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How do you feel about mandatory health insurance?
http://news.yahoo.com/s/nm/20080115/..._healthcare_dc
Is it similar to mandatory car insurance? I understand the concept and how it should work, but will it work on a federal/national level, or should it be state by state? (My car insurance is much cheaper in Ohio than in New Jersey/California. But they are trying to get laws passed that would allow them to buy from different states then they currently live in. Would the same thing happen here, where people move or travel and go from state to state frequently? How do you prevent the quality from being less in smaller states with fewer people?) Do you feel that there is any incentive for doctors/insurance companies to lower prices because everyone has to pay now? Will this increase demand for doctors because of the 'I'm spending all this money, I better get something for it' attitude? How will this effect immigrants (legal one would have to get it, so I'm talking about illegal ones here) and visitors to this country with no health care coverage? How are really sick people covered by this plan (do they have to pay more?) What would be covered by this health care insurance, is it just like we have today in the US (are there strict limits as to what is covered, or can you pay for better coverage)? Do you think this would work better than a single government (or a non-profit) run health insurance company/agency? Do they healthy people still need to pay for people who choose to be unhealthy, or should there be tests and lifestyle factors that determine the rate you pay based on how likely you will need medical assistance? |
You can choose not to drive if you don't want to pay for car insurance. You can't choose not to breathe or live.
I had a discussion with my wife a few years ago. We pay a bloody fortune for health insurance, probably 4 times what it would cost us to just pay for the doctors when we need them. But she refused to let me cancel the insurance and take the risk. Fact is, though, that if everyone refused to buy health insurance the cost of all medical stuff would go down. People behave differntly when they pay for something themselves than when they perceive someone else is paying for it. So - I would PROHIBIT third party payments for health care other than true insurance, for catastrophic events. Everything else, pay from your pocket, cut out the insurance companies and watch the prices come down. Yes, there would need to be some adjustments for certain chronic conditions but overall, this would be the single biggest step we could take to bring down the cost of health care. |
I have always been more of a proponent of sliding scale (based on income, family size, etc) health care, that would have a minimum level and eventually a maximum. While 10% of someone's $25,000 annual income may not seem much to some, 10% of someone's $1,000,000 annual income is quite a bit for the same service. So they should have a maximum pay where the sliding scale tops out at.
I think healthy people should have certain incentives, like safe drivers. However, that poses a serious potential problem. If I am sick and I don't want my health care premiums to go up, I don't see a doctor.... but if those problems get worse and I went from bronchitis where some antibiotics and Albuterol would have cleared it up relatively cheap to now having pneumonia and it costing the insurance and myself a lot more, was staying away worth it? I really like a sliding scale, where no one except the financial department knows how much you are paying and there is no mention of insurance at all. That way the hospital doctors will do what they need to do, not what is covered and the bare minimum. Now, if you want insurance to supplement what you would have to pay... I think that something would eventually appear in the market for people to buy. |
Mandatory employer-provided health care is not a solution to the problem we face.
The driving factor behind the health care issue is cost. Cost cannot be reduced so long as we insist on centering our care finances on a bloated insurance industry that only spends 40-60% of what we pay into it on our health care. The insurance industry is grossly inefficient by any measure, and making purchase of insurance mandatory will not give them any incentive to become more efficient--quite the opposite. Employer-provided health care is a relic of the past and puts our companies at disadvantage when facing competition in the global markets. Enforcing it through making it mandatory or making such a system the center-piece of a health care solution is not a real solution. Costs will continue to hobble us, no matter how we hide them. Make no mistake, health-care benefits are not a gift from your employer. They are your employer spending your wages on insurance. Granted, there are some tax implications because they are not technically wages, but the fact is that is YOUR money being spent on those benefits. Those premiums are coming out of YOUR pocket. Opposite to making insurance companies a mandatory part of the equation, I support making them a purely optional part of the equation. How? By having a universal comprehensive single-payer system to ensure basic health care needs for all people. That way if you want to go above and beyond this level, you can opt into an insurance program to defer costs. Insurance companies will no longer have the sword of Damocles to hang over consumers, since having insurance will no longer mean risking one's basic health, but instead be a merely voluntary item for those seeking more costly optional benefits. Single-payer universal comprehensive health care: - Employers are not hobbled by the cost and administration of health insurance programs. - Elimination of the Insurance Industry black hole (savings of as much 4% of our GNP off the top) - End of most current labor disputes (most strikes in the last decade have centered on health benefits) - Drastic reduction in personal bankruptcies (more than 50% currently are direct result of medical bills) - Vast improvement in national health rates due to coverage extension to all Americans. Mandatory employer-provided coverage (or individually-provided for that matter) will not achieve any of the above benefits. |
why did the government make seat belts mandatory?
