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Old 08-11-2013, 06:27   #376
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by Lake-Effect View Post
I don't think that's anyone's objective though, is it? The goal is a high standard of universal healthcare, at reasonable cost. There are ways to lower costs, and a healthier population will help reduce the medical costs of that last year of life.
There are two ways to lower costs.

The free market, and government regulation. So far, very little of either is being used in the U.S. health care market to control costs.
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Old 08-11-2013, 06:29   #377
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Originally Posted by letsgetsailing3 View Post
The U.S., which comprises more than half of the world pharmaceutical .
The US of Mexico?
Or the US of Brasil?
Or the US of whatever YOU think is the centre of the universe?
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Old 08-11-2013, 06:35   #378
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3
These two statements are in direct contrast to each other.

There is a ceiling on health care, based on availability of resources, even if we pretend there isn't.

The real problem is trying to pretend that there isn't a conflict, and failing to prioritize our resources.

Paying double what other developed countries pay for care, with similar health care outcomes, isn't sustainable indefinitely.



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I agree with your last statement but am confused about the rest. it seems to me we don't lack for resources since we are paying 2, 3 and sometime 4 times as much for comparable results. I think the problem is where are the resources being squandered? Of course, we know but finding the political will to correct the problems is another matter.

Yes, a good bit of what we are spending in the U.S. isn't under effective control, and so profits in the U.S. are eating up a lot of what we pay into the system.

We don't have a free market in health care (we lack cost transparency and consumer input) and we don't have effective government regulation of prices.

Yes, there is some minor amount of competition between insurance companies, but service providers are so far removed from consumers that services don't effectively compete on price. The insurance exchanges are at least a first step towards competition among insurance companies. Too bad they can't operate across state lines. But what we really need are guidelines about what services should cost, or competition to provide those services. But nobody wants to mess with their cash cow, and consumers are participating out of fear that they might not get treated, not out of empowerment of knowing what services cost.

Nobody in the U.S. even knows what services should cost anymore.
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Old 08-11-2013, 06:38   #379
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
Oh, and where do profits in the pharmaceutical industry come from? The U.S., which comprises more than half of the world pharmaceutical market. Given the market size, does the U.S. pay less for pharmaceuticals? Nope.

So yes, the U.S. is subsidizing the world's pharmaceutical development.
Dude, you cannot tell other people to do their research when you refuse to do so. The US comprises 33% of the world pharmaceutical market, and this number has been shrinking rapidly over the years with India and China making large gains in pharmaceutical spending (demand side, that is).

For pharmaceutical products launched within the past 5 years, the US share is 20% of the world market.

The US pays more because it is a free-market system that supports those prices. You may not like the price you personally pay, but enough people are willing to pay those prices for them to make business sense.

It is supply and demand basic free market econ here. If the government stepped in, or people refused to buy product, the prices would lower to some other level.

And the US is not the highest. Japan is in relative terms. They spend more on pharmaceuticals as a percentage of their GDP than the US.

However, for comparison, the US spends 3X more per person on pharmaceuticals than the UK.

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Old 08-11-2013, 06:38   #380
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by Jimbo485 View Post
The US of Mexico?
Or the US of Brasil?
Or the US of whatever YOU think is the centre of the universe?
You're not familiar with the country called the United States?

It may not be the center of the universe, but it certainly has an impact on the pharmaceutical industry.
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Old 08-11-2013, 06:43   #381
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Re: Affordable Care Act - catastrophic plans cancelled

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Dude, you cannot tell other people to do their research when you refuse to do so. The US comprises 33% of the world pharmaceutical market, and this number has been shrinking rapidly over the years with India and China making large gains in pharmaceutical spending (demand side, that is).

For pharmaceutical products launched within the past 5 years, the US share is 20% of the world market.

The US pays more because it is a free-market system that supports those prices. You may not like the price you personally pay, but enough people are willing to pay those prices for them to make business sense.

It is supply and demand basic free market econ here. If the government stepped in, or people refused to buy product, the prices would lower to some other level.

And the US is not the highest. Japan is in relative terms. They spend more on pharmaceuticals as a percentage of their GDP than the US.

However, for comparison, the US spends 3X more per person on pharmaceuticals than the UK.

Mark
When you say "the US share of the world market", do you mean as a producer or consumer?

I think my post was pretty clear that I was referring to the U.S. as a consumer. And no, the pharmaceutical market in the U.S. is far from a "free market". People buy insurance, doctors prescribe expensive medicines, and people don't even know what they cost.


For your consideration:

Chapter 4. World pharmaceutical sales and consumption

SUMMARY
• In 1999, the 15% of the world’s population who live in high-income countries purchased and consumed about 90% of total medicines, by value. This concentration in the pattern of global sales and consumption has increased over the past 15 years, with the share of the low-income countries falling and that of the high-income countries growing. The market share of the USA alone rose from 18.4% of the world total in 1976 to over 52% in 2000.
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Old 08-11-2013, 06:54   #382
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
When you say "the US share of the world market", do you mean as a producer or consumer?

I think my post was pretty clear that I was referring to the U.S. as a consumer. And no, the pharmaceutical market in the U.S. is far from a "free market". People buy insurance, doctors prescribe expensive medicines, and people don't even know what they cost.


For your consideration:

Chapter 4. World pharmaceutical sales and consumption

SUMMARY
• In 1999, the 15% of the world’s population who live in high-income countries purchased and consumed about 90% of total medicines, by value. This concentration in the pattern of global sales and consumption has increased over the past 15 years, with the share of the low-income countries falling and that of the high-income countries growing. The market share of the USA alone rose from 18.4% of the world total in 1976 to over 52% in 2000.
I was presenting consumer spending on pharmaceuticals.

