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Topic Title: Big Pharma
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Created On: 08/24/2016 07:02 AM
Linear : Threading : Single : Branch
 Big Pharma   - miker - 08/24/2016 07:02 AM  
 Big Pharma   - WG - 08/24/2016 07:06 AM  
 Big Pharma   - miker - 08/24/2016 07:09 AM  
 Big Pharma   - RustyTruck - 08/24/2016 07:16 AM  
 Big Pharma   - miker - 08/24/2016 07:24 AM  
 Big Pharma   - Greensleeves - 08/24/2016 07:27 AM  
 Big Pharma   - RegularJoe - 08/24/2016 08:41 AM  
 Big Pharma   - RustyTruck - 08/24/2016 07:39 AM  
 Big Pharma   - StirfryMcflurry - 08/24/2016 07:42 AM  
 Big Pharma   - Cole - 08/24/2016 07:57 AM  
 Big Pharma   - miker - 08/24/2016 08:03 AM  
 Big Pharma   - Cole - 08/24/2016 08:09 AM  
 Big Pharma   - SlimyBritches - 08/24/2016 09:31 AM  
 Big Pharma   - RustyTruck - 08/24/2016 10:20 AM  
 Big Pharma   - Cole - 08/24/2016 10:33 AM  
 Big Pharma   - tpapablo - 08/24/2016 11:02 AM  
 Big Pharma   - Cole - 08/24/2016 12:29 PM  
 Big Pharma   - miker - 08/24/2016 12:33 PM  
 Big Pharma   - RegularJoe - 08/24/2016 12:37 PM  
 Big Pharma   - miker - 08/24/2016 01:20 PM  
 Big Pharma   - scombrid - 08/25/2016 05:36 PM  
 Big Pharma   - RegularJoe - 08/24/2016 11:17 AM  
 Big Pharma   - RustyTruck - 08/24/2016 08:07 AM  
 Big Pharma   - WG - 08/24/2016 08:51 AM  
 Big Pharma   - Cole - 08/24/2016 09:35 AM  
 Big Pharma   - SlimyBritches - 08/24/2016 10:27 AM  
 Big Pharma   - RegularJoe - 08/25/2016 06:27 AM  
 Big Pharma   - RegularJoe - 08/24/2016 10:06 AM  
 Big Pharma   - Pagerow - 08/24/2016 11:15 AM  
 Big Pharma   - tpapablo - 08/24/2016 12:17 PM  
 Big Pharma   - jdbman - 08/24/2016 12:27 PM  
 Big Pharma   - WG - 08/24/2016 12:28 PM  
 Big Pharma   - tpapablo - 08/25/2016 06:57 AM  
 Big Pharma   - WG - 08/25/2016 07:56 AM  
 Big Pharma   - RegularJoe - 08/25/2016 08:50 AM  
 Big Pharma   - tpapablo - 08/25/2016 01:07 PM  
 Big Pharma   - RustyTruck - 08/24/2016 06:48 PM  
 Big Pharma   - WG - 08/25/2016 01:21 PM  
 Big Pharma   - RegularJoe - 08/25/2016 02:30 PM  
 Big Pharma   - RegularJoe - 08/25/2016 02:34 PM  
 Big Pharma   - RustyTruck - 08/25/2016 05:20 PM  
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 08/24/2016 07:02 AM
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miker

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I mostly lean libertarian because, to me, it is by far the best option compared to the republican and democratic parties. One thing I am not always 100% on with extreme Libertarianism is the far end of market deregulation. We have active instances where there is a monopoly, collusion, and/or gouging involved in certain industries.

A current example of this is with drug companies. They jack up prices for no other reason than to line their pockets at the expense of the people who rely on those medications. They have politicians bought and paid for as well as influential people in regulatory government institutions.

It has gone on long enough and the citizens of this country have allowed it. People are getting hurt and are dying because they can no longer afford medication that was jacked up in price to line a pharma executive's pockets. People who depends on medication to live a normal life are suffering as a result.

People no longer have control of their own health because of bribes paid to officials in government institutions like the FDA. Pressure on those institutions from elected officials that were lobbied and/or had their campaign financed by these companies. These very same bought and paid for congressmen and senators pushing legislation through that hurts the American people and assists the pharma companies.

