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Health Care Reform

Discussion in 'All-Star Threads' started by bennyl, Dec 1, 2009.

  1. Crazy Wolf

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    You're as much "giving up" that money as you are putting it into a bank. The government uses your money to do things, that's your money running the government. This lets you step into government-owned land and say "this land is my land!" The soldier who defends you? Your money wasn't "given up", it was turned into his assault rifle. The government is of, by, and for the people. Your money that you just "gave up" is what keeps that banner flying, keeps your roads paved, your garbage cleaned up, your children fed and educated. The government exists to serve the people. If you feel underserved, then petition.


    There's a big difference between just questioning, and interfering. There must have been tons of Americans who thought we couldn't get to the moon within the decade, but did they attack NASA? Did anyone ever feel so strongly about the sovereignty of the Mooninites that they would filibuster for hours to delay NASA's funding for as long as possible?


    saintbastard: what I see from that is that Euro pharmacy companies benefited from government money, and then the French people reaped the rewards. Ideally, we could have a similar but concurrent system, where there's lots of R&D money from the govt. and pill prices are kept low for the consumers.
     
  2. DrFrylock

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    I haven't the slightest idea how to fix this problem.

    However, here are the characteristics of the system I want:

    • Rewards responsible behavior.
    • Punishes (or disincentivizes) irresponsible behavior.
    • Has reasonable controls for accidents of birth and fate.

    I want a system that rewards the person that works hard, lives below his or her means, contributes the most (as a percentage of disposable income, not a dollar amount) to healthcare, and saves for a rainy day. If I happen to make more than these people then I will happily subsidize their care.

    I want people to be held responsible if they skimp on health insurance and then use that money to buy a flat screen TV. I will pay a little extra to hire guards to prevent these people from getting anywhere near the ER.

    The last point seems to be one of great dispute. Most people, for whatever reason, seem to think that we should not deny (at least) emergency health care to even the most irresponsible people. What this means is that "emergency" rooms are full of very expensive, non-paying, non-emergencies (as Savage Henry eloquently points out). So the responsible end up paying either way.

    I do not want to pay for healthcare for the irresponsible, who will not pay their fair share. If, however, we are going to insist on providing some level of health care for everyone - even the irresponsible - then I want everyone to contribute a fair share under penalty of law. I would like people to have an option to contribute more (again, as a percentage of income rather than dollar amount) to receive a higher standard of care.

    Is the system so badly screwed up (through "insurance company greed" or mismanagement or whatever) that even responsible people who have bad luck are getting screwed over? Well, there is the alarming statistic that medical bills are a leading cause of bankruptcy in the U.S., even for people with insurance.

    Here's an interesting article from Consumer Reports on that very issue. Apparently, out-of-pocket expenses for major medical problems average $17,749 for insured and $26,971 for those without insurance.

    Those numbers are high, and we should work to get them down. But is an $18,000 "oh shit" moment really enough to drive that many people into bankruptcy? Is it that people are just living so close to their means that a medical issue is the straw that breaks the camel's back? This study is eye-opening - it indicates that while medical expenses play a role, the people put into bankruptcy are by-and-large those living so close to the edge that any disruption would have done it. Compared to non-bankrupted households, bankrupted ones:

    • Earn about half as much
    • Have higher mortgage expenses, in absolute dollar amounts
    • Have higher car payments, in absolute dollar amounts
    • Have TEN TIMES AS MUCH CREDIT CARD DEBT, in absolute dollar amounts.

    So these people have bigger houses, nicer cars, and more crap than non-bankrupted households, and I'm supposed to feel SORRY for them? What?!?

    The "case study" in the above Consumer Reports story seems to fit the pattern: a family bankrupted by an additional $18000 in medical expenses over two years. They were an ordinary middle-aged two-income family living in a part of the country with a very low cost of living. They had to sell their house and move in with their daughter until they could save enough to pay the security deposit on a small apartment.

    But wait, what? I have one income. It's a very good income. I don't have expensive things these people had - a house? children? Maybe someday I will be able to afford one of those two things if I keep saving. I have just the one car, and it has 180,000 miles on it. They have two. I already live in a small apartment. What I do have is enough in the bank to pay for an $18,000 medical expense if (knock on wood) I ever had one, even though I have had 15+ years less of life and income to save than these people.

