7 ms·

Vacation policies are the least of it. How about the lack of a safety net? Take health care. Civilized people should agree that medical care in a rich countr

Vacation policies are the least of it. How about the lack of a safety net? Take health care. Civilized people should agree that medical care in a rich country should be available to everyone. The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. But for the past 20 years we've been fed the same fabricated FUD about socialized medicine that has no basis in reality. People still genuinely believe that America has the best healthcare, which is arguably true for the 1%, but not for the average person. We have major structural problems the media completely ignores. Just one personal example, last December I needed to buy a 6-pill dose of medication while visiting family for the holidays in the US (I currently live in the UK). This cost me $600, $100 per pill. And it turns out that this medication is not as effective as the generic that would cost $2 per pill. But because there is no profitability this medication is not currently manufactured in the US. Had I been in the UK I could have walked into a pharmacy and bought this medication for £10. Incidentally, while I was in line, the woman in front of me was purchasing a perscription of antibiotics, which cost $200, but she only had $100, so they only sold her half the dosage! I was shocked a trained pharmacist would be allowed to do this considering the perils of antibiotic resistance, but it's also pretty inhumane to withhold medication. Frankly, the patriotic bullshit that Fox News and CNN feeds the populace about how much better we have it than Canada or the UK needs to stop. America needs to pull its head out of its ass and realize we are little better than a third-world country for anyone below median income who doesn't have a good group health insurance policy.

