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I'm voting republican because...
On Sep 16, 1:22*pm, "John R. Carroll"
wrote: wrote: On Sep 12, 5:14 pm, "Hawke" wrote: CLINTON dropped the ball on this one. snip How come you don't address the fact that Clinton could have gotten OBL a number of times but didn't? Was it above his pay grade? (Good thing OBL didn't change his name to "Vince Foster") Don't confuse Ms Carrol with the ugly truth. Your "truth" is a lie told originally by NewsMax. Read the 9/11 Commission Report for the truth. http://www.9-11commission.gov/staff_...tatement_5.pdf (bottom of page 3): If you think that by informing our right wingers of the truth about the subject it will have any effect on their beliefs you are out of your mind. The point is those guys don't care about the truth so informing them won't do any good. They believe what they want to believe and even if you show them they are wrong they still won't change their minds. That's just the way they are. Hawke The truth of your free health care is that I get to pay for mine and I get to pay for yours. A study coming out Tuesday from scholars at Columbia, Harvard, Purdue and Michigan projects that 20 million Americans who have employment-based health insurance would lose it under the McCain plan. There is nothing secret about Senator McCain's far-reaching proposals, but they haven't gotten much attention because the chatter in this campaign has mostly been about nonsense - lipstick, celebrities and "Drill, baby, drill!" For starters, the McCain health plan would treat employer-paid health benefits as income that employees would have to pay taxes on. "It means your employer is going to have to make an estimate on how much the employer is paying for health insurance on your behalf, and you are going to have to pay taxes on that money," said Sherry Glied, an economist who chairs the Department of Health Policy and Management at Columbia University's Mailman School of Public Health. Ms. Glied is one of the four scholars who have just completed an independent joint study of the plan. Their findings are being published on the Web site of the policy journal, Health Affairs. http://healthaffairs.org/blog/2008/0...ninsured-cheap... According to the study: "The McCain plan will force millions of Americans into the weakest segment of the private insurance system - the nongroup market - where cost-sharing is high, covered services are limited and people will lose access to benefits they have now." The net effect of the plan, the study said, "almost certainly will be to increase family costs for medical care." Under the McCain plan (now the McCain-Palin plan) employees who continue to receive employer-paid health benefits would look at their pay stubs each week or each month and find that additional money had been withheld to cover the taxes on the value of their benefits. -- * * * * * *John R. Carroll *www.machiningsolution.com- Hide quoted text - - Show quoted text - What did their study show under the Obama/Weasel health care plan? |
I'm voting republican because...
On Wed, 17 Sep 2008 03:44:13 -0700, hot-ham-and-cheese wrote:
Why can't you grasp the concept of getting your own health care and quit mooching off of me? Do you have any evidence that he does? -- Regards, Curly ------------------------------------------------------------------------------ I Love Republicans, They Taste Just Like Chickenhawks ------------------------------------------------------------------------------ .................................................. ............... Posted via TITANnews - Uncensored Newsgroups Access at http://www.TitanNews.com -=Every Newsgroup - Anonymous, UNCENSORED, BROADBAND Downloads=- |
I'm voting republican because...
If you think that by informing our right wingers of the truth about the subject it will have any effect on their beliefs you are out of your mind. The point is those guys don't care about the truth so informing them won't do any good. They believe what they want to believe and even if you show them they are wrong they still won't change their minds. That's just the way they are. Hawke If you think that by informing our left wingers of the truth about the subject it will have any effect on their beliefs you are out of your mind. The point is those guys don't care about the truth so informing them won't do any good. They believe what they want to believe and even if you show them they are wrong they still won't change their minds. That's just the way they are. |
Health Care
On Wed, 17 Sep 2008 02:49:15 -0400, Ed Huntress wrote:
"Curly Surmudgeon" wrote in message . .. On Tue, 16 Sep 2008 17:33:16 -0400, Ed Huntress wrote: snip Yes, now I would. I just went through six sessions of laser eye surgery for PDR. I don't want to do it again. I'll pay for the best control I can get. Physicians Desk Reference? Dunno "PDR." Most diabetics would opt for injections when the pump is out of pocket, except for those in extreme distress. Sorry, you seemed to know about diabetes so I used the abbreviation for proliferative diabetic retinopathy. As for opting for injections, that's fine if you're lucky enough to have A1c readings of less than 7.0. Some people's systems just won't allow it, even if they do multiple blood-glucose tests and inject ten times a day. I test 5 times a day and inject 6 or more separate doses, but my A1c runs around 7.2. The newest pumps should get someone like me down to something under 6.8. 7.0 will carry you if you have good genes and haven't been diabetic for more than 10 or 15 years. I have the right genes, but it's 35 years for me. Until the eye problem I was the only Type 1 (juvenile) diabetic I knew with more than 30 years on the clock who had no major problems. Now I have one, but, thanks to advanced medical technology (laser surgery) I may not have the problem again. Maybe. I'll keep my fingers crossed for you but do not extrapolate your extreme medical condition to the general populace. Note, I've designed medical instrumentation. One product is not too dissimilar to your insulin pump, it took a blood sample from a drip line and tested for lactate acid giving real time results. I am very familiar with the industry. Well, maybe I should interview you for an article I've had in the can for a year. It's about medical-device manufacturing and meeting the FDA and customer requirements. I have eight interviews done, but I'm losing energy for it. Use my email in the header. Thanks. I've put this message into the file in case I revive that article. I have around 50 hours invested in it so I do want to finish it. snip True but the root cause is that health care insurance is unavailable at rational cost. Kaiser for my wife and I would be $1600/month in the USA and is about $25 in Argentina. So, Argentina has subsidized or government-run insurance. I'm all for it. Kinda, sorta both. Immigrants can buy into the state system but each municipality has an open clinic where the costs are very cheap. A front/side chest x-ray cost about $13, dental extraction of molar with abscess cost a friend $6.70, etc. I've bought into private health care at a local hospital chain. Ambulance service is free, I used it two nights running when semi-conscious and unable to drive. Heh, I had _chicken_pox_ at my age... Never knew it could be life threatening... Being in the seond or third economic tier can produce some wonderful benefits for a country. For example, you don't have to invent or develop much of anything. You just use the same stuff that was developed in the leading countries. You'll find that the companies selling that stuff can be very compliant to your political needs. They'll set up an entirely separate accounting system for dealing with you, one that doesn't have to account for any upfront costs, because those are all paid for in the leading country. Since your market is basically a gift to those companies, providing unanticipated sales on otherwise idle production capacity, they'll be happy to treat you as a source of marginal sales, and all that their books will show as expense against their selling price in your country is the marginal manufacturing costs and shipping. Something that costs $100 in the leading country, where they're amortizing all of the upfront costs, might cost $2 in your country. And it will appear on their books as a profitable sale -- because it's a marginal sale. Accounting can be a very creative thing. d8-) The problem with being a second- or third-tier country in those circumstances is that your economy basically don't exist outside of the orbit of the leading countries. It creates quite a web of dependencies over which you have no control. But it sure saves a hell of a lot of money. All true. On the other hand you are talking about providing cutting edge technology to the general population and that's not a reasonable expectation. Regrettably it's a path that will bankrupt the health care system. Life sometimes sucks and if you are very poor you may not be able to afford a life saving proceedure, that's what charity is for. On the other hand those costs are outrageous and we must bring them down to earth. Your program further inflates costs to the majority for the few, mine chops the hell out of those costs for the majority at the expense of a few. I believe that my program is the more humane by far. There's always a ready market for new drugs and new medical technology. True, and sometimes the costs are justified. But recognize that a full 60% of new drugs are governmentally subsidized through university research then turned over to pharmaceuticals for manufacture and distribution with but a bare tithe to the university while Abbott et. al. gains usuary profits on our own tax dollar. sigh I'm well aware of how that works. My last job in a medical communication agency involved a drug on which Sanofi-Aventis had paid something like $135 million in development costs, and $110 million in pre-approval marketing costs (which was paying my salary). Then the FDA decided not to approve the drug. So my company laid half of us off. d8-) The basic research on that drug was not from a university, however. I know that a lot of the basic research is done in universities. What you may not know is that the testing that the pharma companies have to go through after some basic-science lab makes a discovery often costs ten times more than the basic research. I'm familiar with the problem. The FDA should be an advisory, not regulatory, agency. All the special interest groups like, encourage, support, and fund that evil. I completely disagree about having the FDA become an advisory agency, We disagree then. I see the FDA as a self-serving bureaucracy controlled by special interests. I do not like the idea of a governmental agency telling me what medicines or treatments