Do people 'deserve' universal health care?

[mkemse]

I worked for a pharmaceutical company at one time, a small one, and I can assure you that the R&D costs are astronomical! Even minor medicines went through many months, if not years, of development and testing, and not all of them were successful. So when you are paying those high prices for the drugs that let you lead a comfortable life, you are also having to pay for the research for other drugs which never made it to market.

Add to that the high cost of manufacture for those drugs, too. From the top of my head, every raw material which was purchased for production had to be rigorously tested to meet FDA standards. Every step in the production process had to be tested, repeatedly. Repeated sterilizing of equipment, relatively high cost of training production personel, as compared to average factory workers, added to the cost. Testing continued through the packaging process and even sampling from the warehouse.

That's not to say that the drug companies don't pad their prices, but after seeing the process in action, I can't fault them too much.

My contnetion is not so much the cost of Medication, i know R&D is costly and even ore so when the FDA does not approve the drug for sales, butthe R&D cost doesn
t explain the insane cost of Rooms at a Hositpal or a Docotors office visit, if they give youmeds it is sample that they do not pay for meidcation costs are hgiht, but so are Doctors fees, Hosptial fees ect

[MMI]

I'll have to take your word for that, Thorne. Grudgingly, and noting that, as an ex-employee, you gained from what they did.

Although I know my view is cynical, I do not see why I should regard chemical company chiefs as any different from banking bosses or motor-car manufacturers.

[MMI]

Wouldn't it be cheaper to book in at the Hilton, mkemse, and ask the doctor to visit you there?

[mkemse]

Wouldn't it be cheaper to book in at the Hilton, mkemse, and ask the doctor to visit you there?

Yes but he would still charge me for a "house call" , but yes it would be cheaper

[Belgarold]

I worked for a pharmaceutical company at one time, a small one, and I can assure you that the R&D costs are astronomical! Even minor medicines went through many months, if not years, of development and testing, and not all of them were successful. So when you are paying those high prices for the drugs that let you lead a comfortable life, you are also having to pay for the research for other drugs which never made it to market.

Add to that the high cost of manufacture for those drugs, too. From the top of my head, every raw material which was purchased for production had to be rigorously tested to meet FDA standards. Every step in the production process had to be tested, repeatedly. Repeated sterilizing of equipment, relatively high cost of training production personel, as compared to average factory workers, added to the cost. Testing continued through the packaging process and even sampling from the warehouse.

That's not to say that the drug companies don't pad their prices, but after seeing the process in action, I can't fault them too much.

And still somehow they are able to make astronomical profits and sell their product in other countries at a great loss.

I am not against corporations or companies. I owned my own business at one time and my brother still does. But large corporations become behemoths eating up people and profits. And why isn't there a hue and cry from the right about us subsidizing low-cost drugs in other countries?

I am just saying making profits as the drug companies and health insurance companies do, on the backs of everyday Americans is wrong and hurts the economy.

[Thorne]

My contnetion is not so much the cost of Medication, i know R&D is costly and even ore so when the FDA does not approve the drug for sales, butthe R&D cost doesn
t explain the insane cost of Rooms at a Hositpal or a Docotors office visit, if they give youmeds it is sample that they do not pay for meidcation costs are hgiht, but so are Doctors fees, Hosptial fees ect

No, the "insane" cost of rooms at the hospital are because of the losses the hospital has to take by treating anybody who walks through their doors, whether they can pay or not. It's also caused by the high cost of all of the equipment they have to maintain in order to run batteries of needless tests to cover their asses against those people who will sue them for millions if they catch a cold in the hospital.

The same with Doctor's fees. Doctor's pay exhorbitant insurance premiums to cover their practices because our legal system allows anyone to sue for inane reasons. Did you twist your ankle? Better run a full set of X-rays, and maybe an MRI, just to make sure you didn't fracture something, even though there's no evidence that you did, and you're not really in any pain, but let's give you pain meds, which you can't pay for because the costs are too high, so we'll sue the Doctor for overmedicating.

