Affordable Care Act - catastrophic plans cancelled

[goboatingnow]

Originally Posted by CatInHand

It has been my experience that the majority of prescription drugs are, in reality, optional.

Proper health for a lifetime virtually eliminates the need for most drugs.

Rarely do you need drugs for hypertension, illness, impotence, heartburn, high cholesterol, etc.

One has to wonder how necessary many of the mood-altering drugs would be if other methods were available (group therapy or something).

How many of these would really be necessary with better diet and exercise?

The 10 Most Prescribed Drugs

Sorry while you may or may not have a point , the vast vast majority of people are led by the decisions there doctors make. Few are willing to go it alone and buck that process.

Argue with what we have not what you would like us to have.

To argue the whole field of medicine is irrelevant if you much rabbit food etc is just nonsense. Not to mention its not what people are doing.

Lets free market the auto industry , make everyone walk.

Dave

[colemj]

Originally Posted by letsgetsailing3

If a patient has pharmaceutical coverage with a fixed co-pay, what is their incentive to do this?

Much of the cross-border pharmaceutical purchasing is regulated or illegal.

Wouldn't it be better to open up the markets, at least in the cases where the prescription drug is exactly the same product?

If the markets were opened, then Canadians would be paying more. Why do you think it would be the other direction?

If one stays away from the illegal trade, and works within the regulations, cross-border purchasing is both common and less expensive.

A patient's co-pay coverage has nothing to do with whether pricing is done on a free market or not. You are making my point - without external forces taking hold, NCE pharmaceuticals are priced to what the market will bear.

In other words, a free market.

Mark

[CatInHand]

Originally Posted by letsgetsailing3

True. But the health care industry would lose lots of profits.

Yes. And the U.S. health care system is extraordinarily screwed up, but it is this way, in part, because Americans have given control of their health over to someone else.

[colemj]

Originally Posted by goboatingnow

There is a fundamental difference. One can't forgo treatment , whereas one can not only change ones choice of car completely , one can forgo the whole purchase without life threatening consequences.

Maybe your wife writes you a prescription for a new car and you feel you can't buy anything else. The rest of us have a gamut running from a crap banger to rolls Royce and ultimately abstinence , that " feedback " loop controls pricing because there is significant elasticity of demand.

Prescriptive Healthcare consumers has no such options and its ridiculous to argue they do. I talking both about medical procedures, hospital stay costs and prescription drugs.

Dave

I'm only discussing prescription drugs.

I said you had to put aside the "necessity" part to address that question.

But the curiosity is that there is price elasticity in pharmaceutical drugs (in the US). Quite a bit, actually. This suggests that they are operating in some type of free-market - particularly when compared to other countries.

Mark

[goboatingnow]

Originally Posted by CatInHand

Yes. And the U.S. health care system is extraordinarily screwed up, but it is this way, in part, because Americans have given control of their health over to someone else.

No its because for idealogical reasons ( and no other) they tried to implement a " free market" healthcare environment , which has resulted in a massive price spiral , putting millions of people into no or poor insurance and eventually the system has basically ground to a halt hence the ACA.

Other governments, less ideologically bound ,attempted to deal with Healtcare as a social good. Some have been better at it then others. None have screwed up quite as bad as the US , where to any independent observer , the system is nuts.

The concept that medical bills could force bankruptcy or loose you your home is barbarous in the extreme. Governments would be voted put in 20 secs flat if that happened .
Dave

[letsgetsailing3]

Originally Posted by colemj

If the markets were opened, then Canadians would be paying more. Why do you think it would be the other direction?

If one stays away from the illegal trade, and works within the regulations, cross-border purchasing is both common and less expensive.

A patient's co-pay coverage has nothing to do with whether pricing is done on a free market or not. You are making my point - without external forces taking hold, NCE pharmaceuticals are priced to what the market will bear.

In other words, a free market.

Mark

If drug markets were opened between Canada and the U.S., people would buy where they could purchase for the cheapest price.

Fixed co-pays eliminate the incentive to shop around, and therefore limit, not encourage free market behavior.

[avb3]

Originally Posted by CatInHand

Then you're paying the price that the US company that sells the drug has set.

Interesting it should be five times and three times as much respectively. Both pricings are from Walmart.

My American girlfriend's uninsured cost to see a doctor plus fill a prescription here in Canada was less than her copay in the States for her prescription alone, nevermind what it cost to see her doctor.

I'm not sure what the ACA did to bring down the cost of medical care in the USA. Many of us from the outside are surprised at the continued highest cost of medical services in the USA with arguably no better results for most citizens as compared to most other countries in the OECD.