I can, and can't, have. The thing is, Curly, that you have no experience of buying or using drugs in an environment that isn't dictated by the FDA and similar agencies in other highly developed countries. So you're speculating about how it would work out. To the contrary, remember, I've lived in Argentina for about 3 years now where I can buy just about any drug without a prescription and those that do are drugs that I'm not interested in. Those lower-tier economies have an office that sounds like FDA, but it's usually an empty shell full of rubber stamps, giving supposed approval to drugs and procedures that have gone through the approval process of the FDA or the British, French, or German equivalents. And the drugs they sell over-the-counter are mostly ones that have been vetted, for prescription sale or otherwise, by the leading countries. And it's wonderful. I needn't visit a doctor for simple drugs, I can self-medicate, I can refill my one long term medication without being molested by a self-interested bureaucracy. I can get immunizations and injections at the pharmacy too. This is one major reason I live here, I hate the "Big Brother" attitude. The only direct comparison you can make is to the US before there was an FDA. It was much harder to get a centralized, reliable count in those days of how many people were winding up dead from taking the drugs then available. But the number was substantial. We can tell now, in a lot of cases, because those drugs have since been run through large clinical trials in which the results have been measured. That's an excellent foundation to convert the FDA upon too. That work will not be lost, its the basis for evolving healthcare. for the same reason we got the FDA in the first place. Those greedy corporate types you're complaining about wouldn't mind killing many more people if they could get away with it. Testing on humans first is the way to make more money. That is not what I propose. Let the FDA provide online, honest, data on drugs and let the buyer comment and beware. You're proposing a system by which smart people save a few bucks, and not-so-smart people make minor mistakes and drop dead. I don't really like the sound of it. "A few bucks"????? We're talking thousands and tens of thousands of dollars per person! Do not extrapolate your health condition to the population at large. Not-smart people do not "drop dead" they don't medicate usually and if a few do "drop-dead" then that's life. Or death. Note that I've actually been through the FDA approval process. Not responsible but as an independent contractor responsible for adhering to the requirements on glucose monitors, inhalation dispensers and patient monitoring systems. I should point out here that testing a medical device is NOTHING like testing a drug. It's much simpler, and it's done with much smaller cohorts, so it's vastly cheaper. You don't see $50 million studies for devices, as you often do for drugs. I think I mentioned elsewhere that a new drug requires roughly a half billion dollars to become FDA certified. That is intolerable. Generics, Canadian, and other sources are often 90% cheaper. Of course. Generics just ride on the research, testing, post-marketing studies and marketing that was done for the original drug. All they have to recover is manufacturing costs and quality-control reporting. In Canada, they have price controls and just refuse to allow the drug companies to amortize research and development. The Canadians, and the French, and the Brits, and everyone else knows that they can collect those costs in the US. How long do you think a pharmaceutical should have a monopoly? Is 17 years not enough? It depends on how you structure it. Some kind of regulated, extended and mandatory licensing would reduce prices and keep up enough income to fund big trials. And it's the big clinical trials that cost most of the money in pharma. Patented medicines are too expensive, but generics are too cheap. Precisely why I want to change the FDA to an advisory agency. Today it costs roughly half a billion dollars to bring a drug to market, that is irrational and runs the prices up so that the general tax fund must subsidize use. But what's the basis on which the FDA would "advise"? The last drug I worked on as an employee (rimonabant) was being sold in France, Germany, the UK, and parts of South America before three long-term studies ordered by the FDA turned up the problems with it. The Europeans got egg on their faces -- and some dead citizens -- because they didn't require the long-term studies. Now they're pulling back and black-boxing those drugs. But they never would have known the problems without those huge studies, which cost something like $100 million in total to run. There you go, publish those data, update as more data becomes available. Caveat emptor. Who pays for that if the FDA doesn't impose it as a requirement for approval? You're talking about going back to the dark ages of the drug business, when people died from taking drugs and no one knew the drug was involved in the deaths. Hell, no one even knew that the people who died had been taking the drugs. Statistical review can pull that data from the noise. People died in the example you offered even with testing. Not only test subjects but subjects who were denied the new medications but might have been helped. That's life. And death. **** happens, no one life is worth the cost of FDA regulations. It can be argued that limiting drugs as the FDA does costs lives too. snip You are one of the lucky, many cannot get insurance because they are under employed, unemployed, homeless. Yeah, we know. I'm very lucky. The year before last I paid insurance out of my pocket for six months, and it cost me almost $7,000. How would you change that inequity? Universal health care, with a single-payer system and optional supplemental insurance. Take the European and Canadian systems, analyze the good and the bad in each, and design a better one based on those experiences. You'll have to re-engineer a lot of the health care business to do it. Tort reform, reducing redundancies in testing facilities, etc. Very socialist-sounding. Very politically incorrect. But the only way to reduce costs and provide health care for everyone at the same time. The danger with it is not so much a case of limiting coverage (that will happen no matter what system you use, including our present free-for-all system), but rather limiting innovation. That part will require very careful work. Since the US is the last country of any substance without universal health care, this is where most of the innovation happens. The Europeans and others are tuned to our drum; they adjust their systems so they don't look too bad in the innovation department, given our example. It's hard to say how that would work if there was no free-for-all system like the US against which to compare oneself. It is a concern, if every major country has a controlled system. It's easy to become complacent if there is nothing against which to compare your results. I don't expect a universal system to work really well. I just expect it to produce a better result than we have now, in terms of health statistics. There is no way that it will produce as much innovation. You pay your money and take your choice. My choice is universal coverage. Mandated health insurance, right? What about those who do not want mandate health care? What you propose violates my freedom and monopolizes the health care industry. It is also a license to steal and further empowers the FDA monopoly. Redirecting the FDA to an advisory agency would immediately chop off at least half the cost of health. Remove the AMA monopoly and another quarter might be saved. Cutting health care costs by 75% would be easy and making care available to those who now cannot afford your care would save more lives than are now being lost. What we now have are a number of state protected monopolies which prevent competitive forces to rein in health care costs. I cannot/will not vote for that. This transitions into the quality of care issue too. Another factor we've not discussed is the costs caused by AMA monopoly of providers. Midwives and alternative treatments have essentially been banned to create a monopoly. Then there is the FDA making many drugs prescription only. In fact some years ago the FDA stated that they would have made many current over the counter drugs a prescription item if they had it to do over. They are now trying to rectify that by regulating vitamins, minerals and even tobacco. We Americans have an aversion to reading about dead people who took drugs they were told were OK. **** happens. Life is not guaranteed safe. The government is only permitted to regulate fraud and crime, not what we ingest. I think the law disagrees with you on that. g You realize that I have a very low opinion of laws which violate my liberty, don't you? We have no obligation to obey anti-constitutional laws. Your ideas concerning pharma are ideological, abstract, and unreal based on what we know about drugs, Curly. You're laying out a prescription for ignorance and death. No one would know what drugs are causing what side effects and adverse outcomes; all you'd have is a collection of rumors, marketing claims, and guesswork. That is an unsupportable assertion and one that I disagree with deeply. When market forces are unleashed we also need to revamp fraud laws to keep the manufacturers honest but all major diseases have drug treatment now so the number of new drugs coming onto the market is smaller. And hideously more costly given the current FDA regulations. We cannot permit an industry to blackmail us for health care. We've gone beyond that and hardly anyone who knows the issues would want to go back. Your reactionary approach would result in a meaner and riskier health care system for everyone. It would be cheap, but it would leave a lot of bodies and maimed lives in its wake. Nope, all the current drug treatment programs would continue, no risk involved. Only new drugs coming onto the market might risk, advise the patient rather than burden the health care of every other individual on earth. This is where the FDA would come in, monitor the use of new drugs and provide statistical analysis of the effects for advising other users in the future. -- Regards, Curly ------------------------------------------------------------------------------ I Love Republicans, They Taste Just Like Chickenhawks ------------------------------------------------------------------------------ .................................................. ............... Posted via TITANnews - Uncensored Newsgroups Access at http://www.TitanNews.com -=Every Newsgroup - Anonymous, UNCENSORED, BROADBAND Downloads=- |
I'm voting republican because...
