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The real solution is that we need single payer healthcare that only covers generics. Then if people want to experiment with patent medicine, they can get supple

The real solution is that we need single payer healthcare that only covers generics. Then if people want to experiment with patent medicine, they can get supplemental insurance from the private markets or pay for it out of pocket. Until then the whole system is fucked.

refurb 11y ago
Not sure where you're going with this. That would mean that no one would have access to any drug until it had already been on the market for at least 8 or more years, unless they were willing to pay it out of pocket (if they can't afford the insurance). On Medicaid and have HER+ breast cancer? Tough, you can take some horrible chemotherapy that will give you 6 months, not the new HER2 drugs that will give you 5+ years of life. How would that even work?
- Alex3917 11y ago
  > On Medicaid and have HER+ breast cancer? Tough, you can take some horrible chemotherapy that will give you 6 months, not the new HER2 drugs that will give you 5+ years of life. Which is exactly how it should work. The government should allow limited monopolies as an incentive for innovation, but it shouldn't be subsidizing them with taxpayer dollars. The vast majority of new drugs have few if any benefits over existing drugs, they're just government handouts to the wealthy. So I fail to see how a system that provided the best possible treatments for 99% of health problems for every American at a fraction of the current cost wouldn't be vastly better than our current system.
  - refurb 11y ago
    So I fail to see how a system that provided the best possible treatments for 99% of health problems for every American at a fraction of the current cost wouldn't be vastly better than our current system. If you're excluding patented drugs, you're excluding some of the best possible treatments out there. Also, your statement that "the vast majority of new drugs have few if any benefits over existing drugs" is not true. Some drugs are not any better, but most are better, although many only slightly. You have to realize that similar to tech, not every new drug can be a breakthrough. Most new drugs have incremental benefit, but it expands the boundaries of what's possible. If you look at the treatment of colon cancer, each new drug only added a few months of life, but after 10 years, the benefit had extended to over 5 years.
    - Alex3917 11y ago
      > If you're excluding patented drugs, you're excluding some of the best possible treatments out there. The issue is that allocating taxpayer dollars to the best treatments is bad policy, if you can get better outcomes from worse treatments for the same amount of dollars. E.g. for most diseases the most effective treatments are probably alternative medicine, but it's also probably not cost effective for the government to be paying for everyone to get whatever alternative medicine they want.
    - makomk 11y ago
      Many of the "best possible treatments" are expensive crap, barely better than a cheap generic or even than no treatment at all (especially cancer treatments).
bedhead 11y ago
I consider myself relatively libertarian, so I find myself nearly in shock that I believe a single payer system is the inevitable, and perhaps best, solution. (Although your generic vs branded thing makes no sense, no offense) Our problem is that we have made thing SO dysfunctional that a few laws here and there probably cant fix it - that's how broken it is. There would be drawbacks for sure, but we're at the point where things are so bad that the incremental drawbacks would be far outweighed by the benefits. It's pretty depressing to think about in all honesty.
- refurb 11y ago
  Why do you assume a single payer is inevitable? Are there some countries with great healthcare systems that are multi-payer? Switzerland comes to mind. Singapore?
rjurney 11y ago
This would be fine, so long as we made drugs go generic much faster. Which would require more public funding for drug research. Which would turn the system on its head.
- toomuchtodo 11y ago
  The FDA allowing the purchase of generics from reputable manufacturers in India and China, regardless of patent law, would also decimate the current system.
  - refurb 11y ago
    So basically invalidate the patents that exist? That would certainly disrupt the system and would likely results in no new drugs.
    - toomuchtodo 11y ago
      You mean no new drugs funded by for-profit companies. Drugs would continue to be developed by governments and non-profits.
      - refurb 11y ago
        Please list all of the drugs that have been developed by government and non-profits. And by developed, I mean actually brought to market. The list will be very short. Yes, the NIH funds basic scientific research. The NIH does not create new drugs. Even if an NIH research had discovered a new drug (they usually don't, they discover new science that leads to new drugs), that's about 5% of what it actually takes to get a drug to market. If you look R&D spending by pharma companies, the research part costs about 1/3rd. The development part is 2/3rds of the cost. Take a look at the Nature article that traced who discovered new drugs over the past decade or so. Over 2/3 were NOT invented by gov't or non-profit funding.
        toomuchtodo 11y ago
kejaed 11y ago
There was a really interesting episode of the podcast called White Coat Black Art that generally covers the Canadian health care system. In the recent election a single payer pharamacare system was part of one of the platforms, so the podcast host went to Sweden to see how they do it. http://www.cbc.ca/radio/whitecoat/blog/pharmacare-sweden-style-1.3247068 http://www.cbc.ca/radio/whitecoat/blog/pharmacare-sweden-sty...

refurb 11y ago

Not sure where you're going with this. That would mean that no one would have access to any drug until it had already been on the market for at least 8 or more years, unless they were willing to pay it out of pocket (if they can't afford the insurance). On Medicaid and have HER+ breast cancer? Tough, you can take some horrible chemotherapy that will give you 6 months, not the new HER2 drugs that will give you 5+ years of life. How would that even work?