It has to stop.

 08/24/2016 07:06 AM
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WG

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Health care is never really a free market.
Most nations have figured that out.

-------------------------
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malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill
 08/24/2016 07:09 AM
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miker

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Originally posted by: WG Health care is never really a free market. Most nations have figured that out.

It 'could' be in an ideal situation. The situation, however, will never be idea in this country. We have an issue of corruption in our government at a very base level that will prevent it from ever becoming idea.

 

Bernie had the right idea on so many things, it is just too bad he had just as many wrong.

 08/24/2016 07:16 AM
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RustyTruck

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The free market has no (or very limited) business being involved in healthcare.

The price elasticity of demand is very low for most healthcare products and services. Therefore we must collectively control the market for the good of humanity.

Let the free market work where it should, cheap pizza, cars, personal electronics, so forth.

When capitalists get control of the medicine you or your child needs, raise the price 500% (PharmaDouche, EpiPen) then you should join the revolution.

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“It is the heart of US policy to use fascism to preserve capitalism while claiming to be saving democracy from communism “ - Michael Parenti
 08/24/2016 07:24 AM
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miker

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Originally posted by: RustyTruck  When capitalists get control of the medicine you or your child needs, raise the price 500% (PharmaDouche, EpiPen) then you should join the revolution.

Revolution is needed for Pharma.

 08/24/2016 07:27 AM
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Greensleeves

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That epipen crap drives me nuts.   FDA kicks one competitor out and drags heels on allowing the generic into the market!

Result: skyrocketing prices absorbed by insurance companies for those lucky enough to have it.  The rest put in danger!

Frigging lobbyist/revolving door craziness!

 

 08/24/2016 08:41 AM
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RegularJoe

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Originally posted by: RustyTruck
The free market has no (or very limited) business being involved in healthcare.


I could not disagree with you more. I'm not saying government doesn't have a place in health care, but innovation, competition, and alternatives are not going to exist without free-market involvement.

If it's all government and only government, then your choice is limited to what they provide. If there is no non-government market here, you can still spend your money overseas, but why not spend that money here and innovate here?

Part of the problem here is the mindset of people -- as if there is some inherent right to live forever, and every penny available shall be spent to do so.

But another huge part of the problem is the corruption and marketing, as miker and Rusty pointed out.

When you look at drug pricing, there is SOOOO much wrong. I'm not sure how long patents protect medical products, but if it's 17 years like most objects, that's not an eternity. Once a patent has expired, the prices should drop radically to just above manufacturing cost plus a small business overhead and profit.

I had to get some eardrops for my daughter a few years ago. It was a "new" formulation with only one manufacturer, and the price was about $1000 per ounce. ($250 for a 1/4-oz bottle). It was nothing but a combination of two meds with long-expired patents -- a steroid plus an antibiotic -- that cost a few bucks each separately.

We have the problem of US big pharma using US citizens (and government and insurance companies) to subsidize the discounts they provide to the rest of the world. It's hard to negotiate prices here, in part due to protections, and that has to stop.

So much of it all is so f**ked up, but so much of that has to do with regulation. Every new regulation comes with a cost of compliance, and spawns one industry to ensure compliance and another to figure out ways to get around it or maximize profit from it.

I don't trust our government to do many things right. A free market provides an alternative when they don't. What's unfortunate is that legislators have allowed the "free market" to draft much of our legislation to benefit itself.
 08/24/2016 07:39 AM
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RustyTruck

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We need Bernie people for a job like cleaning up Big Pharm. H Dog isn't going to be much help.

The advertising part pisses me off the most. We have a nation of people doing self diagnosis and demanding the latest potentially dangerous drug because some paid actor on TV between ads for gold on Faux looks like he's having a great time banging women half his age. "Doc I've got XYZ, give me what the shirtless tan guy riding a horse on the beach is having!"

They're pushing pills like they were selling soft drinks.



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“It is the heart of US policy to use fascism to preserve capitalism while claiming to be saving democracy from communism “ - Michael Parenti
 08/24/2016 07:42 AM
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StirfryMcflurry

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It has gone on long enough and the citizens of this country have allowed it.

