall accessibility of appointments with primary care physicians.
• Efficiency: On indicators of efficiency, the U.S. ranks last among the seven countries, with the U.K. and Australia ranking first and second, respectively. The U.S. has poor performance on measures of national health expenditures and administrative costs as well as on measures of the use of information technology, rehospitalization, and duplicative medical testing. Sicker survey respondents in Germany and the Netherlands are less likely to visit the emergency room for a condition that could have been treated by a regular doctor, had one been available.
• Equity: The U.S. ranks a clear last on nearly all measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment, or follow-up care, not filling a prescription, or not seeing a dentist when needed because of costs. On each of these indicators, nearly half of lower-income adults in the U.S. said they went without needed care because of costs in the past year.
• Long, healthy, and productive lives: The U.S. ranks last overall with poor scores on all three indicators of long, healthy, and productive lives. The U.S. and U.K. had much higher death rates in 2003 from conditions amenable to medical care than some of the other countries, e.g., rates 25 percent to 50 percent higher than Canada and Australia. Overall, Australia ranks highest on healthy lives, scoring in the top three on all of the indicators.

Summary and Implications

The U.S. ranks last of seven nations overall. Findings in this report confirm many of those in the earlier three editions of Mirror, Mirror. As in the earlier editions, the U.S. ranks last on indicators of patient safety, efficiency, and equity. Australia and the U.K. continue to demonstrate superior performance. The Netherlands, which was included for the first time in this edition, ranked first overall. In the subcategories, the U.S. ranks first on preventive care, and is strong on waiting times for specialist care and nonemergency surgical care, but weak on access to needed services and ability to obtain prompt attention from primary care physicians.

Any attempt to assess the relative performance of countries has inherent limitations. These rankings summarize evidence on measures of high performance based on national mortality data and the perceptions and experiences of patients and physicians. They do not capture important dimensions of effectiveness or efficiency that might be obtained from medical records or administrative data. Patients' and physicians' assessments might be affected by their experiences and expectations, which could differ by country and culture.

Disparities in access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home. Under health care reform, young adults up to age 26 will be eligible for coverage under their parents' insurance plans beginning in September 2010, and low- to moderate-income families will be eligible for assistance in obtaining coverage in 2014.

With the enactment of the American Recovery and Reinvestment Act, the U.S. has accelerated its efforts to adopt health information technology and provide an integrated medical record and information system that is accessible to providers and patients. Those efforts must come to fruition soon for the nation to deliver more effective and efficient care.

Many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, but the U.S. can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions. Based on these patient and physician reports, and with the enactment of health reform, the U.S. could improve the delivery, coordination, and equity of the health care system.

Read the entire report here: http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2010/Jun/1400_Davis_Mirror_Mirror_on_the_wall_2010.pdf

[jerryskids 6,829]

Ah, the old "best" argument. As others have pointed out it is a bit of an apples and oranges comparison. Defenders of single-payer will point to higher life expectancies in some of those countries. But, many of those have advantages like more homogeneous populations, perhaps better lifestyle choices, and the ability to draft off of medical developments from... us. We also have a ridiculously difficult FDA approval process which allows US developments to be implemented far sooner in other countries.

 

I strongly believe (but have no data to prove, just a theory) that our profit motive drives companies to make superior medical and pharmaceutical advances. One can argue that the majority of medical research professionals are driven more by altruistic means (or commitment to their research) than they are by money, and that may be true, since the majority of them are not becoming rich from their work. But their employers are, and they are the ones that fund the research.

[penultimatestraw 473]

If people go to Mexico for surgery because it's cheaper the reason is not because their system is better...it is because it's cheap.

 

He never said anything about cost. He talked about quality.

 

What a dumbass.

Christ, you guys cannot read critically. My statement:

 

Eventually we'll realize what the rest of the world with better, more affordable healthcare already knows: a centralized single-payer works best.

Affordable refers to cost, which is one component of a multifaceted equation. And I provided a link to data in my response to one of your doppelgangers.

[penultimatestraw 473]

Ah, the old "best" argument. As others have pointed out it is a bit of an apples and oranges comparison. Defenders of single-payer will point to higher life expectancies in some of those countries. But, many of those have advantages like more homogeneous populations, perhaps better lifestyle choices, and the ability to draft off of medical developments from... us. We also have a ridiculously difficult FDA approval process which allows US developments to be implemented far sooner in other countries.

