Affordable Care Act - catastrophic plans cancelled

[Jimbo485]

Originally Posted by letsgetsailing3

Dude, get over it. The United States refers to one country, and one country only. You can hate that, or you can accept it, but that's the way it is.

I really did burst out laughing!

Mate, I want to have a beer with you one day in some anchorage, here or there or wherever. We will swap some stories and a few laughs and then go our separate ways.

But I will remain part of a rational country and you will remain a citizen of yours. And both of us will accept the pros and cons of this situation while sucking on a stubbie and admiring the same sunset!

[colemj]

Originally Posted by Eumelia

Something I'm very curious about...maybe you world travelers could chip in...do other countries have as big of a problem with resistant strains as we do in the US? Things like MRSA, VRSA, ESBL, VRE, MRAB and others are caused by the overuse of antibiotics in all US hospitals. Is the same true of other countries? Here in the US you can go into the hospital for minor surgery and contract one or more of these life-threatening infections. These are a large contributor to health-care costs and the problem will continue to increase.

I don't have an answer to the extent of the problem in other countries. I do know that antibiotics are widely available over the counter in many countries and people prescribe them to themselves for whatever reason they want.

But the problem in the US is not a large contributor to healthcare costs. Other sources of contribution swamp that one by a large margin.

Mark

[goboatingnow]

MRSA and other superbugs are a problem in all hospitals in the developed world and elsewhere . The US is not alone in this issue. Hospitals these days are where you contract disease not cure it.

Dave

[Eumelia]

Originally Posted by colemj

But the problem in the US is not a large contributor to healthcare costs. Other sources of contribution swamp that one by a large margin.

Mark

Mark, without having any real data, my belief is that our legal system in the US is the vampire who is sucking the lifeblood out of our healthcare system...any data on that? All players in US healthcare have to pay expensive malpractice insurance premiums here - drug companies, hospitals, doctors, nurses, you name it.
-Chris

[colemj]

Originally Posted by goboatingnow

I disagree , the purchaser does not have in reality any choice to forgo the purchase. What you Are suggesting is nonsensical , does a cancer patient have any opportunity to forgo treatment , no not if sanity prevails.

Water is tightly controlled in most countries , for exactly the same reason , people must have it and hence profiteering must be controlled , most water supplies are either in public hands, publically controlled , or monopoly providers in a very controlled marketplace , even then you have the option to drive a well.

Electricity is the same, it typically exists in a price controlled marketplace.

Society does not determine what's available, most countries make set no controls on the type,duration and availability of any treatment. The treatment may it be available or not be covered , but that is a tiny proportion of treatments and not a factor in health pricing.

The free market does not mean that ONLY producers are free to set prices, it actually means a system where both suppliers and purchasers are free to act, suppliers set pricing ,purchasers choose to buy from whoever they choose.. That's a free market. Constrain one side or the other and its not a free market. Health can never be free,because people cannot be reasonably asked to trade death for lower prices.

But we agree, your last line is the truth. Healthcare only works in a tightly controlled negotiated marketplace,where governments , being a single huge consumer ( with the added ability to change laws) can dictate pricing, allowing a certain profit margin without excessive profiteering. Hence the single payer healthcare is really the only model that's works ( and then only imperfectly )

Dave

This is a strange debate we are having.

The case was made that US drug prices are high because of government involvement intentionally obscuring the costs and access.

I make the point that pharmaceuticals are acting in a free market in the US, and that is why the price is high. I point out that when the government is actually involved, prices drop.

The counter argument then comes, from those that think free-market forces will lower prices, that if the government were to get involved and use their purchasing power to negotiate, then prices will drop.

And those making this argument are denying that pharmaceuticals are operating in a free market. They are also, confusingly, calling for a controlled and regulated market.

And yes, any patient has the opportunity to forgo any treatment because of cost. It is not non-sensicle and is actually the way things work in places. Name a country with a public healthcare policy where all stops are pulled infinitely and indefinitely. You are arguing relatives here, not absolutes.

Those that are vehemently against any socialized programs have made the exact argument that only people who can afford access should have access and no help should be provided them from others.

