President Bush, Fiscal Policy

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Comments

  • SpoogeSpooge Thunderbolt missile in your cheerios Join Date: 2002-01-25 Member: 67Members
    They can charge that much in the US for medications because they CAN charge that much for medications. If people would stop buying pills for every crazy "crisis of the week" ailment that network news programs try to scare us with, then the prices would immediately drop. Along with that, the years of testing and regulation involved in developing prescription drugs must be paid for somehow.
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    <!--quoteo(post=1609961:date=Feb 28 2007, 08:40 AM:name=Spooge)--><div class='quotetop'>QUOTE(Spooge @ Feb 28 2007, 08:40 AM) [snapback]1609961[/snapback]</div><div class='quotemain'><!--quotec-->
    It seems that everyone missed the point of my example but that doesn't really matter.

    The one major reason medical costs are higher in the US is government regulations. The US is a grossly litigious society. People here will sue for anything. When it comes to medicine, every doctor, nurse, medical device, procedure, etc, must be perfect every time all the time or somebody calls a lawyer.

    What happens when you elect a bunch of lawyers as representatives in government? You get enough red tape beauracracy to drown an aircraft carrier. Rather than spend profits on regulatory officials to protect them against lawsuits, the medical community passes that cost onto consumers.

    Of course, consumers can't afford the cost of a $10,000,000 lawsuit so we have to charge everyone to cover a few overly expensive procedures.

    How do we improve this? <a href="http://www.whitehouse.gov/news/releases/2003/01/20030116.html" target="_blank">Medical Tort Reform.</a> Why won't it happen? Because the legislature isn't going to cut the money flow off from their own.
    <!--QuoteEnd--></div><!--QuoteEEnd-->
    <a href="http://www.oecd.org/dataoecd/10/20/2789777.pdf" target="_blank">http://www.oecd.org/dataoecd/10/20/2789777.pdf</a>
    Look at Chart 1, Norway's per capita public health care expenditures are only a little bit more than ours. (looks like maybe 15% more) And with their system the private expenditures are way down, and also it's preferred (we all prefer that everyone has health care right?). I don't see how this isn't pretty much better in every way.

    You can keep covering your ears and yelling LALALA or you can look at the facts...


    Also note that you claim that these systems are breaking down, but look in table 1.
    Norway's health care spending is growing slower relative to their GDP growth than ours is. Same with Sweden, Finland, and Denmark.
  • moultanomoultano Creator of ns_shiva. Join Date: 2002-12-14 Member: 10806Members, NS1 Playtester, Contributor, Constellation, NS2 Playtester, Squad Five Blue, Reinforced - Shadow, WC 2013 - Gold, NS2 Community Developer, Pistachionauts
    <!--quoteo(post=1610004:date=Feb 28 2007, 12:11 PM:name=Cxwf)--><div class='quotetop'>QUOTE(Cxwf @ Feb 28 2007, 12:11 PM) [snapback]1610004[/snapback]</div><div class='quotemain'><!--quotec-->
    Right. Its the lawyers soaking up all those extra dollars.

    Didn't we explain that already?
    <!--QuoteEnd--></div><!--QuoteEEnd-->
    Show me the numbers.
  • SpoogeSpooge Thunderbolt missile in your cheerios Join Date: 2002-01-25 Member: 67Members
    edited March 2007
    <!--quoteo(post=1610244:date=Mar 1 2007, 04:35 AM:name=Nadagast)--><div class='quotetop'>QUOTE(Nadagast @ Mar 1 2007, 04:35 AM) [snapback]1610244[/snapback]</div><div class='quotemain'><!--quotec-->
    <a href="http://www.oecd.org/dataoecd/10/20/2789777.pdf" target="_blank">http://www.oecd.org/dataoecd/10/20/2789777.pdf</a>
    Look at Chart 1, Norway's per capita public health care expenditures are only a little bit more than ours. (looks like maybe 15% more) And with their system the private expenditures are way down, and also it's preferred (we all prefer that everyone has health care right?). I don't see how this isn't pretty much better in every way.

