Monday, March 29, 2010
Americans are being screwed - royally
I am passionately in agreement with some Republicans who warn us that the health care reform package recently passed by Congress does not go to the roots of the problems and will therefore not solve the health care crisis in America.
The Democrats' health care reform legislation is a very promising start, but the country's efforts to rein in the cost of its health care will not be successful if the root causes are not addressed.
We know that doctors are a major cause. The practice of medicine in this country is an exercise in capitalism. It is no longer considered as a public service, which it is in many countries ranging from the highly industrialized countries such as Canada, Australia, Great Britain, France and Germany all the way to third-world countries such as the Philippines and Cuba.
We know that lawyers drive up costs by going for doctor's jugulars every time doctors make mistakes. If there is no tort reform, costs will remain high.
We also know that drug companies' primary mission is to maximize returns for their stockholders. As public corporations, their ultimate responsibility is to their stockholders. Providing cures or alleviating symptoms is only a secondary mission. Once upon a time, drug companies started out with a mission to find cures for diseases. Not anymore, now Big Pharma's mission is to maximize returns for stockholders.
We know that the same drugs that are sold in the U.S. cost at least twice as much as those sold in Canada. If those drugs were invented by Americans and developed by Americans, how come American consumers pay much more for them than their Canadian counterparts?
There is only one way to explain this. U.S. drug manufacturers made the determination early on that the way to recoup their research and development expenses was to charge American consumers outrageous prices.
The American system is perfect for this. The insurance companies are the ones paying for the drugs, and as everyone knows the huge for-profit insurance companies can afford to pay. They can absorb the costs since they can merely pass them on to their insured by periodically raising insurance premiums. There is no limit to the number of times insurance companies can raise premiums.
The high-cost drugs are absorbed into the health care system in the U.S. because we have a pipeline mentality here. Whatever costs are incurred by the members of the system are merely passed on ultimately to consumers. The drugs go smoothly through the pipeline and as long as the howls and protests are few, drug prices just keep on flowing at prices that have no relation to production costs.
Only the sick notice, but sick people do not have the energy to demonstrate in Congress. They will pay any amount to get well or to keep the symptoms of their ailments under control.
The insurance companies profit from the atrociously high drug prices. Assuming that insurance companies are allowed an 8 percent return on their costs, the higher the cost of the medicines, the bigger the profits for the insurance companies.
We keep reading in the papers that American consumers subsidize the cost of drugs in other countries. To what extent? Below is a comparison of the prices of some life-sustaining and life-saving medicines sold in the U.S., Canada and Mexico.
Prescription Drug-----Dosage------Price in Maryland----Canadian Price--Mexican Price
Zocor--------------5 mg., 60 tab.-----$113.97-------------$46.17----------$67.65
Prilosec-----------20 mg., 30 cap.-----122.62--------------55.10-----------32.10
Procardia XL-------30 mg., 100 tab.----144.89--------------74.25-----------76.60
Zoloft-------------50 mg., 100 tab.----238.44-------------129.05----------219.35
Norvasc-------------5 mg., 90 tab.-----127.17--------------89.91-----------99.32
The average price differential, based on the above drug cocktail, is 98% for Maryland versus Canada and 95% for Maryland vs. Mexico. (Source: Minority Staff Report prepared for U.S. Congressman Elijah E. Cummings of the Committee on Government Reform and Oversight, U.S. House of Representatives - August 10, 1999.)
The prices charged for drugs in Australia are even lower than the prices in Canada, according to one source.
The drug industry apologists do not deny that American consumers are being raked by the drug companies for even their spare change. Every single apologist for the drug industry will tell you that drug companies must be allowed to recoup their huge investments in research and development through atrociously high prices charged American consumers.
Yes, folks, the drug companies have determined that U.S. consumers must underwrite the cost of R & D, ahead of everybody else. We Americans must pay through the nose so that others - Canadians, Mexicans, Australians, Europeans - can have the same drugs at a fraction of the prices charged Americans.
Is this right? Why must it be a disadvantage to be an American compared to being a Candaian, or an Australian? Shouldn't it be the other way around? Shouldn't we Americans pay less for prescription drugs since it is our American drug companies who are constantly coming up with these newer and better drugs with less and less side effects?
Is it because our higher standard of living allows us to afford more? Maybe so. But as we Americans know, and as the whole world now knows, the American standard of living is under attack. We Americans are becoming more and more like the Europeans. The Chinese are fast catching up with us. The Japanese have exceeded us. The Australians and Canadians are right on the trail of the Japanese.
So why do we Americans continue to subsidize the cost of medicines in other countries? Because we allow the drug manufacturers to price discriminate against us. That's the only explanation.
If we Americans stand on rooftops and scream enough is enough, we will no longer be forced to subsidize the world's consumption of life-saving and life-preserving drugs things will begin to change. And this is change that we can believe in.