 

I strongly believe (but have no data to prove, just a theory) that our profit motive drives companies to make superior medical and pharmaceutical advances. One can argue that the majority of medical research professionals are driven more by altruistic means (or commitment to their research) than they are by money, and that may be true, since the majority of them are not becoming rich from their work. But their employers are, and they are the ones that fund the research.

If there were any other examples of private non-universal systems amongst the "best" in the world, I might agree with your premise. But isn't it also possible the US system is badly flawed, especially regarding the delivery of healthcare? Having the best innovation/technology in the world means nothing if the people who need it cannot get it.

 

Our system, which overly rewards procedures (including implanting the devices to which you allude) relative to cognitive skills is one of the major reasons for the shortage of primary caregivers. It also creates incentive for unnecessary procedures, which I can assure you are quite commonplace.

 

Furthermore, drug shortages are created by profit-driven pharmaceutical companies which dedicate resources to production of newer, more expensive, but not necessarily better drugs. In the last ten years the number of drug shortages has skyrocketed, in part because it is more lucrative to sell newer drugs in our system.

[IGotWorms 4,058]

Ah, the old "best" argument. As others have pointed out it is a bit of an apples and oranges comparison. Defenders of single-payer will point to higher life expectancies in some of those countries. But, many of those have advantages like more homogeneous populations, perhaps better lifestyle choices, and the ability to draft off of medical developments from... us. We also have a ridiculously difficult FDA approval process which allows US developments to be implemented far sooner in other countries.

 

I strongly believe (but have no data to prove, just a theory) that our profit motive drives companies to make superior medical and pharmaceutical advances. One can argue that the majority of medical research professionals are driven more by altruistic means (or commitment to their research) than they are by money, and that may be true, since the majority of them are not becoming rich from their work. But their employers are, and they are the ones that fund the research.

 

True, I think this is a legitimate point re: R&D. But why should we be subsidizing the entire world in that regard?

[jerryskids 6,829]

If there were any other examples of private non-universal systems amongst the "best" in the world, I might agree with your premise. But isn't it also possible the US system is badly flawed, especially regarding the delivery of healthcare? Having the best innovation/technology in the world means nothing if the people who need it cannot get it.

 

Our system, which overly rewards procedures (including implanting the devices to which you allude) relative to cognitive skills is one of the major reasons for the shortage of primary caregivers. It also creates incentive for unnecessary procedures, which I can assure you are quite commonplace.

 

Furthermore, drug shortages are created by profit-driven pharmaceutical companies which dedicate resources to production of newer, more expensive, but not necessarily better drugs. In the last ten years the number of drug shortages has skyrocketed, in part because it is more lucrative to sell newer drugs in our system.

I don't disagree with anything you said per se. I certainly think our delivery mechanism has a lot of room for improvement. And I completely agree with your procedure comment -- I believe we've talked before about my experiences with my mother's death and how I think there should by more of a holistic, systemic, "engineering" approach to medicine.

 

That being said, I don't know if a perfect system could be achieved. Using your first point, I could equally say that providing care to everyone means nothing if you don't have any care to give. And remember, people were getting care before Obamacare (perhaps not to the same extent, but they got it).

 

That being said, I've consistently maintained that Obamacare is not the answer. It is Solomon splitting the baby in half, trying to have your cake and eat it too, etc.

[jerryskids 6,829]

 

True, I think this is a legitimate point re: R&D. But why should we be subsidizing the entire world in that regard?

That's a good question. I was going to add to that post, but didn't want to muddy the message: what would happen in the worldwide medical community if we went full single-payer and no longer made the medical advances that we do? It's not a perfect analogy, but I kinda feel like it is like the military situation -- the rest of the world relies on us to do most of the heavy lifting.

[Voltaire 5,317]

That's a good question. I was going to add to that post, but didn't want to muddy the message: what would happen in the worldwide medical community if we went full single-payer and no longer made the medical advances that we do? It's not a perfect analogy, but I kinda feel like it is like the military situation -- the rest of the world relies on us to do most of the heavy lifting.

Huh?

 

Why would full single payer bring about the end of medical advances?

 

That makes no sense. R & D happens, breakthroughs occur, at whatever pace it happens. Full single payer is a way of delivering health care. Whatever is good or bad about single payer is fair to be discussed but it's got zero to do with the pace of medical advances let alone it's halting.

 

People will still be trying to cure AIDS and cancer and others will still try to build a better thingamabob to make you more comfortable or function better when you do whatever it is it is you do. They're not going to be a stop in researching that stuff if single payer comes to be.

