Comments on: Guns, Butter and European Health Care http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/ Cleaning the Augean Stables of the Health Care Debate Thu, 11 Mar 2010 00:33:19 +0000 http://wordpress.org/?v=2.3.3 By: Lisa http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-17212 Lisa Mon, 14 Jan 2008 01:38:27 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-17212 Didn't read through all these posts but I'll say this: Universal healthcare doesn't work. A friend of mine lives in the UK. Her daughter was cutting herself. My friend was very concerned. My friend took her daughter to a therapist, only to be turned away with the explanation that her daughter "wasn't sick enough." Huh? Apparently private insurance is available in the UK but it is very expensive. As for heavily regulated here, yes, we are, at least, we are in the Garbage State of NJ. My husband is a doctor. We are barely making ends meet anymore in part because of regulation. I therefore disagree with the doctor who wrote earlier, saying we are not heavily regulated. It depends on the state you practice in. However, I am also feeling regulated by big business -- the insurance companies -- and I'll be damned if I know how to stop it. No easy answers here. Didn’t read through all these posts but I’ll say this: Universal healthcare doesn’t work. A friend of mine lives in the UK. Her daughter was cutting herself. My friend was very concerned. My friend took her daughter to a therapist, only to be turned away with the explanation that her daughter “wasn’t sick enough.”

Huh?

Apparently private insurance is available in the UK but it is very expensive.

As for heavily regulated here, yes, we are, at least, we are in the Garbage State of NJ. My husband is a doctor. We are barely making ends meet anymore in part because of regulation. I therefore disagree with the doctor who wrote earlier, saying we are not heavily regulated. It depends on the state you practice in.

However, I am also feeling regulated by big business — the insurance companies — and I’ll be damned if I know how to stop it. No easy answers here.

]]> By: drmatt http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9647 drmatt Fri, 02 Nov 2007 17:18:25 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9647 I haven't seen prices drop with copy cat or me too drugs. Besides doesn't being an inventor with a patent give you a short lived monopoly (infact this is protected in the original body of the constitution)? If you remove one chapter from my book and change it should you then be allowed to publish and copy right it as your own? The hospital's and insurance plans get thier medication prices down by bulk purchase. You do make a good point though, can't think of another way to get big pharma to spend research dollars on actually improving health care rather than battling for market share. I am open to suggestions (not that it is up to me). I haven’t seen prices drop with copy cat or me too drugs. Besides doesn’t being an inventor with a patent give you a short lived monopoly (infact this is protected in the original body of the constitution)? If you remove one chapter from my book and change it should you then be allowed to publish and copy right it as your own? The hospital’s and insurance plans get thier medication prices down by bulk purchase. You do make a good point though, can’t think of another way to get big pharma to spend research dollars on actually improving health care rather than battling for market share. I am open to suggestions (not that it is up to me).

]]> By: Rich http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9634 Rich Fri, 02 Nov 2007 14:39:13 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9634 " I propose we put evidence based barriers. A new drug that treats a problem previously untreated or poorly treated should have barriers removed, otherwise increase the barriers, then the drug companies will have to spend thier R and D dollars on new, helpful drugs." This basically creates monopolies for the drugs that are fist to market, and will likely lead to higher prices for everything be removing competition. The hospitals at which I attend choose which PPI to stock. Basedd on what? Based on the lowest price, other things being equal. The health plan formularies and PBMs do the same thing. Do you think they could negotiate if there were only one PPI? ” I propose we put evidence based barriers. A new drug that treats a problem previously untreated or poorly treated should have barriers removed, otherwise increase the barriers, then the drug companies will have to spend thier R and D dollars on new, helpful drugs.”

This basically creates monopolies for the drugs that are fist to market, and will likely lead to higher prices for everything be removing competition.

The hospitals at which I attend choose which PPI to stock. Basedd on what? Based on the lowest price, other things being equal. The health plan formularies and PBMs do the same thing. Do you think they could negotiate if there were only one PPI?