    But now I have to pay for these jokers to BK out AND listen to them cry about it? Bitch please.

    I was a libertarian-leaning person until the recent housing crisis, which taught me one thing: Americans, on the whole, are irresponsible fucks that don't want to be held responsible for any stupid decisions they make, and will happily sell my very responsible ass up the river so they can live larger than me. The logical thing to do is for me to freeload with everybody else, but I will not. I draw the line there. This far, no further. I will not become a traitor to society even if the traitors are in the majority.

    If we are not going to physically prevent irresponsible people from walking into the ER and sucking on the generously-provided teat of the responsible, then we need a different solution. If that solution involves taxation at gunpoint to force these people to pay their share for the system, then so be it.
     
  3. Dcc001

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    This will be a long post, but I hope some of your read it. I think it gives a nice illustration of the implications of different systems – what it means to patients on the ground.

    Malaria In Dubai
    The malaria I had unknowingly contracted in Africa presented in Dubai. Typically, malaria is easily treated in an out-patient process. However, I had a massive allergic reaction to the drugs. I was in the Critical Intensive Care Unit for four days, the hospital for six.

    My symptoms included my liver shutting down, going temporarily deaf and a cycle of dry heaving that lasted twelve (yes TWELVE) hours and broke all the blood vessels in my eyes.

    I had two I.V.s, I was hooked up to a heart monitor, numerous X-rays and MRIs. The rooms (both in the CCIU and on the ward) were private and gorgeous. Cable TV, room service (had I been able to eat), the ward even had a built-in bed for relatives to sleep on.

    Dubai is a cash economy. I had to pay up front for all my treatment, because the hospital didn’t take insurance. If you wanted to use your insurance provider, they would provide you with the bills and you were welcome to submit a claim on your own time. I damn near died, and I was only saved because of the top-notch care and facilities.

    The bill came to roughly 11,000 CAD. I had purchased private health insurance for the year, at a cost of roughly $450CAD. Once the claim was filed, everything was reimbursed, including the airfare of one of my parent’s plane tickets (both of them flew out).

    Bronchitis In Canada
    I’ve had bronchitis since mid-September. Like, bad bronchitis. Cough-induced vomiting at least twice per day, inability to do anything physical beyond walking, terribly weak, etc.

    I’ll give a summation for the sake of narrative:
    · First doctor suggested I drink fresh-squeezed orange juice
    · Hospital doctor told me no less than three times this was an issue for my family doctor.
    · Second walk-in clinic doctor agreed with bronchits, but insisted on switching the medicine to a pill that made me sick and didn’t work.
    · Third walk-in clinic doctor didn’t speak much English. He cut the prescription I told him to, but refused to double the dose.

    There are two doctors in this city that I cold find who were taking new patients. I picked the female one. I made the appointment and waited two months to see them. They refused to take me on as a patient yesterday because my heath card is out-of-province, and they feared the claim would get denied when they submitted it. The claim was for $35. I offered to pay cash, and they explained that it ‘also created lots of paperwork.’ I was denied coverage at a Canadian doctor’s office because they were unsure of my insurance history.

    Bronchitis in Morocco
    It flared up last year. Again, quite bad. We were in the middle of nowhere and the only option was to go to a pharmacy. Typically pharmacists in developing countries know their shit.

    I started to talk to him, he interrupted me. I spoke no Arabic, he spoke no English. I shrugged my shoulders and coughed. He nodded, disappeared behind the counter, and came back with a box of pills. He pointed to the English doseage instructions, I paid him roughly $10CAD. Three days later the bronchitis was gone, although I took the entire course.

    Keep the government the fuck out of healthcare. As far as I’m concerned, they should abolish all clinics and offices in Canada and start fresh with a private system. As it stands, we have no choice right now except to go to a foreign country with cash.
     
  4. no use for a name

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    What about the lazy sacks of shit of America? The 20-40 year old, able bodied men that I see everyday on my way to and from work who sit around outside ALL DAY LONG drinking beer, smoking dope, and having a jolly old time on the dollar of hard working Americans. What about them?

    I couldn't give a fuck less if one of them needed health care and couldn't afford it.
     
