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American health care vs the world!
Posts
You're confusing per country and per capita; there are a lot of people in India and China. And you're confusing reserves with yearly incomes, that few trillion is the result of a decades accumulation.
A few trillion accumulated by China over the years is still only thousands of dollars per chinese person, and since America as whole spends >$1000 per person per year on prescription drugs asking them to pay the American price for things is still likely beyond their means.
If you then look at india with its 300 billion worth reserves gives only $250 per indian person, which would allow them to pay for a delightful three months of American costed coverage.
Beat me to it. Also relevant
http://en.wikipedia.org/wiki/Four_Freedoms
QEDMF xbl: PantsB G+
Who mandates this?
Remember we are talking about sovereign countries. Does India mandate itself to require first world drug companies to provide its with deep discounts? Or does the US / British / etc government require this? Why does any government? Again we seem to be talking about a sovereign government telling a drug company to do what it wants in a way the latter would not do it if it had the choice. Why is it better for the first world government where this company is headquartered to make some sort of mandate as opposed to the third world government simply making it lawful for local manufacturers to make the drug on its own terms?
The fun thing about the US system is that if you want the other one done it might cost $40k. Or it might cost $120k or maybe $15k. Who knows! You certainly won't know until after the procedure is done and you get the bill.
It's like an unfun version of Musical Medical Insurance combined with The Price Is Right - Medical Equipment Edition.
Current Playthroughs: Neverwinter Closed Beta|Let's Build! Sim City
Yes I'm well aware you value calling dibs more than human life.
Yeah no kidding. I had to do nasal surgery last year. I called EVERYONE up and they said it wouldn't be more than my deductible, which was $2500.
Well it would have.... IF they hadn't billed everything separately. They billed the hospital, they billed the surgeon, and they billed the room all completely separate. Ended up being $5500.
Certainly. I was addressing the described situation though. I couldn't give two shits that my country is losing out on a negligible amount of money so that people don't die of preventable and treatable diseases.
This is probably more suited to the IP thread than here, but to quickly address your point, Scientific discoveries are different than products.
Once somebody goes "This is how something works" it's out of the bag. That covers everything from Liquid Soap (which was an interesting read btw) to Nuclear physics.
As it should be, nothing happens in a vacuum, all science is based on what came before.
First past the post, then everybody else must stop working on it, is a very dangerous view to hold when it comes to scientific research.
http://battlelog.battlefield.com/bf3/user/Mort-ZA/
@MortNZ
http://steamcommunity.com/id/mortious
It's not research that is being done it's mass production.
1. education
2. water
3. power
4. health
And how do you achive that?
translation:
"As i said i am coming here you ran about like a swarm of cockroaches."
*pause*
"With your ambition, your incompetence and pure greed you took these people as hostages."
*pause* *glare*
"Thousands of lives are involved. This is absolutely impermissible. Even if the owners can't come to a decision this factory will be opened again. In any case. We will do that without you. Has everybody signed the contract? Deripaska, have you signed?"
*pause* *nodding*
"I can't see your signature. Come here. Sign it. Here is the contract."
*glare* *scribbling*
"Give me my pencil back."
I would say that it ought to be a part of an agreement that a company could reach with a government re: enforcement efforts. Agree to sell your drug to a country at a discount in exchange for a greater ability to be involved in making sure your copyrights are enforced.
"There are no necessary evils in government. Its evils exist only in its abuses. If it would confine itself to equal protection, and, as Heaven does its rains, shower its favors alike on the high and the low, the rich and the poor, it would be an unqualified blessing." -- Andrew Jackson
That's not what it is at all. I value rights in property, and if I have a property right, then it doesn't matter what your claim is to my property. It is my right to decide if it is meritorious enough to warrant giving you use of my property.
"There are no necessary evils in government. Its evils exist only in its abuses. If it would confine itself to equal protection, and, as Heaven does its rains, shower its favors alike on the high and the low, the rich and the poor, it would be an unqualified blessing." -- Andrew Jackson
Yes. If you manage to call dibs on something first you value your ability to decide who can use that thing, even if denying it to them would kill them, more important. You've explained this before.
Well, now I'm good and terrified.
Maddie: "I am not!"
Riley: "You're a marsupial!"
Maddie: "I am a placental mammal!"
Maddie: "I am not!"
Riley: "You're a marsupial!"
Maddie: "I am a placental mammal!"
The only way I get my free lab tests or specialist visits are if they're requested by my GP (who I have to pay for). I guess I can go directly (though I haven't tried tbh) but then it's out of my own pocket.
Similar with medical procedures like having moles removed. Could do it on my own, but then I have to pay for it. Requested by my doctor = free.
http://battlelog.battlefield.com/bf3/user/Mort-ZA/
@MortNZ
http://steamcommunity.com/id/mortious
If I remember that article correctly, it was as much about not researching the effects of different dosages as it was about how the FDA handled it. In which case, it's not necessarily a problem that is inherent only to generic drugs.
Current Playthroughs: Neverwinter Closed Beta|Let's Build! Sim City
The motto of the FDA should not be, "You know, whatevs."
Maddie: "I am not!"
Riley: "You're a marsupial!"
Maddie: "I am a placental mammal!"
