American Medical advancements a thing of the past?

[jreeves]

Cutting edge medical technology doesn't much impress people who cannot afford it.

Bad medical technology and treatments hurts the whole population. So which is easier to deal with providing treatment to a few who can't afford it or destroying the quality of medical technology and treatments for all?

 

[Cecilie1200]

Save the crocodile tears.



Big Pharma Spends More On Advertising Than Research And Development, Study Finds

Perhaps if they didn't spend tens of billions of dollars in marketing and promotion (and hundreds of millions lobbying Congress), they could afford more research. Until they stop that crap, I don't want to hear their sob stories.

It sounds like a bad case of "Penis Envy" by the Canadians. Even if their research were accurate and unbiased - and who would believe that - Pharma companies have a limited amount of time to amortize their investment before a drug goes generic and anyone can make it at cost. If it goes relatively unsold their investment in that first One-Billion-Dollar pill won't be paid for and their won't be others to lose money on.

From the link:

Gagnon’s and Lexchin’s new estimate of total promotional costs is also consistent with estimates of promotional spending by the U.S. pharmaceutical industry from other sources they scrutinized, including reports by Consumers International, a non-governmental organization which represents consumer groups and agencies worldwide; Office of Technology Assessment, which extrapolated results from the cost structure of Eli Lilly, a global pharmaceutical company; Marcia Angell, former editor-in-chief of the New England Journal of Medicine, who extrapolated data from Novartis Inc., a company which distinguishes marketing from administration expenditures in its annual reports; and the United Nations Industrial Development Organization.

Pharma companies have a limited amount of time to amortize their investment before a drug goes generic and anyone can make it at cost.

Once prescription drugs are available OTC, that might make some sense. Prescribers receive all the information they need regarding new medications, new indications for existing medications and clinical trials through journals and other professional sources. The vast amount of the marketing by these companies is not necessary.

So your position is that patients have no need to know anything about new advances in pharmaceuticals, and should just sit around in trusting ignorance, waiting for their doctors - who, of course, don't have hundreds of other patients' medical histories to manage - to realize that some new medication on the market might be better for their condition, rather than taking an active role in managing their own healthcare. Is that about right?

 

[veritas]

Treating a disease with drugs can be a whole lot better option than surgury, if a surgical option is available, especially at end of life (60-80) when a drug solution is far more attractive than suffering with a condition. My little 500 mg tab of naproxen taken twice daily saves me a lot of pain in the knees and allows me to go out and be usefully employed at 68, and put off knee replacement surgery to a point in time that it won't need be repeated a second time. Pharmaceutical companies make things like stints and ceramic prosthetic devices for knee and hip replacements too. It seems to me all this criticism is a lot of nonsense from people looking for something else to be pissed off about, because they completely lack understanding of incentives; to them incentives, particularly profit incentives, can only be evil.

If you are 68, the time to go is now. Due to our lowly stats you'll need to act fast to get your money's worth out of new knees.

I know a guy who works for a company that makes/sells artificial joints and prosthetic devices. We are way behind Europe in that regard. They have a new femur ball joint that requires less cutting, is stronger and easier to recuperate from. We can't have it because some asshole lobbyists are against the tool that makes it so much less invasive [read:better and cheaper] to implant. The implants are the best you can get, healthier overall, but some corporations threw money at it so we lose.

And the prosthetics industry owes their test trials and errors and hard won data to the race horse industry, not pharmaceuticals and their offshoots. You can thank vets and blacksmiths and many a horse for that. In fact, you can thank them for a lot of human advancements and a plethora of medicine, most of which we take for granted.

 

[American Horse]

And the prosthetics industry owes their test trials and errors and hard won data to the race horse industry, not pharmaceuticals and their offshoots. You can thank vets and blacksmiths and many a horse for that. In fact, you can thank them for a lot of human advancements and a plethora of medicine, most of which we take for granted.

Interesting parallel; In the future - after all incentives have been removed for talent to go into medicine - we will most likely depend on veterinary medicine for many more of our advancements in healthcare. Why? because the incentives will remain there for people of talent and money to flow to urgent needs, while in human medicine the government bureaus will fail to take incentives into account. By and large, savings and efficiency will take the crudest form; simple denial of certain "exotic procedures;" availability of medical services will have been effectively leveled.

 

[editec]

We spend billions extending life and damned little improving it in my opinion.

Our medical health care SYSTEM is broke, folks.

I don't have the solution, but I know damned well that what we have now isn't going to last much longer.