maximumoverload 12y ago
Obamacare argument was inevitable, wasn't it.
bluedino 12y ago
>> And it turns out that this medication is not as effective as the generic that would cost $2 per pill. What medication was it, if you don't mind me asking? And why didn't you just ask for the generic? Many pharmacy chains in the USA offer a large list of generics for the low costs like $10/90 day supply
jmct 12y ago
Would you mind naming the generic drug? It seems like this is a powerful argument against having (only) for-profit healthcare. I'd like to be able to point to a specific case of what you're describing.
- brightsize 12y ago
  A data point from the USA: I take a very low dose of lamotrigene extended-release (mild epilepsy). The brand-name cost of this was $1200-$1400 per month. The recently available generic version of this costs nearly $400/mo. And this is, again, for a very low dose. For someone with a moderate or severe seizure (or bipolor - it's used for that too) disorder, the cost might be 4-5x this. While one might argue that the name-brand version costs so much because of high R&D costs (dubious in my opinion), it's difficult to make that argument for the generic. It's expensive because the manufacturer can get away with it -- it's very much needed by the patients but the market is sufficiently limited in size that few potential competitors choose to target it. Generics can be inexpensive if the drug in question has a very large market - statins for example. But if not, and you don't work for a company that provides health insurance with prescription drug coverage, a drug you need may well be a drug that you cannot get because of its cost.
  - kevitron 12y ago
    That's insane. I take the generic lamotrigine, but even at a high dose it's something like $36/month here in Canada. I have a half-decent private insurance policy, but at US prices I'd burn through my yearly prescription rebate limit in a month.
    - deleted 12y ago
      [deleted]
  - zo1 12y ago
    You mean, this "lamotrigene": http://www2.costco.com/Pharmacy/DrugInfo.aspx?p=1&SearchTerm=a&Drug=LAMICTAL http://www2.costco.com/Pharmacy/DrugInfo.aspx?p=1&SearchTerm... The one that costs $17.22 for 50 100mg tablets? Sounds like you might be getting ripped off wherever you bought your medicine.
jjoonathan 12y ago
> lack of a safety net? That's one argument. Here's another: Cost: http://healthcarereform.procon.org/view.resource.php?resourceID=005522#III http://healthcarereform.procon.org/view.resource.php?resourc... http://healthcarereform.procon.org/view.resource.php?resourceID=004083 http://healthcarereform.procon.org/view.resource.php?resourc... vs Quality: http://www.commonwealthfund.org/publications/press-releases/2010/jun/us-ranks-last-among-seven-countries http://www.commonwealthfund.org/publications/press-releases/... http://www.businessinsider.com/best-healthcare-systems-in-the-world-2012-6?op=1 http://www.businessinsider.com/best-healthcare-systems-in-th... EDIT: not sure if downvotes are because people think I'm saying that cost is less important than the lack of a safety net or because people are butthurt over figures demonstrating that universal health care is also cheaper. Please clarify.
- lallysingh 12y ago
  It might help (I didn't downvote, just suggesting) to put an intro to these arguments in the post, instead of just links.
refurb 12y ago
Your example of the cost of medication is an odd one. Most (all?) states in the US have mandatory generic substitution. That means the pharmacy must fill your Rx with the generic unless the doctor wrote "Dispense as Written" on the Rx. Now, if the generic was not available in the US that is a different story. Patents don't all end at the same time, so the drug may already be off patent in the UK, but not in the US. Finally, to say "there is no profitability" in generics is laughable. The US has lower generic prices that most of the EU due to fierce competition for the US market. And finally, although the US may not have a single payer system, we do have public health for the old (Medicare) and the poor (Medicaid). In addition, if you are sick and you go to a hospital, you must be treated regardless of your ability to pay.
- whybroke 12y ago
  >The US has lower generic prices that most of the EU due to fierce competition for the US market This is not the case. From direct person experience I can attest that: Betaserc is 1/25 the price in Spain as the generic in the US Nebivolol is 1/10 Lovastatin is 1/5 Enalapril is 1/2
  - zo1 12y ago
    I quote the parent poster: "The US has lower generic prices that most of the EU" Emphasis mine. Perhaps, if they were consistently "cheaper" than the US, fine. But your singular example doesn't quite contradict the person you're responding to. So it actually is the case, unless you prove your findings for other EU countries. I have no idea if that's the case, just pointing out the obvious flaw in your logic. Perhaps a little too-quick to look for contradictions if you disagree with the general point?
    - whybroke 12y ago
      Quite correct: I have no idea what the price is in Lichtenstein. Nor have I compared the price of every drug manufactured. Nor even a majority of those thousands. I have, however bought a dozen or so different drugs and have done so in France, Italy, Croatia, Spain, Portugal and the Netherlands. All of which were tiny fraction of the price in the US. So given two hypothesis: the US is cheaper vs the EU is cheaper, and a bunch of data points all pointing that same way, a little bit of Bayesian statistics shows us which hypothesis is over overwhelmingly more likely doesn't it? We can agree to use Bayesian statistics even though there's no entry in the conservapedia can't we? Contrast, for example, with the parent poster's hypothesis which comes form no more data than a.m. radio infotainment, I think there's only one rational tentative conclusion don't you?
orky56 12y ago
Therein lies the problem with the US and the mentality of the citizens. Since the proletariat are "temporarily embarrassed millionaires", the safety net is never there. To even take advantage of it is shameful. Perhaps unrelated, but the status of your achievements is reflected by how much you need to pay or put into it such as your job and even that 5-star hotel where you need to pay for breakfast and Wi-Fi.
hueving 12y ago
> The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. Doesn't happen in the US unless the person intends to do so. But that's pretty good fear mongering on your behalf.
- whybroke 12y ago
  So you're saying there has always been universal healthcare in the US even before Obama was elected? That everyone has always gotten all the medical care they need? Or are you saying uninsured people don't get sick? In fact roughly 45,000 die a year due to lack of medical care.[1] Why not embrace the society you're creating? Because I'm sure Miss Rand would not be happy with that level of self delusion. [1] http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ http://news.harvard.edu/gazette/story/2009/09/new-study-find...
  - hueving 12y ago
    Wow, a Rand reference. You must be of such superior intellect that thinking of an original argument is beneath you. Reread my message. A person will not be kicked out of the hospital to die on the street. Preventative Healthcare is a problem, but immediate is not.
    - whybroke 12y ago
      No, not the street: you will be kicked out of the hospital to die at home. But true, if you're shot in the street, an emergency room will accept you. But no, there's no chemotherapy in the emergency room. > You must be of such superior intellect that thinking of an original argument is beneath you. Wow, an ad hominem attack, what a surprise.
      - hueving 12y ago
        Keep shifting those goalposts. It's interesting that you would point out an ad hominem after you felt it was perfectly acceptable to make an idiot reference to Rand with no connection.
wtbob 12y ago
> The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. Funny that you raise FUD in your very next sentence, because that is itself FUD. Since the 1980s hospitals have been obliged to treat anyone who shows up. > And it turns out that this medication is not as effective as the generic that would cost $2 per pill. But because there is no profitability this medication is not currently manufactured in the US. That doesn't make sense. A generic is the same as the name-brand. You mean a different drug for the same disease, I presume. And it doesn't make sense that there would be no profitability; by your numbers, a generic drug manufacturer could produce the $2 pill which works better than the $100 pill and sell it for $50, or $25, or whatever it wanted. > America needs to pull its head out of its ass and realize we are little better than a third-world country for anyone below median income who doesn't have a good group health insurance policy. Actually, one of the nice things about real third-world countries is that one can just go to the pharmacist and buy pills, instead of having to go through a professional gatekeepers' union (the AMA) to do so.
- TylerE 12y ago
  In theory. In practice, the active ingredient(s) are required to be the same, but there can be some variation in e.g. binders that can make differences. The characteristics of the generic (bioavailbility, onset time, etc) are only required to be within a certain range compared to the original, not be identical. See this, for example: http://en.wikipedia.org/wiki/Generic_drug#Efficacy http://en.wikipedia.org/wiki/Generic_drug#Efficacy
cylinder 12y ago
Lack of safety net is why I don't feel comfortable continuing a life of entrepreneurship in the US while I'm building a family; I'll be leaving. I bootstrap and am not going to be getting millions in investment to pay myself ... if there are some lean years, at least I'll have assistance for my children and healthcare! I'm self-employed now, but if I didn't have employer-sponsored healthcare through my spouse, we'd be paying $1,000 per MONTH for a bottom-tier health plan with a $10,000 deductible. My wife staying employed after childbirth isn't an option because her employer expects her back to work after three weeks (yes her coworkers do this). What kind of nonsense life would that be?

