Jan. 19 Sources: Beware Federal Drug Negotiations

Many problems are not really problems & many solutions are not really solutions. Remember the flu vaccine scare? Probably not. Nothing came of it. We are about to see a bogus solution with Medicare prescription drug negotiations. No money will be saved, but Dems did have a good time talking about it, didn’t they?

The Dems implied we were just giving money to the drug firms. In fact, there was significant competition among insurance providers. THEY have been negotiating the best price. Imagine the government stepping in to get Wal-Mart a better deal from suppliers. Would they really get better prices?

And do you really believe that a government bureaucrat (maybe a GS -11 employee who worked his way up from procurement) can negotiate a better deal than guys a specialist who negotiates for a living? The government will probably be able to achieve less consumer choice, but not the lower prices for the drugs people really want and need.

I repeat: the insurance firms ARE negotiating and they are having success. The negotiations have meant that premiums FALLEN by more than 40%. CMS reports that on average, beneficiaries are saving nearly $1,100 annually on their drug costs and the Medicare drug benefit cost nearly $13 billion less than expected in its first year, 30% below what had been budgeted. Of course, you didn’t hear this from the Dems or most of the MSM.

BTW - Kerry managed to panic a bunch of old people with his flu scare deception. Remember all those people who got sick in 2004/5. Neither do I. Maybe it was like the fierce hurricane season of 2006 or the gas shortage we are not currently experiencing. Next year, we will be talking about all the money we didn't save.

Other sources are below:

A New Class of Web-Savvy Political Activists Emerges
A New Direction for Bush Administration Climate Policy
A Skeptic's Case for the Surge
Congress Should Reject New Taxes and Curb Exploding Entitlements
Denzel Washington: America’s Favorite Movie Star
Europe in Pursuit of Excellence
Fueling a New Farm Economy (biofuels)
Home Grown Power Could Ease Energy Crisis
Iran: Profile and Statements of President Mahmoud Ahmadinejad
Iraq: Regional Perspectives on U.S. Policy
Medicare Hot Air
Fiscal Policy for the New Congress *


Posted by Jack at January 19, 2007 11:26 PM
Comments
Comment #204104

Quite right, Jack. This proposal will NOT create competition amongst the pharmaceutical companies to be providers of drugs to the Medicare/Medicaid recipients. In this regard, the Democrat’s proposal does nothing to improve upon the simply awful design of the Republicans on this Rx drug program with its middleman industry driving the costs ever skyward as tax payers pick up the difference between Pharmceuticals dictated price to the government and recipients insurance premiums.

This is an oligopoly after all in which the various pharmaceutical manufacturers protect their sole provider patents on drugs with the help of politicians for 18 years, which means the Government cannot shop at competitor companies for the same drugs and better prices. In other words, we have government sanctioned monopolies on patented drugs allowing the monopolistic manufacturer protection from competition for pricing purposes.

Could Democrat politicians have shares in big Pharma too, like Republicans, profiting handsomely at tax payer’s expense? It’s a question that demands a researched answer.

Posted by: David R. Remer at January 19, 2007 11:57 PM
Comment #204115

Well, given that Big Pharma actually wrote this program to start with, and rewarded the man driving the original bill with a cushy parachute, Somehow, I’m not surprised that this hasn’t been resolved in the 1st 100 hours.

Posted by: gergle at January 20, 2007 2:33 AM
Comment #204120

Actually, the Veterans Administration negotiates for their drug prices and has substantially reduced the price Vets pay.

Funny your article never mentioned that.

Posted by: Juan dela Cruz at January 20, 2007 5:25 AM
Comment #204123

Jack,

It is funny to see the self-proclaimed conservatives not only lining up to defend Medicare Part D, but accusing the MSM of exaggerating the cost.

Very well then. I’m happy if you guys are happy. But whose taxes should we raise to pay for it? Should we aim at the high end or spread the cost across the board?

Posted by: Woody Mena at January 20, 2007 6:06 AM
Comment #204125

“Weve been living in a medicated world, and I am just a medicated girl.”