I get tired of hearing these same old arguments! Those who have, charge too much. Those who don't have, want everything for free. It's a simple case of economics! If the price is too high, DON'T BUY IT!

Of course, everyone expects to live to be 100 and have perfect health, and if they don't, well SOMEBODY better figure out a way to fix it! Just don't expect them to pay for it.

[MMI]

Public health services are a good fix, not perfect, but good.

[Thorne]

And why isn't there a hue and cry from the right about us subsidizing low-cost drugs in other countries?

Because there is such a hue and cry from the LEFT because we aren't doing enough to help the poor people overseas.

You want to send food to starving kids in Nigeria? The cost of food goes up in the US. You're going to send drugs to Kazakstan? The cost of drugs goes up in the US.

But the real problem is that the drug companies make such a large profit, isn't it? They're dealing with sick people here! They're responsible for people's lives, aren't they? They should be giving the stuff away! Why the hell should they make any money doing it?

Just tell me this, people. If the drug companies decide to just give up and shut down, who's going to step in and take their place? Especially if they're no longer allowed to make a profit? You want your drugs manufactured under Federal management? By the lowest bidder? I don't think so!

[MMI]

And still somehow they are able to make astronomical profits and sell their product in other countries at a great loss.

Do you really believe they sell stuff in other countries at a great loss? I don't.

The stuff they sell in Africa, you'd regard as old-fashioned medicine, long since superceded by something else (or maybe the same stuff in a new package). They made thier pile in the West, but this provides a steady trail income.

And the stuff they give away in Africa is out-of-date medicine that would otherwise be destroyed.

[Torq]

OK, Folks it's that time again for my famous


ENOUGH

Comment!!!!!!

Stay ON TOPIC and stop the ""MUD SLINGING,,PERSONAL ATTACKS

There will not be another warning!!!!!!

Be Well
T

[Thorne]

Do you really believe they sell stuff in other countries at a great loss? I don't.

The stuff they sell in Africa, you'd regard as old-fashioned medicine, long since superceded by something else (or maybe the same stuff in a new package). They made thier pile in the West, but this provides a steady trail income.

And the stuff they give away in Africa is out-of-date medicine that would otherwise be destroyed.

That may be so, I don't know. But even so, what of it? It's a business. That's what businesses do. If you have a product which people need, or want, you make money. Tons of money, if your smart.

[mkemse]

No, the "insane" cost of rooms at the hospital are because of the losses the hospital has to take by treating anybody who walks through their doors, whether they can pay or not. It's also caused by the high cost of all of the equipment they have to maintain in order to run batteries of needless tests to cover their asses against those people who will sue them for millions if they catch a cold in the hospital.

The same with Doctor's fees. Doctor's pay exhorbitant insurance premiums to cover their practices because our legal system allows anyone to sue for inane reasons. Did you twist your ankle? Better run a full set of X-rays, and maybe an MRI, just to make sure you didn't fracture something, even though there's no evidence that you did, and you're not really in any pain, but let's give you pain meds, which you can't pay for because the costs are too high, so we'll sue the Doctor for overmedicating.

I get tired of hearing these same old arguments! Those who have, charge too much. Those who don't have, want everything for free. It's a simple case of economics! If the price is too high, DON'T BUY IT!

Of course, everyone expects to live to be 100 and have perfect health, and if they don't, well SOMEBODY better figure out a way to fix it! Just don't expect them to pay for it.

Thanks

[Belgarold]

Do you really believe they sell stuff in other countries at a great loss? I don't.

The stuff they sell in Africa, you'd regard as old-fashioned medicine, long since superceded by something else (or maybe the same stuff in a new package). They made thier pile in the West, but this provides a steady trail income.

And the stuff they give away in Africa is out-of-date medicine that would otherwise be destroyed.

