3 ms·

While I agree that the US could learn a lot from India's billion-payer system, the big drivers in cost differences wouldn't apply. India's system is cheaper sp

While I agree that the US could learn a lot from India's billion-payer system, the big drivers in cost differences wouldn't apply. India's system is cheaper specifically because it doesn't have the complexity of the billing system that the US has (and, for that matter, European countries as well). But in addition, India explicitly does not recognize a wide range of drug patents that the US does. By paying more for prescription medication, the US market funds a huge amount of medical research (50% of the medical research in the entire world) which countries like India are able to access essentially for free.

sonink 9y ago
I guess, the complexity of the billing system in the US is the outcome of an insurance driven market which has kept a status quo due to vested interests. India also has a complicated insurance system, but it is kept in check by a parallel free-market and state funded system. There is competition not just between carriers, but also pressure on them to keep their policies simple, lest customers circumvent and pay themselves. You are right about enforcements about drug patent, but if I am not wrong this is true only for a small set of medicines which are marked essential. My guess is that vast majority of drugs sold are generic copies of off-patent drugs.
kinkrtyavimoodh 9y ago
Your point about the US effectively funding pharma research for the whole world is well taken (I think it's often kinda ignored by a lot of people), but the billing complexity is not inherent to healthcare—it's a result of the system, so I don't think it stands as an argument. Also, while drug costs can be explained, there are a lot of other costs in the system that are not necessarily affected by that argument (for instance, for a surgery, how much of the cost is actually due to said drugs, and how much is due to all the other factors?)

sonink 9y ago

I guess, the complexity of the billing system in the US is the outcome of an insurance driven market which has kept a status quo due to vested interests. India also has a complicated insurance system, but it is kept in check by a parallel free-market and state funded system. There is competition not just between carriers, but also pressure on them to keep their policies simple, lest customers circumvent and pay themselves. You are right about enforcements about drug patent, but if I am not wrong this is true only for a small set of medicines which are marked essential. My guess is that vast majority of drugs sold are generic copies of off-patent drugs.

kinkrtyavimoodh 9y ago

Your point about the US effectively funding pharma research for the whole world is well taken (I think it's often kinda ignored by a lot of people), but the billing complexity is not inherent to healthcare—it's a result of the system, so I don't think it stands as an argument. Also, while drug costs can be explained, there are a lot of other costs in the system that are not necessarily affected by that argument (for instance, for a surgery, how much of the cost is actually due to said drugs, and how much is due to all the other factors?)