There is just such a high demand for drugs, that prices have gone up. Also, the drug companies have to cover their lawsuit costs.
Beaurocrats cannot negotiate. They just demand and get denied. It takes expert businessmen from insurance companies who are trying to control their costs. They make money by providing better services at less prices than the competition.
Politician setting drug prices…smells like socialism.

Posted by: JoeRWC at January 20, 2007 7:15 AM
Comment #204127

And do you really believe that a government bureaucrat … can negotiate a better deal than guys a specialist who negotiates for a living?

It all depends on who you are negotiating on behalf of, doesn’t it?

Posted by: garyq at January 20, 2007 8:58 AM
Comment #204128

Sitting here in my foggy mind and thinking abstractly about our health system, how about the following:

Allow terminally ill people of sound mind to become test patients using experiment drugs and procedures on a volontary basis of course. To my way of thinking, it would be much more preferable to die while helping to cure my illness than merely wasting away in a hospital bed, costing more than anyone should have to bear.

Allow the 1st company that develops a cure for a desease to sell that cure on the open market tax free for 50 years. There would be no loss during that 50 years because without the cure there would be nothing to tax.
Get the government completely out of healthcare financing. No research dollars. There is a disincentive now for finding a cure for any major desease. If you give me $10 mil this year to look for something and I find it I won’t get $15 mil next year.
Research would be handled by private labs, hospitals, and universities as it is being done now except they would have to use private funding.

Any plan like this would have to be developed of course, but in my foggy state of mind it looks pretty good.

Any comments?

Posted by: tomd at January 20, 2007 9:09 AM
Comment #204129

We should put more teeth in that bill then. We should not sit still for toothless laws.

However, lets not treat government bureaucrats as if they were an alien species. Drug companies give lower prices to overseas buyers because they can’t get away with much of what they do here. Now this isn’t the government setting a price, it’s the government setting the price it’s willing to pay, rather than the pharmaceuticals.

We need to do better than this.

Posted by: Stephen Daugherty at January 20, 2007 9:12 AM
Comment #204130

tomd-
Voluntary testing on terminal patients
I was under the impression people already do this to some extent. One ethical issue here is that not all bad drug side effects kill. Mull that over for a bit.

Exclusive patent for fifty years
Patents are limited for a reason: competition. I would think as an advocate of free markets you would like competition. Also, the point of a patent’s eventual lapse is that other drug companies can thereafter innovate on the basis of other company’s research.

There’s a reason our system puts limits on the length of terms certain kinds of intellectual property: that is, the freedom for other to use the knowledge and the material as a common resource. Again, if you’re all about free markets, the eventual public domain use of intellectual material should appeal to you, since it constitutes a deregulation of its use.

There is a great deal of incentive for finding the next cure, actually. It’s built in demand, especially for chronic diseases.

As for the use of private labs, private this and that? I think you place too much of an emphasis on private enterprise as a panacea for all ills. the Government can sponsor research without worrying about turning a profit, and then turn over the results as a public resource rather than a company secret.

Posted by: Stephen Daugherty at January 20, 2007 9:26 AM
Comment #204131

Jack

I get a chuckle out of your never ending endeavours to elevate the business world and republicans to sainthood status. Come on now, do you really think that us americans can be foolish enough to believe that a medicare bill written by the pharma industry could be done with the best interests of the people in mind. And then there are the scruples of the insurance industry to consider. To be honest Jack I do not want to put my trust in either. After all these are profit based industries. And we all know that very few profit based industries have a consience where big money is concerned.

And why can the government not find a professional negotiator or two to do the job. I would think the bigger problem would be finding a government employee who can not be bought off. Does the government not negotiate prices for everything from aspirin to bombers most everyday?

I am sorry Jack but there is just too much corruption when it comes to spending the taxpayers dollars. There is something wrong when for profit business is allowed to write public policy bills at the expense of the taxpayer and also be allowed to determine the costs at the expense of the taxpayer. We all know that the insurance and pharmaceutical industries are very strong in the lobbyist area and are probably both suspect when it comes to raping the public of their tax dollars. I can offer no proof of the latter, but I am indeed a pessimist when it comes to such matters. We the people have been screwed over by government and their ties with corporate greed one too many times.