On Wed, 17 Sep 2008 03:24:44 +0000, Ray Fischer wrote:
wrote: On Sep 16, 8:39*am, wf3h wrote: On Sep 15, 11:29*pm, wrote: On Sep 15, 11:40*pm, wf3h wrote: On Sep 15, 9:55*pm, wrote: The truth of your free health care is that I get to pay for mine and I get to pay for yours which you do now. it's just more expensive now than it would be under universal care. I get first dibs at the doctors under the present system. *And why shouldn't I? *I'm paying for it. so you enjoy having average health care for inflated prices? I enjoy paying my own way. Even if it costs you half again as much. Half? Try 3x or 4x if health care were truly reformed removing the FDA and AMA monopolies. Making health care affordable would eliminate these debates and discussions from the table. Sucker. yep sounds republican. Yeh, that whole, ummm, personal responsibility thingy really upsets some folks. If you're so in favor of "personal responsibility" then why don't you insist on higher taxes? Under the squirrels and the hawkes system, I pay for theirs and I pay for mine, and some else says who gets dibs on appointments and treatments. never heard of an HMO did you? they tell you what doctors you'll go to, what treatment they'll pay for, etc. I could have selected the HMO route and paid less. Instead I selected a Preferred Choice plan. As opposed to paying your own way? you really HAVE swallowed the GOP kool aid, haven't you? you don't have control over your health care at all. your boss does. your insurance company does. As it stands now, I can change plans and I can change bosses. And if you get sick or injured and can't work, you can't get any plan, you can't get any job, and you and your family go broke. The leading cause of personal bankruptcies is medical emergencies. Second leading cause, yes! -- Regards, Curly ------------------------------------------------------------------------------ I Love Republicans, They Taste Just Like Chickenhawks ------------------------------------------------------------------------------ .................................................. ............... Posted via TITANnews - Uncensored Newsgroups Access at http://www.TitanNews.com -=Every Newsgroup - Anonymous, UNCENSORED, BROADBAND Downloads=- |
Health Care
"Ray Fischer" wrote in message ... Ed Huntress wrote: "Ray Fischer" wrote in message . .. Ed Huntress wrote: "Curly Surmudgeon" wrote in message Lets not get sidetracked into the health insurance debate for it masks the underlying problem. The fundamental problem is that our health care system has been hijacked by corporate powers making healthcare too expensive. Nonsense. The main thing that makes it so expensive is that medical technology marches forward, not backward, and there's always more stuff to apply to medical problems -- increasingly expensive stuff. That would be a better argument if not for the fact that US healthcare is the most expensive in the world. Americans pay 50% more then the next most expensive industrial nation. Right. It's the most expensive, and, for those who can afford it, the most effective. The reason it doesn't look very effective in the statistics is that a lot of people can't afford it. Is that an example of right-wing doublethink? Oh, I don't think there's doublethink involved. As we can see from some of the postings here, some of the right-wingers really don't care that there are many people who are uninsured. To them, those people who can't afford the extra $15,000/yr. or so should have thought of that when they were in middle school, or they should have chosen their parents more responsibly, so they'd be making that much more money now. As far as they're concerned, those irresponsible oafs are just screwing up the statistics for the rest of us. And it marches forward because people will pay for it, as an alternative to living in misery or dying. There's always a ready market for new drugs and new medical technology. Meanwhile Americans have shorter lifespans and higher infant mortality. See above. Things are pretty ducky if you have a few million or more. That's why even heads of state and foreign corporations come here to get some of their operations. We're especially good at neurosurgery and plastic surgery. Our nose jobs can't be beat. Ah. Social darwinism. Eliminate the poor. Well, it would make the statistics look a lot better. -- Ed Huntress |
I'm voting republican because...
On Tue, 16 Sep 2008 23:04:18 -0700, Hawke wrote:
wrote in message ... On Sep 16, 3:32 am, Curly Surmudgeon wrote: On Mon, 15 Sep 2008 21:29:20 -0700, hot-ham-and-cheese wrote: On Sep 15, 11:40 pm, wf3h wrote: On Sep 15, 9:55 pm, wrote: The truth of your free health care is that I get to pay for mine and I get to pay for yours which you do now. it's just more expensive now than it would be under universal care. I get first dibs at the doctors under the present system. And why shouldn't I? I'm paying for it. Under the squirrels and the hawkes system, I pay for theirs and I pay for mine, and some else says who gets dibs on appointments and treatments. of course, if you lose your job and don't want health care, just refuse it...for you and your kids. i won't mind That, in part, is what motivates me to keep working. If only we could motivate the little squirrel and the little hawke to work... And you continue to make **** up. What psychedelics do you take? I don't make up ****. The little squirrel and the little hawke are short-sale "investors." What kind of health plan comes with that? None. You guys are waiting for me to pay for your health care. See, this guy is just plain dumb. I've told him myself numerous times that under a universal care program he will only have to pay the same or less than he's paying now. He can't grasp the concept that we are spending more than enough to cover everybody but we are doing it so badly and so wastefully that we don't cover everyone. With all the dough going into health care there is plenty to cover everyone. Unfortunately, this guy is willfully ignorant. No matter how many times you correct him he never understands what's going on. He learned something like an old dog and he can't learn anything new. Hell, that's a typical republican for you. He probably still thinks Bush is going to have a budget surplus before his term in office is over. Hawke Agreed but please use the "reply" button on your newsreader so the msg to which you reply is properly nested. It's not obvious by glance where his words end and yours begin. Remember who you are speaking to. Do you really want people to mix his words with yours? -- Regards, Curly ------------------------------------------------------------------------------ I Love Republicans, They Taste Just Like Chickenhawks ------------------------------------------------------------------------------ .................................................. ............... Posted via TITANnews - Uncensored Newsgroups Access at http://www.TitanNews.com -=Every Newsgroup - Anonymous, UNCENSORED, BROADBAND Downloads=- |
Health Care
"Curly Surmudgeon" wrote in message . .. On Wed, 17 Sep 2008 02:49:15 -0400, Ed Huntress wrote: "Curly Surmudgeon" wrote in message . .. On Tue, 16 Sep 2008 17:33:16 -0400, Ed Huntress wrote: snip Yes, now I would. I just went through six sessions of laser eye surgery for PDR. I don't want to do it again. I'll pay for the best control I can get. Physicians Desk Reference? Dunno "PDR." Most diabetics would opt for injections when the pump is out of pocket, except for those in extreme distress. Sorry, you seemed to know about diabetes so I used the abbreviation for proliferative diabetic retinopathy. As for opting for injections, that's fine if you're lucky enough to have A1c readings of less than 7.0. Some people's systems just won't allow it, even if they do multiple blood-glucose tests and inject ten times a day. I test 5 times a day and inject 6 or more separate doses, but my A1c runs around 7.2. The newest pumps should get someone like me down to something under 6.8. 7.0 will carry you if you have good genes and haven't been diabetic for more than 10 or 15 years. I have the right genes, but it's 35 years for me. Until the eye problem I was the only Type 1 (juvenile) diabetic I knew with more than 30 years on the clock who had no major problems. Now I have one, but, thanks to advanced medical technology (laser surgery) I may not have the problem again. Maybe. I'll keep my fingers crossed for you but do not extrapolate your extreme medical condition to the general populace. Thanks, and I don't extrapolate. Type I diabetics make up just a fraction of 1% of the population. I'm just a shining example d8-) But considering that Type II (adult-onset) diabetics have similar problems -- some of them worse, in fact, including the incidence of loss of limbs -- and make up 23.1% of the US population over age 60 (and those are just the ones that have been diagnosed), my situation is not really "extreme." It's just that I got started earlier and serve as a kind of weathervane for those who acquired the similar condition later in life. If you're in your 50s or older, those 10-15 years of grace that 20-year-olds enjoy may shrink to just a few years. Note, I've designed medical instrumentation. One product is not too dissimilar to your insulin pump, it took a blood sample from a drip line and tested for lactate acid giving real time results. I am very familiar with the industry. Well, maybe I should interview you for an article I've had in the can for a year. It's about medical-device manufacturing and meeting the FDA and customer requirements. I have eight interviews done, but I'm losing energy for it. Use my email in the