Alex3917 11y ago
> On Medicaid and have HER+ breast cancer? Tough, you can take some horrible chemotherapy that will give you 6 months, not the new HER2 drugs that will give you 5+ years of life. Which is exactly how it should work. The government should allow limited monopolies as an incentive for innovation, but it shouldn't be subsidizing them with taxpayer dollars. The vast majority of new drugs have few if any benefits over existing drugs, they're just government handouts to the wealthy. So I fail to see how a system that provided the best possible treatments for 99% of health problems for every American at a fraction of the current cost wouldn't be vastly better than our current system.
- refurb 11y ago
  So I fail to see how a system that provided the best possible treatments for 99% of health problems for every American at a fraction of the current cost wouldn't be vastly better than our current system. If you're excluding patented drugs, you're excluding some of the best possible treatments out there. Also, your statement that "the vast majority of new drugs have few if any benefits over existing drugs" is not true. Some drugs are not any better, but most are better, although many only slightly. You have to realize that similar to tech, not every new drug can be a breakthrough. Most new drugs have incremental benefit, but it expands the boundaries of what's possible. If you look at the treatment of colon cancer, each new drug only added a few months of life, but after 10 years, the benefit had extended to over 5 years.
  - Alex3917 11y ago
    > If you're excluding patented drugs, you're excluding some of the best possible treatments out there. The issue is that allocating taxpayer dollars to the best treatments is bad policy, if you can get better outcomes from worse treatments for the same amount of dollars. E.g. for most diseases the most effective treatments are probably alternative medicine, but it's also probably not cost effective for the government to be paying for everyone to get whatever alternative medicine they want.
  - makomk 11y ago
    Many of the "best possible treatments" are expensive crap, barely better than a cheap generic or even than no treatment at all (especially cancer treatments).

bedhead 11y ago

I consider myself relatively libertarian, so I find myself nearly in shock that I believe a single payer system is the inevitable, and perhaps best, solution. (Although your generic vs branded thing makes no sense, no offense) Our problem is that we have made thing SO dysfunctional that a few laws here and there probably cant fix it - that's how broken it is. There would be drawbacks for sure, but we're at the point where things are so bad that the incremental drawbacks would be far outweighed by the benefits. It's pretty depressing to think about in all honesty.

refurb 11y ago
Why do you assume a single payer is inevitable? Are there some countries with great healthcare systems that are multi-payer? Switzerland comes to mind. Singapore?

rjurney 11y ago

This would be fine, so long as we made drugs go generic much faster. Which would require more public funding for drug research. Which would turn the system on its head.

toomuchtodo 11y ago
The FDA allowing the purchase of generics from reputable manufacturers in India and China, regardless of patent law, would also decimate the current system.
- refurb 11y ago
  So basically invalidate the patents that exist? That would certainly disrupt the system and would likely results in no new drugs.
  - toomuchtodo 11y ago
    You mean no new drugs funded by for-profit companies. Drugs would continue to be developed by governments and non-profits.
    - refurb 11y ago
      Please list all of the drugs that have been developed by government and non-profits. And by developed, I mean actually brought to market. The list will be very short. Yes, the NIH funds basic scientific research. The NIH does not create new drugs. Even if an NIH research had discovered a new drug (they usually don't, they discover new science that leads to new drugs), that's about 5% of what it actually takes to get a drug to market. If you look R&D spending by pharma companies, the research part costs about 1/3rd. The development part is 2/3rds of the cost. Take a look at the Nature article that traced who discovered new drugs over the past decade or so. Over 2/3 were NOT invented by gov't or non-profit funding.
      - toomuchtodo 11y ago

kejaed 11y ago

There was a really interesting episode of the podcast called White Coat Black Art that generally covers the Canadian health care system. In the recent election a single payer pharamacare system was part of one of the platforms, so the podcast host went to Sweden to see how they do it. http://www.cbc.ca/radio/whitecoat/blog/pharmacare-sweden-style-1.3247068 http://www.cbc.ca/radio/whitecoat/blog/pharmacare-sweden-sty...