Affordable Care Act - catastrophic plans cancelled

[CatInHand]

Originally Posted by Jimbo485

I really did burst out laughing!


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!

Sorry Jimbo.

It''s embarrassing that the internet has the ability to show the world how poorly educated (and egocentric) the citizens of the USA are. I'm glad you have a sense of humor about it.

[CatInHand]

Originally Posted by Eumelia

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!

OK, but Colorado is just weird.

[colemj]

Originally Posted by goboatingnow

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

Again, the discussion was narrowly on the pharmaceutical market and not the general healthcare availability. There are many different types of markets underlying the healthcare access entirety. For all intents and purposes, the pharmaceutical industry is operating in as free of a market as exists in the US. The insurance industry is in a protected market with no price controls. The provider industry is in another chimera of a market.

I am not arguing that access to healthcare is not a societal right. Other people have been arguing that. I simply point out that there is no fundamental right to access without society being involved and making choices. The types of choices that are required are unpalatable to some here.

Perhaps I am being too subtle?

Mark

[Eumelia]

Of course, and Washington is also weird. The point is, I think, that when a resource is limited, the government takes control of it. In Washington you wouldn't know about water shortages.

[colemj]

Originally Posted by Eumelia

Of course, and Washington is also weird. The point is, I think, that when a resource is limited, the government takes control of it. In Washington you wouldn't know about water shortages.

Water is controlled almost everywhere in the sense that it is a municipal utility in most places, and highly regulated and price-controlled where privatized.

Those with private wells are the only free-market.

Mark

[Eumelia]

Originally Posted by colemj

Water is controlled almost everywhere in the sense that it is a municipal utility in most places, and highly regulated and price-controlled where privatized.

Those with private wells are the only free-market.

Mark

So for my health-care, I want the equivalent of my own water well. Am I permitted?

[letsgetsailing3]

Originally Posted by Jimbo485

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!

Agreed, but as much as you deny it, you are aware of which country we refer to when we say "The United States".

Yes, the political system has it's warts, as do the political systems of every country I'm aware of.

[John A]

Originally Posted by Eumelia

So for my health-care, I want the equivalent of my own water well. Am I permitted?

Of course! You and your family have the right to be self insured. Yon also have the right to refuse treatment.

[colemj]

Originally Posted by Eumelia

So for my health-care, I want the equivalent of my own water well. Am I permitted?

People here have been trying to figure that out. Perhaps if you live in another country, you are exempt from buying water on the US exchanges. Unless you have a lot of money (it rains a lot where you are), it seems prudent to protect your water supply somewhat by purchasing rights to access other water when yours runs out for a long period of time.

OK, the analogy runs thin at times.

Mark

[Eumelia]

And pay a fine if I exercise my "right". And face jail if I decline treatment for a family member in some cases as determined by the government.

[CatInHand]

Originally Posted by Eumelia

So for my health-care, I want the equivalent of my own water well. Am I permitted?

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.

[letsgetsailing3]

Originally Posted by colemj

Look, you keep making up data in support of beliefs you hold. $5 aspirins, US is >50% of consumption market, socialist regulations are causing high US drug prices, etc.

I keep proving those "facts" wrong. You keep ignoring that and making the same claims while telling me that they are all true regardless of the source of the "actual" data.

And to put an even finer point on it, what I'm really saying is that when we took the time to address health care, we should have also eliminated the provisions that outlaw Medicare being able to negotiate pharmaceutical pricing. Let's not pretend for a moment that the pharmaceutical industry wasn't lobbying very heavily to minimize the ACA's ability to get better pricing for pharmaceuticals.

Try for a moment to understand what is being said.

Mark

I didn't make up data -- I provided the source. You really honed in on one statement, and tried to use that to "prove" the entire discussion was invalid. I provided data from the World Health Organization. You provided what you consider "more up to date" data from the pharmaceutical industry. Even with the "more up to date" data you provided, the underlying argument is correct. The U.S. is a large consumer of pharmaceuticals.

I'm saying that the pharmaceutical market is quite manipulated. In other words, not a true "free market".

I challenge you to admit how drugs in the U.S. are priced. Certainly with your amazing grasp of the industry, you can tell us this.

I think what you're going to find is that large organizations like Medicare or the VA set prices, right? Now is that more like the free market, or government regulation?

Try for a moment to understand what is being said.

