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Old 08-11-2013, 12:45   #481
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Re: Affordable Care Act - catastrophic plans cancelled

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You misunderstand a free-market. A market where price controls in one area is opened up to an area with no price controls is not a free market. The basic economic forces defining it are missing in that equation.

You are confusing markets with distribution and control. Or at least not standing back far enough. If the government forced one Ford dealer to have a fixed lower price than another, is that a free market?

Drug markets are opened between those two countries. Yes, they are regulated, but they are open. But for all drugs - regulated or not, you can simply go to Canada and get them. We get cheap brand-name antibiotics and other drugs right out of drugstores in our travels. That isn't illegal in any way.

Or does your version of free markets include forcing the companies to deliver products right to your doorstep?

Please tell me how you think pharmaceutical prices are set in the US.

Mark
I'm not confusing anything, except perhaps your ability to hold a conversation without trying to skew someone else's point.

Are you making the claim that buying drugs on your travels is the same as marketing pharmaceuticals across borders?

Why are those prices different? Is it the free market, or is it the administrative and regulatory framework ?

Bingo. We're not letting the free market do it's work, we're letting the regulatory framework cloud our ability to hold commerce.
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Old 08-11-2013, 12:48   #482
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Re: Affordable Care Act - catastrophic plans cancelled

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So in your case, the ACA actually lowered the cost of insurance even without a subsidy. It doesn't sound like you are paying more to support lower costs for others. This is interesting data. I wonder if it is because of competition or transparency forced upon the insurers in your state? It sounds like others have not found it the same for them.

Mark
Not sure what else has been discussed since this post but you are correct, for us if insurance was needed, ACA cut our costs over 2/3 of what we could buy on the open market if you roll the deductible into the equation. My understanding of the subsidy if you qualify, it's capped at 9.5%?? of your income. Maybe that is why some people are seeing an increase in their rates. Some on this thread are saying their rates went up due to pre-existing conditions, not supposed happen under the ACA.

We have only one insurer in NH, Anthem. The same folks that would charge us 27K a year for being in the high risk pool prior to the ACA, go figure.
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Old 08-11-2013, 13:01   #483
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Re: Affordable Care Act - catastrophic plans cancelled

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Wow, I don't know what to say to you anymore. "Analyz(ing) the regulatory and market forces in order to price products" isn't how free markets work? Can you think of any other companies operating in free markets that do not analyze the regulatory and market forces to set prices?

Mark

My point was that when the regulatory aspect is more important than consumer demand, it's not really a free market.

I'll throw out the question once more, and please see if you can answer it. How are pharmaceutical prices set? Who determines the prices, and who agrees to pay them?

There. That might help you formulate an actual answer.
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Old 08-11-2013, 13:16   #484
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Re: Affordable Care Act - catastrophic plans cancelled

Who sets the price of a hotel room? The hotel owner. Who pays the price? The people that choose to stay there. Drug prices are the same. How is that not free market?
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Old 08-11-2013, 13:21   #485
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Re: Affordable Care Act - catastrophic plans cancelled

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Who sets the price of a hotel room? The hotel owner. Who pays the price? The people that choose to stay there. Drug prices are the same. How is that not free market?

Great example.

Now, if you could only stay in one hotel for health reasons, and some small group of people set the rate, would THAT be free market?

Moreover, if the way you determined if that hotel was appropriate for you was that you met with a guy in your town, and he wrote the name of the hotel on a piece of paper, would that imply some type of choice on your part?

And if you stayed in the wrong hotel, you might either continue to suffer, or die, would that be the free market?
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Old 08-11-2013, 13:21   #486
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Who sets the price of a hotel room? The hotel owner. Who pays the price? The people that choose to stay there. Drug prices are the same. How is that not free market?
Does your doctor order which hotel to use? Very little choice except generic in some cases.
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Old 08-11-2013, 13:41   #487
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Re: Affordable Care Act - catastrophic plans cancelled

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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.
Yes, it's a big problem here in Thailand where anyone can go to a local pharmacy and buy antibiotics without a doctor's prescription. We have friends who run buy them every time they have a pain and take them only until they feel better which as we all should know contributes to development of resistant strains.
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Old 08-11-2013, 13:48   #488
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Re: Affordable Care Act - catastrophic plans cancelled

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Does your doctor order which hotel to use? Very little choice except generic in some cases.
You're going on the assumption that there is one pill for one condition.