Posted by: ILdem at January 20, 2007 9:43 AM
Comment #204132

Jack,

The government pays for more than 60% of all prescription drugs purchased in America according to a few studies I have read.
I asked David Remer if he thought this is excessive, but never got an answer on a post in the Independent column. What say you?
You are right, the government should not be the price adjustor of the health care industry, and the government should get out of health care nearly all together. I don’t mind them paying for the health care of veterans, and the excessively poor, but that should be it. If the government wasn’t sticking its nose where it doesn’t belong our health care would not be so expensive. The more people there are on the government health care dole, the less people there are for private insurance companies to insure. This means our taxes go up to pay for the freebies, and our insurance premiums go up when less and less people are available to insure through the private sector. Leave insurance and health care to private corporations. That is what small government is all about!

JD

Posted by: JD at January 20, 2007 10:30 AM
Comment #204135

I wonder if there have been studies conducted regarding those on government health progams and the surge in hypochondria? Boy, wouldn’t that be a great study? Having been a social worker I know a lot of people on disability. I know some on disability that are healthier than I am. These persons go to the doctor for treatment on the most minor of things, and will argue with their physicians if they don’t find something wrong with them. They walk around constantly talking about the latest ailment they have. They keep medical journals on the living room coffee table for quick reference. They have had more surgeries than anyone I know in the so-called working world. They take more medications and have their pantries full of every vitamin and herb known to man. It simply disgusts me to constantly hear about how sick they are, but then it never seems to slow them down when they want to do something they like to do. They only seem to be sick when it is convenient for them, or when they have to prove why they should get that disability check in the mail. This is what the government freebies have done to some people out there. I know because I’ve seen it.
I also worked with an organization which helped individuals with disabilities get and hold jobs within the community. Many of these folks could have worked full time. However, they wouldn’t because that would cause them to make too much, and they would lose their disability status and freebies. Most in the social service field actually promote this because they are libs. A conservative in the social work field can not hardly go to work one day without being absolutely so disgusted with it you wish you could write a book. Been there and seen it for myself!!

JD

Posted by: JD at January 20, 2007 10:47 AM
Comment #204136

This is classic Nanny State Conservatism.

The drug companies want government to set up and run the patent and legal system for them and then they don’t want to compete with government buyers who will not have high priced CEO’s and dividends to support. These guys aren’t for “free markets”. What a laugh that anyone thinks they are for them.

Classic conservative hypocrisy. If you are truly for more open markets there is NO reason NOT to let the government negotiate as well. I mean what is PhRMA worried about right. The market is always more efficient then the government. Right?

Posted by: muirgeo at January 20, 2007 10:50 AM
Comment #204140

I have never considered the government to be a part of the free market. The governemtn, in my opinion, is separate from the free market, and could never be a fair player because it sets all of the rules when it enters into this realm.
“Socialists” believe that the government is the free market and that government should set all prices, in my opinion.
If government is going to join in a particular segment of our economy, why should they think that they should be allowed to use their heavy-handed tactics to force down the prices of what everyone else has agreed to pay just because they think those prices may be too high? Government should get no special pricing just because they are capable of buying 60% to 70% of the market share of products. This is big government, no, huge government, at its worst. If the government wants to stick its nose where it doesn’t belong, let them pay the same prices as anyone else. Otherwise, let them stay out of the business all together.

JD

Posted by: JD at January 20, 2007 11:04 AM
Comment #204142

Juan

The VA is the consumer of those drugs. They get some inexpensively, but they also have a limited choice for their patients.

Woody

I do not particularly like the program, but we have it. Because of the way it is organized, it is costing less than it might and it is making the recipients happy. The Dems want to make it more socialistic. Serious people who really study the program (mentioned in Fact Check et al) say that the Dem complaints are unjustified and that their plan to directly negotiate will cause nothing but trouble. That is all I am saying.

Garyq

Yes, it does depend on who he is negotiating for. In these cases he is negotiating for the insurance companies which have an incentive (and greed if you like) to get the best prices to maximize their own profits. Lower prices increase their profits. They have significant direct incentive to do a good job. We do not need to appeal to their virtue.