  5. downndirty

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    I have far more questions than insights with an issue this complex but here are 4 questions that need to be asked:

    1. Why are we so sick? Or perhaps more accurately, why are we constantly seeking a medical professional?
    2. Why is getting treatment so expensive? (Price gouging companies, blank check insurance, bureacracy, incomprehensibly complex state laws, too many freeloaders, all have been mentioned and are valid points.)
    3. Why are the medical systems so overloaded? My theory is a combination of lack of knowledge of things like how bacteria, viruses, and allergies behave and maybe too much faith in medicine and doctors. It seems like if the average person knew first aid, the primary causes of normal illnesses (flu, cold, stomach, muscle) and how to treat the everyday stuff with over the counter stuff, the system would be a lot less congested. For example, recently everyone who has the flu goes to the hospital thinking it´s swine flu.
    4. At what point would a public system be ineffective? For things like flu shots, check-ups, and re-ups of prescriptions, sure I would go to a public doctor. For things like knee surgery, cancer or severe chronic illness (God forbid), I wouldn´t want to have to wait on...some fucker getting a flu shot, a check up or a prescription renewal, so bring out the private option.

    Also, found this on graphjam this morning:
     

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  6. Roboto

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    I don't know much about the law, insurance, or bureaucracy, but there is a weird discrepancy that's bothered me for some time. On daytime TV, the commercials are dominated by car wreck attorneys, who want to sue auto insurance companies for not paying enough. Why don't we see ads for lawyers advertising the same thing over health insurance?

    "Did you get cancer, and now your health insurance company refuses to pay? Call us!"

    Makes sense to me...
     
  7. The Village Idiot

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    Because generally speaking, HMO's (and insurance companies) are not considered medical practitioners (though they act like it, and if you did what they did, you'd have your ass in a sling), and can't be sued under a malpractice theory.

    However, insurance companies are sued for coverage - usually called a dec action in NJ - including medical coverage. However, these cases can be expensive to prosecute, and depending on the amount at issue, not economically viable under either a contingency arrangement or a billable hour arrangement.

    Edit: And based on my personal experience, most hospitals don't treat you (beyond emergency stuff) without funding - or a charity exemption - already in place.
     
  8. ghettoastronaut

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    I see nothing here but parroting pharmaceutical company lines, and blind obedience to the idea that anything that gives pharmaceutical companies more money is automatically a good thing.

    Drug cost development - yes, developing drugs is expensive. This is not new to me. But realize that a lot of what pharmaceutical companies are putting out now are hardly "new" drugs. Consider esomeprazole - it's a stereoselective compound of omeprazole, an achiral compound. In English, this means that an omeprazole pill contains two kinds of molecules, one of which is inactive; esomeprazole contains only the active molecule. Esomeprazole costs more than an order of magnitude more than omeprazole. I don't have any wholesale price lists or good references for U.S. data, but having checked a pharmacy blog and seen wholesale numbers quoted (the most accurate method, naturally), I've seen up to 1300 for a 90 day supply, down to the upper three figure range. In Canada, it's about 270 for the same amount. The same supply of (generic) omeprazole in Canada will be about 150 for the same timeframe. It strains credulity that the U.S price and market is the "only reason" that pharmaceuticals can operate profitably, and pharmaceutical companies (somehow) operate, willingly, at minimal profit for the rest of the world. The simpler explanation? Pharmaceuticals charge more in the U.S. because they can. I've handled one prescription for AIDS in my life, and the wholesale price for a 90 day supply of one drug (HIV/AIDS patients are usually on a minimum of 3 drugs) was on the same order as the wholesale price for esomeprazole in the U.S. That, sir, is fucking insane.

    The economic incentives for drug companies are already to keep costs down and maximize profit, and the way they keep costs down is by doing as little real research, making as few groundbreaking therapies as possible, and filing lawsuit upon lawsuit to extend patent rights on as ridiculous grounds as possible (the makers of desloratidine/Aerius, the active metabolite of loratidine/Claritin, tried to sue for market exclusivity on the basis that generic loratidine violated desloratadine's patent because it is biotransformed into desloratidine by your liver, a common phenomena). The big direction new drug research is going these days is into biopharmaceuticals (antibody therapy and so forth), and a lot of that is done by biotech firms which are then bought up by big companies once a promising therapy comes down the pipeline.

