In article ,
Dave wrote:

On Mon, 18 Oct 2004 10:11:45 -0400, "Vito" said:

This approach offers only two alternatives for a sprained ankle - pay the MD
or hurt; or in the case of diabetes or cancer pay the MDs and drug dealers
whatever they want to charge or die.

You're missing something here. As to amounts below the level where the
deductible is exceeded and true insurance kicks in, yes, it's like any other
service. You can buy the service or you can decide not to buy it and keep
the money, though you'd be paying in after-tax dollars from the first
dollar, unlike the present system where you pay in pre-tax dollars until you
exceed a percentage of adjusted gross. In the case of serious illness the
true insurance kicks in to cover higher costs.

That's hardly "free market". In a free
market, I'd be able to buy my medicines over the counter at *competative*
prices and bargain with MDs for rates but US law forbids the former and AMA
the latter.

Please explain the second part. How does the AMA prevent you from selecting
someone with lower fees, or a reduction by the doc?

So, whether I have a HMO or pay myself, I really have no
choices. Under either Bush's or Kerry's plan I (or my HMO) still have to pay
an MD $400 or more a year for permission to buy medicines I already know I
need.

Good point. There's really no reason to have an annual toll to buy medicines
you know you need.

Then I have to pay 2 - 10 time more for them than in Canada and
Mexico. Kerry says he'd at least let us shop Canada ..... (c:

That's simply snake oil. One of two things happen. Either you create a
shortage in Canada, or the Canadians prohibit export. (Probably both. Or, if
they are sensible about it, they allow the price to rise to a point where it
won't make any difference.)

Completely simplistic. Explain why Canadian (or Aussie or anyone else
with proper manuf. stds) manufacturers simply wouldn't ramp up
production. We have a similar scheme to the Canucks and the US drug
companies hate it. Tough.

Personally, I think it would be a good idea to
allow importation, since it would ultimately force the Canadians to pick up
part of the development costs that are now being born entirely by Americans.

Bwahahahahahahahaha. You get paid off by drug companies?

PDW

And you would be lying since there have not been "low thousands" to read.

--
"j" ganz @@
www.sailnow.com

"Dave" wrote in message
...
On Mon, 18 Oct 2004 10:11:49 -0700, "Jonathan Ganz"
said:

Dave still hasn't explained how he's been able to read "1000s" of Supreme
Court decsisions. We're still waiting Dave.

Actually, what I said was certainly high hundreds and probably low
thousands. The answer is, of course, is that reading decisions in cases is
something lawyers do a lot of. In 35 years of lawyering, I've read a lot
of
decisions.

Not tell me again about that one case you read that makes you an expert on
legal opinions.

In article ,
Dave wrote:

On Tue, 19 Oct 2004 10:03:32 +1100, Peter Wiley
said:

Completely simplistic. Explain why Canadian (or Aussie or anyone else
with proper manuf. stds) manufacturers simply wouldn't ramp up
production. We have a similar scheme to the Canucks and the US drug
companies hate it. Tough.

There's this thing called a patent covering the most recently developed
drugs. If a Canadian manufacturer isn't licensed, he can't produce the drug.

Well, duh! And there are a huge number of drugs out of patent which are
produced in places other than the USA. Are these affected too? Not to
mention trivial patents on delivery mechanism etc to extend the life of
the basic patent and exclude competition - 'evergreening' I think the
term is.


Personally, I think it would be a good idea to
allow importation, since it would ultimately force the Canadians to pick up
part of the development costs that are now being born entirely by
Americans.

Bwahahahahahahahaha. You get paid off by drug companies?

Nope. My only connection to the industry is that years ago I represented an
Australian company in licensing its enteric coated antibiotic in the U.S.
(that's the technology that is now applied to the low-dosage aspirin you see
on the shelves). But I do have an interest in seeing additional development
of new drugs. That's not going to happen if the rewards for the successful
developments are absent. At the present time, Americans bear nearly all of
the development costs. The Canadians get a free ride because once the cost
of development has been covered, the cost of producing each additional dose
is relatively low. So the pharma company can sell the additional production
in Canada at the regulated price and still make a profit. It's the old
marginal revenue vs. marginal cost thing from basic economics. Allow
importation and one of the results I outlined previously will follow.

Hmmm. Didn't basic economics have something to say about monopolies and
monopoly profits? The foreign govts in the case of Australia and Canada
bargain with the drug companies directly. They have sufficient economic
clout to do so on a more level playing field. Funnily enough prices for
drugs are somewhat cheaper.