 

 

It has to stop.

 

Good luck with that

 08/24/2016 07:57 AM
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Cole

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My son's current Epi pen expires in a month.

I'm oh so excited to buy the new one. I'm exited that the new one will expire in a year too!

I should at least get a thank you letter from the CEO to thank me for my contribution to her $18,000,000 raise.

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 08/24/2016 08:03 AM
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miker

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How old is your son?

Are epi ampules and drawing your own an option?

 

Can get the eqiovlent of three regular epipen's for around $5 online ...then just add in the price of of syringes and needles.

 08/24/2016 08:09 AM
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Cole

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The pen is the only option right now. Extra time can be fatal. Would you take the chance?

And he won't outgrow the allergy.

I've paid $20 some-odd thousand in medical expenses in the last several years, what's $300 more....

And no, I don't have Obamacare.

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 08/24/2016 09:31 AM
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SlimyBritches

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Originally posted by: Cole

The pen is the only option right now. Extra time can be fatal. Would you take the chance?



And he won't outgrow the allergy.



I've paid $20 some-odd thousand in medical expenses in the last several years, what's $300 more....



And no, I don't have Obamacare.


I pay over 20000 a year with no ACA. The guy on the TV said that the most expensive part of the epi pen is the pen not the serum. He suggests using hypodermic needles that one fills manually.
 08/24/2016 10:20 AM
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RustyTruck

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Originally posted by: Cole

The pen is the only option right now. Extra time can be fatal. Would you take the chance?



And he won't outgrow the allergy.



I've paid $20 some-odd thousand in medical expenses in the last several years, what's $300 more....



And no, I don't have Obamacare.



Epinephrine is one of the most common emergency drugs, and it sounds like there's about $1 worth of epi in each autoinjector. I would make a new one daily and teach my kid to self inject.

That said, this sort of thing is an example of the "free market" when it's unregulated, and that's what I was referring to. The "free market" trends toward monopoly over time, and that's what big business likes. They pay lip service to the benefits of competition, but in business school they teach you how to "protect your market share". That means stopping anyone from offering an alternative, and those barriers often are created politically.

To me, the opposite of "free market" is a regulated market, not "no" market.

The only people in politics we can trust on something like this are Bernie and Liz Warren. You may not agree with them on everything, but they will damn sure get your kids an affordable Epipen if they need it.



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“It is the heart of US policy to use fascism to preserve capitalism while claiming to be saving democracy from communism “ - Michael Parenti
 08/24/2016 10:33 AM
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Cole

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The mandate to use electronic health records or lose a percentage of Medicare reimbursements is one of many examples. If it were cost-effective and profit-driven, it would be adopted voluntarily.

Possibly, but I find it hard to believe that a $4,000 visit to the ER can be justified by higher administrative costs?

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 08/24/2016 11:02 AM
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tpapablo

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They jack up prices for no other reason than to line their pockets at the expense of the people who rely on those medications.

That's what capitalism is about. All businesses do that. Not a very libertarian viewpoint.  If I really, really need to surf, should shapers lower their profit margins for me?



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 08/24/2016 12:29 PM
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Cole

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Originally posted by: tpapablo

They jack up prices for no other reason than to line their pockets at the expense of the people who rely on those medications.




That's what capitalism is about. All businesses do that. Not a very libertarian viewpoint.  If I really, really need to surf, should shapers lower their profit margins for me?



Shapers have lowered their profit margins for you. They work on a what, 30% markup?

P.S. Not surfing won't kill you.



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 08/24/2016 12:33 PM
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miker

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Originally posted by: tpapablo
They jack up prices for no other reason than to line their pockets at the expense of the people who rely on those medications.

 

That's what capitalism is about. All businesses do that. Not a very libertarian viewpoint.  If I really, really need to surf, should shapers lower their profit margins for me?

 

 

Not the same thing really. If you had a shaper with a monopoly on a product off patent that he helped cause and then threw money at politicians to keep it that way while jacking up the prices 1000% ... You would at least be ball park, except for the whole lives at stake thing.