[jerryskids 6,829]

Huh?

 

Why would full single payer bring about the end of medical advances?

 

That makes no sense. R & D happens, breakthroughs occur, at whatever pace it happens. Full single payer is a way of delivering health care. Whatever is good or bad about single payer is fair to be discussed but it's got zero to do with the pace of medical advances let alone it's halting.

 

People will still be trying to cure AIDS and cancer and others will still try to build a better thingamabob to make you more comfortable or function better when you do whatever it is it is you do. They're not going to be a stop in researching that stuff if single payer comes to be.

I disagree. Also I answered your question before you asked it; I'll presume you didn't see it above since you didn't address it:

 

I strongly believe (but have no data to prove, just a theory) that our profit motive drives companies to make superior medical and pharmaceutical advances. One can argue that the majority of medical research professionals are driven more by altruistic means (or commitment to their research) than they are by money, and that may be true, since the majority of them are not becoming rich from their work. But their employers are, and they are the ones that fund the research.

 

[Voltaire 5,317]

I disagree. Also I answered your question before you asked it; I'll presume you didn't see it above since you didn't address it:

 

And the profit motive disappears in single payer? Nobody will be interested in developing a more reliable pacemaker since they don't think they can make any money off of it?

 

Not that single payer should even be in the discussion. Although IMO Hillarycare is 1000x better than Obamacare, I doubt we'll be seeing that in our lifetime. Cutting off the spiggot of taxpayer money into the pockets of insurance company executives is going to be politically impossible.

[penultimatestraw 473]

I don't disagree with anything you said per se. I certainly think our delivery mechanism has a lot of room for improvement. And I completely agree with your procedure comment -- I believe we've talked before about my experiences with my mother's death and how I think there should by more of a holistic, systemic, "engineering" approach to medicine.

 

That being said, I don't know if a perfect system could be achieved. Using your first point, I could equally say that providing care to everyone means nothing if you don't have any care to give. And remember, people were getting care before Obamacare (perhaps not to the same extent, but they got it).

 

That being said, I've consistently maintained that Obamacare is not the answer. It is Solomon splitting the baby in half, trying to have your cake and eat it too, etc.

I don't think the ACA is perfect either, but it addresses some areas in need of improvement.

 

And no system is perfect, but there are several better than ours. And none of them are based on free market private insurance. Maybe you should read the Commonwealth Fund's report and tell me what you think.

[MedStudent 56]

That's a good question. I was going to add to that post, but didn't want to muddy the message: what would happen in the worldwide medical community if we went full single-payer and no longer made the medical advances that we do? It's not a perfect analogy, but I kinda feel like it is like the military situation -- the rest of the world relies on us to do most of the heavy lifting.

The major medical breakthroughs have been done under government funded research. The pharma industry sees the breakthrough and takes it the last mile and profits on it. Most of the recent work at pharma companies has been simply reformulating products to keep extending their patents. Doing things like making a drug extended release so you only take 1 pill a day as opposed to 2.

[penultimatestraw 473]

The major medical breakthroughs have been done under government funded research. The pharma industry sees the breakthrough and takes it the last mile and profits on it. Most of the recent work at pharma companies has been simply reformulating products to keep extending their patents. Doing things like making a drug extended release so you only take 1 pill a day as opposed to 2.

My favorite pharmaceutical trick is separating a drug into its enantiomers, then marketing one of them as a new product. It's amazing how these drugs seem to be developed just before the original is about to go off patent

 

Meanwhile the hundredth flavor of antihypertensive or cholesterol drug is released, treating the same diseases the same way, and only a handful of antibiotics are developed despite microorganisms developing resistance to all of our existing drugs. But if profit motivates innovation, why wouldn't the companies prefer a drug patients will take for the rest of their lives rather than a 7-day course?

[Frank M 181]

The major medical breakthroughs have been done under government funded research. The pharma industry sees the breakthrough and takes it the last mile and profits on it. Most of the recent work at pharma companies has been simply reformulating products to keep extending their patents. Doing things like making a drug extended release so you only take 1 pill a day as opposed to 2.

 

Obsession with profit extends into every area of healthcare. My group has been given orders that the only tests we will be developing for the clinical lab will be high volume tests that generate income.

 

Lots of interesting and beneficial tests are being passed in favor of the latest sequencing assay technology before we even know what the results from that technology mean.

[penultimatestraw 473]

 

Obsession with profit extends into every area of healthcare. My group has been given orders that the only tests we will be developing for the clinical lab will be high volume tests that generate income.