    Notice that I am not saying that oncology drugs, or new broad-spectrum antibiotics, or chimeric antibody therapy cost too much. These drugs do represent badly needed and novel therapies which are very expensive and research-intensive to produce. I am also far from saying that patent rights need to be infringed upon. In fact, I would support changing patent laws to guarantee companies a minimum time from the day the drug is licensed until the patent expires (the current model is 20 years from the day the patent is registered, and sometimes extended based on various circumstances). But on the topic of patent laws - drug prices have been creeping up and up over the years, even as laws on patents favour the drug companies more and more. In Canada, it used to be that even when a drug company came out with a new patented drug, generic companies were allowed to make copies of it and pay a fee to the original manufacturer, whether or not the original manufacturer liked it. With NAFTA, the 20 year patent law came on the books, and you would think prices could go down now that companies actually had market exclusivity. That hasn't happened. You would think the new influx of cash would lead to more research in badly needed areas of therapy, like new antibiotics, but research has veered away from that direction. Esomeprazole is no pirenzepine.

    I don't know why you say that I don't understand the market forces behind advertising. It seems to me you don't understand the medicine side of it. Now, by profession, my interest is in the patient, and in keeping costs for the whole system down. That is to say, the patient should receive the medication that's necessary for them; and if that can't happen, they should go on an adequate therapy they can at least afford. Direct to consumer advertising results in over-prescribing (see: marginally improved but vastly more expensive new formulations of old drugs). I'm not used to seeing it in Canada, but it seems that physicians in the U.S. are in love with prescribing brand name drugs and specifically preventing a generic from being dispensed (at least until they discover the patient's insurance won't cover it). Now, if the health care system was entirely privatized, I wouldn't have much of a problem with this (your money to spend as you choose, really). But when the government steps in and starts paying for drugs, which is done to an extent in the U.S. and moreso in Canada, it seems to me that it's within its purvey to take reasonable steps to control drug costs; banning direct-to-consumer advertising is one way to do it. Getting other health care professionals like pharmacists more involved in the process of giving out drugs also reduces cost (to the point that in hospital, pharmacists can save the hospital more on drug costs than they earn when properly employed). As for controlling drug price, I'll admit that legislatively enforcing the price of patented drugs seems more than a little anti-free market and definitely won't show up in U.S. health care anytime soon. I'm not even quite sure why it works in Canada, seeing as it isn't legally binding, although there is something distinctly Canadian about getting cheaper drugs by asking politely.

    I hate to tell you this, but you ran into a couple of idiotic doctors, not a wider symptom of a broken health care system. Doctors aren't going to stop being stupid if their money comes from private sources. Furthermore, it's not as though you will have an easier time finding a family doc under a private system. There'll still be the same number of docs running around as before. They aren't created by abiogenesis. Doctors these days are working fewer hours and retiring earlier than the physicians of yesteryear, female doctors especially.
     
  9. KIMaster

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    People who I can understand supporting Obama's health care plan;

    -Illegal immigrants
    -Homeless
    - Extremely low-income

    People who I don't understand supporting supporting Obama's health care plan;

    -Middle, working class
    -Upper class

    It's astonishingly simple; paying ten years of taxes for 5 years of free healthcare is a horrible deal if you already have health insurance through work, and it's also inferior to getting it privately. Regardless of whether you choose private or public under the proposed plan, you have to pay taxes anyways. You get nothing in exchange for thousands of wasted dollars.

    However, if one doesn't work, and by extension, doesn't pay taxes...well, health care reform is a great idea! You get something for nothing!

    That's really all there is to it. As someone who does research in economics, I also have to wonder about the wisdom of significantly raising taxes during a depression, but hey, that's just me...
     
  10. thatone

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    We have no state income tax, the only sales tax is a Goods and Services tax which is 10%. There are additional taxes on cigarettes, booze & fuel. These three items do not constitute a significant proportion of my expenditure. My overall taxes would be about 40-45% of my income. It isn't ideal but it is the price to pay to live in a somewhat civilised society.

    However, to say that the overall tax burden reaches 80% is ridiculous.

    The country is Australia. To reach the "$20,000 to the government" you shrieked about earlier would mean that someone would be earning close to AU$1.3m pa. As far as I'm aware, the last discussion in this country regarding the financial feasibility of the medicare program was a few years ago, where the government introduced legislation which gave tax benefits for people who took up private health insurance.