 

Letting the free market determine price would and will work.... But not when there is corruption and collusion. It requires a fair and level playing field.

 

 

 08/24/2016 12:37 PM
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RegularJoe

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Long and interesting article (and a few reader comments) here:
https://mises.org/blog/how-gov...ealthcare-so-expensive

I've finished a speed-read of about 2/3 of the article so far.

A lot of it seems based on:
1) supply & demand
2) supply & demand
3) supply & demand
4) what suppliers perceive buyers will pay
5) what buyers are actually paying when insurance contributes a chunk
6) what insurers are paying when government-subsidized insurance leads the way
7) supply & demand
8) what happens when government lets doctors and med schools limit the supply

For fun, google "certificate of need new hospital"
http://www.modernhealthcare.co...123/magazine/301239964
https://www2.ncdhhs.gov/DHSR/coneed/index.html
http://ahca.myflorida.com/MCHQ/CON_FA/

e.g.,
Dr. Mark Monteferrante didn't think it would be so hard to help his radiology group's office in Northern Virginia buy a second MRI machine in 2003.

But it took five years and more than $175,000 in lawyers' and other fees to get that second machine.

The reason? Virginia's certificate-of -need law, which requires owners of medical facility-care projects to prove public need and get approval for their projects before embarking upon them.


Back when my mom was battling cancer, I remember reading about a lawsuit in Georgia by one oncology service provider to prevent a nearby competitor from buying a new (and better) radiation machine, trying to leverage their CON laws. Disgusting.


Related to earlier part of thread: That 2.3% medical device tax increased the cost of a $500K MRI machine by about $11K. And we know that cost is not simply absorbed by its manufacturer...

DNA analysis providers like 23andMe used to provide a full map (at very affordable prices) about whatever they could decode regarding your genome when you sent them a sample.

Now they are limited to just providing ancestry information, like "Your ancestors lived in Scotland." A total waste of capability.


Edited: 08/24/2016 at 01:04 PM by RegularJoe
 08/24/2016 01:20 PM
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miker

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What happened to 23andMe is a tragedy. APOE mutations are the greatest single factor when determining Alzheimer's, dementia, and heart disease risk and they used to show your result. (Still do in Canada)

 

Your risk and how you should eat to mitigate that risk could save so many people from health problems and the insurance industry billions... But the FDA *cough* cracked down on them. Wonder why....

 

This is the reason why nutrition recommendations give mixed results, because genetics aren't taken into consideration in older studies. Some people are better with a high healthy fat, low carb diet and others are better with high healthy carb and low fat.

 

 

 

 08/25/2016 05:36 PM
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scombrid

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Originally posted by: tpapablo 

 

That's what capitalism is about. All businesses do that. Not a very libertarian viewpoint.  If I really, really need to surf, should shapers lower their profit margins for me?

 

 

Define need?

Is it like needing a kidney or an antibiotic for a staph infection?

A standard principal of free market capitalism is that all transactions are between fully consenting parties without coersion. There are cases in medicine where the provider has a lot of leverage that a surfboard shaper does not, no matter how much you "need" to surf.

There are natural monopolies in health care. These may exist when demand volume is low but the demand that exists is critical to the demandee. In these cases the high price of the product or service will not entice new players into the market because the volume of demand is too small. Rare fatal diseases with expensive cures or treatments fall into this category. The price naturally has to be high for any profit at all. Sucks if you ever need such a service or product. Double sucks if the provider takes advantage of the monopoly to gouge. Life saving products and services that fall into this category should probably be price controlled if not outright subsidized.

Of course there are a multitude of regulatory monopolies, patent manipulators, etc... We obviously need to fix these.

Then to really control costs I could write my canned rant about the insurance market and how we pay for basic care but that horse is liquified. Or you could just go read a Milton Friedman essay on the topic that dates back to 1968.



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 08/24/2016 11:17 AM
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RegularJoe

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Originally posted by: Cole
Possibly, but I find it hard to believe that a $4,000 visit to the ER can be justified by higher administrative costs?


Sorry for the unintended pun, but that's a case of death by 1000 cuts.