 

Lots of interesting and beneficial tests are being passed in favor of the latest sequencing assay technology before we even know what the results from that technology mean.

But I thought competition for $ always provides the best solutions?

[Recliner Pilot 61]

My favorite pharmaceutical trick is separating a drug into its enantiomers, then marketing one of them as a new product. It's amazing how these drugs seem to be developed just before the original is about to go off patent

 

Apparently you are unaware of the cost of bringing a drug to market. Once the patent runs out Drs. either choose, or are forced, to go to generics. Recouping R&D and start up costs is hard in the time frame the patent is in effect.

 

Drug companies also spend tens of millions developing drugs that never get approved by the FDA, so those costs have to be figured into the equation. I know you think profits are bad, but if you take that out you will get no innovation in drugs, or devices for you to play with. Taxpayers can't flip the bill for all R&D costs.

[Reality 3,121]

Nice little circle jerk going on. I guess all these horrible issues will be fixed in a couple years when Obamacare goes into full effect. The beginning stages of it have been pretty phenomenal so far.

 

I have no doubt this overreach to "fix" the uncovered 15% will rectify every concern you guys currently have.

 

I also love the talking points, evil capitalism. Interesting how you guys like to look at things in a vacuum.

[Recliner Pilot 61]

And the profit motive disappears in single payer?

When the Govt is that payer, yes.

 

Why do you think so many Drs are opting out of Medicare? It's because the reimbursements do not cover their costs...........not to mention the headache the paperwork entails.

 

If you think once the Govt gets complete control of healthcare things will be greta you are a moron. Keep your head in the sand, Volty.

[IGotWorms 4,058]

My favorite pharmaceutical trick is separating a drug into its enantiomers, then marketing one of them as a new product. It's amazing how these drugs seem to be developed just before the original is about to go off patent

 

Meanwhile the hundredth flavor of antihypertensive or cholesterol drug is released, treating the same diseases the same way, and only a handful of antibiotics are developed despite microorganisms developing resistance to all of our existing drugs. But if profit motivates innovation, why wouldn't the companies prefer a drug patients will take for the rest of their lives rather than a 7-day course?

I saw a Frontline special on new bacteria strains that are super-resistant to antibiotics. Scared the sh!t out of me. Are we really all going to be totally focked as the documentary basically implied?

[MedStudent 56]

My favorite pharmaceutical trick is separating a drug into its enantiomers, then marketing one of them as a new product. It's amazing how these drugs seem to be developed just before the original is about to go off patent

 

Meanwhile the hundredth flavor of antihypertensive or cholesterol drug is released, treating the same diseases the same way, and only a handful of antibiotics are developed despite microorganisms developing resistance to all of our existing drugs. But if profit motivates innovation, why wouldn't the companies prefer a drug patients will take for the rest of their lives rather than a 7-day course?

Or simply combining two products. When Glaxo's migraine drug imitrex was going off patent they simply took imitrex and combined it with an over the counter product naproxen (aleve) and called it treximet which they sold for $200 for a PAC of 9. A smart doc would just tell the patient to take imitrex with aleve at a fraction of the cost.

[Voltaire 5,317]

When the Govt is that payer, yes.

 

Why do you think so many Drs are opting out of Medicare? It's because the reimbursements do not cover their costs...........not to mention the headache the paperwork entails.

 

If you think once the Govt gets complete control of healthcare things will be greta you are a moron. Keep your head in the sand, Volty.

We were talking about innovations and advances in HC, you're talking about HC delivery.

 

My point -if you want to address it this time- is that the pace these breakthroughs occur at doesn't logically have anything to do with how HC is paid for.

[Recliner Pilot 61]

We were talking about innovations and advances in HC, you're talking about HC delivery.

 

My point -if you want to address it this time- is that the pace these breakthroughs occur at doesn't logically have anything to do with how HC is paid for.

Ok, you are correct. Any breakthrough, innovation, and advance in HC has nothing to do with how those things will be paid for.

 

[penultimatestraw 473]

Apparently you are unaware of the cost of bringing a drug to market. Once the patent runs out Drs. either choose, or are forced, to go to generics. Recouping R&D and start up costs is hard in the time frame the patent is in effect.

 

Drug companies also spend tens of millions developing drugs that never get approved by the FDA, so those costs have to be figured into the equation. I know you think profits are bad, but if you take that out you will get no innovation in drugs, or devices for you to play with. Taxpayers can't flip the bill for all R&D costs.