In reality there are usually multiple treatments for one condition, and chances are that at least one of those is generic, or even OTC.

I was under the assumption that my asthma inhalers were only available through prescription (and, because of some propellent issues are now only available from a single source which = expensive).

It turns out that there is an OTC medication that's available and in wide usage other places in the world.

It's up to you, as a consumer, to understand your own health and make decisions about what's best.

So, no, your doctor NEVER orders you which hotel to use, but many people mistake his suggestion as an order.

When I hit 40 my doc told me I needed a mammogram. I told her no, and gave her a list of the reasons why not based on the most recent research. A few years later the AMA dropped it's recommendation that pre-menopausal women have mammograms unless there was family history or other factors that made breast cancer more of a concern.

Mammograms in pre-menopausal women have never been a good diagnostic tool, and yet thousands are "ordered" every day.

I've been to a lot of talks by docs where they discuss which drugs to give someone slightly overweight with a familial history of heart disease (but no symptoms of their own). NEVER do they say "I'll explain the risks to his health, recommend diet and exercise AND put him in a program that will teach him how to do these things. Then give him a year to see if it helps." It's all about the drugs.

(Well, not true. Once I heard a talk by an older heart doc that bluntly said "we can't do crap once the disease has set in - we need to focus on prevention." But he was one out of hundreds.)

Health care consumers have a lot of choices, but the industry has worked very hard to keep them from realizing it.
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Old 08-11-2013, 13:50   #489
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Re: Affordable Care Act - catastrophic plans cancelled

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To some extent. You have control over what you eat, what you smoke and how much you walk. You can meditate, chant or do whatever else you think may help keep stress levels under control.

Many people skip Western medicine entirely and go for homeopathic, herbal, shamanic or other types of healing.
Don't forget snake oil!
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Old 08-11-2013, 13:53   #490
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Re: Affordable Care Act - catastrophic plans cancelled

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Don't forget snake oil!
Ah, but the snake oil industry is a monopoly, and therefore very expensive.
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Old 08-11-2013, 13:55   #491
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Re: Affordable Care Act - catastrophic plans cancelled

All this discussion about what's a free market reminds me of the voodoo economics of the Reagan era. I'm still waiting those "trickle down" benefits.
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Old 08-11-2013, 14:00   #492
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Re: Affordable Care Act - catastrophic plans cancelled

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Great example.

Now, if you could only stay in one hotel for health reasons, and some small group of people set the rate, would THAT be free market?

Moreover, if the way you determined if that hotel was appropriate for you was that you met with a guy in your town, and he wrote the name of the hotel on a piece of paper, would that imply some type of choice on your part?

And if you stayed in the wrong hotel, you might either continue to suffer, or die, would that be the free market?
Since none of those concepts are relevant for health care OR hotels, I fail to see your point.
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Old 08-11-2013, 14:10   #493
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Re: Affordable Care Act - catastrophic plans cancelled

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Health care consumers have a lot of choices, but the industry has worked very hard to keep them from realizing it.
THIS is the point. The health care industry really is set up so that people only have limited sources for information on their health care, and can't make economically rational choices.

This, in SPITE of the fact that there is so much information available.
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Old 08-11-2013, 14:22   #494
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Re: Affordable Care Act - catastrophic plans cancelled

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THIS is the point. The health care industry really is set up so that people only have limited sources for information on their health care, and can't make economically rational choices.

This, in SPITE of the fact that there is so much information available.
That seems contradictory. You say that people have "limited sources of information" and that there is "so much information available." How can it be both?

I'm not a conspiracy person, so I tend to believe the information is there it is just complicated and difficult to dig out sometime much like income taxes (something I know a lot about). Tax information is out there for everyone to read and research, but you do have to spend the time, educate yourself, etc. This require a lot of effort and most people aren't willing to do it.

No conspiracy, just life is complicated today.
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Old 08-11-2013, 14:40   #495
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Re: Affordable Care Act - catastrophic plans cancelled

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THIS is the point. The health care industry really is set up so that people only have limited sources for information on their health care, and can't make economically rational choices.
.....uh....internet.....

You can find out pretty much anything...
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