It wasn't to 'save lives', it was to save money for the insurance industry. Same reason for making auto insurance mandatory, it was to create wealth for the insurance industry. mandatory health insurance is only going to create more wealth for yet another insurance industry. |
Once the decision is made that everyone must be provided health care, I don't see how keeping the insurance companies in the loop can be cost effective. Wouldn't they just be middlemen taking in profits that could be spent to provide better care?
As far as controlling costs, I think loquitur has a good point. As long as people with insurance do not care what the overall cost is there will be no competitive reason for providers to lower prices. I read recently that the average person now gets 14 prescriptions a year. I don't think I have had that many in my life. We are becoming a nation of drug users and the doctors are our suppliers. I wonder just how many of these pills are really necessary. |
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Well, Willravel, per my earlier post, I think you CAN live without health insurance. Health CARE you need. Health INSURANCE you probably don't, except for real unexpected events, i.e. true insurance - not third-party payment schemes.
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... Why can't the US just "get with it" like Canada / Europe? I'll take their brand of mediocrity over ours any day. |
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I think the insurance pricing has more to do with ridiculous law suits and such, that is the shit that drives up the premiums.
Also oral health and dentistry is ridiculous. Are you telling me that $20 worth of metal in my mouth and a few 20 minute check ups annually were worth thousands of dollars to correct my janky teeth? The government would be smart to regulate the shit rather than making it mandatory. |
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I also want to examine why it is that other posters here almost never offer opinions "in synch" with those financially backed by Coors, Koch, Olin, Scaife, et al, foundations. I think it is more than a coincidence, don't you? Let us examine who the leading critic of medical malpractice litigation, and malpractice plaintiff attorneys is, and where his funding comes from. Wouldn't you expect it to come largely from medical malpractice insurers and medical practitioners who pay the insurance premiums? I would, but that is not where Walter Olson's funding is coming from, is it? Note how often manhattan institute "fellow", Walter Olson's name appears on the lsit here: http://en.wikipedia.org/wiki/Tort_re...ted_references Examine the funding....from just nine "grantors" to the manhattan institute, at the next two links: http://www.mediatransparency.org/rec...ecipientID=198 http://www.corpreform.com/2003/11/the_manhattan_i.html Walter Olson maintains several websites, designed to dominate the position that you embrace, Mojo.... Here's Walter Olson, in an article in a 2004 TFP post, cited by Ustwo, just the other day: http://www.tfproject.org/tfp/showthr...=130156&page=2 (in post #47 ) Quote:
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Every opinion the foundations listed above, pay for, are opinions with no populist support, because....they are anti populist....they have to be subsidized and distributed by entities cosmetically altered to appear to be populist, scholarly, authorative, trustworthy...just like.....the pentagon, ala Rendon and "the Lincoln Group", and the "Bloggers Roundtable" ! Quote:
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I don't want anything to be mandatory that isn't about safety.
if this comes to fruitition next thing that's going to be demanded is mandatory retirement benefits. |
we need to get rid of health insurance and provide universal health care without the insurers. All they are is a middle man taking way to much of the pie.
