I don't think the government should set prices arbitrarily but can see scenarios where regulations impacting price could be justified.

Take Canada for instance, they have price controls and as a result cheaper drugs. They also have a government system that provides healthcare for everyone, which creates almost a guaranteed customer base. So in this case the price control is balanced (to some degree) with a sure customer. Without price controls they'd risk having to ration some drugs if the manufactures decided to price them above value.

The drug companies don't have to sell to Canada, but they do anyway because the incremental production cost of the drugs is usually small compared to the development, approval and tooling processes...not to mention the tens of billions of dollars it takes to scare us all into demanding drugs for ailments we didn't even know we had.

So price controls in Canada seem to be a win/win for both the consumer and industry, but if you applied the same policy here you'd kill (or perhaps injure) the golden goose.

There is government regulation that helps pharmaceutical companies maintain higher prices across a very large market as well as regulation to ensure quality and safety which adds cost.

I don't think the pharma companies are bad, but when you do hear stories about Americans unable to afford some drugs here that are available across the border 10X cheaper it raises some questions. The pharmaceutical industry is one of the most profitable in the world. Regardless of what happens I'm sure they'll find a way to make a buck.

-spence

[QUOTE=spence;889454]I don't think the government should set prices arbitrarily but can see scenarios where regulations impacting price could be justified.

Take Canada for instance, they have price controls and as a result cheaper drugs. They also have a government system that provides healthcare for everyone, which creates almost a guaranteed customer base. So in this case the price control is balanced (to some degree) with a sure customer. Without price controls they'd risk having to ration some drugs if the manufactures decided to price them above value.
_[QUOTE]

Spence, I would love to see Canada's national formulary. Guarantee it is limited
to one drug per class which means you won't have a choice when it comes
to efficacy or side effect profile. For instance there are many statin drugs
on the market for lowering cholesterol. They are all variations of statins
but each works a little differently. When there is only one,that will be based on the cheapest, and you can't tolerate it or it's not efficacious for you, too bad.
That is One of the biggest problems with government health care, no choice AND
mediocore medicine.

Rationing drugs based on age becomes another problem as expensive chemo
drugs etc. will be too costly to add another 5 years to say maybe a 75 yr old.

Good point on killing the Golden Goose. It is already happening. Companies
will not go out on a limb in R+D if they find a compound that has a limited
use. For instance, Amphotericin B was developed years ago to treat fatal
San Juakien (sp?) Valley ,a disease limited to the valley. They won't
be willing to spend millions and years of development when there will be
no return on investment. They will stay with the large markets for cardiovasculars
and anti effectives.

Same old story, you get what you pay for.

When you said that pharma charging "what ever they want" without any negotiation is not yoiur "idea of market forces at work . . ." it seemed on the one hand a contradiction since market forces do not negate charging what you desire so long as the buyer needs your product and is willing and able to pay your price. But pharma's prices are obviously not a result of market forces, so your comment was gratuitus.

Perhaps you are mixing market "forces" with market "economy"? Market "forces" are thos economic factors strictly peculiar to the market without government input, such as supply and demand. Market "economies" are largely driven by market "forces" but may have varying degrees of government intervention. As government control becomes greater, it becomes a mixed economy, and if that control is great or absolute, it is a centrally planned economy where market "forces" play little or no part.

As far as pharma's prices go, they seem to be a product not of market forces, but of more centrally planned forces--both in the U.S. and abroad.

In a "free" market, driven basically by market forces with little to no government intervention, prices would have to go down in the U.S. and up abroad. This would be so even with basic safety regulations, not with the super cautious, draconian ones of present which have massively ballooned since the thalidomide scandal of 1961-62 and have created a cozy, corrupt partnership between pharma and the FDA at the expense of free market competition and "affordable" drugs.

[Well, Canadians would beg to differ...they love their health care. I think polls are usually 85-90% in favor.

As for prescription drugs, you can still get private insurance to cover prescriptions there...though as was mentioned above, the governments will negotiate costs which Medicare/Medicaid here isn't allowed to do by law.

I'm not sure the claim that only one drug per class is allowed is accurate. For instance, I found one report that listed % market share of the various statin drugs there.

No different than in the USA.

I think a bigger issue is simply that the big companies are making more profit based decisions than just counting how much money is going into R&D. R&D spending is going down as they focus on better returns.

For a large organization it's probably just not practical to go after niche drugs unless you have a business model built around it. This should encourage growth in small companies to meet low volume needs.

There are a TON of companies like this in the Boston area alone.

-spence

Sources please.

If your insurance company won't cover chemo at age 75 for you, ya
betta get another company,you'll be there before ya know it.

BTW, Govt. announced today they want everyones medical records computerized
for Obamacare. :fury: Like they will remain private. :doh:
BIG BROTHER at it's best.
Whats next ?????

Yeah, because when we tried to get my wifes records transfered from one doc to another, it was so effieicent with paper records :smash: it only too a few days/week...