Tomd

We have a bioethics problem. One of my older acquaintances died a couple days ago from a stroke. He was in his 70s and in poor health for many years. He already had a bypass, all sorts of therapy etc. When he had his stroke, they moved him in a helicopter, scores of doctors worked on him employing expensive machines; I bet the whole cost was in the hundreds of thousands of dollars. We often spend more in the last days of a person’s life than in the whole time until then. Everybody dies. Maybe we should just accept that and give up the heroism. It might sound cruel, but it just is not worth it to prolong a miserable life for a couple more months.

Stephen

Overseas consumers benefit as free riders on innovation in the U.S. market. Beyond that, they do not get the range of choices. We can have that system, but we have to recognize what it is. Americans are too much a cry babies. They will demand the highest quality and the latest drugs. Also see what I wrote above to Tomd.

Ildem

Most government employees are honest and steady workers. But the civil service system does not encourage the kinds of skills needed in a fast changing competitive situation.

I am not trying to raise anybody to sainthood. See what I wrote to Garyq. The free market does not require saints. That is why it works, since saints are usually in short supply.
JD

I think it is too high, but that is not an argument anybody can win anymore. I personally do not understand why health care is seen as an entitlement, but I recognize that most people do and that it the world we have to live in.

Re disability, you are right. A lot of people claim they cannot work, but they can usually do other things they want to do. We have also expanded disability to include fat guys who do it to themselves.

Muirego

I do not think the government can do it as well. The reason I usually favor private initiative. Government just cannot handle many situations. It should stick to the big things that require common effort and leave everything else to the people themselves. Think of two terms: public bathroom and private bathroom. If you drop you wallet on the floor, where do you feel more comfortable picking it up?

Posted by: Jack at January 20, 2007 11:31 AM
Comment #204145

Muirego

I do not think the government can do it as well. The reason I usually favor private initiative. Government just cannot handle many situations. It should stick to the big things that require common effort and leave everything else to the people themselves. Think of two terms: public bathroom and private bathroom. If you drop you wallet on the floor, where do you feel more comfortable picking it up?

Posted by: Jack at January 20, 2007 11:31 AM


Jack,


Maybe I’m not understanding how Medicare Part D is set up.
Ideally the government, “medicae” would offer its own drug plan in competition with those offered by private insurance.
When single payer health insurance comes out or school vouchers for that matter the government should offer a plan and compete with private insurers. The key point would be the private insurers would have to offer the same benefits. No denial for pre-existing conditions…..I have little doubt that like the postal service with no high paid CEO’s and stock holders to worry about the government plans would hold their own and drive cost down as well. What’s wrong with that? And guess what I bet some CEO’s would see there true value reflected in their new pay checks.

Posted by: muirgeo at January 20, 2007 11:56 AM
Comment #204150

Oh Come on Jack
The ability to negotiate prices is always a good idea. Just the potential is enough help curtail unwarrantd price hikes. Thats how Walmart keeps prices down ,isn’t it? The VA does it and it saves us taxpayers a bundle. Other countries do it and pay less for drugs.Lets just see how it goes for a time .I think the poor little pharma industry will do just fine,with increased volumn if nothing else.
As too wanting it to be a more socialist program,if you mean getting insurance companies out of the equation, I for one plead guilty. Insurance is NOT healthcare. That industry has a good deal to do with the outsized price increases and access restictions we have been suffering . Keeping them in the solution is a bit like inviting a burgler to dinner to improve home security.Yeah they know all about it but perhaps their interest is not the same as yours.

Posted by: BillS at January 20, 2007 12:27 PM
Comment #204151

Muirego

In theory government should be able to work efficiently and for the common good. There are lots of arguments you can make based on human nature why this will not work, but I think two are key: information flow and organizational incentive.

Information flow

How much is something worth relative to other things? That is a very difficult question to answer w/o reference to markets. In a market you have millions of independent decisions coordinated by the market mechanism that determine prices. It is never “right” but it responds quickly to changes. In order to duplicate this, government bureaucracies would have to have, aggregate and understand a vast array of information. It is literally beyond that capacity of any organization to gather the information and even if it was available, it would be beyond the capacity of any limited number of people to understand.

