Not “nationalized” in the sense that the government owns them, but the fact that there is no competition to buy them means that the government will basically pay (or not pay) whatever it wants for new and existing drugs. It’s not nationalized, but the effects are the same.
You are not suggesting pharmaceuticals are in any way sold in a free market now, are you? How many companies sell Lipitor? Do you think market pressure determines the price?
Sure but you are engaging in a false dichotomy:
‘ability to pay’ vs ‘connections’
What about ‘clinical need’?
In the US, my surgeon may well have been classified as ‘out of network’ by my insurance. So it may be a case of, go with an in-network doc with a 30% kill rate, vs this guy with 10% and pay $10,000.
Whereas in the UK, it was “whoa he’s a difficult case - send him to the best guy”.
zhongguorenmin
There’s also the odd idea that the big pharma companies are in some free market utopia here in the United States. Huh? As if the government doesn’t hand out massive corporate welfare left and right and also give them interesting market protections. Or the fact that a lot of the original works are done in universities or small biotech firms. Or the fact that most of these companies spend way more money on advertising or administrative costs than actual R&D. Or the fact that major medical discoveries are made all the time in those dirty “socialized medicine” European countries.
It’s all very confusing to the average person, listening to some of this rhetoric…yet, the polls don’t lie. It’ll be a very interesting battle: the elderly, small businesses, and the majority of the American population versus big pharma and the insurance industry on the other. This’ll require some popcorn.
It does constantly amuse me how many Americans believe that America is responsible for all drug R+D.
Try telling that to AstraZenica, Hoffmann-La Roche, Novartis, Sanofi-Aventis, and GlaxoSmithKline: five of the top ten drug companies are European, and the other five are American AFAIK.
This is about what you’d expect- until recently the major world economies consisted only of North America and Europe, with Japan on the side. And unless Alex Kerr has lied to me (probably) Japanese drug development is something of a joke.
So European drug companies seem to be holding their own against the Americans.
zhongguorenmin
What if the best guy doesn’t work for the National Health Service?
I’m sure there are a few (cosmetic surgeons and fertility people, maybe) docs who don’t work for the NHS at least part-time, but in the UK there are (AFAIK) no major non-NHS hospitals, that are equipped for cardio-thoracic surgery.
There are no private ERs, and all ‘serious’ acute medicine is done in NHS facilities. Even if I had paid my surgeon to do my op privately, it would have been in the NHS hospital - I’d just be paying for the facilities rather than getting them for free.
There are private hospitals, but they tend to specialise in minor surgical things that people want done quickly. NHS buddies of mine tend to dislike them - they often lack serious staff and expertise, to a level that wouldn’t be allowed in the NHS. When something serious goes wrong, they sometimes put the patient in an ambulance to the nearest NHS place.
zhongguorenmin
Mostly zhongguorenmin is right. There are exceptions, however - I don’t think many people would seriously argue that there’s little difference in the quality of mental health provision in the NHS compared to the private sector.
Ah yes - good point! And dentistry.
zhongguorenmin
There are many competitors to Lipitor, such as Zocor, Pravachol, Zetia, Lescol, Crestor, Advicor and Lovostatin, so Pfizer cannot sell Lipitor for whatever price it wants.
Even if Lipitor were the only cholesterol-lowering drug in the world, there would be price pressures, albeit fewer of them, as patients would simply not be able to afford it, or would look more seriously at diet-based solutions.
I assume that you mean lack of tort reform. Do you have a cite for this claim?
This document - http://tinyurl.com/255cwa - would seem to refute it.
I keep seeing this claim but the impression I’ve gotten is that it’s mostly insurance company propaganda.
In socialized countries are there any provisions for dental, optical or psychiatric.?
Apart from the inaccuracy of the term ‘socialised countries’…
In the UK, NHS dental treatment is subsidised, with free cover for the likely suspects (children, the elderly, on unemployment benefits, etc). However the difficulty in obtaining treatment with an NHS dentist has become a big political issue recently. Optometry has a similar subsidised system, but without the problems of shortages etc.
Psychiatric care is part of the standard remit of the NHS. However, as I said above, it’s a field in which there are massive shortcomings. Not for acute short-term situations (mental and secure hospitals are as much a part of the NHS as general ones), but for ongoing care for depression, schizophrenia, anorexia, etc etc. In theory the system does provide care, but there’s big holes in the safety net which it should be providing, and it’s one area where a cheque book can get, via a private referral, treatment and therapy which just would not be available. Or rather, it’s often available but at the end of a waiting list. And each suggestion of a new therapy or specialist entails another wait.
It certainly isn’t true that American companies are responsible for all drug R+D. But isn’t it true that America’s market is responsible for most drug R+D? Isn’t it the US where these companies make most of their money? Isn’t the US in effect subsidizing other countries national drug programs? These are actual questions, BTW, not disguised statements.
The problem isn’t the doctor’s salaries. The problem is the 18% of health care money the insurance companies take out of the system to line their pockets. Setting up the health insurance companies as health care gatekeepers is a spectacularly bad idea. It gives one group of people a financial incentive to deny health care to another group of people. The health insurance companies are slowly eating this country.
My thoughts are these/
Inequity, yes. Inefficiency - extremely unlikely.
Creating a one-payer system would bail out existing programs only to create a single huge “crunch”.
The assumption that long waits for procedures will not materialize under a similar U.S. system strikes me as, at the least, overoptimistic.
I’m all for preventative care. More of it will reduce illness and suffering, and prolong lives. What it won’t do is save money. It will be politically impossible not to provide access to the latest wundertesting/care for everyone, regardless of debates about benefit and cheaper alternatives. For instance, take just two recent hotly debated advances - breast MRIs as a supplement to mammograms and the HPV vaccine.
Also waiting in the wings are providers of “alternative” medicine, whose lobbyists will be demanding coverage for their various brands of non-evidence-based woo.
And so they will under a one payer system. Or whatever system we have. What you should know, though, is that even in the current system Medicare payments to doctors have been flat or declining in many if not most fields for years. This affects insurance payments for non-Medicare services which are tied to the Medicare rates. Yet health care costs keep rising.
I think universal health care coverage of some sort is needed in America, and that it is inevitable that government will get into it in a big way. Analysts’ projections and politicians’ promises (like Hillary Clinton’s pledge of multibillions in savings) are, however, a total crock. Costs will climb greatly, only the money won’t go to health care providers - it’ll be paid out to accountants, bureaucrats and managers. Or disappear as a result of scams and corruption.
People with poor or no coverage will be better off - those currently with decent plans will be worse off (in terms of cost and services).
I don’t know that doctor shortages will be that big a deal overall - but it’s certainly possible in certain specialties if the compensation goes downhill.
And I can get jobs with 4 of those with out changing my time zone.
As has been noted, at the top there really aren’t European and American drug companies, rather Euro-american drug companies that are incorperated in different countries.