    You can keep covering your ears and yelling LALALA or you can look at the facts...
    Also note that you claim that these systems are breaking down, but look in table 1.
    Norway's health care spending is growing slower relative to their GDP growth than ours is. Same with Sweden, Finland, and Denmark.
    <!--QuoteEnd--></div><!--QuoteEEnd-->


    <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1803767" target="_blank">Quality or equality? The Norwegian experience with medical monopolies</a>

    <!--quoteo--><div class='quotetop'>QUOTE</div><div class='quotemain'><!--quotec-->...The significance of the results of the present study depends on a complete and correct patient volume being reported for the different services. As pointed out earlier, by government control, only the designated hospital would in Norway have access to both the necessary technology and qualified personnel needed to perform the defined treatment (Table 1). <b>If a patient at a local hospital was found to be in need of any of these services, the patient would thus either be remitted to the designated hospital for treatment, or not given the treatment at all</b>. Only isolated cases have been referred to hospitals out of the country, and then usually after being remitted by the monopoly hospital. It should also be noted that in Norway all institutional health care, including highly specialized services, is provided free of charge for all citizens. The patient volumes analyzed for these strictly defined services are therefore as complete as possible and based on all available national health statistics....

    ...<b>The data presented indicate, however, that the fulfilling of the original objects has been achieved at the expense of a loss of equal access for all residents</b>. Despite the fact that the performance of these services has been monitored, highly significant differences in access to the services for patients from different parts of the country has been disclosed. This inequality of access is particularly disturbing since the medical conditions and treatments covered, such as organ transplantation, are among the most severe and critical in relation to life or death, and are services defined as having a high medical and political priority in the Norwegian National Health Service [3]. It seems unlikely that the findings can be explained by a lower true demand in the northern and peripheral parts of the country. Most health statistics point in the opposite directions regarding all main disease groups, particularly in the northernmost counties. Thus, the data have probably disclosed another example of "the inverse care law" [4]...
    <!--QuoteEnd--></div><!--QuoteEEnd-->

    They seem to keep their costs down by severely limiting the availability of services.


    <!--quoteo--><div class='quotetop'>QUOTE</div><div class='quotemain'><!--quotec--><b>moultano</b>

    Show me the numbers.<!--QuoteEnd--></div><!--QuoteEEnd-->

    <a href="http://www.protectpatientsnow.org/site/c.8oIDJLNnHlE/b.1549475/k.CFF/The_High_Cost_of_Medical_Lawsuit_Abuse.htm" target="_blank">The High Cost of Medical Lawsuit Abuse</a>

    <a href="http://www.heritage.org/Research/HealthCare/bg1908.cfm" target="_blank">Code Blue: The Case for Serious State Medical Liability Reform</a>

    <a href="http://www.towersperrin.com/tp/getwebcachedoc?webc=TILL/USA/2006/200611/Tort_2006_FINAL.pdf" target="_blank">Towers-Perrin 2006 Update on U.S. Tort Cost</a>
  • CxwfCxwf Join Date: 2003-02-05 Member: 13168Members, Constellation
    edited March 2007
    Also, its worth noting that despite the large number of people in the US without health <i>insurance</i>, almost no one is forced to go without health <i>care</i>. Those who can't pay simply get free treatment, thus raising the bills for everyone else. In other words, we <i>already have</i> universal health care, just in different terms. <img src="style_emoticons/<#EMO_DIR#>/smile-fix.gif" style="vertical-align:middle" emoid=":)" border="0" alt="smile-fix.gif" />

    <!--QuoteBegin-GreyFlcn+--><div class='quotetop'>QUOTE(GreyFlcn)</div><div class='quotemain'><!--QuoteEBegin-->Not really. Since it's not those administering the drugs who are making the bulk of the profit.
    Or even the HMOs they represent. It's the ones designing the drugs.