That's my biggest issue with my own. I can't just go straight to an optometrist. I first have to go to my primary doctor, tell them my eye sight's getting crappy, which they then verify with an eye chart. Of course when I go to an optometrist it's a repeat of the eye chart test which is annoyingly redundant.
But I suppose the alternative would be letting any jerk off going to the specialist they think they need which I can see getting both very annoying to specialists and very costly very quick.
Well that explains while I was still a nervous fucking wreck while taking the generic Wellbutrin available at my college pharmacy
Jesus
Who can I sue here
That's what we have here. No generalists, you just go to the appropriate specialist. It seems to work, although the lack of GPs still weirds me out. I guess it works for here, ie a nation of health-obsessed very organized people. That's the thing with a lot of systems, I think. They don't work for every nation or culture.
Anecdotes lol but the wife has seen this in a clinical setting. Doctors have just had to shrug and give the non-generic
QEDMF xbl: PantsB G+
This seems like something that could be at least partially remedied by lowering the requirements to become a GP. If it's easier to get such a license, then you'll have more GPs. If you have more GPs, it's faster and cheaper to have them screen you and direct you to the appropriate specialist. Basically, treat GPs explicitly as triage, because that's basically what they are now anyway for anything more serious than a mild infection.
Maddie: "I am not!"
Riley: "You're a marsupial!"
Maddie: "I am a placental mammal!"
Is this a new feature? I love it
It makes sense in a UHC system, to have a gate keeper. If you or your insurance is paying for it then I guess you should be able to throw your money at any specialist willing to take gold from your purse
Except those rights aren't unlimited, and are protected by laws and the monopoly on orce government has to enforce those laws.
If there were to be some form of easement, to use real property terms on your intellectual property - such as fair use doctrine - that is fully within the purview of the government.
Property rights aren't a natural right - you don't have an unlimited right do do anything with your property of any sort. Property rights are given, not simply enumerated.
I moved this to the IP thread. Seems more appropriate.
"There are no necessary evils in government. Its evils exist only in its abuses. If it would confine itself to equal protection, and, as Heaven does its rains, shower its favors alike on the high and the low, the rich and the poor, it would be an unqualified blessing." -- Andrew Jackson
A brand-name drug can only come to market after the manufacturer submits clinical trials on its safety and efficacy. Safety and efficacy tests must be done on all formulations and doses of the drug that they wish to bring to market. If the drug is intended to be used across multiple populations, they have to use broad samples.
In other words, they have to show that it works, and that it works in the populations they intend it to work, in all the forms they intend it to work.
For most generic drugs, all a generics producer has to do is compare blood plasma levels of the active ingredient between a sample of people taking the brand name versus a sample of people taking the new generic.
They don't have to show that the generic actually works. There's no efficacy requirement.
In most cases, they don't have to sample from the target population. There's no particular requirement that a generic antidepressant has to be tested on depressed people, for instance. (The FDA may require a sample from the target population for drugs that are going to be used in particularly metabolically unusual people - say, diabetes drugs.)
In most cases, they don't need to use large samples. A sample of 20 is fine.
Unless the patent specifies a specific isomer, there's no requirement to check for isomerism.
In Wellbutrin's case, they didn't need to check every dosage that Teva intended to market.
These issues have been identified in literature (example: http://www.ncbi.nlm.nih.gov/pubmed/12860486) but the FDA has been slow to adopt change. And understandably so - any additional requirements they put on generics producers to test their drugs will increase the prices of those drugs. We want generics to be affordable.
So there's a necessary balance to be struck; but I think we can pull that balance a little bit more towards patient safety without sacrificing much in the way of affordability.
So the generic that works one month might be different next time you fill your prescription
Anecdote: I brought up the issues with Teva Wellbutrin to my Target pharmacy (I take Effexor, but I requested no Teva medication).
They put a note in my account to that effect and I've never received Teva since. The pharmacist (not the tech, but the staff pharmacist) said something like, "I think we're moving away from Teva entirely for psych meds because of that."
I don't know if she meant that Target location, or the corporation, or what.
That is a very interesting idea and article. Still reading, but interesting.
"There are no necessary evils in government. Its evils exist only in its abuses. If it would confine itself to equal protection, and, as Heaven does its rains, shower its favors alike on the high and the low, the rich and the poor, it would be an unqualified blessing." -- Andrew Jackson
There does appear to be a fairly glaring oversight on someone's part. I don't quite see how the FDA could have agreed that the compounds were equivalent when there's a 50% difference in measured Cmax, unless the study they looked at didn't show that. Conflicting results in different studies aren't that surprising, but the bioavailablity stuff is generally pretty robust.
Nor do I understand why a different salt form would be allowed. It's very well established that altering that component can have a big effect on bioavailablity in oral drugs.
I do think it's interesting that they didn't show any cases of the generic outperforming the brand-name version. Apparently all the time they spend choosing a formulation is good for something.
Then Americans look over at other countries not getting raped and get upset, much like the scabs get upset at the union workers for their better pay and benefits.
Why would someone pay for what they can get for free?
He lives on as cheezburger grease in our hearts.
Well there is costs and plant involved in producing the generic. The pharma company could conceivably sell their drug at a price point that's the same as the generic and get the market that way. It's just that said price point will be very low and the companies don't like that because its really hard to get huge profits that way.