5 ms·

The obvious regulation which almost every other country has is direct price controls on medicines, treatments etc. Not profit percentage controls. A dead simple

The obvious regulation which almost every other country has is direct price controls on medicines, treatments etc. Not profit percentage controls. A dead simple “this is how much you’re allowed to charge”. I don’t really understand why anybody would be against introducing this in the US.

bhupy 4y ago
It is not so obvious at all. Medicare Advantage does not have price controls, and it still costs less per capita than Original Medicare. > A dead simple “this is how much you’re allowed to charge”. This has its own set of unintended consequences, including physician rationing (it's a huge crisis of the NHS right now), and a reduction of investment in new medical research. There are many good reasons to be against introducing this in the US. Switzerland does not have price controls on medicines, treatments, etc. and the reason why it is so often cited is because it enjoys a comparable level of healthcare innovation to the US while still ensuring universal access (through its ACA-like subsidies). It also costs a lot per capita (among the highest in the OECD), but it actually gets what it pays for (https://pubmed.ncbi.nlm.nih.gov/26766626/ https://pubmed.ncbi.nlm.nih.gov/26766626/) (https://www.theweek.in/news/world/2022/05/07/7-reasons-why-switzerland-has-the-best-healthcare-system.html https://www.theweek.in/news/world/2022/05/07/7-reasons-why-s...) In fact, of the countries that usually make up the global leaders in health/medical innovators, all but 1 (the UK) engage in price controls (https://immigrantinvest.com/insider/the-best-healthcare-countries-en/ https://immigrantinvest.com/insider/the-best-healthcare-coun...), and the UK's NHS is suffering from a rationing crisis, and (ironically) a cost crisis.
- formerkrogemp 4y ago
  > In fact, of the countries that usually make up the global leaders in health/medical innovators, all but 1 (the UK) engage in price controls (https://immigrantinvest.com/insider/the-best-healthcare-coun https://immigrantinvest.com/insider/the-best-healthcare-coun...), and the UK's NHS is suffering from a rationing crisis, and (ironically) a cost crisis. The UK's difficulty lie in their leadership and political issues and in the economic consequences of Brexit. I'm not sure it's the best example for your argument.
  - bhupy 4y ago
    The NHS's difficulty lies in the simple fact that it is understaffed (https://www.express.co.uk/life-style/health/1633058/general-practitioners-recruitment-crisis-thousands-doctors-national-health-service-warning https://www.express.co.uk/life-style/health/1633058/general-...) and the staff are underpaid (https://www.bbc.com/news/newsbeat-62290577 https://www.bbc.com/news/newsbeat-62290577) — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is currently failing to address the supply loss with little political will to increase list prices (which propagate to the consumer through increased taxes). Brexit's influence is tenuous at best. Switzerland is also not part of the EU and doesn't face this problem. At best, Brexit exacerbated an already existing pricing problem. Where you're correct is that the difficulty lies in leadership's inability to actually change the prices to attract the supply necessary to reflect the increase in demand — and that's because the Single Provider system is tied to politics rather than market forces. The NHS is a third rail of politics and real reform is extremely difficult given the political buy-in necessary. In contrast, the private sector can (and will) increase prices to overcome demand — we see this happening in Switzerland (https://pubmed.ncbi.nlm.nih.gov/26766626/ https://pubmed.ncbi.nlm.nih.gov/26766626/). > The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times So where we may agree to disagree is that the NHS's woes are in fact a very strong example of the greater argument, on net.
    - TMWNN 4y ago
      >Brexit's influence is tenuous at best. Indeed. It's basically the convenient bogeyman for opponents of the current government. >The NHS is a third rail of politics and real reform is extremely difficult given the political buy-in necessary. Private Eye on "24 Hours to Save the NHS <https://twitter.com/KulganofCrydee/status/833654730849136641 https://twitter.com/KulganofCrydee/status/833654730849136641>
    - nicoburns 4y ago
      > The NHS's difficulty lies in the simple fact that it is understaffed and underpaid — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is currently failing to address the supply loss with little political will to increase list prices. And the US's problem is that the list prices it pays for GPs, nurses, and services are subject to market forces and thus are too high. The government is currently failing to address the service provision loss with little political will to decrease list prices (even though they would propagate through to consumers as decreased costs). It seems to me that there's no getting around the need for good governance here. And that lack of it is no excuse for not governing at all.
s1artibartfast 4y ago
Most countries don't have price controls, they have purchasing controls for their Healthcare systems. There is a huge difference. For example, if someone makes a pill that cost $1 million to live one more day, they can sell it, but most national health services won't buy it. In the US, the national health services and insurance companies are mandated to buy it, and a byzantine system of price controls ensure we only pay 900k.
BurningFrog 4y ago
A big problem with this approach is that if the price limit makes certain medicines unprofitable to invent and produce, they will not be invented and/or produced. This is of course already happening since, most of the world has price controls. The US market is probably financing most of the world's medical research, and if we stop paying so much, it may shrink a lot.