I know drugs are expensive to develop. But the profiteering in the pharmaceutical sector is egregious. Per the World Health Organization: http://www.who.int/trade/glossary/story073/en/

 

Pharmaceutical Industry

The global pharmaceuticals market is worth US$300 billion a year, a figure expected to rise to US$400 billion within three years. The 10 largest drugs companies control over one-third of this market, several with sales of more than US$10 billion a year and profit margins of about 30%. Six are based in the United States and four in Europe. It is predicted that North and South America, Europe and Japan will continue to account for a full 85% of the global pharmaceuticals market well into the 21st century. Companies currently spend one-third of all sales revenue on marketing their products - roughly twice what they spend on research and development.

As a result of this pressure to maintain sales, there is now, in WHO's words, “an inherent conflict of interest between the legitimate business goals of manufacturers and the social, medical and economic needs of providers and the public to select and use drugs in the most rational way”. This is particularly true where drugs companies are the main source of information as to which products are most effective. Even in the United Kingdom, where the medical profession receives more independent, publicly-funded information than in many other countries, promotional spending by pharmaceuticals companies is 50 times greater than spending on public information on health.

To tackle this problem, the World Health Assembly adopted, in 1988, the WHO Ethical Criteria for Medicinal Drug Promotion, dedicated to the rational use of drugs. However, many observers complain that these guidelines have been largely disregarded - as has the voluntary Code of Pharmaceutical Practices developed by the industry's own International Federation of Pharmaceutical Manufacturers' Associations (PharMA).

A similar conflict of interests exists in the area of drug research and development (R&D) particularly in the area of neglected diseases. The private sector dominates R&D, spending millions of dollars each year developing new drugs for the mass market. The profit imperative ensures that the drugs chosen for development are those most likely to provide a high return on the company's investment. As a result, drugs for use in the industrialized world are prioritized over ones for use in the South, where many patients would be unable to pay for them.

Some large pharmaceutical companies support health development through public-private partnerships. In a number of cases, international corporations and foundations have contributed drugs or products free of charge to help in disease eradication. SmithKline Beecham has made a US$500 million commitment to WHO of its drug albendazole, used to treat lymphatic filariasis (elephantiasis). American Home Products has provided a non-toxic larvicide and the DuPont Company has contributed free cloth water filters for the eradication of guinea-worm disease (dracunculiasis). The Japanese Nippon Foundation has enabled WHO to supply blister packs containing the drugs needed for multi-drug therapy (MDT) of TB in sufficient quantities to treat about 800 000 patients a year in some 35 countries. The patients receive the treatments free of charge.

Do you think a 30% profit margin is reasonable? Should promotional spending be so high?

 

I think the answer to both questions is no - both could be reduced (both not eliminated) to increase more medically relevant spending. This does not include pharmaceutical rep salaries BTW.

[penultimatestraw 473]

Nice little circle jerk going on. I guess all these horrible issues will be fixed in a couple years when Obamacare goes into full effect. The beginning stages of it have been pretty phenomenal so far.

 

I have no doubt this overreach to "fix" the uncovered 15% will rectify every concern you guys currently have.

 

I also love the talking points, evil capitalism. Interesting how you guys like to look at things in a vacuum.

No one has asserted anything consistent with your first two statements. The link I provided gives quite a bit of context to global healthcare, but you have to read it first

[Reality 3,121]

No one has asserted anything consistent with your first two statements. The link I provided gives quite a bit of context to global healthcare, but you have to read it first

Your survey was riveting.

[penultimatestraw 473]

I saw a Frontline special on new bacteria strains that are super-resistant to antibiotics. Scared the sh!t out of me. Are we really all going to be totally focked as the documentary basically implied?

I don't think we are screwed, but the pendulum needs to swing away from profit to health necessity when R & D decisions are determined.

 

Despite what some may believe, the pharmaceutical companies are not going to go bankrupt in the process.

[penultimatestraw 473]

Your survey was riveting.

SO you read it?

[Recliner Pilot 61]

I know drugs are expensive to develop. But the profiteering in the pharmaceutical sector is egregious. Per the World Health Organization: http://www.who.int/trade/glossary/story073/en/

Do you think a 30% profit margin is reasonable? Should promotional spending be so high?

 

I think the answer to both questions is no - both could be reduced (both not eliminated) to increase more medically relevant spending. This does not include pharmaceutical rep salaries BTW.

promotional spending by pharmaceuticals companies is 50 times greater than spending on public information on health.