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So, are you telling me that I am misinformed Host? Some super elite council of rich white men subsidize and perpetuate a notion that frivilious law suits are the cause that drive up insurance premiums, and it is completely unfounded and false? It's merely a vast conspiracy? I'll believe you, but besides one line referring how in 06' malpractice suits evened out, which does not at all address how they spiked the several years before that, the only other thing your post touched on was these evil white men and their connections, also they fund groups sympathetic their causes :eek: .
http://www.cbo.gov/ftpdoc.cfm?index=4968&type=0 Quote:
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BUt I'm sure I'm offbase on this, it's probably has nothing to do with anything. |
Mojo please see the following news articles on insurance premiums and lawsuits:
http://www.slate.com/id/2145400/ Quote:
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These are some pretty telling statistics that seem to discount the notion that it is frivolous lawsuits that are causing the premiums to go up and point toward greed being the cause. |
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What has either Bush or Cheney been accurate or truthful about? Quote:
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I'm happy with it.
The more mandatory benefits you have as a society - the less mandatory policing you'll need later on, to keep the poor in their place. That's one take on it anyways. |
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From the CBO study: Quote:
IMO, in the short term, employer-based programs may still be the most practical, with tax (and other) incentives to small businesses to provide basic coverage to all employees. In the longer term, single payer may be the most cost-effective solution. |
I don't understand. Will mandatory health insurance just raise the overall price of health insurance for all? Would it mean that the insurance companies can then set any price they like, knowing that we, have to purchase it because it is mandatory?
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the only thing i see coming out of mandatory health insurance is another over-bloated government entity that will suck even more money out of my pockets.
the general population is the only one to point fingers at about the spiraling cost of healthcare. generally speaking we are fat and lazy. poor diets and a lack of exercise. everyone looking for a pill to cure everything. the problem isnt going to go away till the root causes are addressed. |
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What additional costs are created by the uninsured population?Mandatory health insurance does not necessarily mean a bloated government entity, particularly in a transition period with a reliance on employer based health insurance. The federal government is the largest employer in the country and government workers have a choice between numerous plans from Care First (blue cross/blue shield) to various HMOs and PPos and other options. There is no government bureaucracy. A health pool for those small employers who currently do not provide coverage come be administered in a similar manner. An expanded SCHIP program, administered by the states, not a federal bureaucracy, could cover other working poor. Health care costs will be more manageable when we are all not paying for the uninsured who are presently working w/o insurance, when there is a greater emphasis on educating consumers on the cost effectiveness of preventive rather than remedial treatment, and when the entire system is overhauled to be more technology driven. |
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small businesses banding together to help defray the cost is an excellent idea. maybe offering tax incentives will prompt a majority of them to comply, but again, who is going to check and make sure they are complying? Quote:
there are too many unhealthy individuals in this country with too few hospitals, physicians and nurses to care for them. to me this sounds like the typical American obsession with quick fixes. lets not ID the root causes and fix those. lets throw a band-aid on it so all the important people can stand in front of the cameras and say "look what i did for you." |
Let's assume we did make it mandatory... how are the homeless going to afford it? What about unemployed or extremely poor people? Who is going to pay when the insurance companies deny coverage because it is a "previous condition"?
The health insurance industry is a bunch of crooks that are fleecing America. The last thing we need to do is give them a government sanction. |
Once you give government that control and they make insurance mandatory, you then give them control over YOUR life.
Surveys will come out saying, "this food causes cancer and costs insurance company millions." Government will ban that food. It's fucking bullshit to give government so much damned control in our lives. They have enough control and we keep forfeiting rights over to them in the name of "helping" or "public safety". We are a country that worries more about the petty shit than we do the real problems. Not that health care isn't a problem, it is, but if we make it "mandatory" or we give government too much control it will pendulum over to where the solution is a bigger problem, but we are stuck with it. Why not put tax money to better use, initiatives to better use by creating jobs, opening true small business loans, give corporations incentives and tax write offs if they offer employees better wages and benefits. Come on people, let's look for solutions that don't require us giving government more fucking power. |
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I don't like the idea of having to pay (what happens if I take a year off work and don't make any money? Do I still have to pay, or am I covered by others?)