Yes, this is true. I wasn't even considering these 'giveaways' but the stuff they sell in Canada, for instance, is sold at a great deal less because the country will not allow them to sell at too high of a profit.

Thorne, I am not against them making a profit, but there should be a limit on this, yes. And as a follow-on, what the Health Insurance industry does is criminal. You pay your premium and when something happens and you need the insurance the insurance company does all it can to not do their jobs, pay out. And bean counters let people die every day.

How much is enough profit to make on the misery of every day Americans?

[Thorne]

what the Health Insurance industry does is criminal. You pay your premium and when something happens and you need the insurance the insurance company does all it can to not do their jobs, pay out. And bean counters let people die every day.

The insurance companies are another story, and I have little or nothing good to say about them. But consider, if the Feds take over the management of healthcare, a good portion of those insurance companies won't be needed. And all those bean counters will be looking for jobs. With the Feds. Doing the same thing they're doing now!

[SadisticNature]

The accounting of drugs is incredibly difficult.

If you consider the cost of a drug per unit to be:

Total cost of drug including production and research costs / units sold

Then yes companies sell drugs at a loss.

If you consider the cost of a drug to be:

Production cost of one unit (including labour)

then companies generally sell at a profit everywhere.

However, in many cases, drugs are provided to poor countries as part of the 2.5% of revenue that most organizations spend on charity these days (ala Google). Most companies consider this good branding as it makes it harder to attack them on people dying because they can't afford care.

The US has the worst drug prices even though it doesn't have the highest per capita income because most countries are able to negotiate at a national or state/province-wide level for drug prices. A company is far more willing to sell 2,000,000 units of medication at a smaller price than the small number of units that a particular insurance plan or single hospital would negotiate. It's just not worth the companies time to negotiate over a sale of 10 units.

[SadisticNature]

I think the job description changes a little bit.

After all medicare and medicaid are the two most efficient plans in the country, and there are far fewer cases of them aggressively trying to deny care.

For profit insurance is part of the reason costs are out of control. Taking 23% profits, introducing a huge amount of overhead with high level management salaries and benefits, and saying that there will be savings to the consumer is in general quite laughable. There can be other benefits such as diversity of options and varying levels of quality (pay for premium care etc.), but to say that private industry lowers costs is generally erroneous.

[steelish]

The original post asked, "Do people deserve universal healthcare?


In my opinion, that's not really an answerable question. Healthcare is not an individual right. It is a purchasable good, therefore it is NOT the role of the government to get involved.

Do people deserve a place to live?
Do people deserve a job?
Do people deserve a car?

NO! People have the RIGHT to life. They have the RIGHT to become individuals, with thoughts and opinions. People have the RIGHT to feel what they want and express their opinions. People have the RIGHT to be free and pursue knowledge.

We've lost sight of the fact that having the government provide us with healthcare is against our constitution! Everything America stands for was based upon our rights as humans, and the freedom to live as we see fit.

So basically, what I am saying is that people deserve many things, but I think the original post was stated incorrectly. I do not feel that people have a RIGHT to healthcare. Nor do I think the government has the right to force me to purchase it, which is what is written into the bill.

[DuncanONeil]

Medicare and Medicaid are far from efficient. Were that truly they would not be hemorrhaging money!
Insurance is part of the reason costs are high, but not all of it, Government regulation is also part of the cause, as well as fear of lawsuit. I question your claim of 23% profits. But even at that level their profits are not the highest rate of return!
As for lowering of costs, private industry can do just that. Providers of insurance are forced to compete for small pools of clients, which increase the level of costs. AN example the flies in the face of your claim is the segment of the health care industry dealing with laser eye surgery. An item not covered by most insurers. Making the payment the responsibility of the customer. Since inception the equipment has improved and the costs have been reduced. What was the cause? Competition! If the customer is not happy with the cost or service they will go to another provider, not possible under most insurance plans.