When communism fell in E. Europe, people realized that they did not know the prices of anything. They had been throwing valuable and scarce resources into low value products and conserving things that were abundant. That is why you had all those lines, inefficiencies and environmental problem. The lack of price mechanism is the biggest impediment to government management. Mind you, I am not saying that the government is corrupt. Corruption adds another layer of trouble, but even the most honest and intelligent official just cannot do a good job w/o price data.

Organizational incentive

Government serves political interests and political interests are not the same as the people’s interests. Take this drug benefit and all old age benefits as an example. Old people in the U.S are already among the most financially secure people in our country. Young families would probably be a better “investment”. Why do we give so much to the old? Because they are organized and they vote in large numbers. Government always misallocates resources for this reason. The other incentive problem for government has to do with the lack of a bottom line. There is often no non-political way to judge the effectiveness of a government program, so we tend to measure input and effort rather than result. If a private firm makes a product nobody likes, it changes or goes out of business. If a government agency does the same, its supporters demand a higher budget or they compel the people to take the product.

Government works by compulsion. It does not persuade you to donate money in taxes, nor does it ask you to obey laws. Complusion is necessary, but should be used sparingly.

Government has a very important role to play in a free market system. The free market cannot function w/o government and the rule of law. But it is important to differentiate the productive parts of the economy from the regulatory and distributive parts. Government just cannot do many things, no matter how much we wish it could or how good the government is.

It is also true that there are some things state and local governments can do (because of their smaller size) that the Feds cannot. Our mistake is asking the government to do things it cannot and then compounding that mistake by asking the Feds to centralize it.

Posted by: Jack at January 20, 2007 12:35 PM
Comment #204153

Get rid of the middlemen.
It would also help all around if there weren’t 106,000 deaths per year due to Adverse Drug Reactions, and 195,000 deaths per year due to preventable medical mistakes.

Posted by: d.a.n at January 20, 2007 12:41 PM
Comment #204154

BillS

I am not saying that we should have no negotiations on price. I am saying that we already DO have negotiations on price. The firms doing it are doing a good job (as shown by the cost figures in my sources) and the government would not do a better job (as the factcheck and other demostrate).

As I mentioned above, the VA is the consumer of the drugs it buys. It limits choices to its patients. If you want that system, you can have it (vote for it) but you will be losing the flexibility and innovation inherent in our current health care delivery. Beyond that, the VA is able to take advantage of the innovation and efficiencies created by the bigger system. If our entire health care system worked like that, the general level would decline.

It is kinda like if my neighbor clears the road and I only clear my driveway and then I brag about how it costs me so much less. But if he didn’t clear the road, I could not ride free.

Posted by: Jack at January 20, 2007 12:41 PM
Comment #204159


“Voluntary testing on terminal patients
I was under the impression people already do this to some extent. One ethical issue here is that not all bad drug side effects kill. Mull that over for a bit.”

I don’t know of this happening anywhere. If so I applaud it. I know some side effects can be worse than death. That’s why it would have to be voluntary.

“Exclusive patent for fifty years
Patents are limited for a reason: competition. I would think as an advocate of free markets you would like competition. Also, the point of a patent’s eventual lapse is that other drug companies can thereafter innovate on the basis of other company’s research.

There’s a reason our system puts limits on the length of terms certain kinds of intellectual property: that is, the freedom for other to use the knowledge and the material as a common resource. Again, if you’re all about free markets, the eventual public domain use of intellectual material should appeal to you, since it constitutes a deregulation of its use.”

I understand and appreciate the patent laws that govern drugs. My point is to get government money out of the equasion and if adjusting patent laws are needed, then I think it would be worth it. 50 years is an arbitrary number.

“There is a great deal of incentive for finding the next cure, actually. It’s built in demand, especially for chronic diseases.”

There is a great deal of incentive for finding the next TREATMENT. not cure.

“As for the use of private labs, private this and that? I think you place too much of an emphasis on private enterprise as a panacea for all ills. the Government can sponsor research without worrying about turning a profit, and then turn over the results as a public resource rather than a company secret.”

