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  1. #51
    MattKing's Avatar
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    There is a fundamental difference between the medical care system in the US, and the medical care available.

    All of us elsewhere in the world benefit greatly from the medical care that is available in the US. The "for profit" emphasis in the US has resulted in tremendous advancements, that have spilled over to benefit much of the rest of the world.

    Unfortunately, it is difficult to pay for a "for profit" system, unless one is quite wealthy, or unless the costs are shared between a great many people.

    Various parts of the world approach the problem in a variety of different ways. Most who have a medical system have elected to share that cost publicly, at least to a certain extent - including the US (Medicare). The amount of public involvement varies greatly.

    PE refers to the fact that people travel to the US to obtain medical treatment - and they do.

    And many people (in particular seniors) travel from the US to Canada to do the same - because our medical system controls the price of drugs, thus making them far cheaper in many cases than in the US, even when one takes into account that those people need to pay the (much smaller) charge levied by Canadian doctors to issue the necessary prescription.

    And Mexico has a thriving industry providing medical and dental services to both US and Canadian patients, because prices are great.

    When the US auto industry nearly collapsed, one of the differences that was highlighted between Canadian and US manufactured autos was the huge cost advantage enjoyed by the Canadian plants because of the lower medical costs borne by the employers.

    My father is a Kodak Canada retiree. His pension benefits appear to be secure and fully funded. The most recent assessment (2010?) by the department in the Ontario government that monitors private pension funds based in that province indicates that the pension fund for existing and recently retired employees is at least 98% fully funded. The medical benefits are much less expensive here in Canada, and government funded beyond a certain deductible. The biggest concern is dental benefits. It is not at all clear whether there is any risk to those medical and dental benefits, because Kodak Canada is not part of the bankruptcy, save and except it is a wholly owned subsidiary of Eastman Kodak.
    Matt

    “Photography is a complex and fluid medium, and its many factors are not applied in simple sequence. Rather, the process may be likened to the art of the juggler in keeping many balls in the air at one time!”

    Ansel Adams, from the introduction to The Negative - The New Ansel Adams Photography Series / Book 2

  2. #52
    Photo Engineer's Avatar
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    In my posts, I am merely comparing, on a level playing ground if it were, medical treatment without any concern about who pays what. On that basis, the US still leads. If it did not, then why do so many people come here for treatment. Before you jump in to answer, look at past threads on this and the comments.

    PE

  3. #53

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    Quote Originally Posted by MattKing View Post
    .

    And many people (in particular seniors) travel from the US to Canada to do the same - because our medical system controls the price of drugs, thus making them far cheaper in many cases than in the US, even when one takes into account that those people need to pay the (much smaller) charge levied by Canadian doctors to issue the necessary prescription.
    That is incorrect. It is CANADA that controls the price of drugs, not allowing them for sale unless Canada is allowed to set the price. This price is of course BELOW market costs. Were everyone to do what Canada does, drug design would suffer dramatically.

  4. #54
    MattKing's Avatar
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    Quote Originally Posted by RattyMouse View Post
    That is incorrect. It is CANADA that controls the price of drugs, not allowing them for sale unless Canada is allowed to set the price. This price is of course BELOW market costs. Were everyone to do what Canada does, drug design would suffer dramatically.
    Depends on what you define as market cost.

    Pharmaceutical companies seem quite willing to sell into the Canadian market. They are also very happy to partner with Canadian universities in research.

    Canada also controls distribution costs - pharmacists here are required to sell drugs at cost, save and except a flat dispensing fee that is subject to market pressures.

    If Pharmaceutical companies made the same profits worldwide that they make in the US, they wouldn't be just profitable, they would be insanely profitable.
    Matt

    “Photography is a complex and fluid medium, and its many factors are not applied in simple sequence. Rather, the process may be likened to the art of the juggler in keeping many balls in the air at one time!”

    Ansel Adams, from the introduction to The Negative - The New Ansel Adams Photography Series / Book 2

  5. #55
    Ken Nadvornick's Avatar
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    Quote Originally Posted by Photo Engineer View Post
    In my posts, I am merely comparing, on a level playing ground if it were, medical treatment without any concern about who pays what. On that basis, the US still leads. If it did not, then why do so many people come here for treatment. Before you jump in to answer, look at past threads on this and the comments.

    PE
    Sure, you can make that kind of comparison. Just subtract—or ignore—all of the negatives until only positives remain. Anyone can do that. But it's a specious claim. A meaningless data point. The observation carries no relevance in the real world. It cannot be applied to the true reality of the health care crisis in this country with any expectation that a greater level of insight or understanding will be forthcoming. We can't do anything with it.

    When I finally left through the emergency room eight hours after my wife's arrival I was saddened to see, still patiently sitting in the same chair in the admitting waiting room, the same single mother (no ring, I looked) holding her young daughter with a bandaged head showing some minor bleeding. Along with the thirty or so others also still waiting, presumably all without insurance. Most just staring blankly ahead. Eight hours later. I'm not making that up.

    I didn't have the heart to stop and tell her that she should be thankful for the level playing field that allowed her injured daughter to be treated by the best medical system in the world.

    Ken
    "They are the proof that something was there and no longer is. Like a stain. And the stillness of them is boggling. You can turn away but when you come back they’ll still be there looking at you."

    — Diane Arbus, March 15, 1971, in response to a request for a brief statement about photographs

  6. #56
    Ken Nadvornick's Avatar
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    Quote Originally Posted by RattyMouse View Post
    How could a broken arm cost substantially more than emergency surgery and a delivered baby?? My wife was on the operating table less than 30 minutes after me rushing her to the ER. Our baby was delivered immediately and several surgeons did exploratory surgery to try to find out what was causing her such massive pain. Her entire abdomen was examined by the surgeons.