    The trick with medications for specific treatments.
    Thats the perfect example of Very few players, Very high entry barriers, and Inflexible demand.

    Monopolistic / Cartel(istic?) practices are where market mechanisms fail.<!--QuoteEnd--></div><!--QuoteEEnd-->
    I don't think thats a failing of the market system at all. I think thats a perfect example of the <i>success</i> of the market system! Without the high profit potential of these drugs, they simply wouldn't be made AT ALL. But instead, drug companies invest BILLIONS of dollars into researching hundreds of potential medicines, most of which turn out to be useless, just so that we can discover that handful of miracle cures. And then they get a patent which only lasts for like 10 years, so on first release they get a chance to recover their investment, and then once the patent expires the drug is now available for everyone at a cheap price.

    Remember, the alternative to this is not "cheap treatments", its "non-existant treatments".
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    <!--quoteo(post=1610335:date=Mar 1 2007, 10:46 AM:name=Spooge)--><div class='quotetop'>QUOTE(Spooge @ Mar 1 2007, 10:46 AM) [snapback]1610335[/snapback]</div><div class='quotemain'><!--quotec--><a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1803767" target="_blank">Quality or equality? The Norwegian experience with medical monopolies</a><!--QuoteEnd--></div><!--QuoteEEnd-->
    This is the worst thing you can find on Norway's health care system? There might be some issues related to equal service across the country and the study suggests they regionalize this system (like the rest of their system, apparently). This really doesn't seem like some huge overarching problem with government health care for all. Sure, if there's a problem, fix it, but this doesn't seem to be a huge one.

    <!--quoteo--><div class='quotetop'>QUOTE</div><div class='quotemain'><!--quotec-->Remember, the alternative to this is not "cheap treatments", its "non-existant treatments".<!--QuoteEnd--></div><!--QuoteEEnd-->
    No, that's a false dilemma, the alternative is government funded and university funded research. (particularly government funded)
  • juicejuice Join Date: 2003-01-28 Member: 12886Members, Constellation
    edited March 2007
    The best option for a true fiscal conservative in 2008 is Ron Paul.

    <a href="http://www.youtube.com/watch?v=aewpvcxAwTk&mode=related&search=" target="_blank">Video of Ron Paul slamming conservatives spending</a>
  • CxwfCxwf Join Date: 2003-02-05 Member: 13168Members, Constellation
    <!--quoteo(post=1610674:date=Mar 2 2007, 02:27 PM:name=Nadagast)--><div class='quotetop'>QUOTE(Nadagast @ Mar 2 2007, 02:27 PM) [snapback]1610674[/snapback]</div><div class='quotemain'><!--quotec-->

    No, that's a false dilemma, the alternative is government funded and university funded research. (particularly government funded)
    <!--QuoteEnd--></div><!--QuoteEEnd-->

    Alright then, lets put the dilemma this way:

    A--Nonexistant treatments
    B--Expensive treatments while research costs are recouped, followed by cheap treatments available to all
    C--Taxing everyone to pay for treatments, accessibility determined by government policy, cost-control measures determined by government agency.

    I don't trust government agencies to control costs (isnt that what started this whole thread?), I don't trust the government to control accessibility, and I don't want to be taxed to pay for the entire nations medical problems, so I choose "B". I take it you prefer "C"? Please, explain why.
  • GreyFlcnGreyFlcn Join Date: 2006-12-19 Member: 59134Members, Constellation
    And you trust companies to charge reasonable prices when they have no competition?
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    <!--quoteo(post=1610682:date=Mar 2 2007, 04:29 PM:name=Cxwf)--><div class='quotetop'>QUOTE(Cxwf @ Mar 2 2007, 04:29 PM) [snapback]1610682[/snapback]</div><div class='quotemain'><!--quotec-->
    Alright then, lets put the dilemma this way:

    A--Nonexistant treatments
    B--Expensive treatments while research costs are recouped, followed by cheap treatments available to all
    C--Taxing everyone to pay for treatments, accessibility determined by government policy, cost-control measures determined by government agency.