Their mistake is thinking that open free markets will drive the prices so low as to be almost free.

Using the pricing model of pharmaceuticals in the US, I was pointing out how that can go wrong.

Your example of societal (government) control of electricity, etc makes my point about the current free market for pharmaceuticals in the US. If the US controlled pharmaceutical prices like they do utilities, then prices would be lower.

Mark

[Lake-Effect]

Originally Posted by Eumelia

Something I'm very curious about...maybe you world travelers could chip in...do other countries have as big of a problem with resistant strains as we do in the US? Things like MRSA, VRSA, ESBL, VRE, MRAB and others are caused by the overuse of antibiotics in all US hospitals. Is the same true of other countries? Here in the US you can go into the hospital for minor surgery and contract one or more of these life-threatening infections. These are a large contributor to health-care costs and the problem will continue to increase.

Not really on-topic, but...

Antibiotic-resistant infections are a problem most everywhere. A few, working together, took my Dad. The problem is caused by antibiotic MISuse everywhere, not overuse in hospitals. One big problem is patients not taking the complete course of antibiotics as prescribed by the doctor; they feel ok after a few days, and stop taking it, which increases the odds that bacteria survive. Another problem - use of antibiotics on healthy animals in meat production. Also, the majority of patients who succumb to these infections usually have other conditions that weaken their immune systems.

An expensive problem, sure, but just one of many.

[colemj]

Originally Posted by Eumelia

Mark, without having any real data, my belief is that our legal system in the US is the vampire who is sucking the lifeblood out of our healthcare system...any data on that? All players in US healthcare have to pay expensive malpractice insurance premiums here - drug companies, hospitals, doctors, nurses, you name it.
-Chris

Yes, that is one of the real cost-suckers. I don't have any data on it. I must point out, however, that the US consumers are highly complicit in these lawsuits. I don't mean to defend the lawyers.

Mark

[avb3]

I have two prescription drugs I take. One of them costs 5 times as much in the USA and the other 3 times as much as in Canada.

One is from Germany and the other from Switzerland.

Anecdotal perhaps but indicative.

[colemj]

Originally Posted by Lake-Effect

Not really on-topic, but...

Antibiotic-resistant infections are a problem most everywhere. A few, working together, took my Dad. The problem is caused by antibiotic MISuse everywhere, not overuse in hospitals. One big problem is patients not taking the complete course of antibiotics as prescribed by the doctor; they feel ok after a few days, and stop taking it, which increases the odds that bacteria survive. Another problem - use of antibiotics on healthy animals in meat production. Also, the majority of patients who succumb to these infections usually have other conditions that weaken their immune systems.

An expensive problem, sure, but just one of many.

The problem in hospitals is a bit more complicated. There, microbes travel freely and get exposed to all kinds of antibiotics in short-term doses. A person's microbes being treated with one antibiotic full regimen has many opportunities to be exposed to another person's completely different antibiotics.

The multi-strain resistance here is not due to patients not completing their regimen, or the hospital using antibiotics incorrectly. It is simply the exposure opportunities available in community infections.

Mark

[colemj]

There is a cost to controlling pharmaceutical prices, and that is that the research and development of pharmaceuticals carries a large price. I won't break out why that is, but it is not because the companies just throw money out the window with no thought to efficiency.

So if one wants to have controlled pricing, one can't expect the product to come to them below actual cost or at such a cost as to not make business sense. This means that there also must be government intervention in the supply side of the equation. Better and more updated patent laws, reformed tort laws, tax breaks, market guarantees, etc.

Mark

[goboatingnow]

Originally Posted by colemj

This is a strange debate we are having.

The case was made that US drug prices are high because of government involvement intentionally obscuring the costs and access.

I make the point that pharmaceuticals are acting in a free market in the US, and that is why the price is high. I point out that when the government is actually involved, prices drop.

The counter argument then comes, from those that think free-market forces will lower prices, that if the government were to get involved and use their purchasing power to negotiate, then prices will drop.