maximumoverload 12y ago

Obamacare argument was inevitable, wasn't it.

bluedino 12y ago

>> And it turns out that this medication is not as effective as the generic that would cost $2 per pill. What medication was it, if you don't mind me asking? And why didn't you just ask for the generic? Many pharmacy chains in the USA offer a large list of generics for the low costs like $10/90 day supply

jmct 12y ago

Would you mind naming the generic drug? It seems like this is a powerful argument against having (only) for-profit healthcare. I'd like to be able to point to a specific case of what you're describing.

brightsize 12y ago
A data point from the USA: I take a very low dose of lamotrigene extended-release (mild epilepsy). The brand-name cost of this was $1200-$1400 per month. The recently available generic version of this costs nearly $400/mo. And this is, again, for a very low dose. For someone with a moderate or severe seizure (or bipolor - it's used for that too) disorder, the cost might be 4-5x this. While one might argue that the name-brand version costs so much because of high R&D costs (dubious in my opinion), it's difficult to make that argument for the generic. It's expensive because the manufacturer can get away with it -- it's very much needed by the patients but the market is sufficiently limited in size that few potential competitors choose to target it. Generics can be inexpensive if the drug in question has a very large market - statins for example. But if not, and you don't work for a company that provides health insurance with prescription drug coverage, a drug you need may well be a drug that you cannot get because of its cost.
- kevitron 12y ago
  That's insane. I take the generic lamotrigine, but even at a high dose it's something like $36/month here in Canada. I have a half-decent private insurance policy, but at US prices I'd burn through my yearly prescription rebate limit in a month.
  - deleted 12y ago
    [deleted]
- zo1 12y ago
  You mean, this "lamotrigene": http://www2.costco.com/Pharmacy/DrugInfo.aspx?p=1&SearchTerm=a&Drug=LAMICTAL http://www2.costco.com/Pharmacy/DrugInfo.aspx?p=1&SearchTerm... The one that costs $17.22 for 50 100mg tablets? Sounds like you might be getting ripped off wherever you bought your medicine.

jjoonathan 12y ago

> lack of a safety net? That's one argument. Here's another: Cost: http://healthcarereform.procon.org/view.resource.php?resourceID=005522#III http://healthcarereform.procon.org/view.resource.php?resourc... http://healthcarereform.procon.org/view.resource.php?resourceID=004083 http://healthcarereform.procon.org/view.resource.php?resourc... vs Quality: http://www.commonwealthfund.org/publications/press-releases/2010/jun/us-ranks-last-among-seven-countries http://www.commonwealthfund.org/publications/press-releases/... http://www.businessinsider.com/best-healthcare-systems-in-the-world-2012-6?op=1 http://www.businessinsider.com/best-healthcare-systems-in-th... EDIT: not sure if downvotes are because people think I'm saying that cost is less important than the lack of a safety net or because people are butthurt over figures demonstrating that universal health care is also cheaper. Please clarify.

lallysingh 12y ago
It might help (I didn't downvote, just suggesting) to put an intro to these arguments in the post, instead of just links.

refurb 12y ago

Your example of the cost of medication is an odd one. Most (all?) states in the US have mandatory generic substitution. That means the pharmacy must fill your Rx with the generic unless the doctor wrote "Dispense as Written" on the Rx. Now, if the generic was not available in the US that is a different story. Patents don't all end at the same time, so the drug may already be off patent in the UK, but not in the US. Finally, to say "there is no profitability" in generics is laughable. The US has lower generic prices that most of the EU due to fierce competition for the US market. And finally, although the US may not have a single payer system, we do have public health for the old (Medicare) and the poor (Medicaid). In addition, if you are sick and you go to a hospital, you must be treated regardless of your ability to pay.

