JMS

It's hard for me to believe this. Yesterday's vote was congresses 33rd vote to repeal the ACA. It's really difficult to believe that's not overkill by republicans trying to "exploit" the AFA's "unpopularity", given they haven't been able to pass a budget in 3 years or take care of other important work for the american people. This is like the 3rd bridge in "operation market garden", This is too much; they are overplaying their hand.

I agree it's pure politics... But is it really an unpopular vote? It was 2 years ago, it was 1 year ago.. But I'm not so sure now. After the supreme court folks are starting to warm up to the Affordable care act. This is most likely because the opposition groups aren't spending tens of millions to bash it anylonger.

I just saw Abraham Lincoln Vampire Hunter... guilty pleasure. I read the book ( NYTimes Best Seller ) which wasn't very good, but my HS nephew was really into it so I saw it. It was pretty good... As the film critic Ebert said... "It's without a doubt the best movie you will ever see on this subject matter". I enjoyed it and would recommend it to fans of the genre.

I agree you have 5 starters in B-Ball. We've so far replaced 3 starters on last years roster. It's an entirely new team. Three starters are top 3 lottery picks. That's a pretty decent nucleous.. Problem is two are still very young. I could see them going to the playoffs, I could also see them struggling to find themselves for a few years before they develop into the players they will be.

With respect to my point #2, pharmaceuticals being an "expert" driven marketplace point above... When was the last time you saw a headline like this about the agriculture or computer science industry? 7/2/2012 - 10 Minutes Ago.. http://www.usatoday.com/money/industries/health/drugs/story/2012-07-02/glaxosmithkline-pleads-guilty-3B-fine-illicit-promotion-prescription-drugs/55979616/1 And while one would think penelties like this from the federal government would be a good thing, contained inside of this penelty is actually a pretty nice thing for the offending criminal pharmaceutical company. They cap'ed civil lawsuits as part of this, so evidently they've done an end run around the US judicial system to ensure the offending company's exposure was limited. Makes me want to vomit in my own mouth. There is no limit to the dishonesty or the reach of the trusts which run our healthcare system... They are scum bags who make huge profits on consumers backs. Given the pain it took just to curb growth of the one leg of the healthcare trust ( insurance companies) looks like regulating the other legs is long off.

It's absolutely not true for other industries. (1) Other industries don't have 90% of their research paid for by the US government. (2) Other industries are more consumer driven unlike pharmaceutical industry which is more expert driven (doctors). - this is important because the benifits of the inovations are judged by a market unlike pharma industry. (3) Other industries don't have the perception of a life and death concequence over the product they monopolize. Drug companies don't compete. They monopolize... The underlying US Gov sponsored research is not given to a group of companies, only one company has the right to innovate on a promising new find. There is no compeition in the system until the drugs go to generics and then they cease to be an important revenue stream for the large pharma companies. Again fundimentally we've produced a system set up to provide profits for large companies in a rather obsene way, rather than services to the consumer at a reasonable price. I'll have to take your word for that, cause that's possible the only subject I've encountered on this board in which I feel unqualified to comment, having no personal experience with the subjectmater.

That is what the pharmaceutical companies say. They are such nice guys they sell their goods for 50% of the price in Canada and that is basically at the expense of the US consumer. Which is total bunk... That's not how a market works, even a non free market. The way a market works is you want to buy my goods, I'll sell them to you at a profit. If I can't get a profit, I don't sell my goods to you. There is no force on earth that can get a US Company to sell their goods on a mass scale to another country at a Loss for decades as the US Pharmaceutical companies are doing. They just sell them to US consumers for more, because they can. Unlike Canada we have no downward penelty on these companies to keep them honest. No competition, no collective buying, and no set profit margin to ensure consumer fairness.... We, the US tax payer pay for 90% of the research, and then we gift our patents over the the pharma companies, who rape us until the patents run out.... making huge profits and loads of money along the way. Then the drug becomes a generic and they move onto the next one.

It's really not. US Drug companies make most of their money from Name brand drugs which are devoid of competition due to intellectual property rights legislation. They control the market by being the only guy offering the given service, they don't compete. ---------- Post added July-2nd-2012 at 01:14 PM ---------- Pharma costs are one of the three trusts responsible for out of control Healthcare spending all in the absense of competition.. Pharmaceuticals, Insruance, and healthcare provider companies ( hospitals). ---------- Post added July-2nd-2012 at 01:18 PM ---------- You want to argue the exception... I want to argue the rule. If you want to claim large American pharmaceuticals make most of their profits on generic drugs then please do. But since we both understand well that the vast majority of pharmaceutical profits come from name brand drugs, those are the ones we will discuss when trying to understand the relationship between profits and high consumer costs for drugs which was already documented in your own sources provided..