But I still think that the universal route with different levels of care based on how much you pay and how healthy you are would be a good route. And there needs to be a set of defined procedures that are covered. I liked this article though. http://www.investors.com/editorial/e...84257033287107 Quote:
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Tax abatements? Price controls? People will still be paying from already tight budgets. I think this would be economic suicide for them. Quote:
The problem with giving the government total control, even in the name of helping, is that you open the door for them to take away choices, personal freedoms and rights (excuse me "privileges" because my eating Dorito's, smoking and sitting around the house on my days off are "privileges" not rights... or so they will be defined someday). The sad thing is the government will take away those "privileges" in a heartbeat if they can sell the people a good reason as to why they are. It's no, not, never government's "right" or "duty" to take away any personal choices, rights or freedoms. But it seems people are becoming more and more okay with them doing so and buying into the reasons why it is okay government does. Quote:
So instead of truly working on a way to solve the problem, we'll just have government make people pay for a new expense they won't be able to afford. I have yet to see or hear one person either here or in real life tell me why a sliding scale system won't work. If you have insurance keep it, use it. If you don't or are maxed out, we have a sliding scale so that you can still get the treatment you need. |
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The 47 million uninsured figure that gets bandied about are not the poor and indigent, these are people who don't qualify for public assistance who cannot afford to buy an individual plan and whose employers don't offer plans. As for raw price there's several mechanisms at work. The millions of extra payers decreases risk and depresses prices for consumers. The government's leverage in price negotiation depresses prices for consumers and gives the insurance greater leverage in negotiating reimbursement rates with providers. People who are unable to pay the new lower rate are given waivers/tax breaks/reimbursements, etc. Quote:
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Second, it's still an artificial limitation on access. People are dissuaded from seeking preventative care or any care until they absolutely need it, which drives up cost and burden on providers, which is passed on to consumers, not to mention a decrease in quality of life and economic productivity. Third, the percentage of settled claims for uninsured patients is extremely low. Regardless of the reason for that, it's a reality, and when providers are losing money on the uninsured they're less willing/able to reduce their reimbursement rates from insurance. Any health care scheme is going to have problems, and mandating privatized insurance is fraught with them, but it's a start, it is an improvement over what we have currently, and given the last 20 years of legislation I believe this is the best that can be done right now. |
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<h3>It's all bullshit, pan !!!!</h3> ...paid for by the same f*ckers who paid for the "Harry and Louise ads", in reaction toHillary Clinton's attempt to "reform" healthcare, 15 yeara ago. Read ASU2003's post, preceding yours;specifically the "Investors BS daily" EDITORIAL that he posted a linked excerpt from, and compare what it stated to what we actually know: Here is the UK healthcare system, a government managed and financed, "single payer" system, the pride of the British people. Investors BS daily's propagandist must have worked OT, to get this to appear as he so negatively wrote about it: Quote:
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http://query.nytimes.com/gst/fullpag...pagewanted=all a millionaire who transferrred father's valuable farmland to himself and his brother, a transaction listed as $10, before sending the elderly man to live far away, in a home for indigent former firemen..... Quote:
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However once the decision is made to provide care for everyone then keeping the insurance companies in the loop seems almost like a protection scheme and would rake in billions of dollars which could probably be better spent. The insurance companies seem to be trying to keep costs down by negotiating prices, refusing claims whenever possible and denying coverage to people with existing health problems but costs continue to rise faster than inflation. The question is will total government control make things any better or do we need the insurance companies to continue their role as the middleman to try and control the prices that health care providers charge.. |
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Edit: Ah, found my old link. The US pays $5,711 per capita for healthcare. Canada? About half that at $2,989. http://www.kff.org/insurance/snapsho...s/figure-1.gif |
That chart is misleading and doesn't really mean anything to the average tax payers. I provide health care for my employees and yet that would show up on your chart the same way a tax would on my employees as its just % of GDP.
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I am a little wary of both sides. People pushing privatization usually will make a lot of money on the deal. People pushing state run care don't have a good way to pay for it, or think it will all be perfect for 1/5 the cost as today.