The situation is urgent. Without a reform of the way drug companies price their products in the U.S., health care reform in America will remain just a dream.
We made a great start with the health care reform package passed by Congress and signed by President Obama. But, we must not stop there. Drug companies must charge consumers in other industrialized countries the same or nearly the same prices for their products as they charge American consumers.
It is not only fair, it is one essential way to reduce the cost of health care in America.
(Next week: the hospitals.)
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From Dr. Gene Pulmano (by email):
ReplyDelete"I am passionately in agreement with some Republicans who warn us that the health care reform package recently passed by Congress does not go to the roots of the problems and will therefore not solve the health care crisis in America."
Cesar,
The Republicans have never been interested in getting into the roots of the health care crisis in America.
They are simply obstructionists, Party of NO, and they are the first line of defense for their corporate clients. Greed is what's driving the health care industry.
I have a book to suggest to you: Dr. Arnold Relman's Second Opinion. He's one of the most esteemed doctors in America. He was the past editor-in-chief of the New England Journal of Medicine, the most respected medical journal in the US. Dr. Relman was a professor of medicine at Harvard.
Another book you should read to have a better picture of the health care crisis is: Critical Condition by Donald Barlett and James B. Steele, investigatiive journalists, and both two-time Pulitzer Prize winner and two-time winner of the National Magazine Award.
Gene P.
Hi Gene:
ReplyDeleteI agree with the Republicans to the extent that I know the health care reform package does not solve the cost problems. The quickest way to solve the cost issue is through a single-payer system similar to Canada's or Australia's.
I hope that someday we can get there.
From Frank Jimenez (by email):
ReplyDeleteAs a rejoinder, I would like to add a book written
by Richard Hopstader ( I forgot the title) I read in
the '70s where he pointed out the Conservative
Republicans' theological problems that make them
resistant to change. In effect, their political attitudes
essentially are based on the dogmas set forth in the
Scriptures. It is a known fact that this attitude is also
very evident and strong in the South.
Frank
Hi Frank:
ReplyDeleteI agree. The Republicans believe that God is on their side. Therefore, whatever they say must be true. They are passionate about their causes, especially those causes that spring from their moral senses.
From "Isdang Tumbaga" by email:
ReplyDeleteI have a daughter that works for a drug company, she is a scientist developing drugs. They get paid well, well, not that well.
Drugs themselves were developed in many places, and made in poorer countries where labor is cheap. Human experiments although some were done here in the US, mostly the first stages of the experiment was done in places like India where people were not told they are getting experimental drugs. But they were given drugs for free, without that "consent agreement" they will understand, but with one in the "official language" (in India for example in English, even though official majority really cannot understand it).
As soon as it is developed and made into thousands, the cost of manufacturing is really in the pennies, so cheaply made that even with your example of one at $99.00 in Canada, even at $2.00 they will make money.
So where is the justification for the cost?
They will say in development which is true, development is costly. But the initial introduction really is enough to pay for it. The bulk of the cost is not the people who developed it but at the experimentation stage, first with animals, then human. Animal experimentation is cheap but not humans.
Only a small percentage of drugs get to be approved as "safe" and even then, there is no guarantee that when introduced to the market, it will do everything it says it will and/or the side effects are worth it.
So, bottom line is that the bulk of drug companies' cost happen to be the executives' salaries in those companies, cost of advertising of which do not exist years before, in TV and other media anyways is nothing but an expense to get rid of discretionary funds, that they cannot account for, its "free money" so to speak, if you ever worked for manufacturing like I did you will find that there is lot of these so-called "free money".
Well, if those drug companies can afford to give away free samples to doctors, and they do this heavily, they can really drop down the cost to the consumers.
From Nelson Paguyo by email:
ReplyDeleteGiving free drug samples to doctors stopped several years ago. How they market their products now to doctors – at least in MN – is by sponsoring Continuing Medical Education seminars that are free and/or low cost. These medical seminars are usually conducted by accredited universities/institutions and at the end attendees are given CME credits needed to renew licenses.
Drug agents/representatives are given stalls where they advertise and provide literatures about their new products to doctors
Nelson
From "Isdang Tumbaga":
ReplyDeleteWhen? Because I can get drugs that way from doctor friends.
They just dig into their freebies and give it to me as I need them. Some of them expensive drugs.
From Nelso Paguyo:
ReplyDeleteI would say in the last 10 years when MN discouraged sample giving to doctors especially those with managed care and big clinics.
Maybe in CA some still receive samples but rarely now in MN.
Nelson
From "Isdang Tumbaga":
ReplyDeleteAnyway, the point is that drugs are so cheap to make once it is proven, thousands per second are made easily. Labor cost is also cheap since it is mostly mechanized, robotized and computerized all the way to the bottle.