No, it can't be justified solely by higher administrative costs. Every single aspect associated with your visit contributes to its total cost.

Nobody works for free. Every human who touches the process is going to get some money out of it somehow, and the more people and factors involved, more will be taken and more of it will be obscured in that lump sum.

That starts to make the case for Rusty's goal of a full NHS, but government bureaucrats tend to be less motivated, less productive, and harder to fire than private-industry counterparts. They're also very well versed in creating regulations to justify and expand their empires. SpaceX vs. NASA and the old-school rocket providers make for a good example.

More and more good doctors locally are starting to refuse not only Medicaid and Medicare patients, but rejecting insurance entirely and only dealing with self-pays. They can often provide better care, cheaper care, and make more money themselves by doing so.
 08/24/2016 08:07 AM
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RustyTruck

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What Mike said. Make your own epi "pen".

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 08/24/2016 08:51 AM
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WG

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I sort of agree, we don't want to eliminate the free market from health care, no country has done that either.
But we have to understand that market incentives just don't work completely in this arena

People don't shop around when they are sick.
We mostly can't know enough to make very well informed choices.
And we are not just going to let poor sick people die.

-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill
 08/24/2016 09:35 AM
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Cole

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I hear a lot about regulation driving up cost, but never see links to real information.

The same was said about lawsuits, but that was shut down in Florida - you can't sue for anything unless a body part is missing - and cost has done nothing but rise.

Joe, can you provide a source for your regulation comment?

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 08/24/2016 10:27 AM
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SlimyBritches

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Originally posted by: Cole

I hear a lot about regulation driving up cost, but never see links to real information.



The same was said about lawsuits, but that was shut down in Florida - you can't sue for anything unless a body part is missing - and cost has done nothing but rise.



Joe, can you provide a source for your regulation comment?


This is what drives up costs.
http://usuncut.com/class-war/pharma-ceo-epipen/
 08/25/2016 06:27 AM
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RegularJoe

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Originally posted by: SlimyBritches
This is what drives up costs.
http://usuncut.com/class-war/pharma-ceo-epipen/


As long as corruption is part of the discussion...

What is the chance that any of the FDA's stonewalling is related to the fact this pig of a CEO has a daddy in the US Senate?
 08/24/2016 10:06 AM
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RegularJoe

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I'll let you do the googling; there are so many places to begin. The mandate to use electronic health records or lose a percentage of Medicare reimbursements is one of many examples. If it were cost-effective and profit-driven, it would be adopted voluntarily. Instead, it has spawned a software industry that has a captive audience. Yes, there are benefits to EHRs, but the return on financial investment for them is questionable, and claims about medical efficacy (in terms of ROI) are specious and subjective at best.

Sort of like ISO-9000 and stuff... Your company knows fairly well what it needs to do to remain competent and competitive without ISO, but probably spends a decent chunk of change on audits, documents and policies and inspections to prepare for audits, etc... Again, not inherently bad, but questionable ROI.
 08/24/2016 11:15 AM
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Pagerow

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Should our healthcare be part of the Capitalist part of America?

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 08/24/2016 12:17 PM
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tpapablo

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Originally posted by: Pagerow Should our healthcare be part of the Capitalist part of America?

In my opinion, yes.



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 08/24/2016 12:27 PM
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jdbman

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Without the capitalistic part of "big pharma" the miracle drugs that have been produced would not be. With the heavy regulation from FDA its very difficult and very expensive to get a drug from an idea to reality.

However, I continue to think that we need to include "Healthcare" as a Constitutional right.

-------------------------
So if you are a surfer I wish you the prosperity that allows you more time to pursue the salt water dream, and the true happiness that comes from warm water, clean waves and the companionship of your fellow surfers. If you are an internet troll just spewing bs then f off.
 08/24/2016 12:28 PM
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WG

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broken patent system
maybe this sort of thing ought not deserve the same protection


-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill
 08/25/2016 06:57 AM
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tpapablo

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Originally posted by: WG broken patent system maybe this sort of thing ought not deserve the same protection

Now that is a great idea. What do you think would happen to research spending if a drug company could not get the money invested back? You might look to what happened in Venezuela for a clue.