I think we should have both systems. And I would break it down like this. If you can choose which doctor to go see, then it should be covered under private insurance. If you have to see the closest doctor (read: emergency), then a small tax (income/sales?) would cover it. It wouldn't be the utopian, perfect solution, but it would be a start. One of the biggest worries that I have if I gave up my health insurance, is if I got into a car accident or something where the bill was very high. It is rare and people don't purposely hurt themselves badly to abuse the system or think they need to get their dollars worth out of it. From there, we can discuss transferring more services if it is working ok. |
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50% of 30% is 15%. |
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Canadian TFPers, please explain to your neighbors to the south: what kind of taxes do you pay?
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You're both wrong. Sort of.
Ustwo is right in that the rates quoted on wikipedia above aren't the whole picture. Those are only federal rates and just the income tax. We also pay provincial rates (which, unsurprisingly, vary by province) and sales tax on most goods. From the Canada Revenue Agency Website: Quote:
The other major tax is sales tax, which also varies by province. The federal rate is 5%, where here in Ontario we pay 8%. If we therefore assume that as an Ontarian I make less than $36 000 per year and that all of my income goes towards taxable goods and therefore I pay full sales tax on it I pay 34.5% in total taxes. The reality is different, of course; services such as phone and cable are taxable, but rent isn't and neither, as far as I know, is third party insurance (home, auto, etc). The reality is that I pay significantly less than that in taxes (and this isn't even taking into account any tax credits I may qualify for; for example, rent counts towards a credit on income tax as well as not being applicable for sales tax). So I have no idea where 48% comes from. Our healthcare system is far from perfect and I'll be the first to admit it; on the other hand, it's far from going bankrupt, despite what CBS tells you. Occasionally things ged backlogged and sometimes mistakes are made. Even still, wait times aren't all that significant; usually tests and services can be provided in a timely manner and it's exceedingly rare to hear of a high priority case that doesn't get treated in a reasonable timeframe. Canadians do have private healthcare to an extent, as the article noted. I have additional private insurance that covers dental, eyecare and prescriptions that OHIP doesn't cover for me. For 100% vision coverage, 80% dental coverage and a flat $13 co-pay on all of my prescriptions (some of which run over $100), I pay a princely sum of $9 per week. Do you think I could get such high quality coverage for less than $500/year if OHIP didn't cover much of the essential services, particularly when one considers that I have a chronic condition? In the end, I reckon you lot will do what you want. If privatized health care is really working out for you, than good on ya. I'll take my free commie hospitals, thanks. |
Here is data anticipating most taxes in order to attempt as close a comparison to what our experience in the US is, as far as federal, state. and local taxes:
http://www.taxtips.ca/tax_rates.htm The tax rates increase as income increases. However, the increased rate only applies to the increased income. For instance, the lowest federal tax rate is 15% (in 2007) for income of up to $37,178. The next rate is 22% for income over $37,178 up to $74,357. A person earning $60,000 would pay the 15% rate on the first $37,178, and 22% on the remaining income. ...in addtion, on a $70,000 pre-tax annual income, a provincial tax, ranging from $4,400 in BC to $9,200 in Quebec is also levied. http://www.taxtips.ca/pst/pstrates.htm Sales taxes range from zero in Alberta to 13 percent in Nova Scotia... http://en.wikipedia.org/wiki/Sales_taxes_in_Canada Sales taxes in Canada From Wikipedia, the free encyclopedia Jump to: navigation, search In Canada there are three types of sales taxes: provincial sales taxes or PST, the federal Goods and Services Tax or GST, and the Harmonized Sales Tax or HST. Every province except Alberta implements a Provincial Sales Tax or the Harmonized Sales Tax. The Yukon Territory, Northwest Territories and Nunavut do not have any type of regional sales tax. The federal GST rate is 5% effective January 1, 2008. [edit] Harmonized Sales Tax Main article: Harmonized Sales Tax The Harmonized Sales Tax (HST) is used in certain provinces to combine the federal Goods and Services Tax (GST) and the Provincial Sales Tax (PST) into a single, blended, sales tax. Currently, there is a 13% HST in the provinces of New Brunswick, Newfoundland, and Nova Scotia. The HST is collected by the Canada Revenue Agency, which then remits the appropriate amounts to the participating provinces. [edit] Provincial Sales Taxes Separate Provincial Sales Taxes (PST) are collected in the provinces of British Columbia, Saskatchewan, Manitoba, Ontario, Quebec, and Prince Edward Island. Goods to which the tax is applied varies by province, as does the rate. Moreover, for those provinces whose provincial sales tax is applied to the combined cost and GST, provincial revenues decline or increase with respective changes in the GST. Quote:
