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This is good because it will actually help people... ... but wow, just woooow. It's so incredibly depressing that I'm calling this "good." Sometimes the sheer
by rubyn00bie 5y ago
This is good because it will actually help people...
... but wow, just woooow. It's so incredibly depressing that I'm calling this "good." Sometimes the sheer insanity of the United States health care system overwhelms me. The fact insulin isn't a few dollars or free is beyond disheartening. It's like the system itself saying the Sackler's just didn't have enough imagination exploiting people, and destroying lives, for profit. "Oh? You don't need to get them addicted if they'll die without it... silly, Sacklers. #BusinessMASTER"
I keep hoping one day folks in the US will get tired of being screwed on their healthcare and living in fear of getting sick... shrug
- kevingadd 5y agoInsulin prices have increased SO MUCH over the past 50 years, it's disgusting. The manufacturers' margins just keep climbing because they know they can raise prices without consequence.
- renewiltord 5y agoWell, that's because the insulin has been getting better. You could always buy porcine insulin and shit. It's just not as good (side effects, harder to dose, etc.).
- pimeys 5y agoThe best new analogs cost about 28 euros per 10ml bottle in Spain without insurance... Medicine, such as FIASP...
- WillPostForFood 5y agoEurope is free riding on the US.
- atlasunshrugged 5y agoI heard this argument somewhere (not just about medicine but also on defense, why they can have such lavish perks/holidays/etc.) but can't remember where. Do you have any good articles/papers on this?
- tarsinge 5y ago> can have such lavish perks/holidays/etc Just look at the difference in taxes on salary between France and the US. Half of what is payed by employers to workers goes to social protection (this is in addition to the company taxes). If you add VAT and income taxes the amount of disposable money is a fraction of what you would get in the US, nothing magic.
- hef19898 5y agoAnd yet living standards are at least as high and quite often higher in most EU countries compared to the US.
- tarsinge 5y agoSource regarding insulin?
- munk-a 5y agoThe US is still free riding on Canada when it comes to Insulin development IMO.
- TheRealPomax 5y agoFunny you should say that. Let's have a look at what the out-of-pocket costs would be if you live in, say, the Netherlands: https://www.farmacotherapeutischkompas.nl/bladeren/preparaatteksten/kostenoverzicht/modal/insuline__gewoon https://www.farmacotherapeutischkompas.nl/bladeren/preparaat... because those prices look a hell of a lot more normal than US dependents get squeezed (literally) to death for.
- pimeys 5y agoYep. And if some insulin gets too expensive, at least in Germany they kick it out from the system completely. It's either you can sell your product in the country with a price we think is reasonable, or we will not let you to be in the market. 20 euros per 10ml (about 2 weeks of use for me) is still kind of a good money for a product I cannot stop using...
- renewiltord 5y agoSure, there's a price difference across regions. That's nothing new. The important thing is that insulin prices haven't been going up. You can continue to get the same insulin as 50 years ago for pretty much the same price modulo inflation. And anyway, the Netherlands getting cheap stuff is a side-effect of innovation here. America builds for America, driven by American needs, and you guys benefit as a result. There's a reason recombinant DNA tech (which backs modern insulin) came from the Bay Area and not the Netherlands. NL has twice the pop of the Bay and a fraction of the inventions. A single university here has like 5x as many Nobel Prize winners as that entire country. I mean, I'm glad you're able to buy insulin cheap but we're richer and we're the ones driving progress, so we'll keep at it because we want a better life for ourselves (and if you benefit, it's fine). You're not capable of making that for us, yourselves, or anyone really.
- hef19898 5y agoOh yeah. Where would the world be without the SV innovations in targeted ads, social media and buying cheap stuff over the internet.
- gruez 5y ago>The manufacturers' margins just keep climbing because they know they can raise prices without consequence. They have? According to testimony by Sanofi, even though list price have went up 126%, net price has actually gone down 25%. https://www.finance.senate.gov/imo/media/doc/26FEB2019BRANDICOURT-SANOFI.pdf https://www.finance.senate.gov/imo/media/doc/26FEB2019BRANDI...
- peytn 5y agoAh yes, “net price.” Don’t remember my accounting class covering that. What about revenue?
- gruez 5y ago>Ah yes, “net price.” Don’t remember my accounting class covering that Good thing it's covered in the report >What about revenue? Surely your accounting class tell you that rising revenue doesn't necessarily mean that "margins just keep climbing"
- sjansen 5y agoAnd most blockbusters movies never turn a profit. Color me skeptical. There’s probably similar accounting tricks at play.