header. Thanks. I've put this message into the file in case I revive that article. I have around 50 hours invested in it so I do want to finish it. snip True but the root cause is that health care insurance is unavailable at rational cost. Kaiser for my wife and I would be $1600/month in the USA and is about $25 in Argentina. So, Argentina has subsidized or government-run insurance. I'm all for it. Kinda, sorta both. Immigrants can buy into the state system but each municipality has an open clinic where the costs are very cheap. A front/side chest x-ray cost about $13, dental extraction of molar with abscess cost a friend $6.70, etc. I've bought into private health care at a local hospital chain. Ambulance service is free, I used it two nights running when semi-conscious and unable to drive. Heh, I had _chicken_pox_ at my age... Never knew it could be life threatening... Being in the seond or third economic tier can produce some wonderful benefits for a country. For example, you don't have to invent or develop much of anything. You just use the same stuff that was developed in the leading countries. You'll find that the companies selling that stuff can be very compliant to your political needs. They'll set up an entirely separate accounting system for dealing with you, one that doesn't have to account for any upfront costs, because those are all paid for in the leading country. Since your market is basically a gift to those companies, providing unanticipated sales on otherwise idle production capacity, they'll be happy to treat you as a source of marginal sales, and all that their books will show as expense against their selling price in your country is the marginal manufacturing costs and shipping. Something that costs $100 in the leading country, where they're amortizing all of the upfront costs, might cost $2 in your country. And it will appear on their books as a profitable sale -- because it's a marginal sale. Accounting can be a very creative thing. d8-) The problem with being a second- or third-tier country in those circumstances is that your economy basically don't exist outside of the orbit of the leading countries. It creates quite a web of dependencies over which you have no control. But it sure saves a hell of a lot of money. All true. On the other hand you are talking about providing cutting edge technology to the general population and that's not a reasonable expectation. Regrettably it's a path that will bankrupt the health care system. Life sometimes sucks and if you are very poor you may not be able to afford a life saving proceedure, that's what charity is for. On the other hand those costs are outrageous and we must bring them down to earth. Well, that's all true, too. The healthcare issue as many people see it is that everyone should have the same cutting-edge technology available to them. That's a majority position in the US (as in most of the world) now, as unrealistic as it may be. It will be the guiding idea behind health care reforms. The practical outcome will be different. The question is how much different it will be, because health care reform is coming, whether the conservative ideologues want it or not. It's a tsunami that's racing across the seas from all directions. Your program further inflates costs to the majority for the few, mine chops the hell out of those costs for the majority at the expense of a few. I believe that my program is the more humane by far. If you follow the polls, you realize that yours is definitely a minority position, and the trend is against you. It will lose, politically. It's just a question of how soon it will come to a vote and move. What will happen is that universal health care will be sold in a package with efforts to cut medical costs. Some efforts will be successful. Others will not. It will extend the delay to the crisis point for a while, maybe for many years. And then we'll decide what we want and can have, once again. There's always a ready market for new drugs and new medical technology. True, and sometimes the costs are justified. But recognize that a full 60% of new drugs are governmentally subsidized through university research then turned over to pharmaceuticals for manufacture and distribution with but a bare tithe to the university while Abbott et. al. gains usuary profits on our own tax dollar. sigh I'm well aware of how that works. My last job in a medical communication agency involved a drug on which Sanofi-Aventis had paid something like $135 million in development costs, and $110 million in pre-approval marketing costs (which was paying my salary). Then the FDA decided not to approve the drug. So my company laid half of us off. d8-) The basic research on that drug was not from a university, however. I know that a lot of the basic research is done in universities. What you may not know is that the testing that the pharma companies have to go through after some basic-science lab makes a discovery often costs ten times more than the basic research. I'm familiar with the problem. The FDA should be an advisory, not regulatory, agency. All the special interest groups like, encourage, support, and fund that evil. I completely disagree about having the FDA become an advisory agency, We disagree then. I see the FDA as a self-serving bureaucracy controlled by special interests. I do not like the idea of a governmental agency telling me what medicines or treatments I can, and can't, have. The thing is, Curly, that you have no experience of buying or using drugs in an environment that isn't dictated by the FDA and similar agencies in other highly developed countries. So you're speculating about how it would work out. To the contrary, remember, I've lived in Argentina for about 3 years now where I can buy just about any drug without a prescription and those that do are drugs that I'm not interested in. No, because Argentina's health care system, as I explained above, exists in the shadow of the FDA and the European (and Japanese) equivalents of our system. I don't know Argentina in particular but most countries are in that situation. Argentina's health care system can only function because it's parasitic on the systems of the major players, in terms of what drugs are available, how they've been vetted, and what experience from those more regulated countries tells the Argentinians about what works and what doesn't. They don't operate in a vacuum. A friend of mine who was the Carter-Wallace rep for Africa, and who also repped throughout the Caribbean, explained it in fine detail to me over a period of years. What I learned from working for Big Pharma confirms the same thing. They're all riding on information that comes from the drug development, testing, approval process, and record-keeping of the major western countries. They make their own decisions, but they don't have any significant amount of their own information on which to base them. They can get all the information they need from us, for free. You can go online and collect the PIs (prescribing information) forms from the FDA for 1,000 drugs in a couple of days; put a team of physicians and other specialists together to review them; and develop a drug policy and approvals for a medium-sized country in less than a month. And that's the skeleton of how they actually do it. Those lower-tier economies have an office that sounds like FDA, but it's usually an empty shell full of rubber stamps, giving supposed approval to drugs and procedures that have gone through the approval process of the FDA or the British, French, or German equivalents. And the drugs they sell over-the-counter are mostly ones that have been vetted, for prescription sale or otherwise, by the leading countries. And it's wonderful. I needn't visit a doctor for simple drugs, I can self-medicate, I can refill my one long term medication without being molested by a self-interested bureaucracy. I can get immunizations and injections at the pharmacy too. This is one major reason I live here, I hate the "Big Brother" attitude. It's only possible because there is a Big Brother who provides them with all the information, for free. Then they make their own decisions, based on their politics, their sense of responsibility to their people, their legal structure, and their tolerance for a few unfortunate deaths resulting from people who are medically ignorant making life-and-death medical decisions. In the case of many countries, their willingness to institute a system of controls -- that is, their willingness to pay for such a system -- enters as a big factor. The only direct comparison you can make is to the US before there was an FDA. It was much harder to get a centralized, reliable count in those days of how many people were winding up dead from taking the drugs then available. But the number was substantial. We can tell now, in a lot of cases, because those drugs have since been run through large clinical trials in which the results have been measured. That's an excellent foundation to convert the FDA upon too. That work will not be lost, its the basis for evolving healthcare. It won't be lost, but it's only available for drugs that are already available. New ones need new studies and analysis. for the same reason we got the FDA in the first place. Those greedy corporate types you're complaining about wouldn't mind killing many more people if they could get away with it. Testing on humans first is the way to make more money. That is not what I propose. Let the FDA provide online, honest, data on drugs and let the buyer comment and beware. You're proposing a system by which smart people save a few bucks, and not-so-smart people make