That's not the point, your doctor controls your records now, paper or computerized.
Point being the Govt.wants control of everyone's records and hackers or bureacrats can get in.
Remember Wilkileaks.

I'd think that government influence (here and abroad) as part of a free market economy would have a large impact on both supply and demand.

Today we have regulation that impacts both profit and loss, take away it all away and the results would be unpredictable. Perhaps lower prices from competition but also increased costs if quality standards are not maintained. Undoing a heavily regulated industry is a lot different than pretending it never existed in the first place.

I wouldn't say that proving a drug is safe and effective, or that it actually does what you claim it does...is "draconian". This relationship must be pretty unbearable what with all the private sector profit it creates.

-spence

Not going to spend the time to Google, but I'll take the Wiki as good enough...

I'm not saying that the Canadian system is perfect, or even that I'd want it, but that Canadians seem to like it.

The point was that a huge amount of money is spent keeping people alive those extra years regardless if it's government sponsored or through private insurance.

Rationing, already exists in both scenarios as neither private or public care will fun increasingly expensive treatment with little return. There's also indirect rationing where charging more for drugs here than other countries either forces them to travel or prices Americans out of the treatment.

Privacy is certainly a concern, but you also complained about 600B in fraud earlier. How do you think they're going to fight this without a clear grasp of what's really going on?

If implemented property, I'd think the benefits (reduced costs, quality of care) outweigh the risks.

-spence

eQUOTE=spence;889719]
Not going to spend the time to Google, but I'll take the Wiki as good enough...
--__________________________________________________ ___________________
Spence,the info you gave was done between 2003-2009, hardly recent.

----------------------------------------------------------------------------------------------
__________________________________________________ ____________________
The point was that a huge amount of money is spent keeping people alive thoseimplemented property, I'd think the benefits (reduced costs, quality of care) outweigh the risks.
-spence[/QUOTE]

Spence, don't grow old. :)
__________________________________________________ ___________________
Don't know how cutting Medicare fraud increases quality of care?

BTW, without giving up your privacy,the medicare payment form sent
should be outlined in laymans terms. If the patient questions the procedure,
or what Doc performed it, just check it and send it back to Medicare to check
it's legitamacy with the provider
They can also check on their side which Docs over use of a code.

When regulation is so expensive that it can bankrupt a country, I would say that it is draconian. Medicare has an unfunded liability of $24.6 trillion (downgraded from $37 trillion in 2009 by fictitious "assumptions" to hide the true liability). That's just Medicare. Not Social Security, the national debt, the military, etc., just Medicare. Subsidizing drugs are a major portion of that liability. And, as you have implied several times, the "relationship" (between the government and pharma) is what sustains the profits that bother you.

more from your WIKI




Health care in Canada is delivered through a publicly-funded health care system, which is mostly free at the point of use and has most services provided by private entities.

I'm shocked that 82% prefer a system that is "mostly free" and when asked if they prefer it to one that they never use (American) and would have to pay for....... they chose the "mostly free" one...go figure?????

also wonder how enthusisatically they'd support their healthcare system if they were denied access to American made pharmaceuticals, American medical technology and advancements, or denied travel for American medical care when they cannot get it on their own side of the border and had to rely soley on what Canadians produced through their own "mostly free" price controlled system... ????

might still be 82% I suppose as it would still be the only thing that most of them have known since birth....and the alternative, particularly if you have to pay something...can be scary

http://www.reuters.com/article/2010/...64u3xo20100531

"We can't continually see health spending growing above and beyond the growth rate in the economy because, at some point, it means crowding out of all the other government services.

"At some stage we're going to hit a breaking point."


"It's an area that Canadians don't want to see touched," said TD's Burleton. "Essentially it boils down the wishes of the population. But I think, from an economist's standpoint, we point to the fact that sometimes Canadians in the short term may not realize the cost."

[QUOTE=detbuch;889131]If there are loop holes, if they are not "targeted" to help create a more productive outcome, they should be eliminated. If capital gains is, ultimately, a scam and doesn't produce the desired investment, it shouldn't be tweaked, it should be eliminated and all gains should be considered income as earned.
QUOTE]

I agree with some of what you are saying, but it isn't really apples to oranges. It is about income and capital gains are a huge part of income for some people who have enormous amounts of money to invest. I am not sure what the answer is, but it basically equates to a tax shelter. For the guy making $50,000 working, they are limited in what they can put in an ira or 401k or roth. Are there limits on the amount of capital gains that are taxed at the 15%? I may be wrong, but it seems like the economy is driven by middle class people buying homes, cars etc. The very richest people are still investing today and many businesses are typically sitting on more cash then ever. The problem is consumer confidence is low. Call it what you like, the middle class guy that gets most of his money from working gets taxed at a rate higher than the rate for alot of money the rich guy makes through stocks. I am not sure buying stocks necessarily helps the economy in the same way the middle class guys car, home, restaurant, and gift purchases do.