- gruez 5y ago>And most blockbusters movies never turn a profit net price =/= profit. The report also covers what exactly goes into the difference between gross and net price. If you can point out what the accounting tricks are, that'll be great.
- Spooky23 5y agoIf you look at the chart in the link, about 45% of the difference between “list price” and “net price” is discounts or rebates to insurers. It’s particularly gross and brazen, even by pharmaceutical rent-seeking standards, to justify cocaine-like profit margins because large buyers can negotiate. Insulin prices are driven by anticompetitive behavior. If you look at metformin, a generic drug treating the same disease, profit margins are tight, driven by competitive economics. A 90-day supply is < $10 retail.
- skeeter2020 5y agoInsulin has actually gotten cheaper; it's the pricing due to customization, branding and applicators that is totally out of control. Coupled with the history of insulin's invention and "open source" nature this is unconscionable .
- sharkweek 5y agoDon't worry, one day we all end up working for Amazon and they provide Amazon Healthcare at their Amazon Hospitals (wait times decreased to see a doctor based on PPH [picks per hour] minus TOT [time off task]). On your way back to work, don't forget to grab your prescription at the Amazon Pharmacy, where you can buy some Amazon Drugs (side effects might include decreased productivity, please use sparingly).
- rasz 5y agoThe depressing part is the realization that it was supposed to be Costco, the good guys in retail, but we will end up with Amazon universities instead :( https://www.youtube.com/watch?v=Z8zNsUTWsOc https://www.youtube.com/watch?v=Z8zNsUTWsOc
- sneak 5y agoThis is the result of prohibition. Many other people wish to manufacture and sell cheaper insulin, it is just illegal to do so. This is a government problem, not a healthcare system problem.
- MattGaiser 5y agoAre you talking about patents or just regulatory standards?
- snemvalts 5y ago"Many other people wish to manufacture and sell cheaper alcohol/paracetamol/antibiotics/COVID19 vaccines" To maintain this standard of living you're always going to be dependent on someone, it's not a government problem.
- wyager 5y ago> The fact insulin isn't a few dollars or free is beyond disheartening 90-95% of type diabetics have type 2 diabetes. Of those, around 95% can completely eliminate insulin dependency by straightforward dietary modifications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104272/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104272/ Under what moral framework should these people (around 90% of diabetics) receive insulin at others’ expense? I can see at least a first-order argument for having everyone else pay for obligate insulin dependents’ medication, but I struggle to see an argument for foisting the cost of an entirely preventable dependency on everyone else.
- war1025 5y agoGreat. Restrict the handouts to Type-1 diabetics. They certainly didn't get the disease by choice.
- thatguy0900 5y agoI think society has largely given up on the concept of a not awful diet being a reasonable thing to ask of people.
- munk-a 5y agoSociety continues to push back on any regulations on addictive junk food and loading down budget food with excessive amounts of added salt and sugar - so yea, the company's freedom to make a buck exploiting addiction trumps your freedom to live a healthy and happy life.
- thatguy0900 5y agoWe're not talking about being fat, but eating suger to the point you neet to start taking medication to keep the suger in your blood from ripping your veins apart. At some point there's some personal responsibility. It takes more than a little suger added to your food to do that.
- schemescape 5y agoCan you clarify where that 95% figure came from? From your link: > Forty percent (31/78) of CCI participants who began the study with insulin prescriptions … eliminated the medication
- war1025 5y ago> I keep hoping one day folks in the US will get tired of being screwed on their healthcare and living in fear of getting sick... shrug As someone with good but very expensive health insurance, any time I bring up health insurance prices, the response from people who get cheap health insurance through their employers is basically, "F* you, got mine" Unfortunately, the block of people with stable corporate jobs also tend to have a lot of political power and are in no hurry to see their perks upended.
- loonster 5y agoI would support it being free for Type 1 diabetics. They had no say in their genetic lottery. Type 2 can pay for it themselves. Their condition was caused by themselves.
- beached_whale 5y agoThat's not true. Type-2 is genetic too and there are high performance athletes suffering from it. Just as you have very obese people without it.
- loonster 5y agoAn obese person has 2x the probability of developing type 2 as a person of normal weight. Regardless of obesity, Type 2 can be managed with a low carb diet.
