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> I swear, the richest businesses in America could be so much richer if they banded together to lobby Congress for legislation that benefits all of them. Exampl
by AnthonyMouse 2y ago
> I swear, the richest businesses in America could be so much richer if they banded together to lobby Congress for legislation that benefits all of them. Example: Imagine if the US switched to a single-payer healthcare system; how much money that would save the big tech companies.
You're misunderstanding how the corruption works.
Single-payer isn't the thing that causes other countries to pay less for healthcare. For example, Medicare and Medicaid pay significantly more per-patient than healthcare systems do in other countries, even for patients in the same demographic groups. Other countries with hybrid or private healthcare systems also have lower costs than the US.
The US system is so expensive because it has been captured by healthcare companies. If you change the funding source without changing the other aspects of the system, it doesn't get any cheaper; if you change the other aspects of the system, it gets cheaper regardless of the funding source.
But the healthcare industry makes the tech industry look like chumps. US healthcare spending is $4.9 trillion. The people getting all that money don't want it to cost less and lobby Congress to make sure it doesn't.
And it's to their advantage to deflect blame to insurance companies so they can propose laws that make it even worse, like capping insurance company profits to a percent of claims to keep the insurer's incentives aligned with increasing rather than decreasing costs, because then the only way for the insurer to make more money themselves is to pay out more claims to the healthcare companies, depriving them of the opportunity to profit from reducing waste.
- robertlagrant 2y agoI broadly agree, with two caveats: 1) some of the extra cost is used to buy state of the art treatments and systems, that help drive down their cost in other countries, and 2) it's been just as captured by legislative tug of war over the decades, that cause strange loopholes and constraints.
- scarface_74 2y agohttps://marylandmatters.org/2024/01/19/report-finds-some-drug-manufacturers-spend-more-on-advertising-executives-salaries-than-new-research/ https://marylandmatters.org/2024/01/19/report-finds-some-dru...
- robertlagrant 2y agoNot everything is drug discovery. Even stuff like "this digital system would save you going into a hospital in person" is done very well in the US, as it can afford it. Kaiser Permanente IT is particularly amazing, from what I hear.
- scarface_74 2y agoIt really doesn’t take billions of dollars for that type of system - coming from someone who worked at healthcare SaaS companies between 2014-2020. That’s not where the money is going
- robertlagrant 2y agoMy question would be - which countries did your companies target if not the US for their SaaS solutions? What was the place that made you the money if not the US?
- scarface_74 2y agoFor the most part, because of laws, regulations and certifications, all healthcare IT systems are localized to the country. Investments in software in the US, only helps the US.
- robertlagrant 2y agoThat's definitely not the case. I've worked in the UK on two health platform things, and the US market was by far the only one that could sustain normal prices. And the UK buys US software (EPIC/Cerner, for example) from the US. It's not localised at all. There aren't that many systems. Plenty of countries use the FDA's rules, and many standards are relatively global.
- AnthonyMouse 2y agoThat one's kind of a math problem. Suppose you're selling your new drug for a net margin of $100/unit and then you put all of that back into R&D. If you don't buy advertising, you sell 10,000 units and put $1M back into R&D. If you buy $7M in advertising, you sell 100,000 units, get $10M, $7M goes to pay for the advertising and you put $3M back into R&D. Then you're spending more on advertising than R&D. But then you're spending three times as much on R&D. So which one of these is better?