minor mistakes and drop dead. I don't really like the sound of it. "A few bucks"????? We're talking thousands and tens of thousands of dollars per person! Do not extrapolate your health condition to the population at large. Not-smart people do not "drop dead" they don't medicate usually and if a few do "drop-dead" then that's life. Or death. Huh? Over 125,000 people die in the US each year from drug reactions and mistakes alone. Misprescribing leads to some of the reactions; lack of clinical-study information about drug interactions leads to most of them. That's not "a few" who are dropping dead. As for the "tens of thousands of dollars per person," the average pharmaceutical bill in the US is $850/person. The way to cut that is with some reforms in health care and the way the pharma industry is regulated, not in deep-sixing the FDA, because it's the FDA that keeps that 125,000 deaths from being a much larger number. We pop a hell of a lot of pills, and a lot of them are deadly if they're used ignorantly. Note that I've actually been through the FDA approval process. Not responsible but as an independent contractor responsible for adhering to the requirements on glucose monitors, inhalation dispensers and patient monitoring systems. I should point out here that testing a medical device is NOTHING like testing a drug. It's much simpler, and it's done with much smaller cohorts, so it's vastly cheaper. You don't see $50 million studies for devices, as you often do for drugs. I think I mentioned elsewhere that a new drug requires roughly a half billion dollars to become FDA certified. That is intolerable. Half of that number is marketing. Cut the marketing, not the clinical studies or drug regulations. I don't care how much the marketing people get anymore. g Generics, Canadian, and other sources are often 90% cheaper. Of course. Generics just ride on the research, testing, post-marketing studies and marketing that was done for the original drug. All they have to recover is manufacturing costs and quality-control reporting. In Canada, they have price controls and just refuse to allow the drug companies to amortize research and development. The Canadians, and the French, and the Brits, and everyone else knows that they can collect those costs in the US. How long do you think a pharmaceutical should have a monopoly? Is 17 years not enough? It depends on how you structure it. Some kind of regulated, extended and mandatory licensing would reduce prices and keep up enough income to fund big trials. And it's the big clinical trials that cost most of the money in pharma. Patented medicines are too expensive, but generics are too cheap. Precisely why I want to change the FDA to an advisory agency. Today it costs roughly half a billion dollars to bring a drug to market, that is irrational and runs the prices up so that the general tax fund must subsidize use. But what's the basis on which the FDA would "advise"? The last drug I worked on as an employee (rimonabant) was being sold in France, Germany, the UK, and parts of South America before three long-term studies ordered by the FDA turned up the problems with it. The Europeans got egg on their faces -- and some dead citizens -- because they didn't require the long-term studies. Now they're pulling back and black-boxing those drugs. But they never would have known the problems without those huge studies, which cost something like $100 million in total to run. There you go, publish those data, update as more data becomes available. Caveat emptor. That's precisely what they do. It's all available to the public, once it's submitted for FDA approval. I read around 360 studies related to the marketing for one drug, alone. Regarding "caveat emptor," how many do you have time to read? They run around 8 or 10 pages each, on the average, and they're not very entertaining. I've read thousands of clinical studies but I'll do the emptoring, and let the FDA do my caveating, thank you. d8-) Who pays for that if the FDA doesn't impose it as a requirement for approval? You're talking about going back to the dark ages of the drug business, when people died from taking drugs and no one knew the drug was involved in the deaths. Hell, no one even knew that the people who died had been taking the drugs. Statistical review can pull that data from the noise. People died in the example you offered even with testing. Many die even with the testing we have now. Many more would die without it. Not only test subjects but subjects who were denied the new medications but might have been helped. That's life. And death. **** happens, no one life is worth the cost of FDA regulations. FDA fast-tracks cancer drugs and many other critical drugs now. You might want to make the track faster. I think it's about right. It can be argued that limiting drugs as the FDA does costs lives too. I've read the arguments. The data is available. You'll find it with a good search on PubMed. snip You are one of the lucky, many cannot get insurance because they are under employed, unemployed, homeless. Yeah, we know. I'm very lucky. The year before last I paid insurance out of my pocket for six months, and it cost me almost $7,000. How would you change that inequity? Universal health care, with a single-payer system and optional supplemental insurance. Take the European and Canadian systems, analyze the good and the bad in each, and design a better one based on those experiences. You'll have to re-engineer a lot of the health care business to do it. Tort reform, reducing redundancies in testing facilities, etc. Very socialist-sounding. Very politically incorrect. But the only way to reduce costs and provide health care for everyone at the same time. The danger with it is not so much a case of limiting coverage (that will happen no matter what system you use, including our present free-for-all system), but rather limiting innovation. That part will require very careful work. Since the US is the last country of any substance without universal health care, this is where most of the innovation happens. The Europeans and others are tuned to our drum; they adjust their systems so they don't look too bad in the innovation department, given our example. It's hard to say how that would work if there was no free-for-all system like the US against which to compare oneself. It is a concern, if every major country has a controlled system. It's easy to become complacent if there is nothing against which to compare your results. I don't expect a universal system to work really well. I just expect it to produce a better result than we have now, in terms of health statistics. There is no way that it will produce as much innovation. You pay your money and take your choice. My choice is universal coverage. Mandated health insurance, right? What about those who do not want mandate health care? Screw 'em. As it is, they're winding up in the ER and taxpayers are footing the bill. This isn't Zimbabwe or the Sudan so we aren't going to just let them die, so ram health care coverage down their throats, for the same reason we don't let people drive without liability insurance. What you propose violates my freedom and monopolizes the health care industry. Yup. When your "freedom" becomes my tax bill, because you can't or won't cover your own ass, you've just forfeited some of your freedom, IMO. Or you can move out. That's your freedom. It is also a license to steal and further empowers the FDA monopoly. What's your gripe with the FDA? I can see bitching about Big Pharma, or hospitals, or doctors, but the FDA does a pretty good job, IMO. What is it you think they do? Redirecting the FDA to an advisory agency would immediately chop off at least half the cost of health. Baloney. It would just speed up the casket business. Remove the AMA monopoly and another quarter might be saved. Great. We'll let anybody put out a shingle. I told my wife, after studying endocrinology for some of my work, that maybe I should go into the business and start prescribing hormones. It would be a great experiment and fun, too. d8-) Cutting health care costs by 75% would be easy and making care available to those who now cannot afford your care would save more lives than are now being lost. Hey, you aren't in the market for a Bridge to Nowhere by any chance, are you? What we now have are a number of state protected monopolies which prevent competitive forces to rein in health care costs. I cannot/will not vote for that. Significant competitive forces don't exist in health care; never did, and never will. You don't shop around when you're having a heart attack. This transitions into the quality of care issue too. Another factor we've not discussed is the costs caused by AMA monopoly of providers. Midwives and alternative treatments have essentially been banned to create a monopoly. Then there is the FDA making many drugs prescription only. In fact some years ago the FDA stated that they would have made many current over the counter drugs a prescription item if they had it to do over. They are now trying to rectify that by regulating vitamins, minerals and even tobacco. We Americans have an aversion to reading about dead people who took drugs they were told were OK. **** happens. Life is not guaranteed safe. The government is only permitted to regulate fraud and crime, not what we ingest. I think the law disagrees with you on that. g You realize that I have a very low opinion of laws which violate my liberty, don't you? We have no obligation to obey anti-constitutional laws. shrug The Founding Fathers didn't anticipate CT scans and open-heart surgery. They were lucky to get leeches. Your