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 08/25/2016 07:56 AM
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WG

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Cons always go off into the weeds on stuff like this with comments like those.
Question monopolistic practices makes one a commie. There is plenty of room to regulate and still maintain a free market that support innovation.


But I was wrong, this isn't even a patent thing, neither the drug nor the delivery mechanism are patented.

The real reason the EpiPen and other off-patents are so expensive

Here's how we fix the problem

-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill
 08/25/2016 08:50 AM
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RegularJoe

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If I read them right... the delivery mechanism (injector) WAS patented, but the patent has expired, and the problem is that potential competitors have not been able to get their own injectors or other delivery mechanisms approved?

Other angle on R&D aspect of the EpiPen: The product had long been developed, approved, and profitable.

The company responsible for the price hikes (Mylan) simply acquired the patent (and producer?) in 2007 and started raising the prices there.

At the end of it all...
TextMylan CEO Blames Obamacare for EpiPen Sticker Shock
 08/25/2016 01:07 PM
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tpapablo

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Originally posted by: RegularJoe If I read them right... the delivery mechanism (injector) WAS patented, but the patent has expired, and the problem is that potential competitors have not been able to get their own injectors or other delivery mechanisms approved? Other angle on R&D aspect of the EpiPen: The product had long been developed, approved, and profitable. The company responsible for the price hikes (Mylan) simply acquired the patent (and producer?) in 2007 and started raising the prices there. At the end of it all... TextMylan CEO Blames Obamacare for EpiPen Sticker Shock

Yup, FDA holding up competition to the Epipen. You progs should exalt.



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 08/24/2016 06:48 PM
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RustyTruck

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We need to take off the campaign buttons to talk about a subject as important as this.

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 08/25/2016 01:21 PM
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WG

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Did you read the link?
"She said that employers' increased use of high-deductible plans, one of the side-effects of the law, has resulted in patients paying more out of pocket for the drug, and that's "where you're seeing a lot of noise around EpiPen."

LOL, because the cost is more visible to some consumers now, it's Obamacare's fault!

FYI, I've recently selected one of those "high deductible" CDH Plans, because it actually costs me far less out of pocket (very low premiums and a hefty employer contribution to an HSA).
A gamble on my part, we'll see how it works out.

-------------------------
"The truth is incontrovertible.
malice may attack it,
ignorance may deride it,
but in the end,
there it is." -Sir Winston Churchill
 08/25/2016 02:30 PM
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RegularJoe

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Most of the plans are high-deductible now, compared to a few years ago.

Those with low deductibles are getting sticker shock from their premiums,
while those with high deductibles get sticker shock buying EpiPen.

Either way, the price of EpiPen has soared, and Mylan executive salaries along with it.

We had some precautionary EpiPens for my daughter back before 2007. Once those expired and we got a scrip to renew, insurers balked and wanted lots more info from the doc before filling. Thankfully, we do not appear to need them.

The CEO blaming Obamacare was pretty rich though, given that her dad (former WV governor and now senator) is a Democrat.

She's flailing to direct blame anywhere but herself, after offshoring company HQ to The Netherlands, collecting $18M more in salary, and planning to hike the price of EpiPens even further to profit more in the absence of competition. (No doubt they needed more of that income to pay the lobbyists who have helped keep competitors off the market.

Her latest statement:
Bresch has defended the price hike, pointing to factors like the U.S.'s complicated health care system as well as the costs associated with raising patient awareness and subsidizing the devices in schools and other parts of the world.

"No one's more frustrated than me," Bresch told CNBC.

 08/25/2016 02:34 PM
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RegularJoe

Posts: 3679
Joined Forum: 11/20/2011

But true again to miker's original point: Corruption abounds, while greed and hypocrisy clearly have taken root in altruistic Democrat CEO's as well.

Both major parties have been insanely protective of many diverse industries, and Big Pharma just happens to be one of those with overlap support in both.

 08/25/2016 05:20 PM
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RustyTruck

Posts: 33412
Joined Forum: 08/02/2004

This is a job for Liz.

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“It is the heart of US policy to use fascism to preserve capitalism while claiming to be saving democracy from communism “ - Michael Parenti
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