    I don't trust government agencies to control costs (isnt that what started this whole thread?), I don't trust the government to control accessibility, and I don't want to be taxed to pay for the entire nations medical problems, so I choose "B". I take it you prefer "C"? Please, explain why.
    <!--QuoteEnd--></div><!--QuoteEEnd-->
    I don't see why the government has to control costs? Why can't they do the research and publish it as free information?
  • SariselSarisel .::&#39; ( O ) &#39;;:-. .-.:;&#39; ( O ) &#39;::. Join Date: 2003-07-30 Member: 18557Members, Constellation
    Obviously because that would upset the monopolies of capitalism.
  • CxwfCxwf Join Date: 2003-02-05 Member: 13168Members, Constellation
    <!--quoteo(post=1610850:date=Mar 2 2007, 11:27 PM:name=Nadagast)--><div class='quotetop'>QUOTE(Nadagast @ Mar 2 2007, 11:27 PM) [snapback]1610850[/snapback]</div><div class='quotemain'><!--quotec-->
    I don't see why the government has to control costs? Why can't they do the research and publish it as free information?
    <!--QuoteEnd--></div><!--QuoteEEnd-->

    You misunderstand me. I mean the cost of doing the research and publishing it, not selling it.

    Selling it is cheap. Developing it is extremely expensive. And most projects produce useless products that offer no return on all that money invested into them. Corporations have a strong incentive to identify those failed projects as quickly as possible, and redirect the money into more successful projects. Government has no such incentive, and will continue to pour large sums of money into useless products for a long time.

    There is no such thing as "free" medical information. Someone has to pay to CREATE that information.
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    <!--quoteo(post=1611060:date=Mar 3 2007, 07:15 PM:name=Cxwf)--><div class='quotetop'>QUOTE(Cxwf @ Mar 3 2007, 07:15 PM) [snapback]1611060[/snapback]</div><div class='quotemain'><!--quotec-->
    You misunderstand me. I mean the cost of doing the research and publishing it, not selling it.

    Selling it is cheap. Developing it is extremely expensive. And most projects produce useless products that offer no return on all that money invested into them. Corporations have a strong incentive to identify those failed projects as quickly as possible, and redirect the money into more successful projects. Government has no such incentive, and will continue to pour large sums of money into useless products for a long time.

    There is no such thing as "free" medical information. Someone has to pay to CREATE that information.
    <!--QuoteEnd--></div><!--QuoteEEnd-->
    I'm not saying it's free in the cost sense, obviously someone has to pay for it, but after it's developed they could easily release it for free. The cost burden should be placed more on the extremely wealthy than it is right now, I think.

    I understand that developing it is expensive but you're missing a crucial factor, that scientists <b>compete just like any other field</b>. You're arguing against it because of the off chance that they just give money out to bad research, which I'm sure will happen sometimes (and does with corporations too) but it can easily be minimized. I don't think it is that hard to give government money out for research and have it be used very effectively. (we do it right now!)
    Corporations have an incentive to make money. That's their only incentive, and it can easily lead to bad or very expensive medicine.
  • lolfighterlolfighter Snark, Dire Join Date: 2003-04-20 Member: 15693Members
    But the only way you burden the wealthy more is by taxing them more. A medical treatment costs the same whether you're rich or poor, and people don't get more ill the more money they have, so relative to their fortune or income, the rich spend far less on medical bills. I can't really think of a way to change that expect by having the state foot the medical bills and making it back through taxes, where the rich pay more than the poor.
    But taxes are communist and such, so there won't be any of that. At the same time, like Cxwf says, there needs to be an incentive for medical research, and that incentive is money. Lots of money.