Your data from 1999(!) compiling a trend starting in 1984(!) only describes "high-income" countries, which encompass many more than the US. The 52% share in 2000(!) is of those countries, not the world. It is like stating that the US has a 40% share of land mass in North America and confusing that with their % of world land mass.

My career was 18yrs in pharmaceutical R&D, so I'm happy to show you where you misunderstand things.

Markets are markets whether you think there is any mixture or conflation with insurance, doctors, etc. The same is true for every product with distribution and financing interplay.

Go get a loan and buy an automobile and the required insurance to go with it. Now complain about the artificially high price of automobiles because they are sold through confusing distribution methods using uncontrolled financing and needing required insurance that you don't want. Not to mention that the competition in them are highly colluded. Do people know what the real cost of an automobile they buy is?

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Old 08-11-2013, 06:55   #383
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Re: Affordable Care Act - catastrophic plans cancelled

Here, try some fresh world-wide data:

Global pharmaceutical industry and market - ABPI

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Old 08-11-2013, 06:59   #384
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Re: Affordable Care Act - catastrophic plans cancelled

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I was presenting consumer spending on pharmaceuticals.

Your data from 1999(!) compiling a trend starting in 1984(!) only describes "high-income" countries, which encompass many more than the US. The 52% share in 2000(!) is of those countries, not the world. It is like stating that the US has a 40% share of land mass in North America and confusing that with their % of world land mass.

My career was 18yrs in pharmaceutical R&D, so I'm happy to show you where you misunderstand things.

Markets are markets whether you think there is any mixture or conflation with insurance, doctors, etc. The same is true for every product with distribution and financing interplay.

Go get a loan and buy an automobile and the required insurance to go with it. Now complain about the artificially high price of automobiles because they are sold through confusing distribution methods using uncontrolled financing and needing required insurance that you don't want. Not to mention that the competition in them are highly colluded. Do people know what the real cost of an automobile they buy is?

Mark
In 1999, the 15% of the world’s population who live in high-income countries purchased and consumed about 90% of total medicines, by value.


I don't care if you're a president of a pharmaceutical company.

I got my data from WHO. Feel free to provide your own, but don't knock mine without providing any.

*** Thanks for providing your data, though I believe it supports my point that the U.S. should be paying LOWER, not HIGHER prices for pharmaceuticals.
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Old 08-11-2013, 07:09   #385
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Re: Affordable Care Act - catastrophic plans cancelled

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Here, try some fresh world-wide data:

Global pharmaceutical industry and market - ABPI

Mark
Yes, and even accepting your data, the U.S. is the single largest consumer of pharmaceuticals. What are we arguing about?

The point I was trying to make is that with that share of the pharmaceutical market, the U.S. has significant negotiating power. So why would prices of pharmaceuticals not be LOWER in the U.S. than other countries?
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Old 08-11-2013, 07:10   #386
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Originally Posted by letsgetsailing3 View Post
You're not familiar with the country called the United States? It may not be the center of the universe, but it certainly has an impact on the pharmaceutical industry.
LOL. There is no such country called the United States. Wow! Back to school, put the dunce cap on.

However, there are many, many countries that have those 2 words in their countries' names.

http://en.m.wikipedia.org/wiki/Unite...disambiguation)

The biggest impact the USA has on the international pharmaceutical industry has more to with cocaine than anything else.

C'mon, get international, go global.

You think calling some city "the Municipality" means there is only one? You think no other country has a grouping of states that are "united"? You think only English defines the world?
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Old 08-11-2013, 07:22   #387
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Re: Affordable Care Act - catastrophic plans cancelled

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LOL. There is no such country called the United States.

You think only English defines the world?

http://en.wikipedia.org/wiki/United_States
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Old 08-11-2013, 07:23   #388
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
Yes, and even accepting your data, the U.S. is the single largest consumer of pharmaceuticals. What are we arguing about?

The point I was trying to make is that with that share of the pharmaceutical market, the U.S. has significant negotiating power. So why would prices of pharmaceuticals not be LOWER in the U.S. than other countries?
I was correcting your statement about global market share. You were using it to make a point, but you were way off.

The largest gross spending is not the same as the largest market share. You are still using these data incorrectly to support your predetermined point.

Obtaining the answer to your last question is your homework. I will give you two hints: 1) "negotiating" does not involve free-markets and no regulation 2) there is no such entity as the "US" in determining market prices - no more so than for tv's or automobiles. Market prices are determine IN the US.

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Old 08-11-2013, 07:25   #389
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Re: Affordable Care Act - catastrophic plans cancelled

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Originally Posted by letsgetsailing3 View Post
Yes, and even accepting your data
BTW, those are not my data and it doesn't seem like there is much room for "accepting" or "not accepting" them.

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Old 08-11-2013, 07:39   #390
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Originally Posted by letsgetsailing3 View Post

Nice response. Now, go back and research the issue. Google is your friend, and the information is readily available.
The figures published show that Switzerland UK and Germany about equal the US markets . Furthermore where multi national companies book spend and profits is not the same as where they actually do the work

However you look at it , you cannot justify the US pricing on the nonsensical notion that some how US pharma is subsidising the world. That's just nonsense. US drugs pricing is a function of the crazy system. Don't try and justify it along the lines of " they took our jobs"


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