 

 

I won't comment on you using the World Health Organization as a source since it's too easy, so I will take their "30%" with a huge grain of salt.

 

However, I will point out your link has no date on it.

 

Apparently, you are ignorant of just what pharma companies can do these days for "promotional" spending. Reps can no longer even give out gimme pens and note pads.

[Frank M 181]

Nice little circle jerk going on. I guess all these horrible issues will be fixed in a couple years when Obamacare goes into full effect. The beginning stages of it have been pretty phenomenal so far.

 

I have no doubt this overreach to "fix" the uncovered 15% will rectify every concern you guys currently have.

 

I also love the talking points, evil capitalism. Interesting how you guys like to look at things in a vacuum.

 

I work for a not-for-profit entity that's main concern is profit.

 

Sorry, I think that's focked up.

[penultimatestraw 473]

 

 

I won't comment on you using the World Health Organization as a source since it's too easy, so I will take their "30%" with a huge grain of salt.

 

However, I will point out your link has no date on it.

 

Apparently, you are ignorant of just what pharma companies can do these days for "promotional" spending. Reps can no longer even give out gimme pens and note pads.

Ok, so give me a better source.

 

This is five years old: http://money.cnn.com/magazines/fortune/fortune500/2009/performers/industries/profits/ Pharma and medical products are numbers 3 & 4 amongst the fortune 500's most profitable industries.

 

This last year's data: http://money.cnn.com/magazines/fortune/fortune500/2012/industries/21/ I don't know the overall industry's numbers, but all but three of the twelve listed are doing pretty well.

 

I am well aware that pharmaceutical spending on physician-related promotions has been curtailed. Meanwhile, their marketing directly to consumers has increased. Why the fvck do we need TV ads for prescription drugs? Do you think a 30 second commercial supplants years of medical training when deciding what medication to prescribe?

[Recliner Pilot 61]

Ok, so give me a better source.

 

I am well aware that pharmaceutical spending on physician-related promotions has been curtailed. Meanwhile, their marketing directly to consumers has increased. Why the fvck do we need TV ads for prescription drugs? Do you think a 30 second commercial supplants years of medical training when deciding what medication to prescribe?

Get your own "better source".

 

Curtailed?

 

Like I said, you can't even give them a fukking pen.

 

My wife's company has never run a TV ad.

 

Next?

[Recliner Pilot 61]

 

I work for a not-for-profit entity that's main concern is profit.

 

Sorry, I think that's focked up.

Seems to me if you had any ethics you would leave the sham of an organization that signs your paycheck.

 

I look forward to your post that informs the bored of your new, altruistic position.

[Sho Nuff 720]

Pen dropping knowledge yet again when it comes to these things...

[penultimatestraw 473]

Get your own "better source".

 

Curtailed?

 

Like I said, you can't even give them a fukking pen.

 

My wife's company has never run a TV ad.

 

Next?

I've given a source which I think is reputable. You've given none. Hint: Google Pharmaceutical industry profits.

 

Why in Tebow's green earth should a pharm rep be giving doctors any "gifts"? You realize those fvcking pens cost $, are free advertising, and have been shown to influence prescribing practices?

 

Also, you should know your wife doesn't work for the only pharmaceutical company, nor the biggest one. Are any of her wares advertised in other ways (the answer is yes)? Restroom walls don't count.

[Recliner Pilot 61]

You realize those fvcking pens cost $, are free advertising, and have been shown to influence prescribing practices?

 

I'm shocked that a pen would influence the drugs you prescribe.

 

Good thing they don't allow that anymore.

[Frank M 181]

Seems to me if you had any ethics you would leave the sham of an organization that signs your paycheck.

 

I look forward to your post that informs the bored of your new, altruistic position.

 

 

Cool story, bro.

[Sho Nuff 720]

Pen brings sources...links...knowledge.

In return we get to read parsed quotes...poor logic...and failed attempts at humor that fall flat.

 

Just another day in the Geek Club.

[penultimatestraw 473]

Pen dropping knowledge yet again when it comes to these things...

To be fair, I work in healthcare, prescribe medications and have performed research. But those guys have cable TV and the internet.

[IGotWorms 4,058]

SO you read it?

[Recliner Pilot 61]

 

 

Cool story, bro.

I'll take that to mean you will continue to compromise your ethics for a paycheck.

 

We don't care how long you have done this in the past, but don't try to fool us in the future with this tripe.