Don’t lick your fingers 
If I showed you a slice of the total death count of the US over some period of time, with the years cropped out, you would not be able to tell me whether or which year was 2001, despite the death count attributable to 9/11. The total value obscures the number because the size difference is too extreme.
Things can be big and significant by the standards of human expectation and not even a blip when you add math into the mixture.
The math is the math. The US buys more, newer, fancier drugs and equipment than other countries do. Our lifespan, when adjusted for BMI is effectively the same as other, comparable, countries. Maybe there is another explanation, but the conclusion would seem to be that the extra oomph we’re paying for isn’t actually giving us any extra oomph.
I’ll also note that, as said, countries with state run healthcare perform cost benefit analysis. You’re making the assumption that your lupus medication wouldn’t have passed muster with that analysis. If it is as effective as you say, then it likely wouldn’t fall under the heading of “things the US has supported financially that doesn’t perform well enough to have been worth paying for.”
The sorts of things that the US pays for that aren’t really good investments are more along the line of things like WiFi enabled dentistry x-ray receivers, CAT scans, “brand name” pharmaceuticals, elective surgery procedures, hospital beds with built in TVs and all sorts of other fancy features, etc.
UK hospital bed: Number of NHS hospital beds has halved in three decades | Daily Mail Online
US hospital bed: https://www.hill-rom.com/usa/Products/Category/Hospital-Beds/centrella-smart-bed/
We also overdiagnose and go above and beyond the call of duty in things like treating cancer:
There’s a certain level at which there’s value in proceeding. In the US we ignore that cost benefit analysis. We just spend and go for “extra safety”, without any actual benefit (from the standpoint of lifespan - our increased use of elective surgery does mean, for example, that people with bad knees can live more comfortably in the US. Comfort is downplayed in the UK and elsewhere.)
It tells me that some of the Federal Drug Administration’s decisions are politically motivated not based on sound science or medicine.
In this case, someone like me questions the need for a drug to be prescription only. Their reply is, “Are you a doctor? If not, shut your mouth!” They ask dermatologists who have a strong financial interest in forcing patients to be examined and they say, “Yes, you need a prescription.” Of course, Big Pharma feels the same way.
You didnt read this?
Originally Posted by SuperAbe :
Unless you’re a woman of reproductive age in which case serious birth defects are a significant issue in tretinoin usage . Other side effects (leukocytosis, etc) are more rare, but tretinoin isn’t as safe as aspirin/ibuprofen (which have their own issues).
So, significant risks, combined with rather minor benefits.
I am totally unconvinced this proves the system is meant to increase drug sales. In no way have you established that this increases drug sales.
It’s all well and fine for you to claim YOU are skeptical of the need for a prescription but that’s you. That does not prove the average person, and therefore the market as a whole, would take fewer drugs, and indeed my personal experience is that they might well take more. People want solutions and often go to the doctor demanding a prescription.
I think SuperAbe is confusing Tretinoin aka Retin-A with Isotretinoin also known as Accutane which is an oral medication and should be prescribed in only the most severe cases of acne and under the supervision of a physician due to extremely severe side effects. In fact, isotretinoin has never been approved for use in Japan. Pregnant women should be careful about anything and everything they do so I consider that a minor issue.
Expecting a reduction in medical spending is wishing for moon. The CBO, I believe, did find that ACA reduced the expected cost of Medicare and let it be solvent further into the future.
The ACA also had some features, like publication of medical costs and a push for evidence based medicine, that could reduce costs. We’ll never know now, will we?
Implementing single payer a state at a time is unlikely to be successful, and might destroy the concept in the US even more than it is destroyed now.
Yep. I was prescribed Accutane when I was in the Navy. My acne wasn’t very severe, nor does there seem to have been as much known about it 35 years ago (obviously). Luckily for me, I developed nosebleeds and fairly severe dehydration within a week of being started on it, and the doc took me off. Even if I had acne anymore, I wouldn’t come within a mile of the stuff.
Yes, I did read that. Let me explain:
It means oraltretinoin.
Even in 1990, I think that prescribing Accutane for “not severe” acne indicates a rather blase attitude towards drug prescription.
1982, actually. It had only just been approved by the FDA in that same year.
See also https://en.wikipedia.org/wiki/Isotretinoin#History, especially the first two paragraphs.
So?