And I think you place too much emphasis on the government for the same reasons. The government can’t sponsor research without worrying about a profit. No matter who does the research, there has to be a profit. Instead of worrying about a profit for the government, they INSURE a profit for the ones they sponsor.


Posted by: tomd at January 20, 2007 2:14 PM
Comment #204162

Jack,

My two cents worth on this are pretty simple. This program is funded with taxpayer dollars. The congress is responsible for providing us the most “bang for the buck”. The Democrats have been able to show in black and white that the VA’s practices have been more cost efficient to the taxpayer.

The Republican’s OTOH show nothing in black and white but big pharma BS about how this will adversely effect pharmaceutical availability, research, cost, ya-da, ya-da, ad nauseum. I know you disagree.

Part of the “Medicare Privatization Plan” that included the part D benefit also included a huge conversion plan to move those eliglble for Medicare to a Medicare Advantage Plan. So far the “advantage” has largely been in favor of the provider. OK, for “healthy” seniors these plans provide a wider range of services, ie: dental, eyeglass, etc, but recent CBO reports show it actually costs the taxpayer 11% more than traditional Medicare coverage.

The Part D plan was little more than a “snake oil” sales shakedown to get Americans to buy into Bush’s Medicare privatization plan. The thought that current expenditures will bankrupt the whole darn thing faster just makes the deal even sweeter. Every Republican president since Ike has hoped to end “entitlements”.

Luckily he didn’t get away with the sham of piratizing Social Security. At the end of the day Bush will veto HR-4 and I doubt that congress will be able to overide the veto, so part-D will keep costing you more than neccessary.

Posted by: KansasDem at January 20, 2007 3:53 PM
Comment #204166

KansasDem, excellent analysis of the Medicare Rx debacle. And its costs will continue to grow and grow as time moves forward, adding fuel to Republicans self fulfilling prophecy that entitlement spending is not sustainable.

The alternative of course is, when it is no longer sustainable, millions of Americans will not receive life saving medical, and will be bankrupted in the process of trying. So be it, says Republicans, if they had just worked smarter in their lives, they could have been rich too. It is their own fault, let them die.

Posted by: David R. Remer at January 20, 2007 4:08 PM
Comment #204171

JD,

I usually try to avoid answering your rants, but I’ve been disabled since Decemeber 2001 and began collecting Social Security Disability in 2004. I know nothing about the approval process other than what I went through. In spite of having my PCP and my Neuro recommend that I pursue disability benefits I was required to see two more doctors at the expense of the taxpayer.

Their reports supported my need for SSDI but due to a clerical error on my part I was originally denied. On appeal I was quickly approved. I’m told many people have much greater trouble getting benefits. Maybe some recipients don’t deserve benefits. I don’t know.

But, you seem to put yourself in the “driver’s seat” as a diagnostician. Are you? You even suggest that you’re aware of surgeons having performed unneccessary procedures to get “hypochondriacs” to shut the f**k up. I seriously doubt that. If true they should be reported to the appropriate state medical board and, if billed to medicaid or medicare, they should also be notified.

Finally, if you’re aware of Social Security fraud just report it right here:

http://www.ssa.gov/oig/hotline/

They want you to! I did it once! Many moons ago the government ran ads re: the “war on drugs” stating “if you’re not part of the solution you’re part of the problem”. I believe that’s true of everything concerning America.

If you’re truly aware of government waste or abuse for goodness sake report it! I’ll just thank my lucky stars that I’ve never had you as a social worker.

Posted by: KansasDem at January 20, 2007 5:00 PM
Comment #204176

If a private firm makes a product nobody likes, it changes or goes out of business. If a government agency does the same, its supporters demand a higher budget or they compel the people to take the product.


Posted by: Jack

Jack,

Your are perverting my argument…or maybe making it for me.
If government offers its plan and people don’t like it they can go with a private plan. I’m not talking about the government being the sole proprietor here…..just one more competitor. But with distinct advantage of not having stockholders or CEO’s…..Again what’s wrong with that?

Posted by: muirgeo at January 20, 2007 5:20 PM
Comment #204178

Jack,

You are trying to prove your point about market efficiencies by referencing the US health care system??? Poor choice.