ideas concerning pharma are ideological, abstract, and unreal based on what we know about drugs, Curly. You're laying out a prescription for ignorance and death. No one would know what drugs are causing what side effects and adverse outcomes; all you'd have is a collection of rumors, marketing claims, and guesswork. That is an unsupportable assertion and one that I disagree with deeply. Well, fine. Spend four or five years studying and writing about pharmaceuticals and health insurance, and we'll have another talk. When market forces are unleashed we also need to revamp fraud laws to keep the manufacturers honest but all major diseases have drug treatment now so the number of new drugs coming onto the market is smaller. And hideously more costly given the current FDA regulations. We cannot permit an industry to blackmail us for health care. You tell 'em. We've gone beyond that and hardly anyone who knows the issues would want to go back. Your reactionary approach would result in a meaner and riskier health care system for everyone. It would be cheap, but it would leave a lot of bodies and maimed lives in its wake. Nope, all the current drug treatment programs would continue, no risk involved. Only new drugs coming onto the market might risk, advise the patient rather than burden the health care of every other individual on earth. This is where the FDA would come in, monitor the use of new drugs and provide statistical analysis of the effects for advising other users in the future. That's what they do now. Then they regulate the ones that would kill us off the market. That's about it. -- Ed Huntress |
Health Care
On Wed, 17 Sep 2008 12:52:18 -0400, Ed Huntress wrote:
Feel free to prune as you feel fit, if I think something important was left out I'll reinsert it and not attribute ill intent on your part. You are not a gunner, HH&C or Jerry... "Curly Surmudgeon" wrote in message . .. On Wed, 17 Sep 2008 02:49:15 -0400, Ed Huntress wrote: "Curly Surmudgeon" wrote in message . .. On Tue, 16 Sep 2008 17:33:16 -0400, Ed Huntress wrote: snip Yes, now I would. I just went through six sessions of laser eye surgery for PDR. I don't want to do it again. I'll pay for the best control I can get. Physicians Desk Reference? Dunno "PDR." Most diabetics would opt for injections when the pump is out of pocket, except for those in extreme distress. Sorry, you seemed to know about diabetes so I used the abbreviation for proliferative diabetic retinopathy. As for opting for injections, that's fine if you're lucky enough to have A1c readings of less than 7.0. Some people's systems just won't allow it, even if they do multiple blood-glucose tests and inject ten times a day. I test 5 times a day and inject 6 or more separate doses, but my A1c runs around 7.2. The newest pumps should get someone like me down to something under 6.8. 7.0 will carry you if you have good genes and haven't been diabetic for more than 10 or 15 years. I have the right genes, but it's 35 years for me. Until the eye problem I was the only Type 1 (juvenile) diabetic I knew with more than 30 years on the clock who had no major problems. Now I have one, but, thanks to advanced medical technology (laser surgery) I may not have the problem again. Maybe. I'll keep my fingers crossed for you but do not extrapolate your extreme medical condition to the general populace. Thanks, and I don't extrapolate. Type I diabetics make up just a fraction of 1% of the population. I'm just a shining example d8-) But considering that Type II (adult-onset) diabetics have similar problems -- some of them worse, in fact, including the incidence of loss of limbs -- and make up 23.1% of the US population over age 60 (and those are just the ones that have been diagnosed), my situation is not really "extreme." It's just that I got started earlier and serve as a kind of weathervane for those who acquired the similar condition later in life. If you're in your 50s or older, those 10-15 years of grace that 20-year-olds enjoy may shrink to just a few years. Note, I've designed medical instrumentation. One product is not too dissimilar to your insulin pump, it took a blood sample from a drip line and tested for lactate acid giving real time results. I am very familiar with the industry. Well, maybe I should interview you for an article I've had in the can for a year. It's about medical-device manufacturing and meeting the FDA and customer requirements. I have eight interviews done, but I'm losing energy for it. Use my email in the header. Thanks. I've put this message into the file in case I revive that article. I have around 50 hours invested in it so I do want to finish it. snip True but the root cause is that health care insurance is unavailable at rational cost. Kaiser for my wife and I would be $1600/month in the USA and is about $25 in Argentina. So, Argentina has subsidized or government-run insurance. I'm all for it. Kinda, sorta both. Immigrants can buy into the state system but each municipality has an open clinic where the costs are very cheap. A front/side chest x-ray cost about $13, dental extraction of molar with abscess cost a friend $6.70, etc. I've bought into private health care at a local hospital chain. Ambulance service is free, I used it two nights running when semi-conscious and unable to drive. Heh, I had _chicken_pox_ at my age... Never knew it could be life threatening... Being in the seond or third economic tier can produce some wonderful benefits for a country. For example, you don't have to invent or develop much of anything. You just use the same stuff that was developed in the leading countries. You'll find that the companies selling that stuff can be very compliant to your political needs. They'll set up an entirely separate accounting system for dealing with you, one that doesn't have to account for any upfront costs, because those are all paid for in the leading country. Since your market is basically a gift to those companies, providing unanticipated sales on otherwise idle production capacity, they'll be happy to treat you as a source of marginal sales, and all that their books will show as expense against their selling price in your country is the marginal manufacturing costs and shipping. Something that costs $100 in the leading country, where they're amortizing all of the upfront costs, might cost $2 in your country. And it will appear on their books as a profitable sale -- because it's a marginal sale. Accounting can be a very creative thing. d8-) The problem with being a second- or third-tier country in those circumstances is that your economy basically don't exist outside of the orbit of the leading countries. It creates quite a web of dependencies over which you have no control. But it sure saves a hell of a lot of money. All true. On the other hand you are talking about providing cutting edge technology to the general population and that's not a reasonable expectation. Regrettably it's a path that will bankrupt the health care system. Life sometimes sucks and if you are very poor you may not be able to afford a life saving proceedure, that's what charity is for. On the other hand those costs are outrageous and we must bring them down to earth. Well, that's all true, too. The healthcare issue as many people see it is that everyone should have the same cutting-edge technology available to them. That's a majority position in the US (as in most of the world) now, as unrealistic as it may be. It will be the guiding idea behind health care reforms. The practical outcome will be different. The question is how much different it will be, because health care reform is coming, whether the conservative ideologues want it or not. It's a tsunami that's racing across the seas from all directions. Your program further inflates costs to the majority for the few, mine chops the hell out of those costs for the majority at the expense of a few. I believe that my program is the more humane by far. If you follow the polls, you realize that yours is definitely a minority position, and the trend is against you. It will lose, politically. It's just a question of how soon it will come to a vote and move. What will happen is that universal health care will be sold in a package with efforts to cut medical costs. Some efforts will be successful. Others will not. It will extend the delay to the crisis point for a while, maybe for many years. And then we'll decide what we want and can have, once again. There's always a ready market for new drugs and new medical technology. True, and sometimes the costs are justified. But recognize that a full 60% of new drugs are governmentally subsidized through university research then turned over to pharmaceuticals for manufacture and distribution with but a bare tithe to the university while Abbott et. al. gains usuary profits on our own tax dollar. sigh I'm well aware of how that works. My last job in a medical communication agency involved a drug on which Sanofi-Aventis had paid something like $135 million in development costs, and $110 million in pre-approval marketing costs (which was paying my salary). Then the FDA decided not to approve the drug. So my company laid half of us off. d8-) The basic research on that drug was not from a university, however. I know that a lot of the basic research is done in universities. What you may not know is that the testing that the pharma companies have to go through after some basic-science lab makes a discovery often costs ten times more than the basic research. I'm familiar with the problem. The FDA should be an advisory, not regulatory, agency. All the special interest groups like, encourage, support, and