    However, as a proportion of GDP, we spend a bit less than half of what the US spends on health care yet everyone has access to the system and no-one lives in fear of being denied treatment as a result of a decision made by an insurance company drone.


    Who controls the health care system now? Private enterprise.

    What is their primary motive? Profit.

    Does this profit motive result in mutually beneficial outcomes for private enterprise and consumers (sick people)? Sometimes. But when the easiest way to increase profitability is to cut costs, and the easiest way to cut costs is to deny treatment, you have given private enterprise one hell of an incentive to look for reasons to cut people loose.

    If your government runs health care for the military and senior citizens, why can't it do the same for the general population?
     
  11. Robbie Clark

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    It has been said and shown many times in this thread that private enterprise is not in control of health care in the US. You can find huge amounts of evidence for this position. So your starting assumption is wrong and you can prove anything if you start from a false premise.

    Also note that veterans care is typically shit in this country. Just google Walter Reid hospital. Veterans care is a very poor example if you're trying to promote the idea that government (at any level) would run the health care system well. The political motive substituted for the profit motive is the main reason for government failure being so rampant.

    Edit: Had profit and political backward.
     
  12. scotchcrotch

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    I have a crazy idea, so we have the most expensive health care in the world yet aren't even in the top 20 in regards to quality of service.

    How about we audit the health care system and insurance industry and find out why we're paying so much for so little?


    Everyone does know that Social Security is insolvent and Medicare is fast approaching, right? I wouldn't plan on SS supplementing your retirement if you're not retiring within the next 20 years.


    As with most social issues, there needs to be a happy medium. No one wants health care they can't afford and "free" health care is a pipe dream that isn't going to be funded by the richest citizens. Tax revenue estimates are always off, we're going to run up the deficit causing inflation, and yes, the average American will end up paying for this in the long run in one form or another.

    So let's audit the system first, and then on to Tort reform.

    As far as Obama's plan to tax businesses that don't supply benefits, coming from a small business owner, there's no stipuation that I can't just cut their salary and use the extra money to supply benefits. But career politiicians don't think about stuff like that when they have their own benefits.
     
  13. Dcc001

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    I agree with you in some respects. Yes, if we suddenly made Canada's healthcare system private and for-profit tomorrow I have every confidence that the receptionist at the clinic yesterday would have her beady little bureaucratic eyes light up and would simply start charging money for the exact same level of care that they are providing now.

    I don't pretend to have the slightest idea as to how to fix our system...it is so complex and deeply entrenched. However, I strongly feel that the doctors and clinics in Canada are substandard, as compared to a private system. No way would a doctor as talented and knowledgable as the one who treated me for malaria in Dubai work in Canada - what would her motivation be? Long hours, bad pay and substandard equipment?

    Apart from two solid family doctors that I've had in my life, not once - not once - has a Canadian doctor impressed me. I could go on and on.
    - my uncle drove himself to the hospital two weeks ago. He complained of feeling ill. He waited several hours, and once he was admitted they realized he was bleeding internally and had to be transfused with four pints of blood.
    - my dad has collapsed several times. Once, he was even rushed to the hospital in an ambulance. No doctor has been able to diagnose anything, despite extreme symptoms. He suspects there's something wrong with his heart, but no one will listen.
    - my uncle had a bad heart, and a bad ankle. He had to wait two years for a test that measured his heart without requiring him to walk/run (as on a treadmill). He had quadruple bipass the next day because the blockage in his heart was so severe.

    This is across three different provinces. I have no clue why people claim our system is so good. If they'd ever seen what the private sector could offer, they'd shut up. I would gladly pay money I didn't have if I could get my father treatment, my uncle diagnosed (they still don't know why/where he's bleeding), or to remove the two years of my other uncle's life where he was unable to even walk out to the barn.
     
  14. MooseKnuckle

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    Exactly! And my point is that I would be better off if I got to keep and spend the majority of my own money. Some of the things that government is doing with our money:
    -$2.3 million for the U.S. Forest Service to rear large numbers of arthropods, including the Asian longhorned beetle, the nun moth and the woolly adelgid.
    -$3.4 million for a 13-foot tunnel for turtles and other wildlife attempting to cross U.S. 27 in Lake Jackson, Fla.
    -$300,000 for a GPS-equipped helicopter to hunt for radioactive rabbit droppings at the Hanford nuclear reservation in Washington state.
    -$219,000 for Syracuse University to study the sex lives of freshmen women.