Your poor experience at with the Norwegian health care system notwithstanding the average cost of healthcare in other developed countries is about one half as much, every single citizen is covered and outcomes our in general as good or better then ours.

Posted by: muirgeo at January 20, 2007 5:30 PM
Comment #204182


My first encounter with VA healthcare was in the early 90’s. The care was mediocre at best. In the late 90’s, the care and the facilities started to improve. During Bush’s first term, the improvements stopped, things didn’t get worse but improvement stopped. Since 2004, the care has steadily improved and I consider it to be very good now. I would not trade my VA care for my friends medicare.

Choice may be somewhat limited with VA care but, I don’t think it affects the quality in any way. The Veterans Administration forces some displine on health care and in my opinion that is a good thing. Some people who have excellent health care plans make demands for procedures and medications that more often than not will not improve their condition. Example: People who demand that their childs cold virus be treated with antibiotics. All healthcare providers should refuse such a request.

Some say that the American people are to spoiled and to demanding to accept Veterans Administration type healthcare. I don’t believe that at all. I think the majority of Americans would be glad to have the health care that the VA provides. I know they will like the price.

Posted by: jlw at January 20, 2007 5:49 PM
Comment #204185

Jack,

In your reply to Tom D you say, “We have a bioethics problem. One of my older acquaintances died a couple days ago from a stroke. He was in his 70s and in poor health for many years. He already had a bypass, all sorts of therapy etc. When he had his stroke, they moved him in a helicopter, scores of doctors worked on him employing expensive machines; I bet the whole cost was in the hundreds of thousands of dollars. We often spend more in the last days of a person’s life than in the whole time until then. Everybody dies. Maybe we should just accept that and give up the heroism. It might sound cruel, but it just is not worth it to prolong a miserable life for a couple more months.”

There’s already an answer to that. It’s called a DNR (do not resuscitate order) but it requires “free will” and a persons desire to live or die. I have a DNR, not because I’m suicidal, but because I’ve lived in this constant state of “flux” for several years and I’m tired of having my “oil changed” (plasmapheresis) regularly.

I find it odd that the same party who’d call a special session to debate the death of one woman or continue to question the reproductive rights of women would prefer that we “ration” healthcare. Maybe America would be better off if we adopted the principles of a a ‘caste’ society.

The state could decide who gets health care and who doesn’t. Or we could just leave it to financial fate. Either way sounds good to me. There’s more than one way of weeding out the losers.

Posted by: KansasDem at January 20, 2007 6:16 PM
Comment #204221

Muirego

Since under the government program the person who pays might not be the person who gets, the recipient might be perfectly happy to ignore inefficiencies and unnecessary costs. You probably remember the old saying that nobody washes a rental car. I might be happy to take a service that cost the taxpayers $5 when it could have been obtained for $1 if they only charge me $.50. That is the other flaw in government programs. If it was voluntary to all, I would accept your argument but the government will coerce some into paying.

Re Norwegian health care - I did NOT have a poor outcome. I liked the system. I do not think it is transferable to the U.S. Americans demand a lot more. We are a nation of cry babies when it comes to health.

I had a root canal done in Oslo. The dentist asked me if I wanted anesthetic and implied it would not take him long so I probably didn’t need it. I think he lost some respect for me when I told him to give me the shot. You have to admire that, but I do not see my fellow Americans behaving that way.

Jlw

See above. Actually I think MOST Americans would accept the simpler care, but the troublesome 5% would get lawyers and bother their congress people and ruin it for the rest of us.

Kansas

With socialized medicine comes rationing. It might be subtle and it might involve just waiting people out. The medical mindset is different in Europe. Read about how it works in Holland. There were articles re that recently in the U.S. media.

People rightly say some Euros produce better overall results with less money. It is easy to do if you look at the population and not the individual. My old buddy sucked up enough medical coin to pay for thousands of vaccinations or hundreds of pre-natal screenings and it bought him around 48 hours.

Posted by: Jack at January 20, 2007 9:46 PM
Comment #204227

“My old buddy sucked up enough medical coin to pay for thousands of vaccinations or hundreds of pre-natal screenings and it bought him around 48 hours.”

