As I said, we have the best system if cost is no object. In that case, it’s trivially easy to find a medical provider with electronic records and so forth. Is that true of all our providers? Absolutely not, which is why our system is not the best in any number of real-world scenarios.
The U.S. medical records system is horribly badly organized. I had a major accident out of state last year, so I’ve experienced having to arrange continuity of care from the E.R. to the trauma center to various providers back home.
There is no central database that providers can access. Providers seem to have no way to obtain somebody’s medical records in a timely fashion even in an emergency. The only way to get well organized medical records across all providers who have treated you is to keep them yourself. And I have experienced unreasonably long delays in getting my own medical records released to me from past providers. I now habitually start the process of requesting records be sent to me (including radiology on disk) as I leave any facility where I have had treatment.
If this were 1985, the system would be state of the art.
There is some database both my general practitioner and the pain guy can both access. Perhaps it is a state thing.
you go to France or Taiwan and you get a credit card you carry with you at all times. This card has your entire medical history on it, and any medical provider can scan it to get your medical history. We don’t have that in the US.
Actually, according to two of my former clients (one pharma, one parapharma) that’s greatly due to US agencies requiring fresh paperwork for everything. Other countries don’t, so passing EU or Japanese or Australian… requirements once you’ve passed in the US is easier than the other way 'round, simply because you can reuse most of the documentation.
If they’re like the ones in the Spanish system, the cards do not contain your medical history. What they do is give access to the computers which have it. And it’s not a credit card; it’s credit-card-sized but not a credit card. I promise you can’t use it to pay at the supermarket.
When my mother had surgery I had to go to the hospital where she had emergency treatment and pick up the records myself so I could give them to the new hospital.
Did they charge you for them? When I wanted my scans to show my doc back in Spain I was charged.
- Extend life, but no as much as the horrible socialist European systems. Probably because of your reason 2.
Within an HMO like Kaiser or my provider, which is quite large and has all the specialists you’d ever need, electronic records work really well. I have no idea if they can be exchanged with providers outside their network. And certainly not small ones. It is coming, but it is taking a while.
And their marketing budget is bigger than their R & D budget. If drug advertising was prohibited, like in many places, they’d have plenty for R&D and for buying small companies who innovate.
Speaking of Kaiser, they made a mistake on one of my tests and put “there is evidence of serious disease” rather than “there is NO evidence of serious disease”. Took them three weeks to correct it, but they only added an addendum rather than actually changing the original wording
Made it difficult to explain when I sent my results to my employer overseas.
Erm…eh?
You reckon that over half of global (population 7.6 billion) sales for pharma companies (i.e. the thing that creates the revenue for the R&D, wherever the actual research labs may be) is in the US (population 323 million).
Now I know it’s the pit and all, but I’m going to have to ask for a cite that supports that, because it smells like bull to me.
They turned me into a newt 
He is FOS. Half of Glaxo’s revenue is international: GSK revenue by region 2023 | Statista
Actually, it’s a lot more than half:
"Geographically, the US markets contributed nearly 37.2% of GSK’s total revenues at ~2.7 billion pounds for 2Q17, representing 5% operational growth compared to 2Q16. The European markets contributed nearly 26.8% of the company’s total revenues at ~2.0 billion pounds for 2Q17, representing 2% operational growth compared to 2Q16.
International markets contributed ~36.0% to GSK’s total revenues at ~2.6 billion pounds for 2Q17—1% operational growth compared to 2Q16. The increase in revenues across all geographical areas is due to strong performance of new pharmaceutical products including HIV products and vaccines products."
So, 63% of GSK’s revenue comes from the rest of the world, but somehow the US is the one generating their their research budget. Because…reasons?
Dunno - it feels to me like, to be properly fair, there needs to be some sort of ‘per disease type’ weighting in those stats.
Outcomes per patient are fair to compare per capita; new treatments, not so much.
Was the first garage in Scarfolk?
Because we’re comparing the US and the UK, not the US and the rest of the world. The point is that GSK makes far more money here than it does in the UK.
Except here’s what you actually said:
" Glaxo et al. sell most of their drugs in the US, and most of their R&D budget comes from US sales."
And, as pointed out above, that’s just not true. 2/3 of their revenue is from sales around the globe.
By the way, with regards to an earlier statement of yours:
“If cost is no object, the US has the best healthcare system in the world, bar none.”
You can get top tier treatment in pretty much any first world country if you’ve got the funds. However if you’re a billionaire and really want the very best, you cherry pick hospitals depending on your disease, for example Steve Jobs going to Basel for hormone radiation therapy.
Rocío Dúrcal (artistic name) was a child prodigy singer/actress in Spain who eventually spent most of her adult career based in México, working on both sides of the Atlantic and becoming famous mostly for her rancheras (the woman could make the violins run out of air, when she put her throat to it). When she got cancer, she went to the best hospital in Houston. Her doctor told her “from what I hear you and your family say you still have a house in Madrid, right?” “Well, yeah, we live between both countries.” “So why don’t you go back there?” “But… isn’t this hospital better?” “The techniques I’d use in your case are completely cutting-edge. I learned them in La Paz.”
So yeah, she came home.