    If I spend $10,000 myself, I get things that are worth $10,000 to me. If the government spends $10,000 of my money, I'll maybe get services worth $5,000. So no, I don't think the bank analogy fits this situation. A bank will give me interest, not a negative return on my investment. And I realize that I'm providing extreme examples that one could argue should be left out of the debate. I'll give you that. But if THAT is what is allowed to be an extreme example, I don't want to know what passes as 'worthwhile spending'.

    I don't disagree with anything you said. You're taking my "gave up" words too literally. Not many people are going to raise a stink over paying taxes for the military, roads, garbage, education, police and fire departments. That's what government is for according to the philosophies of Locke and Hobbs that this country was mainly founded upon. But when we start nearly half of our income to government so they can not only protect us from each other (the social contract), but protect us from ourselves and provide what we should be providing for ourselves, that's where I draw the line.

    I think I've contributed as much to this thread as I'll be able to because I feel like I'm repeating myself and straying off focus, but I'll add something that I think I said in the double standards thread. The government should be in the business of providing an equal opportunity to the citizens. That means everyone is treated equal and in this area of discussion, nobody is denied health care by the government's actions. I don't see any government officials directly taking health care away from people or denying them care. In theory, everyone can go out and buy health care if they want. But instead of ensuring equal opportunity, we're moving toward providing equal results. When government tries to provide everyone with equal results, more often than not they only succeed in making everyone equally miserable.

    And I appreciate how civil and respectful this discussion has been. Tip of the hat to everyone for that.

    Edit:
    So you're saying that the ONLY taxes someone who makes $1,300,000/year pays is 1.5%? Why isn't every millionaire in the world living in Australia? Is the exchange rate messing with my perception? What am I missing here? Because in some state in the US, someone making millions of dollars can fully expect to pay 70% of their income on taxes. Not just income, but EVERY tax on all levels of government.
     
  15. SaintBastard

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    Something is better than nothing. Once a drug is developed, the marginal costs of production are low enough for branded pharmaceuticals to cover them even with prices that are significantly below their average total cost. So, there is a strong incentive for drug manufacturers to accept the prices offered by a regulatory board rather than holding out and perhaps getting nothing, especially if they can recoup the difference in more profitable markets such as the US. Over 60% of global pharmaceutical profits come from the US. If you kill the golden goose, don’t be surprised when operating models change and innovation slows.

    You seem like a smart guy, but you can’t keep breaking down business problems into these absurd dichotomies. Every business decision is made on the margin. Price controls in the U.S. won’t be the end of pharmaceuticals or innovation, but we will see (as we already have) branded pharmaceuticals continue to branch out into generics and consumer products, significantly decrease their R&D expenditures and thereby slow the pace of medical progress.

    I questioned your grasp of the industry because your reasons for banning direct-to-consumer advertising makes me wonder if you’ve ever seen an income statement before. Sure, it’s a contentious issue and banning that form of advertising will appease certain subsets of the population, but it will do fuck all to the company’s bottom line. They wouldn’t spend the money if the additional sales didn’t make up for it.

    But like I said, this is not going to happen in the US anytime soon, so it shouldn’t be a large part of the debate. Until then, enjoy your cheap drugs, fucker.
     
  16. Natty

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    I believe any American tax payer should have access to affordable, quality health care. Please note the operative words in that assertion. American. Tax Payer. Affordable. Quality. I don't think that this is too much to ask in a society that boasts promotion of the welfare of its constituants. Can it be done? I don't really know. To me, a complete dullard in this arena as I've used my healthcare plan all of 5 times in the last decade, it seems like weening ExxonMobile from gasoline to alternative energy sources.

    General practitioners to surgeons to insurance companies to drug companies have been making a shit-ton of money for a long time now, and the type of reform proposed [seems to] jeopordize a model that has been very profitable for few. However, I don't believe, nor do my friends who are in fact doctors, that the health and welfare of our countrymen should have a price tag associated with it. But there I go being idealistic again.

    In all, I think anything that gets passed is going to be an extremely cumbersome process with a littany of obstacles and red tape, but I hope that in the decades to come it makes us a stronger nation.
     