fund that evil. I completely disagree about having the FDA become an advisory agency, We disagree then. I see the FDA as a self-serving bureaucracy controlled by special interests. I do not like the idea of a governmental agency telling me what medicines or treatments I can, and can't, have. The thing is, Curly, that you have no experience of buying or using drugs in an environment that isn't dictated by the FDA and similar agencies in other highly developed countries. So you're speculating about how it would work out. To the contrary, remember, I've lived in Argentina for about 3 years now where I can buy just about any drug without a prescription and those that do are drugs that I'm not interested in. No, because Argentina's health care system, as I explained above, exists in the shadow of the FDA and the European (and Japanese) equivalents of our system. I don't know Argentina in particular but most countries are in that situation. Argentina's health care system can only function because it's parasitic on the systems of the major players, in terms of what drugs are available, how they've been vetted, and what experience from those more regulated countries tells the Argentinians about what works and what doesn't. They don't operate in a vacuum. A friend of mine who was the Carter-Wallace rep for Africa, and who also repped throughout the Caribbean, explained it in fine detail to me over a period of years. What I learned from working for Big Pharma confirms the same thing. They're all riding on information that comes from the drug development, testing, approval process, and record-keeping of the major western countries. They make their own decisions, but they don't have any significant amount of their own information on which to base them. They can get all the information they need from us, for free. You can go online and collect the PIs (prescribing information) forms from the FDA for 1,000 drugs in a couple of days; put a team of physicians and other specialists together to review them; and develop a drug policy and approvals for a medium-sized country in less than a month. And that's the skeleton of how they actually do it. How does that pertain to the cost of health care in the United States? Simply because the USA pays too much isn't an indictment against others. Those lower-tier economies have an office that sounds like FDA, but it's usually an empty shell full of rubber stamps, giving supposed approval to drugs and procedures that have gone through the approval process of the FDA or the British, French, or German equivalents. And the drugs they sell over-the-counter are mostly ones that have been vetted, for prescription sale or otherwise, by the leading countries. And it's wonderful. I needn't visit a doctor for simple drugs, I can self-medicate, I can refill my one long term medication without being molested by a self-interested bureaucracy. I can get immunizations and injections at the pharmacy too. This is one major reason I live here, I hate the "Big Brother" attitude. It's only possible because there is a Big Brother who provides them with all the information, for free. Then they make their own decisions, based on their politics, their sense of responsibility to their people, their legal structure, and their tolerance for a few unfortunate deaths resulting from people who are medically ignorant making life-and-death medical decisions. In the case of many countries, their willingness to institute a system of controls -- that is, their willingness to pay for such a system -- enters as a big factor. The only direct comparison you can make is to the US before there was an FDA. It was much harder to get a centralized, reliable count in those days of how many people were winding up dead from taking the drugs then available. But the number was substantial. We can tell now, in a lot of cases, because those drugs have since been run through large clinical trials in which the results have been measured. That's an excellent foundation to convert the FDA upon too. That work will not be lost, its the basis for evolving healthcare. It won't be lost, but it's only available for drugs that are already available. New ones need new studies and analysis. Therefore only affecting new drugs, not the existing supply. Focusing then on new products, do you believe that a half billion dollars to release a new drug for, say, gout, is justified? for the same reason we got the FDA in the first place. Those greedy corporate types you're complaining about wouldn't mind killing many more people if they could get away with it. Testing on humans first is the way to make more money. That is not what I propose. Let the FDA provide online, honest, data on drugs and let the buyer comment and beware. You're proposing a system by which smart people save a few bucks, and not-so-smart people make minor mistakes and drop dead. I don't really like the sound of it. "A few bucks"????? We're talking thousands and tens of thousands of dollars per person! Do not extrapolate your health condition to the population at large. Not-smart people do not "drop dead" they don't medicate usually and if a few do "drop-dead" then that's life. Or death. Huh? Over 125,000 people die in the US each year from drug reactions and mistakes alone. Misprescribing leads to some of the reactions; lack of clinical-study information about drug interactions leads to most of them. That's not "a few" who are dropping dead. I'd have to see verification of that number before accepting it. As for the "tens of thousands of dollars per person," the average pharmaceutical bill in the US is $850/person. The way to cut that is with some reforms in health care and the way the pharma industry is regulated, not in deep-sixing the FDA, because it's the FDA that keeps that 125,000 deaths from being a much larger number. And the average health care cost is over $10,000 per person. We pop a hell of a lot of pills, and a lot of them are deadly if they're used ignorantly. I will not pay for stupidity or ignorance. Tough luck but that's the way the belly buttons. It's their life, if they don't do the homework that is not a societal problem nor responsibility. Note that I've actually been through the FDA approval process. Not responsible but as an independent contractor responsible for adhering to the requirements on glucose monitors, inhalation dispensers and patient monitoring systems. I should point out here that testing a medical device is NOTHING like testing a drug. It's much simpler, and it's done with much smaller cohorts, so it's vastly cheaper. You don't see $50 million studies for devices, as you often do for drugs. I think I mentioned elsewhere that a new drug requires roughly a half billion dollars to become FDA certified. That is intolerable. Half of that number is marketing. Cut the marketing, not the clinical studies or drug regulations. I don't care how much the marketing people get anymore. g Again, I'd have to see some verification of that claim. Not that it makes the FDA any less onerous, $250,000,000.00 is still intolerable. Generics, Canadian, and other sources are often 90% cheaper. Of course. Generics just ride on the research, testing, post-marketing studies and marketing that was done for the original drug. All they have to recover is manufacturing costs and quality-control reporting. In Canada, they have price controls and just refuse to allow the drug companies to amortize research and development. The Canadians, and the French, and the Brits, and everyone else knows that they can collect those costs in the US. How long do you think a pharmaceutical should have a monopoly? Is 17 years not enough? It depends on how you structure it. Some kind of regulated, extended and mandatory licensing would reduce prices and keep up enough income to fund big trials. And it's the big clinical trials that cost most of the money in pharma. Patented medicines are too expensive, but generics are too cheap. Precisely why I want to change the FDA to an advisory agency. Today it costs roughly half a billion dollars to bring a drug to market, that is irrational and runs the prices up so that the general tax fund must subsidize use. But what's the basis on which the FDA would "advise"? The last drug I worked on as an employee (rimonabant) was being sold in France, Germany, the UK, and parts of South America before three long-term studies ordered by the FDA turned up the problems with it. The Europeans got egg on their faces -- and some dead citizens -- because they didn't require the long-term studies. Now they're pulling back and black-boxing those drugs. But they never would have known the problems without those huge studies, which cost something like $100 million in total to run. There you go, publish those data, update as more data becomes available. Caveat emptor. That's precisely what they do. It's all available to the public, once it's submitted for FDA approval. I read around 360 studies related to the marketing for one drug, alone. Regarding "caveat emptor," how many do you have time to read? They run around 8 or 10 pages each, on the average, and they're not very entertaining. If my life is dependent upon the results I'll read every last one in detail. I've read thousands of clinical studies but I'll do the emptoring, and let the FDA do my caveating, thank you. d8-) That should be your option too but not my obligation to subsidize. Who pays for that if the FDA doesn't impose it as a requirement for approval? You're talking about going back to the dark ages of the drug business, when people died from taking drugs and no one knew the drug was involved in the deaths. Hell, no one even