[QUOTE=zimmy;889854]I don't favor a capital gains at different rates than any other special taxes at different rates. I like the flat tax on everything. Probably won't happen. The current tax code is ridiculous. I also don't like a flat tax that has different brackets. I think eliminating people from the burden of paying taxes is wrong. If the pain of paying taxes at an equal rate is shared by all, the government is less likely to waste or spend "irresponsibly" or suffer the wrath of everybody rather than play phony games of divide and conquer.

That said, as of now, capital gains tax at lower rates is a different tax than income, or other types of tax. And the rich do pay higher capital gains tax than the rest of us. Those of us who fall in the 10% to 15% tax bracket pay no capital gains on anything we sell of value. Supposedly, as I said, giving a tax break of a rate less than that of income tax, is an incentive to invest. Maybe that is bogus. Maybe those who have "income" solely from investments would do so even at higher rates up to the 39% rate on income. Investments are often risky. A lot of money is lost on bad investments. As long as you have a job, the income is not at risk. Many who have both earned income and investment "income" might not want to risk as much on investment. Investment in new business might be hurt the most, and it is new business that is most needed. Some few who are good at it make obscene profits by investing. The amount of money that the government would realize by equalizing capital gains rates to that of income tax rates, if investment remained the same, is not huge. And if needed investment went down, revenue might drop a bit. If wealth is spent rather than invested it is it is transferred once into the economy.

I don't know if it all really works this way. I understand the bad feeling of those who see some rich folks paying a lesser rate of tax. I do see the mess of a tax system that creates jealousy and animosity between us. I do see us divided.

Ya, they like the mostly free stuff part of it, but I read last week where 51% of
Canadians are concerned about the length of time it takes to get an appointment
with their family doctor.

[QUOTE=detbuch;889942]Another promise broken. Divide and try to conquer is what's happening now
for the sake of an election a year + a way. It's only getting worse.

For the sake of the country I'd like to see Obama take what's left of his term,
and as a true leader bring us back to a united nation. That would take a
selfless man who truly wants to put his country first and serve the American
people. Swell chance.

It'd also take completely dissolving the House and Senate, enacting term limits, putting limits on PACs and strict regulation on lobbying.

Our political system is broken from top to bottom and it's not because Obama hasn't delivered on most of his campaign promises and is a crappy domestic leader. This isn't something that just "popped up" in the last 3 years.

Jeezus Johnny, that sounds like a line from Chancellor Palpatine!

Liberty Dies - YouTube

the future according to Johnny D

Dissolving the Old Republic - YouTube

Debateable about his campaign promises and wether or not he's a
crappy leader.

However, the man has had 3 years, 2 of which he had control of the House
and Senate and did nothing to bring people together.
He imediately went to his own agenda of rushing HC, when the majority of the
country were against it.Same with the rush to the stimulus, and nice try to
rush for his secret jobs plan.
He started his campaign a few months ago, and I doubt he has the time
to actually do his job. He, his agenda and fund raising are the only things he has time for.

[QUOTE=zimmy;889854]A guy works hard to earn an income, pays some % in taxes then puts his money at risk by loaning it to a business so they can grow. If the business grows, he makes some money, if not he loses it. He has already been taxed on the initial investment, by taxing him at a higher rate on the profits from his loan, you reduce the amount of money available to grow other businesses he may make a loan to.. In my eyes helping companies grow through loaning them money is at least as powerful as growth through consumption, but a business can't grow without some level of both.

[QUOTE=Fishpart;890071]Well put.
Politicans are well aware of the jealousy factor and love to use it to
try to make points by making it sound like, "its just not fair" with out
reminding people of the risks that are taken, and the good effects the
market has on the economy and jobs.

I wonder why someone like Buffet has confidence that the government will spend his excess money more wisely, more productively, more beneficially, more anything good, than he. Hasn 't he been more successful in producing wealth than the government? Why would he want to fund a wasteful, irresponsible government that is better at getting in debt than it is at producing wealth--a government that borrows and prints vastly more money than he or others like him combined can give? Why wouldn't he use his excess money to actually do usefull, beneficial things--build hospitals, repair roads, donate to charities, create scholarships? It is admirable that he has lead a frugal life and has already been abundantly charitable and he plans to give most of it away. But he, apparently feels that he still has too much money and wants the government to take more in taxes. Couldn't this excess money more efficiently go directly to needed places, rather than giving it to a government that would return less of it, if at all, to those places, and squander much of it to pay off its chosen winners and supporters. I guess he must think the government is doing a great job. Stupid of me to wonder.

And how about, instead of raising the tax rate of the ultra rich from 16-17% to the same rate as those earning $100,000 or so, LOWERING the rate of the latter so the ultra rich payed the same rate. Isn't the 17% rate what some calculate a flat tax rate should be. Everybody pay 17%.