    She had several weeks of recovery care due to the extensive nature of the surgery done on her.
    Well, I still have all of the paperwork. And my wallet is still $4,000 lighter...

    Ken
    "They are the proof that something was there and no longer is. Like a stain. And the stillness of them is boggling. You can turn away but when you come back they’ll still be there looking at you."

    — Diane Arbus, March 15, 1971, in response to a request for a brief statement about photographs

  7. #57

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    Quote Originally Posted by RattyMouse View Post
    ...It is CANADA that controls the price of drugs, not allowing them for sale unless Canada is allowed to set the price. This price is of course BELOW market costs...
    Bold added by me. That is incorrect. Canada's permitted prices for drugs are below US market prices, not below what the pharmaceutical industry's costs of production and distribution are. If your statement were correct, there would be no prescription drugs for sale in Canada.

    Quote Originally Posted by RattyMouse View Post
    ...Were everyone to do what Canada does, drug design would suffer dramatically.
    Such is the fiction / scare tactic promulgated by big pharma. Also, I'm not sure that, as a whole, the country has seen much benefit from drugs developed with huge profit potential in mind. Unless one thinks Viagra is of great value to society.

    Overall, in my opinion, we'd be much better off with R&D for medications to attack disease being funded by the government. Then, production would be handed off (at no licensing cost if they agree to make the drug for at least a certain period of time) to manufacturing firms that produce generics. Of course, I thought the Affordable Care Act was an anemic half measure, with single-payer medical insurance being a much better solution.

  8. #58

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    Quote Originally Posted by Sal Santamaura View Post
    Bold added by me. That is incorrect. Canada's permitted prices for drugs are below US market prices, not below what the pharmaceutical industry's costs of production and distribution are. If your statement were correct, there would be no prescription drugs for sale in Canada.

    Such is the fiction / scare tactic promulgated by big pharma. Also, I'm not sure that, as a whole, the country has seen much benefit from drugs developed with huge profit potential in mind. Unless one thinks Viagra is of great value to society.

    Overall, in my opinion, we'd be much better off with R&D for medications to attack disease being funded by the government. Then, production would be handed off (at no licensing cost if they agree to make the drug for at least a certain period of time) to manufacturing firms that produce generics. Of course, I thought the Affordable Care Act was an anemic half measure, with single-payer medical insurance being a much better solution.
    First off, if you were unable to have sex, you'd be damn grateful for Viagra. You show incredible insensitivity towards people who suffer from that condition.

    Second of all, countries like Canada drive up US prices because they pay lower costs. That's a fact. Few industries are as risk intensive as drug design. For every drug that reaches commericalized status, 1,000 or more fail. The amount of money risked to produce a working drug that cures or mitigates a disease is enormous. Such risk should be rewarded no? Otherwise who would risk such money?

    The average drug design chemist see ONE of his drugs reach commercialization during his entire CAREER. I'm not in drug design, but I am a chemist with several colleagues in that industry. Close to 20 years of cancer research and he has yet to get a drug into the market. 20 years of work. I work in Industrial lubricants for manufacturing. I get 10-15 products into the market per year.

    Further, the amount of equipment needed to do drug design is enormous. A 50,000 dollar GC is a baby's toy compared to NMR spectrometers, X-Ray crystallography etc, that runs into the hundreds of thousands or millions. Very few PHD's work i my industry. Drug companies have PHD's coming out of the wood work. They get the highest salary.

    Finally, drug companies over the past several years are laying off THOUSANDS of research chemists all over America. My friend over at (what used to be Abbott) is hanging on for his life right now. 20 years in cancer research and he has told me that he expects to be laid off at any moment now, the pressure on pharmaceutical companies is that intense now. He said if that comes to pass, his days of medicinal chemistry are over. There is no hope to get a job anywhere else in that field.

    I always wanted to be in drug research and cursed that I never got into that field. But after seeing what goes on in there, I am grateful to have escaped that pressure filled pot.

  9. #59

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    One other thing Sal. At my former company, I worked next to a chemist, a lady who suffered from a very rare form of gastrointestinal cancer. This cancer is completely untreatable by chemotherapy or radiation. ONE year before she got this cancer, it would have been a death sentence. Her great luck was that GLEEVIK (not sure if I am spelling that right) came on the market before she developed this cancer. This drug keeps her alive, as long as she takes it. It took decades to develop a drug like this and the costs of that R & D must be recovered. The drug is amazingly expensive. I cant remember the price she told me, over $10,000 a month I'm sure. But it has kept her alive over 5 years. She got to see her kids graduate from college thanks to that drug.

    You can be damn sure that the people who funded that research did so for a return. NIH funded work pays for some drug design work but never in its entirety. Private money must be used.

    It is incredibly ignorant to say "I'm not sure that, as a whole, the country has seen much benefit from drugs developed with huge profit potential in mind."

    Amazingly ignorant.

  10. #60
    MattKing's Avatar
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    It is true that in a purely profit based pharmaceutical research environment, one needs a whole bunch of profits to develop pharmaceuticals.

    The question is, is that the best environment for the purpose? It has had great successes, but I wonder how many other wonderful drugs and other treatments might have been developed if the market for them wasn't such an important determinator.

    And I wonder if the costs of developing drugs might be much lower if there wasn't so much potential profit to be made.
    Matt

    “Photography is a complex and fluid medium, and its many factors are not applied in simple sequence. Rather, the process may be likened to the art of the juggler in keeping many balls in the air at one time!”

    Ansel Adams, from the introduction to The Negative - The New Ansel Adams Photography Series / Book 2



 

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