  17. Crazy Wolf

    Crazy Wolf
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    MooseKnuckle: assuming Warren Buffet isn't a fucking liar, he pays a 17.7% tax rate. His employees payed an average of a 32.9% tax rate. Granted, he's a billionaire and not a millionaire, but I don't think the taxation sliding scale is supposed to punish you for making less money.

    When it comes to availability of healthcare: yeah, health insurance is equally available to all private citizens. Just like a Ferrari is*.

    I'm not saying we need to provide equal results and give everyone free shiatsu massages and blowjobs with their government healthcare, but I think there's a basic level of care that should be provided to all citizens.


    *Ferraris cost more than most healthcare plans to maintain for the length of your life, but I think you got my point
     
  18. scotchcrotch

    scotchcrotch
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    This post is assuming that health care reform would create massive inflation because there is no such thing as a "deficit free" health care plan. The very idea of this is both mind numbing and insulting to the public.

    To those that would like us to adopt Europe's health care system-

    [​IMG]

    Obviously, this is before any health care reform. Our inflation is comparative without the rest of the world, and we don't even have health care! Where the hell are we spending it all?

    Can you imagine our inflation after the trillion dollar reform that is supposedly "deficit neutral"? I find it hard to believe we could balance this expenditure considering how well we've done so far.

    Every American citizen benefits from our status as world leader right now, whether it be through our military, relatively strong economy, etc. To keep it simple, WW3 happens tomorrow, who's going to protect you?

    If we adopt health care reform in its current form, the global power that is the US will suffer significantly and maybe by then the dollar will still be worth enough to buy a ticket to socialist Cuba.

    If you're an American citizen and you're going to die from lack of health care, you should either- a) sign up for medicaid b) reallign your priorities.
     
  19. MooseKnuckle

    MooseKnuckle
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    It doesn't. Top marginal rate is 35%. I don't know where those numbers came from but it wouldn't surprise me if he pays that rate. I'm not sure what the guy has for taxable income anymore. And when you own as much property and investments and shit as he does, you can write off a whole fuck load. But to some Average Joe employee with a good job who pulls in a couple million dollars, he'll pay 35% in federal taxes. If he lives in the state of NY he'll pay about another 9% to the state. If he lives in NY city, he'll pay about another 12.5% Source. Added all up, that's 56% just in income tax.* That's money that he never even sees. Now throw in property tax and sales tax and all the other taxes I've mentioned before and you're talking about a lot of fucking money. I don't care how rich someone is, I don't think it's right that they should be stripped of that much of their money. And I don't think they should be forced to either take it up the ass or move to a different location just to avoid this kind of tyranny from the governments.

    *I'm no accountant so maybe I'm not figuring this out properly.

    Again, I'll agree with you on this. Government should provide some basic level of service. But not to everyone. I just don't see it being feasible. What they should provide is a safety net for those who are in extraordinary situations and can't get coverage/pay bills. The rest of us will just have to make a decision between insurance and that new car or TV. Prioritize and take some personal responsibility for yourself. If you don't then that is fine and well within your rights as a human. But don't expect me to foot your bill.

    I make between $20,000 and $25,000. Not much at all. And this is a job that anyone can get. You should see the fucking street bums my company hires. You need no education other than a GED. And you need no skills other than not being a complete waste of space. Through the company I get insurance for about $80/month. It's really not that hard to get a job with an employer that offers insurance.* And I don't like the idea of some fuck up riding on the coattails of what little money I make. Maybe I'm just too cruel and heartless, but I have no sympathy for someone who can afford insurance but opts for the plasma instead.

    *Seriously, if you want a job you can come here and apply at my company. If you can walk and breath they will hire you. And unless you rape someone, quit or fail a drug test, you'll keep that job as long as you want.
     
  20. Mild Sedative

    Mild Sedative
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    I try to follow what economic news, I can, and honestly, I can't say whether or not this heath care reform will work as well as anticipated. I do know that one thing that it promises to fix is the sheer number of bills paid for emergency services. The last time I was in the hospital (it was for a ski accident) I was flooded with bills for the next month or so. An ambulance bill, an x-ray bill, a doctor's bill, and a separate bill for a dozen other small things they did to me. If any one thing happens with this reform, I hope to God that I can get one single bill for emergency services. The last thing you need in recovering from a spinal injury is the stress of getting bill upon bill and not knowing when they'll stop.