[colemj]

Originally Posted by letsgetsailing3

I didn't make up data -- I provided the source. You really honed in on one statement, and tried to use that to "prove" the entire discussion was invalid. I provided data from the World Health Organization. You provided what you consider "more up to date" data from the pharmaceutical industry. Even with the "more up to date" data you provided, the underlying argument is correct. The U.S. is a large consumer of pharmaceuticals.

I'm saying that the pharmaceutical market is quite manipulated. In other words, not a true "free market".

I challenge you to admit how drugs in the U.S. are priced. Certainly with your amazing grasp of the industry, you can tell us this.

I think what you're going to find is that large organizations like Medicare or the VA set prices, right? Now is that more like the free market, or government regulation?

Try for a moment to understand what is being said.

At least you are now starting to admit that some of the data and examples you use are incorrect.

I provided you with data that was 20yrs fresher than the data you used. It also shows that the US is not the major consumer of pharmaceuticals. It does spend the most in absolute terms, but not in relative terms. It does throw a lot of money into the arena, however.

None of that matters to your arguments here. The absolute amount of money people spend on pharmaceuticals is meaningless unless those people organize their purchasing power. There is no real way of doing this without the government being involved.

Your arguments in this thread have been against government involvement and toward letting the free-market decide prices. Pharmaceuticals are in a free market.

I can tell you exactly how they are priced - they charge as much as the market will bear. I have been in the meetings where these calculations are made. They have economists working on determining just how much the market will pay to provide X% of profit and funding of further research. It really is econ 101, with some sensitivity to the topic of gouging unleashing future restrictive legislation.

When the government is involved, as it is in medicare and VA, the prices are much lower for those select people covered by those programs. These government programs do not set the prices on the open market. If they did, the prices would be lower than they are. You seem to be under the impression that prices are higher in these programs?

The market for pharmaceuticals in the US is not manipulated in the sense you think - it is as free as it gets there. There are minimal controls in place, and these actually keep prices lower.

I asked you to provide evidence that this market is being manipulated so that prices are higher than if it wasn't. You have not done that - you only continue to make this claim.

I have shown you how prices are lower when the market is manipulated/regulated (medicare, VA, etc), and not when free.

Again, I challenge you to describe just how this market is manipulated. With facts, not paranoid thoughts and conspiracy theories. I have done what you asked - it is your turn.

I don't think you have understood any of this.

Mark

[letsgetsailing3]

Originally Posted by colemj

At least you are now starting to admit that some of the data and examples you use are incorrect.

I provided you with data that was 20yrs fresher than the data you used. It also shows that the US is not the major consumer of pharmaceuticals. It does spend the most in absolute terms, but not in relative terms. It does throw a lot of money into the arena, however.

This is EXACTLY my point. The U.S. buys a lot of pharmaceuticals, and is in a position to negotiate better prices. This was an epic fail of the Affordable Care Act, as this would have been the perfect opportunity to reduce the cost of prescription drugs.

PolitiFact | The Obameter: Allow Medicare to negotiate for cheaper drug prices

Originally Posted by colemj

None of that matters to your arguments here. The absolute amount of money people spend on pharmaceuticals is meaningless unless those people organize their purchasing power. There is no real way of doing this without the government being involved.

I agree.

Originally Posted by colemj

Your arguments in this thread have been against government involvement and toward letting the free-market decide prices. Pharmaceuticals are in a free market.

No, I haven't argued the first point anywhere. I don't believe it is possible to have a free market regarding pharmaceuticals. It's not the way our health care system is set up. I do believe that either we need to have MORE free market principles in play, or more government regulation. Either would work to lower prices.

As for your second point, you're living in pure fantasyland if you think the free market is setting prices for prescription drugs.

Originally Posted by colemj

I can tell you exactly how they are priced - they charge as much as the market will bear. I have been in the meetings where these calculations are made. They have economists working on determining just how much the market will pay to provide X% of profit and funding of further research. It really is econ 101, with some sensitivity to the topic of gouging unleashing future restrictive legislation.

If you sat in on those meetings, you surely understand the difference between prescription drugs and the over-the-counter market. Those are two different things, and they're affected by different factors. Which do you think we're talking about?

Originally Posted by colemj

When the government is involved, as it is in medicare and VA, the prices are much lower for those select people covered by those programs. These government programs do not set the prices on the open market. If they did, the prices would be lower than they are. You seem to be under the impression that prices are higher in these programs?

Insurance companies often use the rates negotiated by the government. So yes, prices are set for pharmaceuticals in these programs. I challenge you to do a little more research in this area.

