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Thread: Looking for SLN Pundits on the Democratic Debate

  1. #81
    Senior Member catherine's Avatar
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    Quote Originally Posted by Rogar View Post
    Sometime I'd like to hear Bernie's rationale behind his rants on big pharma greed. Last night he quote a figure of big pharma profits as something like an outrageous many billions. I wonder where he got that figure. My basic understanding of accounting is that profits are either distributed to shareholders as dividends or reinvested in the company for expansion or R+D. Big pharma companies are publicly owned through the stock market. Those "greedy" profits" would provide value to the company in terms of either income or increases in book values of the company. Which then would be passed on to the stock holders, as in the general stock owning public. If these profits were indeed so huge, people would be flocking to buy stock in big pharma?

    No doubt it's not a perfect system. I'm sure there are grossly overpaid CEO likes, just like all big companies. And there are a few pill pushers and bad players. But are the profits really that extraordinary or just a normal return on investment just like any other big corporation?
    Well, even though I'm going to nibble at the hand that feeds me, I'll give you my perspective, FWIW. Here are some of the dynamics behind the "greedy Big Pharma" diatribe:

    1) Pharmaceutical companies, unlike almost ALL other industries, can only profit off of their products for a very limited time. Suppose Apple's patent ran out on their iPhone in just 20 years? That's what happens in the drug world. Unless they can extend their patent life somehow (one of the reasons you see some drugs with multiple dosages or modes of delivery), the generics are available and the Pharma company's product is all but dead, especially since it's difficult to get a brand drug approved by insurance companies if there is a generic available.

    As a result, they have to shore up their revenues. What would happen if you had to retire from your job in 20 years? You'd be an aggressive saver. So, yes, pharmaceutical companies aggressively price their products. The market research projects I hate the most are price-sensitivity projects, where they push and push the ceiling for what they can ask for and get. So, this aggressive pricing can be interpreted as "greed."

    2).Pharmaceuticals have been responsible for over-drugging the public, but also saving the public. They have given us unbelievable high-tech innovations that have increased cancer survival rates incredibly. I worked on one project for a drug that saves babies from certain death by tinkering with their genomes. Even the bread and butter drugs like anti hypertensives have driven down cardiac mortality rates.

    But these novel high-tech drugs come with an ENORMOUS price tag, which they feel is justified because they are so high-tech and so effective. But insurance companies are quaking in their boots because in some cases one course of therapy of these drugs is 1M or more. So, charging 1M to cure one person may be seen as "greedy"

    BTW, MOST drugs that go to clinical trials, at tremendous expense, fail. I've started researching many drugs very early in the lifecycle--many drugs that never came to fruition, after millions have been spent. That cost is absorbed into the price of the drugs that make it.

    OTOH, who is better at selling diseases so they can sell the cure than Big Pharma? Who ever heard of "overactive bladder" or "erectile dysfunction" in the mass market years ago? Of course they existed, but no one named those conditions and then created the cure before. But if you can make someone believe they have something to be treated, and it's a chronic condition, you can make a lot of money.

    So, marketing pharmaceuticals the same way that any other company fills an unmet need in the market can be seen as "greedy."

    And of course, these huge companies have a lot of shareholders, and they have to please their investors above all. So their mandate to make a profit can be seen as "greedy." Now, are they making "too much" profit? That's the debate. In the system that we have we don't have systems in place to limit the profit of any other corporation, so why should Pfizer be any different?

    My opinion is that Big Pharma is just one piece of this whole healthcare albatross we have. Taking away the profit motive would make healthcare much less expensive. People ask, well, won't that reduce innovation? I don't know. I just know that it's the fact that no one person is paying. Pharma can charge big prices because he insurance companies will pay. But not for long...

    It will be interesting to see how this pans out.

    In answer to the question, as much as I love Bernie and hate this healthcare system and wish it were replaced by Medicare for All, I think "greed" is not quite the right word. I'll try to figure out the right word after I finish my next interview which is in 15 minutes..
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
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  2. #82
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    There seem to be multiple reasons US healthcare is costlier than other countries. Apart from the stock corporate villains, we pay our practitioners more, are less open to long waiting times and euthanasia, and have a more litigious response to medical mistakes. People tend to pick their favorite explanation more to score political points than to truly analyze the problem.