 

[American Horse]

We spend billions extending life and damned little improving it in my opinion.

Pharmaceutical innovations do more to improve the quality of life for the elderly than anything else an external agent can do; the rest is up to the individual.

Our medical health care SYSTEM is broke, folks.

I don't have the solution, but I know damned well that what we have now isn't going to lat much longer.

And we are finally beginning to question how it got that way. The politicians have interfered with what was an efficiently run healthcare system in the 50's, since the 60's, making it ever more broken.

Remember that the talent of physicians is there to provide medical services, if we'd let them, do what they and the system are best at; attend to our health-care needs. I heard a doctor recently say he has three full time people in his office to take care of paperwork required by a government agency. How about the amount of his resources put into defensive medicine, or costly insurance for defenses against the tort bar. Which political party gets huge donations from the tort bar?

The Insurance companies are there to calculate medical risks and write a contract to allow people to insure against those risks; people need to understand their contract, and find the best one they can and sign and understand that legally binding agreement.

I have carried individual health (non-group) insurance policies on myself and my family from 1965, since immediately after leaving military service. I shopped and got the best policies available. Those policies have always been affordable, and I always chose to do the right thing and be insured. The 'rub' has come from government interference between me and my insurer.

Medical services are available to the very poor through Midicaide for chronic or urgent illnesses outside of the Emergency Room.

Health insurance policies are available to people with pre-existing medical conditions through group policies through their employers, and those pre-existing conditions are covered after one year. If they don't have an employer who provides health insurance they should perhaps find one, if it is important to them. The politicians should end preventing the creation of group policies for health insurance through associations like the NFIB (Nat'l Fed of Independent Businesses), and make policies available across state lines to promote competition.

There are cases of "Orphan Diseases" which are so rare as to not have medical science doing anything for their cure (my own wife has one of those; Bechets Syndrome). Insurance is available for people afflicted with those through state insurance pools which require insurance companies who do insurance business within their states to provide such insurance without prejudice.

A huge part of the problem, is the infection of cynicism for a certain political advantage: Tell people their case is hopeless, and they will despair and become a supporter of the party which keeps it broken by standing in the way of meaningful change, while promising to repair it.

Now those same politicians mentioned above say only they can or will fix it by replacing it with another grand scheme; one designed by those same people who have effectively wrecked it.

A useful "fix" would be if the Mainstream Media would only stop treating vital issues like this one as part of the political horse race, and actually present useful options; truthfully say that the Republicans DO have a plan to compete with the Democrats, instead of being so politically invested in the outcome to the president and the party of government. Instead it is taken as a true fact that the Rs offer no new ideas. Advancements (like MSAs and MSAs in the past) have been made, and the Ds have fought them every step of the way, biding their time for a day like this one, when they could, with the help of the MSM, grab the whole thing and re-make it to their heart's desire.

 

[Cecilie1200]

Cutting edge medical technology doesn't much impress people who cannot afford it.

Bad medical technology and treatments hurts the whole population. So which is easier to deal with providing treatment to a few who can't afford it or destroying the quality of medical technology and treatments for all?

Which reminds me. I wonder in what category pharmaceutical companies put their programs to provide medication for people who can't otherwise afford them? Sounds like "public relations" to me, which would fall under "advertising". They sure aren't doing it for the profit.

 

[Toro]

It would have an effect but it would be a modest one.

The medical companies would still make a ton of money, just not as much as before. People go into research for many other reasons besides money.

 

[American Horse]

Which reminds me. I wonder in what category pharmaceutical companies put their programs to provide medication for people who can't otherwise afford them? Sounds like "public relations" to me, which would fall under "advertising". They sure aren't doing it for the profit.

Cecilie, a more appropriate question might be what category did the two Canuk PHDs assign those costs to. It's their version of marketing costs that is super-inflated versus what the Pharma companies say. There is not much doubt those guys put it as advertising/marketing.

The Pharma Co's probably assigned it as direct product cost as necessary shrinkage.

 

[Emma]

So your position is that patients have no need to know anything about new advances in pharmaceuticals, and should just sit around in trusting ignorance, waiting for their doctors - who, of course, don't have hundreds of other patients' medical histories to manage - to realize that some new medication on the market might be better for their condition, rather than taking an active role in managing their own healthcare. Is that about right?

No.

The information is out there for anyone who wants to find it. Nice strawman, though.