Now you know. American brand name drugs sell in Canada for half the price they sell in the United States ON AVERAGE!... So What? If our discussion is that large pharma companies are rapeing the US consumer, basically because they can.. What does the cost of generics have to do with that discussion? ---------- Post added July-2nd-2012 at 12:44 PM ---------- With respect pharmaceutical companies have one price. The price to the consumer. There is no force on earth that could get a US pharmaceutical company to sell their product in Canada at a loss. Thus we are forced to acknowledge they are making a profit when they sell their drugs in Canada. They sell them here for 50% more for the last few decades, simple because they make more doing so and their is no protection for US consumers to stop them.

You know fundimentally why, U.S. drug companies sell their goods to Canada at 50% of cost they sell them here domestically? Because it's profitable for them to do so. There is simple no other explaination. There is no force on earth that could get a for profit company to sell goods at a loss. Why do they sell them here so much more expensively... Because they can!. Because it's more profitable for them to do so. Why wouldn't they? In a free market competition would create a downward pressure on raising profit margins. Our system has no competition, the insurance companies are free to charge what they can devoid of their own costs which they don't share with the American consumer. The way socialized programs deal with our for profit corporations to exact 50% cost on goods is throught consolidated purchasing. That doesn't make our lack of consolidated purchasing the primary driver of our expensive pharmisuticals. The primary reason our goods cost more is our for profit corporations simple charge us more. Our healthcare systems framework was designed in the mid 1940's to work via non profits, devoid of competition. In the 1980's we switched over to primarily for profit system while leaving the anti competition and collusion frameworks in place.... ( McCarran–Ferguson Act ) I think drug companies being one of the most "profitable" stock investments segments of our economy beginning in the 1980's and 1990's is a far greater cause for our higher prices for goods. I don't think book keeping is even a blip on the radar since those costs are primarily absorbed by the retailers and not the pharma's responsible for the cost of the drugs. Medical schools and doctors costs are not a primary driver of our healthcare costs today as they were back in the 1970's. Today the three trusts which run our healthcare industry are the drug companies, the hospital companies, and the insurance companies.... Cost to physicians is not worth even mentioning when compared to the ever increasing funds being driven by these three blocks of companies.

Ok, you are right.. not entirely... primarily.

Capitalism is the most efficient way of distributing goods and services ever invented. If we take that as a fact.. What then does it tell us logically that Socialized Canada sells US Drugs at 50% of the cost as they are sold here? I tells us we don't have anything approaching capitalism currently in the healthcare delivery in this country... Now that's not a bad thing, because capitalism while efficent is not exactly very equitable, and we've decided as a society we don't want to limit medical procedures to the .001% of the population who could afford to pay for them out of pocket if nobody else in the country were able to participate. IT's a fact, that given the great improvements in healthcare over the last 100 years, specialization has made affording these benifits unaffordable to any individual. Thus we knowingly use a form of collectivism to pay for services. Healthy people pay for the costs of those in need in the way of insurance.. I healthy guy, pay monthly and sick people get services on my dime, and when I'm sick other healthy people will help pay for my bills. Even those who can afford to pay as they go, and don't buy insurance today benifit from this collectivism. The biggest difference between our system and what the rest of the industrialized world employs is that our collective system is designed to create profits, and the rest of the world has systems designed to create services. This occured in the early 1980's when Ronald Reagan (bless his soul) changed the US healthcare system from non profit, to for profit. He did so because he reasoned nobody was better at holding down expenses and ratcheting up efficiency than Big Business. Only Ronie had it wrong. Big Business is primarily great at making profits. If they can do that by efficency, or holding down expenses they will do that; but if they can do it by charging more in an economic niche already devoid of competition; they'll do that too. And that's exactly what has happenned. The costs as a percentage of GDP which motivated Reagan to implement reform have exploded, and now we are looking at basically trying to slow down that growth in spending before it sucks us under the rapids... Set to happen sometime in the next 5-10 years when healthcare costs will reach 20% of GDP and will bankrupt the government. For refference sake healthcare costs were 5% of GDP when Nixon was in office 9% of GDP under Reagan, 13% under Clinton... ---------- Post added June-29th-2012 at 04:39 PM ---------- I don't disagree with that. Since most people follow there doctors orders when seeking services, even if we get a few more services that's still a function of our healthcare system... Ultimately though our proceedures, drugs, hospital stays, all cost more; and that is the primary reason we spend more per capita on healthcare.

Let me support myself then in this thread, since this thread is the thread you reponded too and which I am currently involved in. To which I said.. To which you said. To which I said To which you said And no, Young healthy Americans taking more expensive drugs doesn't support Americans are less healthy. Nor does American Women ages 50-54 getting 40% more mamograms. Rather both of these points support the hypothesis that our healthcare system excells at creating profits for itself, not in addressing the legitamate health needs for the population.