And those making this argument are denying that pharmaceuticals are operating in a free market. They are also, confusingly, calling for a controlled and regulated market.

And yes, any patient has the opportunity to forgo any treatment because of cost. It is not non-sensicle and is actually the way things work in places. Name a country with a public healthcare policy where all stops are pulled infinitely and indefinitely. You are arguing relatives here, not absolutes.

Those that are vehemently against any socialized programs have made the exact argument that only people who can afford access should have access and no help should be provided them from others.

Their mistake is thinking that open free markets will drive the prices so low as to be almost free.

Using the pricing model of pharmaceuticals in the US, I was pointing out how that can go wrong.

Mark

What I am arguing is that fundamentally the health care market is not a market , not even a free market and it cannot be regarded as one. The US has found itself in a position where it " attempted" from ideological reasons to have a kind of free market and as a result of the infinite demand problem, has led to excessive pricing and profiteering.

Where you control and tightly regulate , to the extent that perhaps the gov is the single consumer, then you force pricing down. Equally if the government controls medical salaries , it also helps keep costs down. ( to a point )

We are both agreeing for a regulated system,


Ps no patient really has a option to forgo costs , are you saying a parent would say , ok let my child die cause I need to keep the BMW. What nonsense. Healthcare is a right , plain and simple , not a luxury. It's the same as education, water and basic amenities. Until you ( or society ) accept that , you are condemning those without sufficient wealth to perpetual illness and those that can are treated by a gold plated system

Far better to ensure the median is well provided for , and leave the top ( toffs) float off. But what we have is a system that panders to the wealthy.

Imagine in a civilised society you denied people water on the same basis , ie wealth . Crazy.
Dave

[goboatingnow]

Originally Posted by colemj

There is a cost to controlling pharmaceutical prices, and that is that the research and development of pharmaceuticals carries a large price. I won't break out why that is, but it is not because the companies just throw money out the window with no thought to efficiency.

So if one wants to have controlled pricing, one can't expect the product to come to them below actual cost or at such a cost as to not make business sense. This means that there also must be government intervention in the supply side of the equation. Better and more updated patent laws, reformed tort laws, tax breaks, market guarantees, etc.

Mark

Sure , but the fact is in controlled single payer systems , all drug companies are players. If a company CAN profiteer IT will.

Dave

[Eumelia]

I like to think of sailors as freedom-loving "I can take care of myself" type people. In this whole discussion, I would like to learn ways to apply these principles to the health care needs that I and my family face. Sure, I'm an idealist. Aren't most sailors?

[CatInHand]

Originally Posted by goboatingnow

I disagree , the purchaser does not have in reality any choice to forgo the purchase. What you Are suggesting is nonsensical , does a cancer patient have any opportunity to forgo treatment , no not if sanity prevails.

Of course you have the choice. You can take the hypertension drugs, or control your exercise and diet. Take the prilosec or watch what you eat. Stay home and get over the virus or go to the doc and get an antibiotic that won't help anyway. I've even known two people that chose to stop their cancer treatments because the cure was making them sicker than the disease.

The USA consume a lot of optional pharmaceuticals.

Originally Posted by goboatingnow

Water is tightly controlled in most countries , for exactly the same reason , people must have it and hence profiteering must be controlled , most water supplies are either in public hands, publically controlled , or monopoly providers in a very controlled marketplace , even then you have the option to drive a well.

The only country I've ever been to that controlled water was a former Soviet Union country. Most do not. unless you are only considering the poorer countries that many cruisers visit.

Originally Posted by goboatingnow

Society does not determine what's available, most countries make set no controls on the type,duration and availability of any treatment. The treatment may it be available or not be covered , but that is a tiny proportion of treatments and not a factor in health pricing.

Dave[/QUOTE]

[Eumelia]

Originally Posted by CatInHand

The only country I've ever been to that controlled water was a former Soviet Union country. Most do not. unless you are only considering the poorer countries that many cruisers visit.

Oops, bit of misinformation here. Actually, water is strictly controlled in the western states of the US. As a former resident of Colorado, I can tell you firsthand it is illegal to collect rainwater there!