I have some sympathy with the arguments about cost of development since
the number of successes is so low. However the drug companies
collectively are very unethical organisations who don't publish the
results of failed trials and cherry-pick results wherever they can to
get their 'success' rate up. Therefore my sympathy is pretty limited.

Perhaps there needs to be a different method for companies to recover
R&D costs. Meanwhile I'm a lot bette off living where I do right now
than you people are.

PDW

"Dave" wrote
On Mon, 18 Oct 2004 10:11:45 -0400, "Vito" said:

This approach offers only two alternatives for a sprained ankle - pay the
MD
or hurt; or in the case of diabetes or cancer pay the MDs and drug
dealers
whatever they want to charge or die.

You're missing something here. .....

I understand that - it just doesn't go far enough to be called a competative
free market. Which brings up a point about insurance. MDs historically
charge "all the market will bear" meaning wealthier patients pay more than
poor ones. After sizing me up my MD decides I'm good for say $100/visit.
Then I mention that $100 is exactly what my insurance will pay. Guess what?
I just became a $200/visit patient. That's one reason MDs never advertise
prices. It follows that any/all insurance plans raise medical costs so long
as MDs charge every penny the patient can afford.

That's hardly "free market". In a free
market, I'd be able to buy my medicines over the counter at *competative*
prices and bargain with MDs for rates but US law forbids the former and
AMA
the latter.

Please explain the second part. How does the AMA prevent you from
selecting
someone with lower fees, or a reduction by the doc?

By "recommending" fees and "sanctioning" MDs who bargain or advertise their
prices. An MD who refuses to obey could well loose his license. The proof?
When is the last time you saw an MD advertise his fees?


So, whether I have a HMO or pay myself, I really have no
choices. Under either Bush's or Kerry's plan I (or my HMO) still have to
pay
an MD $400 or more a year for permission to buy medicines I already know
I
need.

Good point. There's really no reason to have an annual toll to buy
medicines
you know you need.

But that's the law!

Then I have to pay 2 - 10 time more for them than in Canada and
Mexico. Kerry says he'd at least let us shop Canada ..... (c:

That's simply snake oil. One of two things happen. Either you create a
shortage in Canada, or the Canadians prohibit export. .....

You'd be right if I enjoyed a free, supply & demand driven drug market in
the USA but we do not. Thanks to laws against reimportation US drug
companies charge US druggists 2-10X more than they do foreign druggists. US
druggists could buy medicines at retail from Canada at a fraction of the
wholesale price they pay in the USA if our law allowed reimportation but it
does not. Often part of this 'gouge' funds the kickbacks drug companies pay
the MDs for prescribing their brand vs another. Hey - its enough to make
the mob jealous!

"Peter Wiley" wrote
I have some sympathy with the arguments about cost of development since
the number of successes is so low. However the drug companies
collectively are very unethical organisations ..... Therefore my sympathy
is pretty limited.

"Unethical" is an undertatement. There currently is no "approved" cure for
diabetes so millions of people throughout the world each spend $100s per
month to stay alive. OTOH scientists can take a few of your cells, strip
out your DNA and inject it into, say, a frog egg stripped of its frog DNA,
and that cloned egg will divide into YOUR stem cells. That's a fact
(Remember Dolly the sheep?). Now if my stem cells were injected into my
pancreas they would say "Gee, we must be Vito's pancreas cells!" and begin
making insulin - and my diabetes would be cured. So why isn't that
happening? Because additional research is needed to get the proceedure
approved and who is going to pay for that? Not the drug companies! It'd cost
them $billions!! Maybe that's why Bush won't allow federal funding. Y'see
it takes PATIENT DNA to do the research and Bush only allows a dozen or so
"established strains" to be used. Or maybe it's because the good folks who
eat their god every sunday also think that every lump of stem cells is a
baby.

Vito wrote:
... There currently is no "approved" cure for
diabetes so millions of people throughout the world each spend $100s per
month to stay alive.

There is no cure for diabetes, period. It isn't a matter of "approval."

... OTOH scientists can take a few of your cells, strip
out your DNA and inject it into, say, a frog egg stripped of its frog DNA,
and that cloned egg will divide into YOUR stem cells. That's a fact
(Remember Dolly the sheep?). Now if my stem cells were injected into my
pancreas they would say "Gee, we must be Vito's pancreas cells!" and begin
making insulin - and my diabetes would be cured.