From Nelson:
ReplyDeleteI agree. There is not reason why we in the US have to pay 2 to 3 time more than people in other industrialized nations.
Nelson
From Lynn Abad Santos (by email):
ReplyDeleteCHAY,
DIDN'T MICHAEL MOORE EXPOSE THIS? WHEN I MENTIONED HIS NAME TO MY REPUBLICAN FRIENDS, THEY CALLED HIM GAY
SO I ASKED WHAT HAS GAY GOT TO DO WITH THE TRUTH
IN OTHER WORDS THEY COULD NOT REFUTE IT
AND THEY THINK THEIR PARTY IS PROTECTING THEM FROM US?
THEY DON'T SEEM TO HAVE THE BRAINS TO UNDERSTAND THAT THE DRUG COMPANIES CAN ONLY ABUSE BECAUSE THEY HAVE THE REPUBLICAN PARTY PROTECTING THEM FROM THE REGULATORY AGENCIES OF THE GOVERNMENT
SOMEHOW THAT MENTAL PROCESS IS TOO COMPLICATED FOR THEM TO UNDERSTAND.
LYNN
From Aquilino Alcantara (by email):
ReplyDeletelynn ...
this is what people like me cannot understand:
when drug companies are abusing, only the republicans are allowing it or only the republicans are protecting them ... meaning only republicans are not doing their oversight job or only the republicans are closing their eyes to this shenanigans ... only the republicans in the govt are not doing their job ...
and yes I agree, that these republicans are probably to blame ...
but what we cannot understand is in the meantime: where are the democrats?
boy
From Ken Sherman via email:
ReplyDeleteI probably am going to upset someone, but a little sense needs to be added to this debate. When did anyone ever get a job from a poor guy? Or someone who didn't have a business? When did it become fashionable to persecute someone just because they are successful?
Here is a good example why taxing the rich guy is not a good idea. I will use a real example. Look at California, who the liberals have controlled for years. Incidentally, I registered as an Independent because I don't always agree with the Republicans either.
California has increased the taxes on the rich, and companies who have provided jobs. The result? Many moved out of the state and suddenly California has a 40 billion dollar debt it can't pay because there is no one left to pay it! And that is where it all ends every time!
In the health care issue they said 30 million were uninsured, yet 20 million of those were illegal aliens. Five million chose not to insure themselves, which leaves only five million or so who wanted health insurance but could get it. So why did we choose, and some people support, the insuring of 20 million people who did not respect our laws and chose to come here illegally? So now we place the cost to take care them on the backs of our children. How does this make sense?
Why have we suddenly demonized those who are successful? Who of us deserves anything? The biblical principle is the we reap what we sow. If we don't sow anything, why should we be given a big harvest?
You never get something for nothing, and in this case the people have chosen a socialist who wants to take what people have worked hard for and give it to people who are just looking for a hand out, and not a hand up.
One of the reasons I am a little frightened about moving to the Philippines is that social security is broke. This year for the first time there is more going out than is coming in. What if Obama and his socialist friends decide to stop payments to those already receiving payments or reduce the amount all in the name of fiscal responsibility? So there I am in a country thousands of miles from the US and no way to get home, and too old to work! Its a scary thought.
Our forefathers had had it with kings, and a government that did what it wanted. What so many people fail to understand is that our constitution has protected us in the past. Now it is in a shambles. With health care they are forcing you to buy something for will fine you. Where does the constitution offer that position?
The problem is not a Democrat or a Republican thing. From my point of view they are all crooks and looking after themselves and not the people. America is losing something very precious and if the people don't wake up, they may never be able to get it back again.
Hi Ken,
ReplyDeleteNot too long ago, most people who had jobs in this country had medical insurance. The U.S. was the most powerful militarily and economically. We were the envy of the world.
Now, a lot of Americans have jobs but don't have insurance. That is because health insurance in this country has become so expensive many employers do not provide it any more.
Even Wal-Mart, the biggest U.S. corporation, does not give insurance to many of its employees by classifying them as part-time workers.
What is the consequence of this? A lot of Americans don't get health care until they get real sick and have to end up in emergency rooms. The cost of this to the American economy is huge. And a lot of people who end up in hospitals without insurance cost the average insured American more than $1000 a year in increased premiums. Everybody pays for the Americans who use our health insurance facilities without insurance.
The government requires practically everyone to have insurance because of the cost factor. It is like auto insurance. People who own cars must have car insurance. People who use emergency rooms and check into hospitals must have health insurance, according to the new health care reform law. And that is just about everybody in the country.
The law prohibits the government from providing health insurance to illegal aliens. And it's not true that the additional 30 million uninsured who will be insured under the health care reform law are mainly illegal aliens. None of the 40 million Americans who are known to have no health insurance are in fact illegal aliens.
From manilalaguna29 by email:
ReplyDeleteI agree with you 100% Ken, great post.