  3. #83
    Senior Member catherine's Avatar
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    Quote Originally Posted by LDAHL View Post
    There seem to be multiple reasons US healthcare is costlier than other countries. Apart from the stock corporate villains, we pay our practitioners more, are less open to long waiting times and euthanasia, and have a more litigious response to medical mistakes. People tend to pick their favorite explanation more to score political points than to truly analyze the problem.
    My feeling is it's the bloated system. I make more than my primary care doctor, and I only have a B.A. I think the "long waiting times" is a myth. We do have a litigious response to medical mistakes, but I feel that's a small piece of the puzzle. The problem is systemic. Medicare for All would solve so many of these problems.
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
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  4. #84
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    As someone who is in the middle of figuring out a health diagnosis, I would say that is all way too complicated., ie bloated. I get the sense that potential litigation is the reason behind too many costly tests and procedures.

  5. #85
    Senior Member iris lilies's Avatar
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    In Hermann, I am going to a direct primary care physician. So far it is cheaper than going to my vet for an office visit, and my vet is not an expensive veterinarian.

    and simple, Oy vey!

    I drive up to her little store front office and park right in front. No meters, no big garage, no traversing multiple storied building to find her office, the “doctor is in “sign hangs on the door. That is cute.

    She wanted me to get a mammogram ASAP due to a lump that was a cyst but she wanted confirmation. Called the radiology dept at the hospital up the hill, they got me in within 15 minutes. It was a five minute drive. I parked right in front of the building and walked in.

    The huge hospital complexes and palaces of sickness in my city overwhelm me.

    I do realize that someday I will have to traverse that world, and I appreciate that St. Louis has all kinds of great specialists, but so far I don’t want to touch that if I can help it

  6. #86
    Senior Member Rogar's Avatar
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    I understand the many legitimate reasons why medications provided by big pharma are expensive and add to our health care costs. Without more information, I don't see eye to eye with Bernie's one basket fits all reasoning that it's greedy big pharma taking excessive profits, any more than other bloated bureaucratic big business tries to make a fair return on investment. I'm sure he has more to it, but it needs a better cause and effect analysis. Something really needs fixing.

    When I get statements for my medical needs there is a list of charges sent to the insurance provider, then the charges allowed that the insurer will pay. The second list is invariably much smaller. So, the uninsured, and often those least able to pay, can have a much higher medical expense for the same procedures. I can see some version of medicare for all leveling the playing field and having more control or limiting allowed medical expenses. However, most people I know who are on senior medicare also have some form of supplemental insurance through a private insurer, often at little or no cost. If I could pretend to be an expert, I'd say that there are just too many tiers of bureaucratic hurdles that could somehow be streamlined or consolidated. There is always the option of nationalizing healthcare.

    It's a complicated problem and maybe by drilling down into each of the candidates proposals there are more comprehensive solutions. But I think when Bernie attributes this to the broad categories of greedy big pharma or greedy big corporations in general is a gross oversimplification to create some sort of basic common enemy people can try to rally against. That is one reason why I didn't vote for him. (Plus he keeps yelling at me).

    Who ever gets chosen will be better than Donald.

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    " However, most people I know who are on senior medicare also have some form of supplemental insurance through a private insurer, often at little or no cost."

    ??? How is this happening? They look pretty costly to me, when I am hunting for them for next year.

  8. #88
    Senior Member catherine's Avatar
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    Quote Originally Posted by Tybee View Post
    " However, most people I know who are on senior medicare also have some form of supplemental insurance through a private insurer, often at little or no cost."

    ??? How is this happening? They look pretty costly to me, when I am hunting for them for next year.
    Compared to what I was paying in the private sector (1600/month), I'm thrilled with Medicare. We have Supplemental Plan F (which is being phased out apparently) which covers so much. We have a very small deductible and hardly ever have copayments. It picks up everything Medicare B doesn't.

    If you want details on what we're paying, PM me.
    "Do any human beings ever realize life while they live it--every, every minute?" Emily Webb, Our Town
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  9. #89
    Senior Member Teacher Terry's Avatar
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    It depends on where you live. My sister pays 600/month for herself in Chicago.

  10. #90
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    Quote Originally Posted by Teacher Terry View Post
    It depends on where you live. My sister pays 600/month for herself in Chicago.
    Yeah, that as kind of what I was seeing.
    Catherine, will pm you. I saw about the best most comprehensive plan going away this year.

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