Originally Posted by colemj

The market for pharmaceuticals in the US is not manipulated in the sense you think - it is as free as it gets there. There are minimal controls in place, and these actually keep prices lower.

I asked you to provide evidence that this market is being manipulated so that prices are higher than if it wasn't. You have not done that - you only continue to make this claim.

I have shown you how prices are lower when the market is manipulated/regulated (medicare, VA, etc), and not when free.

Again, I challenge you to describe just how this market is manipulated. With facts, not paranoid thoughts and conspiracy theories. I have done what you asked - it is your turn.

I don't think you have understood any of this.

Mark

I see the problem. Your discussion is entirely focused on over-the-counter drugs, which is significantly different than prescription drugs.

The prices for over-the-counter drugs is consumer driven. The prices for prescription drugs isn't determined by consumer choice.

Perhaps this is the source of your confusion. I welcome you to provide a treatise on how prescription drugs are priced. The conversation will finally get interesting.

Now for the million dollar question: Which drug is cheaper? One where the price is negotiated by the government, or one that is classified as generic and moved to the over-the-counter marketplace?

Ah, see? There is a place for the free market in this discussion after all.

[colemj]

Originally Posted by letsgetsailing3

This is EXACTLY my point. The U.S. buys a lot of pharmaceuticals, and is in a position to negotiate better prices. This was an epic fail of the Affordable Care Act, as this would have been the perfect opportunity to reduce the cost of prescription drugs.

PolitiFact | The Obameter: Allow Medicare to negotiate for cheaper drug prices



I agree.



No, I haven't argued the first point anywhere. I don't believe it is possible to have a free market regarding pharmaceuticals. It's not the way our health care system is set up. I do believe that either we need to have MORE free market principles in play, or more government regulation. Either would work to lower prices.

As for your second point, you're living in pure fantasyland if you think the free market is setting prices for prescription drugs.



If you sat in on those meetings, you surely understand the difference between prescription drugs and the over-the-counter market. Those are two different things, and they're affected by different factors. Which do you think we're talking about?

Insurance companies often use the rates negotiated by the government. So yes, prices are set for pharmaceuticals in these programs. I challenge you to do a little more research in this area.

I see the problem. Your discussion is entirely focused on over-the-counter drugs, which is significantly different than prescription drugs.

The prices for over-the-counter drugs is consumer driven. The prices for prescription drugs isn't determined by consumer choice.

Perhaps this is the source of your confusion. I welcome you to provide a treatise on how prescription drugs are priced. The conversation will finally get interesting.

Now for the million dollar question: Which drug is cheaper? One where the price is negotiated by the government, or one that is classified as generic and moved to the over-the-counter marketplace?

Ah, see? There is a place for the free market in this discussion after all.

OK. One more time. I am talking about prescription drugs. I have explained to you how they are priced. Did you pay attention? Why do you keep telling me I have not?

Now it is your turn to explain to me how you think they are priced. You seem reluctant to do so. If you think I am wrong, please explain to me your version rather than just say I am wrong.

I also see your confusion. Over-the-counter drugs are those that have been approved by a government agency to no longer require a prescription for access. They may or may not be generically produced by several manufacturers.

Generic drugs are those that have lost patent protection and others can make them without having to do any R&D beyond very basic stuff like proving they are the same as the non-generic version and that their manufacturing process is safe.

Generic drugs are not necessarily OTC. In fact, a vast number of them are not OTC in the US - they are still regulated requiring prescriptions for access to them and their distribution is highly controlled.

Some drugs, like aspirin, ibuprofen, etc become both generic and OTC.

Your statements show that you do not understand the differences listed above.

Generic drugs are cheaper because there are no R&D costs associated with them and many manufacturers can make them and compete the price down.

You aren't really suggesting that patent protection and profits are bad, are you? You don't really think that as soon as a company invests $1 billion dollars into an R&D program to discover, develop and bring a drug to market, that anyone should be able to immediately manufacture and sell it, do you?

If so, you undermine the entire free-enterprise system and suggest that no further pharmaceutical products will ever be discovered and developed. Along with software and all other marketable products.

If insurance companies are using the rates set by the government programs, why are drugs costing them more than the government? Do you think insurance programs are intentionally choosing to pay more?

Sorry, but for all intents and purposes, pharmaceuticals are priced in a free market environment in the US - particularly in comparison to other aspects of healthcare access.

Mark