]]> By: drmatt http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9624 drmatt Fri, 02 Nov 2007 11:11:37 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9624 Interesting, I think consumer driven medicine works in elective health care, but how does anyone in the midst of an acute MI, apendicitis, auto accident, cancer, shop around? it doesnt work in those areas. Additionally the complexity of understanding the differences between good medical care, medical care, and bad medical care far exceed the abilities of the general population, this type of health economics will drive demand for "popular" medical care not "evidence based" medical care. Let people shop for elective crap, let's find a way to provide "needed" care. As far as his implication about pharm, well, I agree "price controls" are the wrong answer but for different reasons. If you read how drug companies do research it is market based not health based. If a medication has proven to get market share, the other companies quickly shift a molecule around and sell a similar drug (no true benefit but increased cost), How many PPIs do we have? How many do we really need. Additionally a great deal of thier research is funded by universities and the NIH (that means you and I). In many cases you pay for these money makers three times, you pay for the research through the NIH (thanks to a bill by dole), you pay through medicare, and if you need that medication again you pay yourself. I propose we put evidence based barriers. A new drug that treats a problem previously untreated or poorly treated should have barriers removed, otherwise increase the barriers, then the drug companies will have to spend thier R and D dollars on new, helpful drugs. As far as the 1 billion in research, much of that money isn't thiers and it pales in comparison to what they get back. Interesting, I think consumer driven medicine works in elective health care, but how does anyone in the midst of an acute MI, apendicitis, auto accident, cancer, shop around? it doesnt work in those areas. Additionally the complexity of understanding the differences between good medical care, medical care, and bad medical care far exceed the abilities of the general population, this type of health economics will drive demand for “popular” medical care not “evidence based” medical care. Let people shop for elective crap, let’s find a way to provide “needed” care.

As far as his implication about pharm, well, I agree “price controls” are the wrong answer but for different reasons. If you read how drug companies do research it is market based not health based. If a medication has proven to get market share, the other companies quickly shift a molecule around and sell a similar drug (no true benefit but increased cost), How many PPIs do we have? How many do we really need. Additionally a great deal of thier research is funded by universities and the NIH (that means you and I). In many cases you pay for these money makers three times, you pay for the research through the NIH (thanks to a bill by dole), you pay through medicare, and if you need that medication again you pay yourself. I propose we put evidence based barriers. A new drug that treats a problem previously untreated or poorly treated should have barriers removed, otherwise increase the barriers, then the drug companies will have to spend thier R and D dollars on new, helpful drugs. As far as the 1 billion in research, much of that money isn’t thiers and it pales in comparison to what they get back.

]]> By: Rich http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9589 Rich Thu, 01 Nov 2007 21:22:35 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9589 I think I recall it in _Give_Me_a_Break_ - but there are several shorter articles on the topic. Here are some examples: http://www.realclearpolitics.com/articles/2007/02/no_drug_price_controls.html http://www.realclearpolitics.com/articles/2007/10/medical_competition_works_for.html I think I recall it in _Give_Me_a_Break_ - but there are several shorter articles on the topic. Here are some examples:

http://www.realclearpolitics.com/articles/2007/02/no_drug_price_controls.html

http://www.realclearpolitics.com/articles/2007/10/medical_competition_works_for.html

]]> By: drmatt http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9582 drmatt Thu, 01 Nov 2007 19:43:15 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9582 PS, do you know which book the essay is in, or where I could get a copy of the essay itself. PS, do you know which book the essay is in, or where I could get a copy of the essay itself.

]]> By: drmatt http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9581 drmatt Thu, 01 Nov 2007 19:42:17 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9581 I will have to read that, I have always been open to new ideas, opinions and viewpoints (not that I will disagree with him). In any case, now that we are driving on the road to hell, I can't help but think regulations are a necessary evil to protect us from tyranny (which is one of the govt's primary jobs) but it is how they come about. I personally would picture a room full of experts who understand all the different complexities of the sytem (including reps from docs and patients) with the latest facts and studies hashing it out. Never happens that way though, it is lobbyist and special interest groups who propogate rhetoric the way catron does here. I will have to read that, I have always been open to new ideas, opinions and viewpoints (not that I will disagree with him). In any case, now that we are driving on the road to hell, I can’t help but think regulations are a necessary evil to protect us from tyranny (which is one of the govt’s primary jobs) but it is how they come about. I personally would picture a room full of experts who understand all the different complexities of the sytem (including reps from docs and patients) with the latest facts and studies hashing it out. Never happens that way though, it is lobbyist and special interest groups who propogate rhetoric the way catron does here.

]]> By: Rich http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9576 Rich Thu, 01 Nov 2007 19:08:52 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9576 "I dont think any of the authors of any such regulation was ringing his proverbial hands saying “let’s screw the doctors and/or patients” when it was written." Unfortunately, the road to hell is paved with good intentions. Government intervention and regulation has been shown, time and again, to limit freedoms, increase costs, and degrade products and services. John Stossel has an excellent essay on this subject (even if you are not a fasn of Stossel, it is an excellent essay) in one of his books. “I dont think any of the authors of any such regulation was ringing his proverbial hands saying “let’s screw the doctors and/or patients” when it was written.”