Well, if it's that simple, why don't you do it yourself?

... So why isn't that
happening? Because additional research is needed to get the proceedure
approved and who is going to pay for that?

Actually, it is happening. But very little of it is happening in the
U.S. The type of "cure" you envision may be possible in ten years, or it
may never be possible... the research may lead to something else.

Meanwhile, approval of implantable blood metering devices and
micro-controlled insulin metering devices is proceding, too.


... Not the drug companies! It'd cost
them $billions!! Maybe that's why Bush won't allow federal funding. Y'see
it takes PATIENT DNA to do the research and Bush only allows a dozen or so
"established strains" to be used. Or maybe it's because the good folks who
eat their god every sunday also think that every lump of stem cells is a
baby.

You may be blaming the wrong folks. It turns out that George Bush Jr.
ain't "church people" after all.

In any event, you're crying for the moon and getting mad at Daddy for
not fetching it for you. How much have you donated to the American
Diabetes Society this year? Last year? How much translational research
have you funded?

You're angry at the docs & drug companies for making a profit, and
insisting that they cure you for free. That doesn't make much sense.

DSK

"Dave" wrote
Ah, the latest variation on the urban legend about the oil companies
buying
up and killing that invention that would allow cars to get 200 miles to
the
gallon. Some things never change.

If so it is being promulgated by no less than Ronald Reagan Jr.

"Dave" wrote
Nice populist rhetoric, but there's no such thing as a "drug company"
aside
from its people, .....

It's not so much a question of ethical vs unethical, it is what one's ethics
are. Las Vegas was a nice place to visit when "The Mob" ran the casinos. I
could stay in a nice hotel, enjoy a couple top entertainers' shows, and eat
like a king for peanuts so long as a budgeted my gambling. But then we
replaced the mobsters with honest businessmen - beancounters devoted to
squeeing every cent of profit out of every visitor. Used to be you could
play 5 nickles and get 3 back, sometimes winning a jackpot. Oh yes, the
house would get all you were willing to play, but they were patient and let
you have fun giving it to them. Not so the beancounters.

Sadly, the same is true of most US companies. If you own a company you run
it according to your own ethics. If you run a company for somebody else
then you maximize his profits even if that means some people must go without
the medicines they need. That's why "companies" often lack any sense of
ethics.

In article ,
Dave wrote:
On Mon, 18 Oct 2004 16:16:20 -0700, "Jonathan Ganz"
said:

And you would be lying since there have not been "low thousands" to read.

Jon, you're continuing to demonstrate your own ignorance of the field.
Currently, plenary review with oral argument is granted for approximately
100 cases per term. The Court hands down formal written opinions in
approximately 80-90 cases per term. The difference between the two figures
is because sometimes after oral argument the Court decides that it shouldn't
have granted cert.

And, you continue to try and weasel out of the fact that you claim
you've read "thousands" of decision; whereas, the Supremes haven't had
thousands. You're a liar.


--
Jonathan Ganz (j gan z @ $ail no w.c=o=m)
http://www.sailnow.com
"If there's no wind, row."

"Dave" wrote
You're proving my point.......

Yes, a point on which we have no disagreement - I just think that the rest
of the system needs fixing too.

By "recommending" fees and "sanctioning" MDs who bargain or advertise
their
prices. An MD who refuses to obey could well loose his license. The
proof?
When is the last time you saw an MD advertise his fees?

If that's indeed the case, somebody ought to go after them for price
fixing.
Such activities violate the Sherman Act, as a cases against the ABA in the
60s established.

That's exactly what needs to be done but I see neither candidate proposing
it.


One reason MDs don't advertise their fees is that it makes no economic
sense to do so. ...

But it would under your (Bush's?) plan which BTW is exactly what we all had
before HMOs. I'd price shop if I was paying the first $xxxx. I tried to
back then but MDs wouldn't (couldn't?) disclose their rates over the phone
let alone advertise them.

Often part of this 'gouge' funds the kickbacks drug companies pay
the MDs for prescribing their brand vs another. Hey - its enough to make
the mob jealous!

If anyone has proof of that he ought to get in touch with Eliot Spitzer,
since commercial bribery is a crime in his state, and he has great
political
ambitions.

Who's Eliot Spitzer? I think they call it "commisions" instead of
commercial bribery. Isn't it legal?