bhupy 4y ago

It is not so obvious at all. Medicare Advantage does not have price controls, and it still costs less per capita than Original Medicare. > A dead simple “this is how much you’re allowed to charge”. This has its own set of unintended consequences, including physician rationing (it's a huge crisis of the NHS right now), and a reduction of investment in new medical research. There are many good reasons to be against introducing this in the US. Switzerland does not have price controls on medicines, treatments, etc. and the reason why it is so often cited is because it enjoys a comparable level of healthcare innovation to the US while still ensuring universal access (through its ACA-like subsidies). It also costs a lot per capita (among the highest in the OECD), but it actually gets what it pays for (https://pubmed.ncbi.nlm.nih.gov/26766626/ https://pubmed.ncbi.nlm.nih.gov/26766626/) (https://www.theweek.in/news/world/2022/05/07/7-reasons-why-switzerland-has-the-best-healthcare-system.html https://www.theweek.in/news/world/2022/05/07/7-reasons-why-s...) In fact, of the countries that usually make up the global leaders in health/medical innovators, all but 1 (the UK) engage in price controls (https://immigrantinvest.com/insider/the-best-healthcare-countries-en/ https://immigrantinvest.com/insider/the-best-healthcare-coun...), and the UK's NHS is suffering from a rationing crisis, and (ironically) a cost crisis.

formerkrogemp 4y ago
> In fact, of the countries that usually make up the global leaders in health/medical innovators, all but 1 (the UK) engage in price controls (https://immigrantinvest.com/insider/the-best-healthcare-coun https://immigrantinvest.com/insider/the-best-healthcare-coun...), and the UK's NHS is suffering from a rationing crisis, and (ironically) a cost crisis. The UK's difficulty lie in their leadership and political issues and in the economic consequences of Brexit. I'm not sure it's the best example for your argument.
- bhupy 4y ago
  The NHS's difficulty lies in the simple fact that it is understaffed (https://www.express.co.uk/life-style/health/1633058/general-practitioners-recruitment-crisis-thousands-doctors-national-health-service-warning https://www.express.co.uk/life-style/health/1633058/general-...) and the staff are underpaid (https://www.bbc.com/news/newsbeat-62290577 https://www.bbc.com/news/newsbeat-62290577) — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is currently failing to address the supply loss with little political will to increase list prices (which propagate to the consumer through increased taxes). Brexit's influence is tenuous at best. Switzerland is also not part of the EU and doesn't face this problem. At best, Brexit exacerbated an already existing pricing problem. Where you're correct is that the difficulty lies in leadership's inability to actually change the prices to attract the supply necessary to reflect the increase in demand — and that's because the Single Provider system is tied to politics rather than market forces. The NHS is a third rail of politics and real reform is extremely difficult given the political buy-in necessary. In contrast, the private sector can (and will) increase prices to overcome demand — we see this happening in Switzerland (https://pubmed.ncbi.nlm.nih.gov/26766626/ https://pubmed.ncbi.nlm.nih.gov/26766626/). > The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times So where we may agree to disagree is that the NHS's woes are in fact a very strong example of the greater argument, on net.
  - TMWNN 4y ago
    >Brexit's influence is tenuous at best. Indeed. It's basically the convenient bogeyman for opponents of the current government. >The NHS is a third rail of politics and real reform is extremely difficult given the political buy-in necessary. Private Eye on "24 Hours to Save the NHS <https://twitter.com/KulganofCrydee/status/833654730849136641 https://twitter.com/KulganofCrydee/status/833654730849136641>
  - nicoburns 4y ago
    > The NHS's difficulty lies in the simple fact that it is understaffed and underpaid — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is currently failing to address the supply loss with little political will to increase list prices. And the US's problem is that the list prices it pays for GPs, nurses, and services are subject to market forces and thus are too high. The government is currently failing to address the service provision loss with little political will to decrease list prices (even though they would propagate through to consumers as decreased costs). It seems to me that there's no getting around the need for good governance here. And that lack of it is no excuse for not governing at all.

s1artibartfast 4y ago

Most countries don't have price controls, they have purchasing controls for their Healthcare systems. There is a huge difference. For example, if someone makes a pill that cost $1 million to live one more day, they can sell it, but most national health services won't buy it. In the US, the national health services and insurance companies are mandated to buy it, and a byzantine system of price controls ensure we only pay 900k.

BurningFrog 4y ago

A big problem with this approach is that if the price limit makes certain medicines unprofitable to invent and produce, they will not be invented and/or produced. This is of course already happening since, most of the world has price controls. The US market is probably financing most of the world's medical research, and if we stop paying so much, it may shrink a lot.