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Cutting reimbursements for drugs by 40% is going to have impacts on everything from R&D to what drugs are available. Drug companies median profit margin varies

Cutting reimbursements for drugs by 40% is going to have impacts on everything from R&D to what drugs are available. Drug companies median profit margin varies widely but its about on average 12-14% [0]. I don't think you can just wave a magic wand and say now you get 40% less and you'll just deal with it. It's also naive to believe you can just export some reimbursement model from another country to the US and just plug and play. Are we still all supposed to pretend that giant pharmaceutical companies aren’t raking in money hand over fist? Is this like how we have to pretend that if game publishers don’t batter us with always-online, microtransaction-laden cash-grabs, games wouldn’t get made? R&D happens in other countries which don’t run a pump and dump scheme on their citizenry for the benefit of oligarchs. Maybe they’re just more efficient? Or maybe they don’t have the marketing budget American pharma does. Maybe they depend on America subsidizing global R&D? Maybe it’s time for China to take a turn, if they’re so intent on being top dog.

candiodari 8y ago
I think the point is that we can in fact quantify what "money hand over fist" is, exactly. It is a 12% cost increase over zero profit, according to GP. Not the sort of cost savings anyone's looking for. It's like the oil companies. With the exceptions like Aramco and other national oil companies all have margins something like 6% to 8%. That's the maximum price drop outlawing all that "hand over first money" can bring. > Maybe it’s time for China to take a turn, if they’re so intent on being top dog. 1) if there's one great example of a closed and fully regulated market, it's the drugs market. 2) They're doing it illegally already (which also means they're poisoning thousands of Americans to death, of course mostly with full permission of said Americans). Also when it comes to widely known drugs people really want ... it's not ibuprofen we're talking about, it's strong pain meds and illegal drugs. > Maybe they’re just more efficient? How about you answer a question of mine: your solution to the problems in the most regulated market on earth failing to perform is just-a-little-more regulation. Wanna bet it won't work ? Second: save money on healthcare ? Easy ! Here's your choices: 1) don't cover really old age and/or exceptional problems (let's call this -for unspecified reasons- the European approach). Sucks for quite a few patients in total, but not that many, really, let's say 2% or so. Outlawed in the US. Generally speaking, this sucks pretty bad if you've got an uncommon cancer, and if you get to 80 years old or so, this becomes more and more likely to happen to you. Also you could consider outlawing a few your-own-damn-fault treatments (like lung cancer for chainsmokers). 2) don't cover everyone, and by not everyone at the very least include everyone who won't take care of themselves very well (effectively more or less the poor). Also we don't mean 1%, we mean like 20-40%. You can cover them for trivial problems without issue, but not in general. 3) don't take responsibility for patient outcomes. This one is more complex, but it is another great and costly difference between US and European health systems. Essentially a doctor fucks you over in the EU ? You've got zero recourse, unless the doctor was actively trying to kill you (and even then). Medication solves your headache but kills your liver ? You don't get treatment for that paid, again EU rules. 4) there are many things you can do to make healthcare cheaper. Starting with making becoming a doctor cheaper. Fix the education problem the healthcare system has. (e.g. https://news.ycombinator.com/item?id=18831524 https://news.ycombinator.com/item?id=18831524 on this very site seems to indicate there's a problem here) Without a combination of the above (with 1) the clear champion of cost savings), there's nothing to do. So which do you want to do ? Simplifying this to yet another communism/capitalism discussion ... I mean sure ... everybody does for everything these days ... but not going to get us anywhere. Those are organizing systems, they direct which of the above cost saving measures we take. By themselves they mean nothing. Capitalist systems can be much cheaper than communist systems as well as the other way around. It depends on the market they operate in. I mean to say, this is not the problem. Everything-covered unlimited healthcare for all is not something we can do. Sucks, but it just isn't.
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candiodari 8y ago

I think the point is that we can in fact quantify what "money hand over fist" is, exactly. It is a 12% cost increase over zero profit, according to GP. Not the sort of cost savings anyone's looking for. It's like the oil companies. With the exceptions like Aramco and other national oil companies all have margins something like 6% to 8%. That's the maximum price drop outlawing all that "hand over first money" can bring. > Maybe it’s time for China to take a turn, if they’re so intent on being top dog. 1) if there's one great example of a closed and fully regulated market, it's the drugs market. 2) They're doing it illegally already (which also means they're poisoning thousands of Americans to death, of course mostly with full permission of said Americans). Also when it comes to widely known drugs people really want ... it's not ibuprofen we're talking about, it's strong pain meds and illegal drugs. > Maybe they’re just more efficient? How about you answer a question of mine: your solution to the problems in the most regulated market on earth failing to perform is just-a-little-more regulation. Wanna bet it won't work ? Second: save money on healthcare ? Easy ! Here's your choices: 1) don't cover really old age and/or exceptional problems (let's call this -for unspecified reasons- the European approach). Sucks for quite a few patients in total, but not that many, really, let's say 2% or so. Outlawed in the US. Generally speaking, this sucks pretty bad if you've got an uncommon cancer, and if you get to 80 years old or so, this becomes more and more likely to happen to you. Also you could consider outlawing a few your-own-damn-fault treatments (like lung cancer for chainsmokers). 2) don't cover everyone, and by not everyone at the very least include everyone who won't take care of themselves very well (effectively more or less the poor). Also we don't mean 1%, we mean like 20-40%. You can cover them for trivial problems without issue, but not in general. 3) don't take responsibility for patient outcomes. This one is more complex, but it is another great and costly difference between US and European health systems. Essentially a doctor fucks you over in the EU ? You've got zero recourse, unless the doctor was actively trying to kill you (and even then). Medication solves your headache but kills your liver ? You don't get treatment for that paid, again EU rules. 4) there are many things you can do to make healthcare cheaper. Starting with making becoming a doctor cheaper. Fix the education problem the healthcare system has. (e.g. https://news.ycombinator.com/item?id=18831524 https://news.ycombinator.com/item?id=18831524 on this very site seems to indicate there's a problem here) Without a combination of the above (with 1) the clear champion of cost savings), there's nothing to do. So which do you want to do ? Simplifying this to yet another communism/capitalism discussion ... I mean sure ... everybody does for everything these days ... but not going to get us anywhere. Those are organizing systems, they direct which of the above cost saving measures we take. By themselves they mean nothing. Capitalist systems can be much cheaper than communist systems as well as the other way around. It depends on the market they operate in. I mean to say, this is not the problem. Everything-covered unlimited healthcare for all is not something we can do. Sucks, but it just isn't.

deleted 8y ago
[deleted]