And on a lighter note:

[ame=http://www.youtube.com/watch?v=mYodDH4qZQo]YouTube - The drugs I need[/ame]

 

[veritas]

And the prosthetics industry owes their test trials and errors and hard won data to the race horse industry, not pharmaceuticals and their offshoots. You can thank vets and blacksmiths and many a horse for that. In fact, you can thank them for a lot of human advancements and a plethora of medicine, most of which we take for granted.

Interesting parallel; In the future - after all incentives have been removed for talent to go into medicine - we will most likely depend on veterinary medicine for many more of our advancements in healthcare. Why? because the incentives will remain there for people of talent and money to flow to urgent needs, while in human medicine the government bureaus will fail to take incentives into account. By and large, savings and efficiency will take the crudest form; simple denial of certain "exotic procedures;" availability of medical services will have been effectively leveled.

We already do. As I said before most prosthetics advancements were due to veterinarians and blacksmiths trying to help, and then it was used for veterans. Most all cardiology has been exhaustively mined from studying the TB heart which is huge in comparison to other horses, so we have interval training which is "aerobics" for people. Then there's reproductive medicine, sports medicine, deep tissue massage and on and on.

Economic incentives were rather low on the list I'd imagine for these endeavors. If you want to be a vet, you have to be the best of the best in everything, and have sponsors to get into vet school, there are only 3 in the US. The rest are people doctors. Very few people can cut it as blacksmiths either, and the pay isn't that stellar. Then there are the little people along the way that make next to nothing that assist in these things.

Doctors aren't machines, they're people. I can't imagine what it would be like to want to practice your trade and be restricted in treating your patients by INSCos.

 

[American Horse]

And the prosthetics industry owes their test trials and errors and hard won data to the race horse industry, not pharmaceuticals and their offshoots. You can thank vets and blacksmiths and many a horse for that. In fact, you can thank them for a lot of human advancements and a plethora of medicine, most of which we take for granted.

Interesting parallel; In the future - after all incentives have been removed for talent to go into medicine - we will most likely depend on veterinary medicine for many more of our advancements in healthcare. Why? because the incentives will remain there for people of talent and money to flow to urgent needs, while in human medicine the government bureaus will fail to take incentives into account. By and large, savings and efficiency will take the crudest form; simple denial of certain "exotic procedures;" availability of medical services will have been effectively leveled.

We already do. As I said before most prosthetics advancements were due to veterinarians and blacksmiths trying to help, and then it was used for veterans. Most all cardiology has been exhaustively mined from studying the TB heart which is huge in comparison to other horses, so we have interval training which is "aerobics" for people. Then there's reproductive medicine, sports medicine, deep tissue massage and on and on.

Economic incentives were rather low on the list I'd imagine for these endeavors. If you want to be a vet, you have to be the best of the best in everything, and have sponsors to get into vet school, there are only 3 in the US. The rest are people doctors. Very few people can cut it as blacksmiths either, and the pay isn't that stellar. Then there are the little people along the way that make next to nothing that assist in these things.

Doctors aren't machines, they're people. I can't imagine what it would be like to want to practice your trade and be restricted in treating your patients by INSCos.

There are other incentives for people of talent than economic ones, and I believe those types of people will still want to get into veterinary medicine; I admire them. I also admire medical doctors. I've had the honor to build homes for a large number of MDs over a period of 30 years. I admire them greatly. I'm aware of what they are up against.

But as to the insurance issue, insurance companies only agree to pay for medical services according to a contract. As of now anyone who wants a medical service can pay for it themselves, or put it on a credit card to pay for it in the future over time.

But once a government bureacracy is involved, what you describe will actually have taken place. I had knee surgery (at age 63) back in 2004, and the total bill for hospital and surgeon was $3,500. I was insured, but a lack of insurance, or if the insurance company had refused to pay for it, would not have kept me from getting that surgery. They didn't refuse, because we had a contract, and I understood my contract, and their obligations and my own obligations under that contract. I had bought that insurance understanding their obligations and I had compared several policies for price and coverage before buying that particular one. The premium for that policy was $117-per month and I had a $1,000 deductible.

Most medical services could be paid for by individuals, and they do, by and large, when they pay for them out of their "deductible." Today we don't have catastrophic insurance policies with high deductibles purely because of government regulation, and that was a D party contribution to the situation we find ourselves in. With MSAs and HSAs high deductible policies are permitted, but only there, an R innovation.