I think the job description changes a little bit.

After all medicare and medicaid are the two most efficient plans in the country, and there are far fewer cases of them aggressively trying to deny care.

For profit insurance is part of the reason costs are out of control. Taking 23% profits, introducing a huge amount of overhead with high level management salaries and benefits, and saying that there will be savings to the consumer is in general quite laughable. There can be other benefits such as diversity of options and varying levels of quality (pay for premium care etc.), but to say that private industry lowers costs is generally erroneous.

[SadisticNature]

I think the idea that health care is not a right is unique to those countries without universal medicare. Ask almost any Canadian including the vast majority of Conservatives up here and they see it as a right. This is the same in Britain and France where public systems are prevalent.

If the majority of Americans do not see public health care as a basic right then public health-care will likely fail. The current senate bill is so weak I think they'd be better off blocking it and trying again.

As for drug costs in Canada its not that the prices are regulated, its that the government can negotiate for the medications in massive quantities. If every American in the state of California was on the same drug plan and the insurance company running said plan went to the pharmaceutical companies to get a bulk rate negotiated on medications, prices would fall dramatically. The American system is made up of so many tiny pieces, none of which could get good deals and as such costs skyrocket.

My question for conservatives in the states is:

How does it make sense to tax the middle class so heavily they can't pay for health care and then leave them without medical care when they get sick in order to pay for things like Corporate Bailouts (Auto, Banking, etc..) and Foreign Wars (Iraq, Afghanistan, etc..)?

Social Security, Welfare and other such programs are a tiny amount of spending compared to wars and bailouts.

[VaAugusta]

Social Security, Welfare and other such programs are a tiny amount of spending compared to wars and bailouts.

According to Macroeconomics Principles and Applications by Robert E. Hall and Marc Lieberman, transfer payments are are approximately 12% of GDP, and military spending is at around 4% GDP.

This is in contrast to what I have quoted you on. Please refrain from posting about things you have no idea about.

[steelish]

I think the idea that health care is not a right is unique to those countries without universal medicare. Ask almost any Canadian including the vast majority of Conservatives up here and they see it as a right. This is the same in Britain and France where public systems are prevalent.

If the majority of Americans do not see public health care as a basic right then public health-care will likely fail. The current senate bill is so weak I think they'd be better off blocking it and trying again.

As for drug costs in Canada its not that the prices are regulated, its that the government can negotiate for the medications in massive quantities. If every American in the state of California was on the same drug plan and the insurance company running said plan went to the pharmaceutical companies to get a bulk rate negotiated on medications, prices would fall dramatically. The American system is made up of so many tiny pieces, none of which could get good deals and as such costs skyrocket.

My question for conservatives in the states is:

How does it make sense to tax the middle class so heavily they can't pay for health care and then leave them without medical care when they get sick in order to pay for things like Corporate Bailouts (Auto, Banking, etc..) and Foreign Wars (Iraq, Afghanistan, etc..)?

Social Security, Welfare and other such programs are a tiny amount of spending compared to wars and bailouts.

I'm not disputing how Canadians and any other country with Universal Healthcare view it. In AMERICA, healthcare is NOT A RIGHT. As per our Constitution, rights are bestowed upon us by God, NOT by the government. I personally do not care how successful and/or horrid Universal Healthcare might be for countries that have it. What I feel and what I am saying is that in America, it is not a right and is unconstitutional for the government to be involved with.

Oh, and by the way, I am "middle class" and have no problem with my healthcare (and I pay for it myself, it's not an employee benefit). In America, NO ONE can be denied medical care. All you need to do is go to a county run hospital and they have to treat you, no matter what. I know, I've done it myself when I was homeless...once upon a time.

[SadisticNature]

The constitution doesn't mention health care at all. This doesn't make dealing with health care unconstitutional. Something is unconstitutional if it is done in violation of the constitution. Plenty of legal things in the US are done by government that are not mentioned in the constitution.