    Personally, I still think public healthcare is the way. I haven't heard any compelling arguments against it, considering that I see it working in my own country. I've heard claims that it's not sustainable, but no sources to back those claims up. There are issues with Denmark's healthcare system, but issues that can (and must) be overcome. At least people don't lose everything they own because a hospital throws a gigantic healthcare bill at them and they thought they could make do with insurance.
  • Rapier7Rapier7 Join Date: 2004-02-05 Member: 26108Members
    Type European population implosion into Google.
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    <!--quoteo(post=1611091:date=Mar 3 2007, 09:43 PM:name=lolfighter)--><div class='quotetop'>QUOTE(lolfighter @ Mar 3 2007, 09:43 PM) [snapback]1611091[/snapback]</div><div class='quotemain'><!--quotec-->But the only way you burden the wealthy more is by taxing them more.<!--QuoteEnd--></div><!--QuoteEEnd-->
    Yeah that was my point <img src="style_emoticons/<#EMO_DIR#>/smile-fix.gif" style="vertical-align:middle" emoid=":)" border="0" alt="smile-fix.gif" />

    <!--quoteo(post=1611144:date=Mar 4 2007, 01:51 AM:name=Rapier7)--><div class='quotetop'>QUOTE(Rapier7 @ Mar 4 2007, 01:51 AM) [snapback]1611144[/snapback]</div><div class='quotemain'><!--quotec-->Type European population implosion into Google.<!--QuoteEnd--></div><!--QuoteEEnd-->
    Ok, I'm dumb, exactly what argument/connection are you trying to make between Europe's generally low birth rates and their health care?
  • lolfighterlolfighter Snark, Dire Join Date: 2003-04-20 Member: 15693Members
    edited March 2007
    I don't know what he's getting at either. In my opinion, the world is OVERpopulated, so falling populations are a good thing. Just ask China what they'd prefer.
  • CxwfCxwf Join Date: 2003-02-05 Member: 13168Members, Constellation
    Remember what started this thread in the first place? The party of "less spending, less taxes" took control from the party of "more spending, more taxes", and then we found out that they're BOTH fiscally irresponsible spenders when given the chance, and the government is spending more money than we ever thought possible.

    Now you're telling me you want the government to take responsibility for spending money to develop new medical technology, and you believe that they will be just as efficient at controlling the costs of that research as private investors would be? Do you <i>really</i> believe that? Or are you just considering that an acceptable risk of the "greater good" of having the government own the finished research, so they can give it away?
  • GreyFlcnGreyFlcn Join Date: 2006-12-19 Member: 59134Members, Constellation
    edited March 2007
    Actually I think a hybrid mechanism would work out best.

    Don't fund the R&D
    If the government controls where R&D funds go, usually it just gets put in the wrong places.
    Usually the most well-connected, not the best market performers.

    But do fund performance based "buy downs" of the cost.
    And control the upper limit of the cost
    Making sure that the cost is low enough for consumers to reasonably buy,
    but also making sure that the rate-of-return is profitable by a healthy margin. But not overly so.
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    <!--quoteo(post=1611228:date=Mar 4 2007, 11:18 AM:name=Cxwf)--><div class='quotetop'>QUOTE(Cxwf @ Mar 4 2007, 11:18 AM) [snapback]1611228[/snapback]</div><div class='quotemain'><!--quotec-->Now you're telling me you want the government to take responsibility for spending money to develop new medical technology, and you believe that they will be just as efficient at controlling the costs of that research as private investors would be? Do you <i>really</i> believe that? Or are you just considering that an acceptable risk of the "greater good" of having the government own the finished research, so they can give it away?<!--QuoteEnd--></div><!--QuoteEEnd-->
    I'd say I think it's an acceptable level of risk for the amount of good it would do. (and given the Nordic countries we've been talking about it seems that reality backs me up) I don't think government is as horribly wasteful as you make them out to be and I don't think corporations are as unbelievably efficient as you make them out to be.
  • CxwfCxwf Join Date: 2003-02-05 Member: 13168Members, Constellation
    The Nordic countries cant provide you with a real life example of this scenario, because the real life scenario is that the majority of medical research in the world today is done by private US companies. Once the research is completed, then everyone in the world copies it essentially for free, plus whatever copyright restrictions apply in that location.

