Where could I begin with my O'Reilly problem? ..... why bother. I rarely listen to him, just enough to find him unpleasant. His finest broadcast virtues are that he's well-organized and adept at controlling the direction of conversation.

I ind him somewhat less obnoxious than that drunken lout comedian, whatsisname. Their not much different once you get pastthe drunk differential.

Canadians pay a lower price by legislating the market. Guess who provides the profit margin and research overhead, in effect subsidizing Canadian welfare?

Botnst

...well, the O'Reilly thing was my feeble attempt to make a point--I'm actually glad you don't like him since I find his kind of bully polemics to be repugnant. And no, I don't like Franken either.

Anyhoo, economies of scale are what they are. If bulk buying works for WalMart, Costco, and the other mega-titans of the corporate world, it'll work for public sector drug purchases as well.
Sorry dude, the world don't operate like that...we all suffer.
...healthcare ain't a commodity. That's why HMO's have failed so miserably at trying to introduce profit-driven market mechanisms into a the Hippocratic system--bad fit--immoral outcomes. The thought of hospitals 'competing' for patients is downright creepy.

Well, I don't appreciate that my government forces me to "operate" a forced charity system either. Because when my government steals my money to give to someone else, I suffer, my daughter suffers, my family suffers...and I do not appreciate it.

EVERYTHING is a commodity. There is no such thing as a truly unselfish act. If folks like you would just use that to your own everyone's ADVANTAGE instead of trying to repress it all the time, we'd all be a lot better off.

Mike

Canadians pay a lower price by legislating the market. Guess who provides the profit margin and research overhead, in effect subsidizing Canadian welfare?

Botnst

PICK ME, PICK ME, I know! PICK ME!!!! (waving arm frantically in the air...)

:)
Mike

...not sure who you're referring to here, but I bet if the entity in question utilized bulk pricing, they wouldn't be subsidizing anything but the services of their own constituency. Just a guess...

In a market economy, supply and demand set price. The price cap is set by whatever folks are willing to pay for a product. Each country is looked at as a separate market and prices adjusted accordingly. Some markets would therefore be more or less profitable to the companies' bottom line than others. High margin markets, in effect, subsidize low margin markets. This is why even third world countries have access to advanced medicines. Of course, some markets are so poor that there is not a break-even possibility for those countries.

Whom should pay for medicine to those markets?

A wealthy country that legislates a low profit margin limits the profit available to the company, saving the taxpayer money. Locally, that's a great advantage to the taxpayer and doesn't hurt the company much. Win-win, right?

But downstream, it hurts. The company gains less money for research and development and less money for profits. Where could it make-up for that reduced profit?

By cutting the barely marginal third world countries from the market.

Thus, artificially reducing the profit margin in wealthy countries will necessarily force companies to cut costs elsewhere to maintain income to satisfy stockholders and remain competitive.

Botnst

...this profit thingee sounds like a major stumbling block to the equitable distribution of needed services. Call me an 'outside the box' kinda guy, but what if we cut out that annoying stumbling block? A fair amount of the primary research for drugs is in fact done at state-funded research universities, so why not have state-funded production of something already owned by the public?

Then the government sets the price and the terms and conditions, and taxpayers are left to deal with it, and pay the bill.

No competition, no variety, no way to force them to improve the service. Kind of like the DMV, the Post Office, Airport Security, and Public Schools!

Brilliant.

:rolleyes:

Mike

...thanks Mike, ya know I do kind of fancy myself to be a sort of socialist entrepreneur.

Hey, entrepreneur, that's a pretty fancy French word isn't it?

BTW: The post office has plenty of competition. Private firms skim off most of the profitable package shipping business, while leaving them hustling low/no margin letters.

Hmm. A little late to the party, but what the heck.

There's a difference between "not-for-profit" health care (say, Kaiser) and "public" health care (say, Canada), the latter being what I think everyone seems to be arguing about.

With respect to the former, nonprofit is better than for-profit because it reduces the influence of profit motives on the medical care provided to patients. Theoretically, doctors are supposed to make treatment decisions based on the best interest of the patient, not on the best interest of their bottom line, or their employer's bottom line. Nonprofits are better in this respect than forprofits, although even they are not totally immune.

A good example of how it's not supposed to work happened here in California recently - the FBI is currently investigating a Tenet Healthcare facility in Redding for performing thousands of unnecessary cardiac operations. While the doctors involved are the subject of the prosecutions, I have heard that management leaned heavily on the staff to increase their procedure rate because they could get significantly more revenue out of payers for it.

With respect to public health care facilities/systems, there are a couple reasons why they are useful.

First, health care is not like other industries. Not everyone needs a car, or a tailored suit, or broadband internet. But, everyone needs health care.

The problem is, the free market is not designed for, nor interested in, providing goods and services to the entire spectrum of purchasers. They only care about the spectrum of purchasers who they can serve conveniently at a profit.

If we let the market dictate the distribution of health care services, there are going to be lots of people with little or no access to health care, because there are lots of markets where medical services don't make money - rural areas, most emergency departments, vaccine research. Who steps in and provides those services? The only entity with the resources and the interest (assuming the constituents are interested in things like open emergency rooms) is the government.

The other reason why public health care is useful is because it can be incredibly efficient at delivering services. Not all services, not the best services, but most services to most of the people. A real life example? Compare Canada's national health service to the United States' private health care delivery system.

The US spends over three times as much on administration of health care ($1,059 vs. $307, per capita), as Canada does. As a percentage, administrative overhead is 1.7% in Canada's NHS, but 11.7% among private US health insurers.

If America could recapture just half the difference in administrative costs between the US and Canada, it could pay for health insurance for every uninsured person in the entire country.

See my post about why Canada is able to charge so little for drugs.

Since drugs are a major fraction of healthcare costs, artificial suppression of costs passes the profit margin to other countries to provide.

Why do doctors from every country on the planet want to come to the USA? Because we pay them right well. Why do they not all leave the USA and flock to the "fair and balanced" systems in Canada and Euro? Duh, where would you go?

The USA has provided the majority of the drug and technological advances in medicine for the past 50 years. Could there possibly be a correlation?

Now lets all guess what the effect would be of stifling the reward system.

How much of our 401k's are invested in the healthcare industry? Lets have a show of hands of everybody who would forego their profits "for the benefit of healthcare"? Right.

Don't like it? Invent a better way rather than hobbling a system that works well for the majority of citizens.

Botsnt

Botnst, your 'system' is failing. If you can't recognize this fact, then you're not paying attention. The vast majority of citizens are slipping into the 'under-insured' category.

There are multiple definitions, and crass profit motives are but one measure of reward. Please re-read further up in the thread when we were discussing indirect benefits and costs. Our national 'reward' would be the elimination of a huge drag on our economy, not to mention having a healthier citizenry.

Its the same argument, just a different industry and product.

If we could only remove the dastardly profit motive from "X" industry, we could more equitably distribute "Y" product.

All industries follow the same rules of economics until governments start mucking around in their fundementals.

Want reform? Make each individual choose whether to have insurance and to pay the full price of the premiums or full price of his treatment.

Botnst

...there are social costs associated with your approach, do you really think these costs are sustainable given the rates of population growth and wealth inequality?

Again, what price do you put on surrounding yourself with a healthy, stable and well-educated populace? Universal access to preventive healthcare would save businesses billions in lost productivity, save millions of lives, and reduce the overall drag on our economy. Your insistance on hewing to purist Libertarian economics just doesn't make sense in this case.