Regarding the Economics textbook I refer you to:

en.wikipedia.org/wiki/2008_United_States_federal_budget

In particular note that by calling wars "Special Appropriations" their cost is not listed in the budget entirely. With special appropriations actually included military spending skyrockets.

Even without the special appropriations the following is a breakdown of expenses related to the military:

1. 481.4 Billion in DoD non appropriated spending
2. 145.2 Billion in War on Terror non appropriated spending
3. 39.4 Billion for Veterans Affairs
4. 34.3 Billion for Homeland Security

Social Security costs:

608 Billion which is more than paid for by Social Security Deductions (927.2 Billion).
386 Billion is spent on Medicare
209 Billion on Medicaid and SCHIP.
324 Billion on all Welfare, EI and other such programs.

The total is approximately 1.5 Trillion (as interest in national debt is not social security and shouldn't be included in this line item).

In comparison the government debt at the end of 2007 is 5.04 trillion en.wikipedia.org/wiki/2007_United_States_federal_budget

While the projected government debt at the end of 2008 is 10.8 trillion. As the deficit of declared items was approximately 240 billion dollars or approximately 0.25 trillion (rounded up for convenience), the total special appropriations is:

10.8 -0.25 -5.04 = 5.51 Trillion Dollars. A number which radically dwarfs
social security spending. The vast majority of this are the Iraq and Afghanistan wars.

There is a point to be made that the entirety of federal level social programs is not as insignificant as I claimed, but trying to argue that military spending is only 4% of actual spending is rather erroneous.

[steelish]

It is unconstitutional for the government to REQUIRE me to purchase something from a private party. THAT is written into the current bill.

[VaAugusta]

I would like to not respond as I can see there's no getting through to you, but since you made such a lengthy post, I don't want people to get the impression that all your numbers add up to anything.

Therefore I will post using your own sources now:
en.wikipedia.org/wiki/Government_spending

4.8% on defense.. my bad.

And if I may quote your source:

Figures shown in this article do not reflect the actual appropriations by Congress for Fiscal Year 2008

[Lion]

Please refrain from posting about things you have no idea about.

I would like to not respond as I can see there's no getting through to you

I don't care if you studied the principles of Economics and Political theory, and that if your knowledge in the subject is far suprior to everyone elses on the subject. But twice you said something to another member that wasn't called for. Present your facts, theories and opinions, and let the other decide for themselves. If someone isn't getting your point, then try to rephrase your arguement, but please don't include these sort of comments in the future.

It is unconstitutional for the government to REQUIRE me to purchase something from a private party. THAT is written into the current bill.

You know what, I completely disagree with your stance on healthcare. After what my family has gone through in the last couple of years, and what my friend's family has gone through, I think it's inhumane to not have it free for everyone.

BUT

For the first time, I actually got what you meant, being on the other side of this topic, and respect that.

[SadisticNature]

The figures in the article don't include appropriations, however the total appropriations are included in the national debt, and can in fact be estimated by calculating the change in debt (actual) and subtracting the change in debt (budgetary). Note that the budget includes the interest on the debt, so that is not a factor to worry about in this calculation. As an economist, you should have some experience at estimating hidden information using publicly available financial data.

Again as per your own quotations of the article, the appropriations items are not included in the budgets. I continue to contend that claiming defense spending is only 4.8% of GDP when the appropriations dwarf this amount and most of those appropriations are related to wars is rather disingenuous. It may be true in a certain sense, but only in the sense that the budget doesn't reflect the spending of the country at all since all the appropriations dwarf it and hide the real picture.

I'm sure if the situation were reversed, and the military spending was entirely on the budget while all the social programs were appropriations and I claimed social spending was 0% of GDP, and military spending was 40% you'd cry foul just as quickly, and correctly so.