    Certainly there is some research done by institutions in other countries, but again, once ONE institution does the research, the whole world copies it. I'm not criticising this model...its very efficient, to be sure. But it means that the Nordic public health care system doesn't have to worry about investing money in medical R&D at all, and so they can't offer their experiences on how to best make that investment.
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    Well thats a nice theory but it doesn't hold up in reality...
    <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673603153536/fulltext" target="_blank">http://www.thelancet.com/journals/lancet/a...153536/fulltext</a>

    You have to register (free) to view it, but basically it's a study that says that Sweden has the highest citation rate per 1000 people.

    The USA is 9th. Norway, Denmark, Finland, and Sweden are all above us.

    Here's the table in case you don't want to register... Dunno if it will work
    <a href="http://images.journals.elsevierhealth.com/images/journalimages/0140-6736/PIIS0140673603153536.si1.lrg.gif" target="_blank">http://images.journals.elsevierhealth.com/...536.si1.lrg.gif</a>

    Hm... something I didn't think about. If the government did the research, they wouldn't have to market it.
    <a href="http://dcc2.bumc.bu.edu/hs/sager/pdfs/020402/Pharmaceutical%20Marketing%20and%20Research%20Spending%20APHA%2021%20Oct%2001.pdf" target="_blank">http://dcc2.bumc.bu.edu/hs/sager/pdfs/0204...%20Oct%2001.pdf</a>
    Says that pharmaceutical companies spend about 31% of their budget on marketing and administration, 16% of their budget on profit, and about 11% towards R&D.
    I have no doubt that the government could be more efficient than that.
  • CxwfCxwf Join Date: 2003-02-05 Member: 13168Members, Constellation
    Note that your table is ranked in terms of papers <i>per unit population</i>, and that the US has 32 times as much population as Sweden. The paper rate per person is only slightly lower in the US, meaning again most of the research is done in the US. Just like I said. The comparison is even worse for all the other Nordic nations, which have even lower populations and lower per capita research rates.

    And once its been done somewhere, the whole world can copy it for free. Just like I said. So most of the research used in Nordic health care was not researched in a Nordic nation. Maybe it was done in the US, maybe in England, maybe in Italy for all I know...but very little was done in Sweden or Norway or Finland.
  • NadagastNadagast Join Date: 2002-11-04 Member: 6884Members
    edited March 2007
    But you can't use the large population of a country as a point to support the system... Sorry.

    And I notice you ignored the entire point about the large parts of pharmaceutical companies' budgets wasted on marketing.
  • UltimaGeckoUltimaGecko hates endnotes Join Date: 2003-05-14 Member: 16320Members
    <!--quoteo(post=1611194:date=Mar 4 2007, 07:32 AM:name=lolfighter)--><div class='quotetop'>QUOTE(lolfighter @ Mar 4 2007, 07:32 AM) [snapback]1611194[/snapback]</div><div class='quotemain'><!--quotec-->
    I don't know what he's getting at either. In my opinion, the world is OVERpopulated, so falling populations are a good thing. Just ask China what they'd prefer.
    <!--QuoteEnd--></div><!--QuoteEEnd-->

    I haven't bothered typing it in to google, but I'd assume he's referring the inverse age pyramid you get in populations with low birth rates (that means a small young population has to support a relatively large older population's medical bills and such). I think that might actually be an argument for socialized welfare working in populous nations (with high birthrates), but Europe's model will most likely not be able to withstand the pressure that a much older population puts on a smaller younger population (that doesn't necessarily mean there needs to be more retirees than workers, just that the difference between the groups is going to get small enough at some point that the money is going to have to run out somewhere).

    Otherwise I'm not entirely sure how he intended it to fit into the discussion.

    (I think it's a particularily good sign after the 'overpopulation crisis' that we were bombarded with in High School ~10 years ago, but not necessarily economically)
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