It is an issue only Americans can eventually solve for themselves. Hopefully.

[letsgetsailing3]

Originally Posted by CatInHand

Yes. And the U.S. health care system is extraordinarily screwed up, but it is this way, in part, because Americans have given control of their health over to someone else.

Again, I agree.

[goboatingnow]

Originally Posted by letsgetsailing3

Again, I agree.

Who have they " given their Healthcare over too " the Healthcare industry and the private insurance industry , neither of which care anything about Health

Dave

[CatInHand]

Originally Posted by goboatingnow

Sorry while you may or may not have a point , the vast vast majority of people are led by the decisions there doctors make. Few are willing to go it alone and buck that process.

Argue with what we have not what you would like us to have.


Lets free market the auto industry , make everyone walk.

Dave

Not entirely sure what you're trying to say.

The majority of people without insurance HAVE decided to go it alone. It's the 'rich' people who have someone else buying their meds that are setting the exorbitant prices.

To argue the whole field of medicine is irrelevant if you much rabbit food etc is just nonsense. Not to mention its not what people are doing.

Clearly you are one of those that don't feel that personal responsibility has a place in healthcare, which does make your position more understandable. You, personally, would not survive without the US healthcare system providing you with meds, and, therefor, you need for it to continue as it always has.

Since I know I can't afford the cost of hypertensives and cholesterol-lowering drugs, I make sure I won't need them. Sometimes you have to lose something to realize you really didn't need it to start with.

My parents never really bought in to the "doctors are gods" thing, so here's my story.

Diabetes (type 1.5/2) runs in my family. My grandfather died from it. My dad knew this and spent his life making sure he was taking all the steps to prevent it from occurring in his body.

At age 76 he finally started to need to actively monitor his blood sugar and take an oral med.

Proper personal care kept him from needing drugs for oh, 50 years or so. Two of my brothers and my sister need diabetes drugs. I do not, and I will continue to live my life in such a way as to keep me from needing them.

[letsgetsailing3]

Originally Posted by goboatingnow

No its because for idealogical reasons ( and no other) they tried to implement a " free market" healthcare environment , which has resulted in a massive price spiral , putting millions of people into no or poor insurance and eventually the system has basically ground to a halt hence the ACA.

Dave

I disagree with you on that.

A free-market approach, with some modification, could work, just like a regulated system can work.

The problem is that the U.S. is stuck in a bad place in the middle.

Some countries have at least a hybrid model that works. In Japan, insurance covers 70%, and individuals cover the other 30%. Their system seems to work well.

[CatInHand]

Originally Posted by avb3

Interesting it should be five times and three times as much respectively. Both pricings are from Walmart.

My American girlfriend's uninsured cost to see a doctor plus fill a prescription here in Canada was less than her copay in the States for her prescription alone, nevermind what it cost to see her doctor.

I'm not sure what the ACA did to bring down the cost of medical care in the USA. Many of us from the outside are surprised at the continued highest cost of medical services in the USA with arguably no better results for most citizens as compared to most other countries in the OECD.

It is an issue only Americans can eventually solve for themselves. Hopefully.

I think the goal is to bring it down, not have it immediately drop. And I'm with you on the 'hopefully' part.

[colemj]

Originally Posted by letsgetsailing3

If drug markets were opened between Canada and the U.S., people would buy where they could purchase for the cheapest price.

Fixed co-pays eliminate the incentive to shop around, and therefore limit, not encourage free market behavior.

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

[CatInHand]

Originally Posted by goboatingnow

No its because for idealogical reasons ( and no other) they tried to implement a " free market" healthcare environment , which has resulted in a massive price spiral , putting millions of people into no or poor insurance and eventually the system has basically ground to a halt hence the ACA.

Other governments, less ideologically bound ,attempted to deal with Healtcare as a social good. Some have been better at it then others. None have screwed up quite as bad as the US , where to any independent observer , the system is nuts.

The concept that medical bills could force bankruptcy or loose you your home is barbarous in the extreme. Governments would be voted put in 20 secs flat if that happened .
Dave

Ok, how about:

There are many complex and intertwined reasons why the US healthcare system has arrived at it's current state. Correcting this will, therefor, require more than a single approach.

[colemj]

Originally Posted by letsgetsailing3

A free-market approach, with some modification, could work, just like a regulated system can work.

This makes no sense. Japan's system is more like a regulated power utility, with those outside the common grid provided power by the government. All prices are government set and access is guaranteed to all.

How is that a free market in any sense? Do you consider your power utility as operating in a free market?

Mark