Also using % of GDP is misleading as it doesn't given a clear fiscal picture of a country given widely disparate tax policies. What is the federal government revenue as a % of GDP? If you're spending 4.8% of GDP on military and your revenue is under 20% of GDP then non-appropriated military spending is going to be over 25% of the budget.

[SadisticNature]

Actually this is nothing new. The US has consistently privatized many essential services, in some cases with monopolies. If you're so convinced its unconstitutional feel free to quote the portion of the constitution or a particular amendment it violates. Since very similar things have happened before you are also welcome to cite court cases where things of a similar vein were called unconstitutional. I think you are unlikely to find any.

As for requiring you to purchase healthcare: If you face a dire health problem that requires expensive medical care the most likely scenario is that you go broke.

At this point you are likely to be unable to work due to health complications, and as a result will be on 1) Welfare and 2) Medicaid.

Since the government will have to pay for all these situations, I see no problem with the government levying a specific tax on those who choose not to buy healthcare in order to pay for these added costs. The government already levies certain specific taxes and benefits for social problems/boons. Most income tax benefits fall into this category.

[oww-that-hurt]

We in Montana need a new Senator that remembers what a working stiff earns here. In my house we are working middle class that can't afford health insurance but make too much for 'assistance', not that we would take it anyway. We don't have cable/satellite TV, a cell phone, high-speed internet (just this 56K modem), new cars, don't go to movies or fancy restaurants or even RENT movies, and the list is endless of what some folks think they need but we do without. This isn't a 'oh-poor-me' stand, just background info. Our Senator wants to fine us over $3,000 if we don't get insurance. Insurance for us would be over $1,000 per month, which will just never happen. We can cut a few more corners (lower thermostat, less driving, etc.) to cover the 'fine'. We still won't have insurance, but also won't be able to pay for medical and dental and eye-care check-ups, which we now do. So much for preventive care. We even have enough budget left over to donate a BUNCH of food to the food bank (Pantry Partners). Well, with the 'fine', there goes that item, too. It all just gets under my skin. Sorry for the rant. Y'all have a nice Christmas!

[MMI]

Do people deserve a place to live?
Do people deserve a job?
Do people deserve a car?

IMHO, Yes, Yes and Of Course Not.

I might have crazy principles, but I'd rather house my family in a state-owned home than let them freeze, even if by freezing they nobly upheld their right to freedom.

As for entitlement to work, so long as I'm not press-ganged into the service of the state, or enslaved by some other person or organisation, I would be glad of the opportunity to work for pay, rather than having to depend upon others for alms and succour. If such jobs are available, I believe I am entitled to one.

You might think a car equates to the right to a home, or a job, or to health care, but I imagine few others would.

[steelish]

Actually this is nothing new. The US has consistently privatized many essential services, in some cases with monopolies. If you're so convinced its unconstitutional feel free to quote the portion of the constitution or a particular amendment it violates. Since very similar things have happened before you are also welcome to cite court cases where things of a similar vein were called unconstitutional. I think you are unlikely to find any.

As for requiring you to purchase healthcare: If you face a dire health problem that requires expensive medical care the most likely scenario is that you go broke.

At this point you are likely to be unable to work due to health complications, and as a result will be on 1) Welfare and 2) Medicaid.

Since the government will have to pay for all these situations, I see no problem with the government levying a specific tax on those who choose not to buy healthcare in order to pay for these added costs. The government already levies certain specific taxes and benefits for social problems/boons. Most income tax benefits fall into this category.

We have a Congress pushing hard to get this thing past cloture by Christmas. In fact, they plan to vote on it tomorrow morning.

To get this thing to a cloture, Bill Nelson has been offered exemptions on Medicare/Medicaid cutbacks for three counties in Florida. HUH? I thought there WEREN'T going to be any cutbacks at all! I guess bribery (again) is what is needed to get bills passed, rather than Congressmen working on what their constituents want.

As for unconstitutional; by FORCING me (or anyone else) to purchase healthcare, they are taking away free choice.