Jack,

Did the time spent on your “old buddy” result in a lower level of care for others in need? I doubt it. The people were there to deal with just such a situation and if they were not needed they wouldn’t be washing bed pans.

Your freind recieved the proper level of care. Those providing the care would have been there even if he hadn’t been. Hospital personel don’t get paid on a “peice work” scale.

Posted by: KansasDem at January 20, 2007 10:16 PM
Comment #204235

Thanks for your comments Kansas Dem.

Funny how people who have never faced the need for extensive medical care have all the solutions. At least, until they find themselves in need and out of luck.

Posted by: gergle at January 20, 2007 11:20 PM
Comment #204238


Don’t worry, the president has introduced legislation to end the health care problem. He want’s to bribe those who can afford health care or have it through their employer so that they won’t give a damn about those who can’t afford health care. $7,500 tax break for singles, $15,000 for families.

A family of four that has an income of $25,000 per year, can’t afford health care, is above the poverty line and doesn’t qualify for government assisted health care, and pay’s very little if any federal taxes.

Posted by: jlw at January 20, 2007 11:36 PM
Comment #204239

KansasDem,

I figured I would probably get such an answer from someone on SSDI. I was just telling people what I have seen inside the profession, and in personal contact with some of those outside of the profession.

I have nothing against those who need help, but did it occur to you that the probable reason you had such difficulty getting on the program is because of all the “priors” who abused it?

In your response to Jack, are you proposing a DNR for anyone on government healthcare in order to cut costs?

JD

Posted by: JD at January 20, 2007 11:45 PM
Comment #204254

Kansas

I bet that cost hundreds of thousands of dollars. It cost maybe $3-5000 per hour and he was unconscious. The Medicare drug benefit costs about that in a year per person. Our very expensive machines and highly trained people must stand ready for these things. In Europe they are less enthusiastic about such thing, which is one reason they get a better health care bargain.

That goes exactly to my point about why the socialized heath care cannot be exported to us. We think it is a good thing to keep a man’s body alive after his soul has shuffled off the mortal coil. Our science allows us to keep the body alive for a long time, maybe forever. But we cannot keep people alive that long.

Posted by: Jack at January 21, 2007 12:48 AM
Comment #204264


“We think it is a good thing to keep a man’s body alive after his soul has shuffled off the mortal coil.”

Jack: Why is it that we think this? Could it be that we have been coached and encouraged to think this way. If we often spend more on a persons health care in the last few days of their lives than the rest of their live combined, isn’t it also true that more health care profits are earned in the last few days of a persons life? Doesn’t the companies who benefit from this profit bonanza have a vested interest in encouraging this kind of thinking. I wonder if the health care industry has given donations to organizations that fight against assisted suicide laws.

You mentioned the troublesome 5%, actually there are two troublesome 5%’s. One is the doctors who repeatedly make negligent mistakes that cause deaths and are protected by the AMA.

Posted by: jlw at January 21, 2007 3:31 AM
Comment #204274

jlw

I do not think you have to look to manipulation to see the reason why people want to keep the body alive. It is a hard decision to end life. People do not want to make it.

You have little confidence in the intelligence of the common man and exaggerated confidence in the ability of the evidently much smarter rich people to manipulate them.

I think you are right that the incentive system is wrong. If someone is terminally ill, he and his family usually pay little of the cost of buying those few additional days.

Posted by: Jack at January 21, 2007 9:20 AM
Comment #205279

I think it is time for universal health care. After all who has our best interest at heart if not our government? They certainly wouldn’t negotiate drug deals or health care needs based on DNA footprints, or for just a plain ole kickback would they?

Now I know that universal health care would not discriminate between old and young.

After all, if you look at how well they have done with housing, Welfare programs, and how well they have taken care of immigration, no signs of corruption or graft there, well who else to run a well oiled health care system. It will start off with good doctors, the best facilities and equipment and after just a few years of good ole government supervision it will be just like our public school, welfare, and housing. The cream of the crop the pearl of the orient.

Well enough kidding around; back to work getting them damn dims out of office.


Posted by: im at January 26, 2007 8:59 PM
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