Unfortunately, the road to hell is paved with good intentions.

Government intervention and regulation has been shown, time and again, to limit freedoms, increase costs, and degrade products and services. John Stossel has an excellent essay on this subject (even if you are not a fasn of Stossel, it is an excellent essay) in one of his books.

]]> By: drmatt http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9566 drmatt Thu, 01 Nov 2007 15:12:06 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9566 A purist definition of "free market" would have no regulation at all, is that what we want? an everyman for himself medical system? the pharmacuetical industry can then go back to selling snake oil. I submit that most if not all regulations have one of two intention (the spirit of the regulation) to protect the public from undue harm, or to level the "business" playing field. I dont think any of the authors of any such regulation was ringing his proverbial hands saying "let's screw the doctors and/or patients" when it was written. I further submit that it is the same generalized, unsubstantiated, opinionated statements ringing in the ears of the authors of such regulators delivered by lobbyists and special interests that got us into trouble in the first place. I doubt there is a single person who understands the whole system and all its complexities, thus any single person who is pushing for thier idea of a cure is suffering from paralex (physics term that based on your grand unification theory I know you understand). A purist definition of “free market” would have no regulation at all, is that what we want? an everyman for himself medical system? the pharmacuetical industry can then go back to selling snake oil. I submit that most if not all regulations have one of two intention (the spirit of the regulation) to protect the public from undue harm, or to level the “business” playing field. I dont think any of the authors of any such regulation was ringing his proverbial hands saying “let’s screw the doctors and/or patients” when it was written. I further submit that it is the same generalized, unsubstantiated, opinionated statements ringing in the ears of the authors of such regulators delivered by lobbyists and special interests that got us into trouble in the first place. I doubt there is a single person who understands the whole system and all its complexities, thus any single person who is pushing for thier idea of a cure is suffering from paralex (physics term that based on your grand unification theory I know you understand).

]]> By: drmatt http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9564 drmatt Thu, 01 Nov 2007 14:07:57 +0000 http://www.healthcarebs.com/2007/10/23/guns-butter-and-european-health-care/#comment-9564 Sorry to hear about the fingerprinting, what a pain. However, the arguement is whether "health care" is the most heavily regulated industry. Despite the regulations I dont think the argument is secure. In fact if you include OSHA, then you must also include building codes, fire codes, banking regulations, tax regulations, federal, state, county, town and so on. Then what we have here is a discussion about governments over regulation of industry in general, hardly supports an argument that "health care" in the most heavily regulated industry. I challange you to open a bank. Let us then define health care, is that not completely based on the interaction between you and patient? (I think you wrote a similar notion on your blog) which part of your actual interaction with the patient is actually regulated? Cant really include insurance requirments here, you dont have to take insurance. Bottom line is this, "health care is our most heavy regulated industry" is another example of a very general statement to support a personal opinion/arguement. If Catron is to base his argument on this notion it should be backed up, define health care, define regulation, give me comparisons! Actually, my home is the most heavily regulated industry, I have to live up to building codes, zoning law, there are massive codes that outline the sale and use of my heating oil, fire codes, neighborhood standards, the sale fell under the unbelievable list of codes and regulations required to buy a house (I didnt need a lawyer to open my practice but I did to buy my house). If Catron can show me that it is in actuality the most heavily regulated industry i will submit, otherwise he is spitting in the wind. Sorry to hear about the fingerprinting, what a pain. However, the arguement is whether “health care” is the most heavily regulated industry. Despite the regulations I dont think the argument is secure. In fact if you include OSHA, then you must also include building codes, fire codes, banking regulations, tax regulations, federal, state, county, town and so on. Then what we have here is a discussion about governments over regulation of industry in general, hardly supports an argument that “health care” in the most heavily regulated industry. I challange you to open a bank. Let us then define health care, is that not completely based on the interaction between you and patient? (I think you wrote a similar notion on your blog) which part of your actual interaction with the patient is actually regulated? Cant really include insurance requirments here, you dont have to take insurance. Bottom line is this, “health care is our most heavy regulated industry” is another example of a very general statement to support a personal opinion/arguement. If Catron is to base his argument on this notion it should be backed up, define health care, define regulation, give me comparisons! Actually, my home is the most heavily regulated industry, I have to live up to building codes, zoning law, there are massive codes that outline the sale and use of my heating oil, fire codes, neighborhood standards, the sale fell under the unbelievable list of codes and regulations required to buy a house (I didnt need a lawyer to open my practice but I did to buy my house). If Catron can show me that it is in actuality the most heavily regulated industry i will submit, otherwise he is spitting in the wind.

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