A small business, structured as a "C" corp, can fully deduct the cost of providing employee medical benefits, including coverage of majority stockholders, with an active role in operating the business. We also paid annual wokers comp.insurance premiums of $20,000. Most of that coverage is insurance protection for medical treatment of on the job injuries, so it should cost much less in a country with a single payer system. Ustwo, with the cost of providing group employee benefits today, either you're offering a lesser plan, do not offer employer paid family benefits, or if you are, you're requiring a sizeable employee payroll deduction as a condition of paying your employer portion of family coverage. Fifteen years ago, we were excited about the potential of the reforms espoused by Hillary Clinton, lessening the burden to our business of employing family medical coverage. Our expense was running at nearly three percent of our business's gross revenue. I cannot fathom how, if you're paying for most of your staff's family coverage, as well as your own, you could be opposed to reform. We have a broken system, just in the misplaced expense and busy work of finding who pays.... a bill for medical treatment.... a worker's comp or auto insurance carrier, the patient, medicare or medicaid, or a private medical insurer, and then the issue of eligibility for medicaid paid long term nursing home care, "look backs" related to attempts of the elederly and heirs to "shelter" inheritance that rightfully, should be sold to provide care before becoming medicaid eligible, or assets that should be surrendered to medicaid, in exchange for it's coverage, instead of illegally sheltered , Huge numbers of uninsured, yet the highest average cost per patient for care in the world, wihout being even in the top ten of highly rated medical care environments. |
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http://www.annals.org/cgi/content/summary/141/12/938 http://content.nejm.org/cgi/content/...ct/348/22/2218 Quote:
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There's also the free-riding aspect of other countries' health care systems. Many of them (yes, Canada included) keep costs low by, in effect, shifting R&D costs to the US.
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TY, Martian and host.
So we're all now understanding that 48% statistic is right out. Further mention of the erroneous 48% statistic will get the poster sacked. Then the sackers will be sacked. |
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The pharmaceuticals business is the most profitable of major industries. Companies doing business in the US, employ more than 90,000 "detailers" to call on 120,000 issuers of prescription drugs, US physicians. I find no data to support your contention that R&D budgets, compared to what is spent on marketing, just in the US, is of major consequence. I've found your "shifting R&D costs argument", pushed by conservative talkshow hosts Medved and Prager, but I see no data to support it. What do you think it costs to keep an army of "detailers", that size....the most prolific prescription writers are reported to have 65 of these people a week at their doors...1300 visits in a 200 day year, in the field? The compensation for these 90,000, plus expenses, plus the lunch they bring in daily to the staffs of care providers offices, plus the packaging, product, and distribution costs of the drug samples that they drop off on their office calls....none of those costs are related to the TV, print, internet, and promotional "doo dad" media blitz costs incurred by big pharma to inform us about their products. I submit that your notion of R&D cost "shifting", is a shift of profits to marketing, and not into R&D, and that using the notion is the product of a "K" street lobbyist /republican politician misinformation, "Op", a smokescreen to dissuade growing drug purchases from Mexico and Canada, that cut (so far..) inconsequentially into Pharma profits that would otherwise be spent on marketing, not on R&D. If there is such a great concern about activities drawing money out of R&D, why not support legislation to limit some of the marketing done by Pharma, putting them all on an even keel? Could it be because the advertising industries political influence is as great or greater, than big phrama's? Musn't let anything interfere with locking the consumer into a restricted source to purchase medicine, that will bleed him dry, one at a time, with the resulting least political consequence, than to choose to diminish in any way, the big money flowing to the largest, best organized, and most powerful political lobbies, is there? |
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