- beached_whale 5y agoAlso, false(to the later point), having type-2 still does damage to the beta cells and given time many will require insulin. Also, this still gets back to the OP placing blame on the individual based on ignorance. There are many reasons for an individual having a large mass, low insulin production, and insulin resistance. Low card can be part of it, but it's not a panacea, once an individual has diabetes, the damage has been done.
- eropple 5y agoPeople being squeezed for time and money by soul-crushing, self-grinding subsistence-level employment so that, tapped of executive function for the day, they buy a cheeseburger and fries, maybe collapse in front of YouTube to turn their brains off for a bit-- --those are the people you feel comfortable shitting on for their circumstances? (And there absolutely is a predisposition to Type 2 diabetes in some populations and not in others.)
- loonster 5y agoI see no need to subsidize their choices. Its not shitting on them, its just not enabling them. The vast majority of type 2 diabetics have a BMI >25. It is a user preventable disease. If for some reason they still have diabetes with a BMI <25, then subsidize it.
- hansel_der 5y ago>The fact insulin isn't a few dollars or free is beyond disheartening meanwhile there are people dying from lack of food in the richest nations on earth. don't get me wrong, there is plenty wrong with healthcare.
- MattGaiser 5y agoIs anyone actually starving to death in wealthy nations? I get that there are people who have to skip meals in the USA, but does anyone really get to the point of dying?
- dls2016 5y agoCan almost guarantee the bigger issue is the low quality “food” options, leading to obesity and diabetes.
- munk-a 5y agoIt would be really nice if we could actually recognize this issue and address it as a society instead of getting up in arms about a mayor taking away the Big Gulp.
- arsome 5y agoThe only people dying of starvation in the western world are people who refuse to accept help or have severe addiction or mental health problems that prevent them from seeking it in the first place.
- zamalek 5y agoYup. > severe addiction problems that prevent them from seeking it in the first place. ... and we're right back at health care.
- toomuchtodo 5y agohttps://ourworldindata.org/hunger-and-undernourishment https://ourworldindata.org/hunger-and-undernourishment https://www.feedingamerica.org/hunger-in-america/facts https://www.feedingamerica.org/hunger-in-america/facts (disclosure: food bank logistics and tech volunteer in the sunbelt)
- diob 5y agoI think a lot of us are sick of it (if you look at the polling for single payer, it crosses party lines in support). Unfortunately, our politicians are fairly well captured by entrenched interests.
- jonathanwallace 5y agoPoliticians aren't "captured," they're "grown." Captured implies a change in behavior or an outside force acting on them, and that isn't accurate. Only politicians that fall in line are given the support necessary to succeed. To me, the term captured reduces the agency which is our responsibility to exercise as citizens (at least in the U.S. where I'm based.) /steps off soap box.
- germinalphrase 5y agoThere is a perspective out there that says our current extremity of partisanship is actually a product of the parties themselves becoming weaker. When parties were strong, they had greater leverage over their members so the party could be whipped more effectively on compromises. Now - the efforts to reduce party influence over their members (smoke filled rooms, etc etc) has led to more and more extreme members and leadership has fewer levers to pull them towards the center.
- mrguyorama 5y agoIt doesn't really cross party lines if republicans refuse to vote out politicians who don't want single payer health care.
- deregulateMed 5y agoWho pays the bills is not the problem in healthcare, it's a supply issue. The various medical cartels have lobbied to artificially decrease the supply of competitors, workers, and companies in the healthcare industry. Single payer healthcare doesn't magically create more physicians, hospitals, or drug companies.
- mcguire 5y agoKeep in mind that large segments of US citizens believe both poverty and ill-health are moral judgements. https://news.ycombinator.com/item?id=27858491 https://news.ycombinator.com/item?id=27858491 https://news.ycombinator.com/item?id=27858456 https://news.ycombinator.com/item?id=27858456
- gruez 5y ago>"large segments" >links to two hn comments really?
- mcguire 5y ago...in the current thread...which is four hours old...and mirrors the comments from others in the US....
- gruez 5y ago>...in the current thread...which is four hours old Well if we apply your logic to this other thread: https://news.ycombinator.com/item?id=27860162 https://news.ycombinator.com/item?id=27860162, can we assume that "large segments" of the US population are knowledgeable in debating the merits of the rust programming language? >and mirrors the comments from others in the US.... Mirrors what? I certainly didn't see any reference.
- agumonkey 5y agoi take comfort in the fact that there's no true ideal system, as long as the good bits find light, it's ok, that's how it had to be