knew that the people who died had been taking the drugs. Statistical review can pull that data from the noise. People died in the example you offered even with testing. Many die even with the testing we have now. Many more would die without it. So? I'm not belittling your point, in fact I'll submit that it is true, but artificially extending a dying persons life simply isn't worth the cost in most cases. Not only test subjects but subjects who were denied the new medications but might have been helped. That's life. And death. **** happens, no one life is worth the cost of FDA regulations. FDA fast-tracks cancer drugs and many other critical drugs now. You might want to make the track faster. I think it's about right. It can be argued that limiting drugs as the FDA does costs lives too. I've read the arguments. The data is available. You'll find it with a good search on PubMed. snip You are one of the lucky, many cannot get insurance because they are under employed, unemployed, homeless. Yeah, we know. I'm very lucky. The year before last I paid insurance out of my pocket for six months, and it cost me almost $7,000. How would you change that inequity? Universal health care, with a single-payer system and optional supplemental insurance. Take the European and Canadian systems, analyze the good and the bad in each, and design a better one based on those experiences. You'll have to re-engineer a lot of the health care business to do it. Tort reform, reducing redundancies in testing facilities, etc. Very socialist-sounding. Very politically incorrect. But the only way to reduce costs and provide health care for everyone at the same time. The danger with it is not so much a case of limiting coverage (that will happen no matter what system you use, including our present free-for-all system), but rather limiting innovation. That part will require very careful work. Since the US is the last country of any substance without universal health care, this is where most of the innovation happens. The Europeans and others are tuned to our drum; they adjust their systems so they don't look too bad in the innovation department, given our example. It's hard to say how that would work if there was no free-for-all system like the US against which to compare oneself. It is a concern, if every major country has a controlled system. It's easy to become complacent if there is nothing against which to compare your results. I don't expect a universal system to work really well. I just expect it to produce a better result than we have now, in terms of health statistics. There is no way that it will produce as much innovation. You pay your money and take your choice. My choice is universal coverage. Mandated health insurance, right? What about those who do not want mandate health care? Screw 'em. And the opposition feels the same about your program. In fact there is more justification on the liberty side than the mandatory side given that we are a nation based upon individual liberties. As it is, they're winding up in the ER and taxpayers are footing the bill. Not a justification, stop doing that at the same time we cut the burden and make health care affordable. That argument is self justifying. This isn't Zimbabwe or the Sudan so we aren't going to just let them die, so ram health care coverage down their throats, for the same reason we don't let people drive without liability insurance. I'll fight you on using coercion every time. What you propose violates my freedom and monopolizes the health care industry. Yup. When your "freedom" becomes my tax bill, because you can't or won't cover your own ass, you've just forfeited some of your freedom, IMO. Or you can move out. That's your freedom. It's your tax bill because you voluntarily assume the costs, a self serving argument. Stop doing that and your justification evaporates. It is also a license to steal and further empowers the FDA monopoly. What's your gripe with the FDA? I can see bitching about Big Pharma, or hospitals, or doctors, but the FDA does a pretty good job, IMO. What is it you think they do? The FDA violates my right to choose and treats me like a child. I do not like being patronized by anyone, especially my government. Redirecting the FDA to an advisory agency would immediately chop off at least half the cost of health. Baloney. It would just speed up the casket business. Probably both. Remove the AMA monopoly and another quarter might be saved. Great. We'll let anybody put out a shingle. I told my wife, after studying endocrinology for some of my work, that maybe I should go into the business and start prescribing hormones. It would be a great experiment and fun, too. d8-) No prescriptions required, remember? Along with advising buyers on drugs the FDA must keep open records for health care providers, both the positives and negatives. If you like a provider then rate them, kind of like what Ebay does. Bad providers, snake oil salesmen, and charlatans are subject to fraud laws and would soon be out of business. FDA advisories should include herbs, vitamins and minerals too. There are many herbs that can be life threatening. I do not want them regulated either, I want my government to _inform_ me to the risks and allow me the liberty of self medication. Cutting health care costs by 75% would be easy and making care available to those who now cannot afford your care would save more lives than are now being lost. Hey, you aren't in the market for a Bridge to Nowhere by any chance, are you? Nope, I'm not a Trojan Moose. What we now have are a number of state protected monopolies which prevent competitive forces to rein in health care costs. I cannot/will not vote for that. Significant competitive forces don't exist in health care; never did, and never will. You don't shop around when you're having a heart attack. That is why health care is so expensive, no competition. $1,800 taxi rides (ambulance) for 1.5 miles and no alternative, intolerable. This transitions into the quality of care issue too. Another factor we've not discussed is the costs caused by AMA monopoly of providers. Midwives and alternative treatments have essentially been banned to create a monopoly. Then there is the FDA making many drugs prescription only. In fact some years ago the FDA stated that they would have made many current over the counter drugs a prescription item if they had it to do over. They are now trying to rectify that by regulating vitamins, minerals and even tobacco. We Americans have an aversion to reading about dead people who took drugs they were told were OK. **** happens. Life is not guaranteed safe. The government is only permitted to regulate fraud and crime, not what we ingest. I think the law disagrees with you on that. g You realize that I have a very low opinion of laws which violate my liberty, don't you? We have no obligation to obey anti-constitutional laws. shrug The Founding Fathers didn't anticipate CT scans and open-heart surgery. They were lucky to get leeches. The FDA wants to regulate the medicinal use of leeches too. Your ideas concerning pharma are ideological, abstract, and unreal based on what we know about drugs, Curly. You're laying out a prescription for ignorance and death. No one would know what drugs are causing what side effects and adverse outcomes; all you'd have is a collection of rumors, marketing claims, and guesswork. That is an unsupportable assertion and one that I disagree with deeply. Well, fine. Spend four or five years studying and writing about pharmaceuticals and health insurance, and we'll have another talk. When market forces are unleashed we also need to revamp fraud laws to keep the manufacturers honest but all major diseases have drug treatment now so the number of new drugs coming onto the market is smaller. And hideously more costly given the current FDA regulations. We cannot permit an industry to blackmail us for health care. You tell 'em. No, I pretty much ignore them but those still in the USA do not have my options. They are saddled with monopolies which rape, pillage, and destroy the economy, leave many with unacceptable or no health care, and enrichen the few at the expense of the many. That is not what America is about. We've gone beyond that and hardly anyone who knows the issues would want to go back. Your reactionary approach would result in a meaner and riskier health care system for everyone. It would be cheap, but it would leave a lot of bodies and maimed lives in its wake. Nope, all the current drug treatment programs would continue, no risk involved. Only new drugs coming onto the market might risk, advise the patient rather than burden the health care of every other individual on earth. This is where the FDA would come in, monitor the use of new drugs and provide statistical analysis of the effects for advising other users in the future. That's what they do now. Then they regulate the ones that would kill us off the market. That's about it. I do not want the FDA to "regulate" anything, I want the FDA to "advise" on much more than drugs. They should assist us in selection practitioners, herbs, minerals, vitamins, exercise programs, maternal care, infant care, all health related data. Governmental treatment as infants is not the American way. Nor is coercion, punishment, or regulation. -- Regards, Curly ------------------------------------------------------------------------------ I Love Republicans, They Taste Just Like Chickenhawks ------------------------------------------------------------------------------ .................................................. ............... 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