One can see that high deductibles for those who only want to insure for those unbearably costly medical services, like cancer care, or coronary problems, and others like that would make people think about finding price competitive medical services, in their own behalf; the deductible, after all, is the patients own funds being spent. All the innovations which have helped keep the field competitive have come from the R side; MSAs, HSAs, and promotion of neighborhood clinics for instance. My primary provider is a clinic. I can walk in there, and in no more than 15 - 20 minutes see a Doctor or a Practitioner for an office call charge of $50.00; for that fifty dollar bill they will look at any number of health complaints that I might have, and order tests, and then give me results over the phone later without additional charges.

If the health insurance business survives, I would suggest that everyone take the purchase of their health insurance seriously, and shop for it even as they would a new TV or heck, even a new truck or car or an important tool for their business. I would also suggest that ANYONE IN THE MARKET FOR INSURANCE go to a commercial insurance agency. They will have a slew of companies and policies to pick from and an agent not actually associated with those insurance companies to give you guidance in evaluating price and coverage, as well as ratings for the companies whose policies they sell, and how they have treated customers in the recenty past.

 

[veritas]

That's all well and fine for you that you've been able to get insurance and have a clinic and yada yada yada. That's a best case scenario. You seem to be healthy and to be of an age when a lot of people have been able to maintain insurance because there was an era of great coverage. I know because my grandmother had it, and she got it from being added to my grandfather's policy back in the 60's and she kept paying on it and was aghast when the YEARLY premium went up to $400. She died in 2004 at almost 105. The insurance was wonderful. Her doctor wasn't, so much. She'd probably still be alive it it wasn't for his negligence.

But anyhow these are best case scenarios. People lose their jobs and their coverage, or accidents occur and then there is violent crime. Young people are looking at huge premiums that they can't justify paying. Their pay hasn't increased to meet what things cost. They have rent to pay, food to buy and transportation and what they are left with is not enough to purchase any health insurance. You're older, have assets and a cushion. Many people do not.

 

[American Horse]

But anyhow these are best case scenarios. People lose their jobs and their coverage, or accidents occur and then there is violent crime. Young people are looking at huge premiums that they can't justify paying. Their pay hasn't increased to meet what things cost. They have rent to pay, food to buy and transportation and what they are left with is not enough to purchase any health insurance. You're older, have assets and a cushion. Many people do not.

I think you are wrong about this. They aren't doing due dilligence in shopping if they are shopping at all. Perhaps they are being discouraged by the cynics among us so that they just join in with the cynicism. I say that, and reflect back on my example: I was able in 2003 to get a policy for $117-per month with a $1,000 deductible, yada yada yada....(and have knee surgery the next year). A 62 year old man is not going to get the same low rate as a young person.

People complain without ever even making an effort. I would accept that certain STDs would probably drive up insurance premiums to levels that seem too high, but that reflects on lifestyle choices, like obesity for instance.

In my own case, for the insurance (AETNA) I did not have to have a physical exam; after all, if I had something that I should've reported for their evaluation, or failed to answer their question honestly and it were turn up within a year, or if I had some condition which was in my medical file, it would turn up later then treatment would've been correctly denied. People have to accept some responsibility for their honesty. Otherwise the contractual agreement between insurance company and insured has been based on false information.

 

[veritas]

You can shop all you want, but if you don't have the money to buy the cheapest option, you are still SOL. I suppose health insurance should be a priority, but a self contingency plan for normal things like maintaining your car would take precedence if you were barely scraping by if that is how you get to and from work. That's a question for Solomon I guess.

 

[American Horse]

You can shop all you want, but if you don't have the money to buy the cheapest option, you are still SOL. I suppose health insurance should be a priority, but a self contingency plan for normal things like maintaining your car would take precedence if you were barely scraping by if that is how you get to and from work. That's a question for Solomon I guess.

In some cases no doubt. But people are so damned ignorant about insurance, or perhaps a little fatalistic about their chances with disease, and accidents so that they just let it go. Most parents would keep their minor children insured until the age of majority, and even after if their adult child isn't doing well in employment; that's just responsible parenting.

If an adult "child" has gotten married, and has a child for which they are responsible, and their income is as low as you describe, they probably qualify for medicaid, which is a form of health insurance, until their situation improves and they can afford to insure their family on their own. There are always people who can't make it, but those are nowhere near the majority, and disinformation about what's available and the costs too often discourage people from really taking a look at what is available to them at relatively low cost.

It would behoove a young person without many skills to seek a job in a factory or even at a McDonalds, or other employer that offered a group health benefit plan as a part of their compensation, dontchathink? Or is it just too darned tough, and we need to let the government do it for us? That seems to be the case with millions and millions of people by some accounts.