whybroke 12y ago
>The US has lower generic prices that most of the EU due to fierce competition for the US market This is not the case. From direct person experience I can attest that: Betaserc is 1/25 the price in Spain as the generic in the US Nebivolol is 1/10 Lovastatin is 1/5 Enalapril is 1/2
- zo1 12y ago
  I quote the parent poster: "The US has lower generic prices that most of the EU" Emphasis mine. Perhaps, if they were consistently "cheaper" than the US, fine. But your singular example doesn't quite contradict the person you're responding to. So it actually is the case, unless you prove your findings for other EU countries. I have no idea if that's the case, just pointing out the obvious flaw in your logic. Perhaps a little too-quick to look for contradictions if you disagree with the general point?
  - whybroke 12y ago
    Quite correct: I have no idea what the price is in Lichtenstein. Nor have I compared the price of every drug manufactured. Nor even a majority of those thousands. I have, however bought a dozen or so different drugs and have done so in France, Italy, Croatia, Spain, Portugal and the Netherlands. All of which were tiny fraction of the price in the US. So given two hypothesis: the US is cheaper vs the EU is cheaper, and a bunch of data points all pointing that same way, a little bit of Bayesian statistics shows us which hypothesis is over overwhelmingly more likely doesn't it? We can agree to use Bayesian statistics even though there's no entry in the conservapedia can't we? Contrast, for example, with the parent poster's hypothesis which comes form no more data than a.m. radio infotainment, I think there's only one rational tentative conclusion don't you?

orky56 12y ago

Therein lies the problem with the US and the mentality of the citizens. Since the proletariat are "temporarily embarrassed millionaires", the safety net is never there. To even take advantage of it is shameful. Perhaps unrelated, but the status of your achievements is reflected by how much you need to pay or put into it such as your job and even that 5-star hotel where you need to pay for breakfast and Wi-Fi.

hueving 12y ago

> The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. Doesn't happen in the US unless the person intends to do so. But that's pretty good fear mongering on your behalf.

whybroke 12y ago
So you're saying there has always been universal healthcare in the US even before Obama was elected? That everyone has always gotten all the medical care they need? Or are you saying uninsured people don't get sick? In fact roughly 45,000 die a year due to lack of medical care.[1] Why not embrace the society you're creating? Because I'm sure Miss Rand would not be happy with that level of self delusion. [1] http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ http://news.harvard.edu/gazette/story/2009/09/new-study-find...
- hueving 12y ago
  Wow, a Rand reference. You must be of such superior intellect that thinking of an original argument is beneath you. Reread my message. A person will not be kicked out of the hospital to die on the street. Preventative Healthcare is a problem, but immediate is not.
  - whybroke 12y ago
    No, not the street: you will be kicked out of the hospital to die at home. But true, if you're shot in the street, an emergency room will accept you. But no, there's no chemotherapy in the emergency room. > You must be of such superior intellect that thinking of an original argument is beneath you. Wow, an ad hominem attack, what a surprise.
    - hueving 12y ago
      Keep shifting those goalposts. It's interesting that you would point out an ad hominem after you felt it was perfectly acceptable to make an idiot reference to Rand with no connection.

wtbob 12y ago

> The thought of people dying in the streets from preventable disease and injury sounds pretty horrendous. Funny that you raise FUD in your very next sentence, because that is itself FUD. Since the 1980s hospitals have been obliged to treat anyone who shows up. > And it turns out that this medication is not as effective as the generic that would cost $2 per pill. But because there is no profitability this medication is not currently manufactured in the US. That doesn't make sense. A generic is the same as the name-brand. You mean a different drug for the same disease, I presume. And it doesn't make sense that there would be no profitability; by your numbers, a generic drug manufacturer could produce the $2 pill which works better than the $100 pill and sell it for $50, or $25, or whatever it wanted. > America needs to pull its head out of its ass and realize we are little better than a third-world country for anyone below median income who doesn't have a good group health insurance policy. Actually, one of the nice things about real third-world countries is that one can just go to the pharmacist and buy pills, instead of having to go through a professional gatekeepers' union (the AMA) to do so.

TylerE 12y ago
In theory. In practice, the active ingredient(s) are required to be the same, but there can be some variation in e.g. binders that can make differences. The characteristics of the generic (bioavailbility, onset time, etc) are only required to be within a certain range compared to the original, not be identical. See this, for example: http://en.wikipedia.org/wiki/Generic_drug#Efficacy http://en.wikipedia.org/wiki/Generic_drug#Efficacy

cylinder 12y ago

Lack of safety net is why I don't feel comfortable continuing a life of entrepreneurship in the US while I'm building a family; I'll be leaving. I bootstrap and am not going to be getting millions in investment to pay myself ... if there are some lean years, at least I'll have assistance for my children and healthcare! I'm self-employed now, but if I didn't have employer-sponsored healthcare through my spouse, we'd be paying $1,000 per MONTH for a bottom-tier health plan with a $10,000 deductible. My wife staying employed after childbirth isn't an option because her employer expects her back to work after three weeks (yes her coworkers do this). What kind of nonsense life would that be?