I think Jumbo's point was oil companies conspire to set prices... They buy verticals in their markets such as oil production, transportation, refining, distribution of refined gasoline, storage and finally gas resellers.... When crude oil is plentiful they say refinaries are charging more... When refinaries have surplus they say storage farms have excess whicih have to be paid for. They always have a reason why gasoline goes up when it seemingly should go down and typically the bad guy they are pointing too is themselves... Regardless it doesn't matter because 3-4 companies control all the pumps and the costs go up together so the consumer has no choice but to shell out. Contrast this with the Large Drug companies, who sell their drugs at half the price of what they charge here in the united states abroad. Canada for instance sells US drugs at half the price as the US market. Not one drug mind you, but as a general rule. So much so Bush took the extrodinary step of making it illegal for Americans to travel to Canada and buy American drugs and return to the United States with them !! US drug companies aren't selling those drugs in Canada at a loss. They sell them here for more siimple because they can... Thus the big oil comparison. Bottom line is our economy in 2012 is more akin to the US economy of the 1890's when Trusts ran everything, and less like the US economy of the 40's - 60's when we were at our economic heights.

Always good advice. I appologize pete if my flipant response lowered the tone of our discussion.

And you can see my rebuttle to your previous link. This doesn't prove what you suggest it does. In the abstract it goes on to say.. Note nowhere in this study does it suggest Americans are less healthy than any other country, much less twice as unhealthy, or three times as unhealthy as the per capita spending would suggest.. Rather your paper supports my hypothesis directly that We pay more, simple because the companies charge us more... Your study also says relatively young and healthy people use more perscriptions which further disproves the hypothesis you are trying to support. These are diagnostic proceedures and are generally done as a result of policy. This is not evidence that Americans are less healthy. Neither of which are on topic. The hypothesis you are addressing is whether Americans are less healthy than every other nation combined by a factor of 100-200% as reflected in our spending per capita. That is what I was refuting, and that is what you are thus trying to prove. Serious question, when you comment on threads, do you ask yourself if you addressing the Topic before you get flipant, or only after it's pointed out to you? There is no study which shows Americans are less healthy as a population than say France, Italy, or Germany by a factor approaching our percapita spending delta. Yes we get more mamograms for women ages 50-54... Does that mean we are less healthy? No. Does it mean we spend more on mamograms per capita...only for women in that demographic. I assert to you now, Americans are not the least healthy people on the planet, never have been. We pay more for healthcare almost entirely because we can and because the companies who are in a position to dictate our consumption, do so to benifit their own bottom line, which of coarse is to be expected from for profit corporations.

The AMA is not the end, it is just the beginning. Medical costs are the 800 lb gorilla in the room in budgetary talks. We will definitely see more legislation on this issue. ---------- Post added June-29th-2012 at 02:20 PM ---------- Kilmer, where have you been living for the last 42 years. Healthcare in this country is one of the most heavily regulated segments of our economy. Ever doctor, company, medicine, procedure are all liscensed and veted through the government. Every institution is subsidized by the government. To say you want "no government involvement in HC"; is advocateing the return to the days of Dodge city when Doc patched up all of Marshal Dillin's victems / foes. Specialization has made "no government involvement" unworkable for 60 years..... No government involvement is not on the table. The question is how do you ensure competition in a heavily government regulated system? Should you? For the last 70 years the answer to that question has been no. AMA does not fundimentally change that. It could, should and hopefully eventually will.

Americans don't consult with doctors twice as much as the french, Germans or Italians. Nor do we get 2 or 3 times more services per capita than do these other countries... Our spending per capita difference is entirely based upon the fact that our services cost more, not that our institutions provide more services. Our healthcare services cost more souly because it's to the benifit of our service providers to charge us more, and in the absense of competiton that's an easy way too high profits, which is the primary goal of any corporation.

I'm not sure a state could do it by themselves. There are lots of federal regulations and issues which come up even in our existing system which is heavily supported with federal dollars. Good luck though. Yeah because extremism is usually the best answer.

Do you know who set up the World Health Organization? We did. Do you know why? To be a resource for countries looking to improve their healthcare delivery systems. Why not copy ideas from the top ranked system... hell in france doctors still make house calls. and they are saving about 50% of the cost per capita while covering every citizen.

Not just higher... astronomically higher based upon our how it performs for our population.. United States--------------------$ 7,164 per capita -------------------- 15.2% GDP Germany--------------------------$ 3,922----------------------------------- 10.5 Canada--------------------------- $ 3,867----------------------------------- 9.8 France---------------------------- $ 3,851----------------------------------- 11.2 Italy ------------------------------- $ 3,137----------------------------------- 9.5 Costa Rica ----------------------$ 1,059 ----------------------------------- 9.4 Cuba --------------------------------$495 ------------------------------------ 12.0 World Health Organization Rankings of Healthcare Systems by Country. France ---------------------------------- #1 Italy -------------------------------------- #2 Germany ------------------------------- #25 Canada ------------------------------- #30 Costa Rica ----------------------------#36 United States -------------------------#37 Cuba -------------------------------------#39 Which seems to be more fiction than actual reality... Canadians and Europeans love their healthcare systems. The politician who inplemented Canada's system was recently voted most admired politician. Those countries can't believe the US still has a for profit system.

Our system is about twice per capita what other countries with better rankings spend. It is by far the most expensive system being employed. The "savings" in ACA do not come from reducing costs, but reducing the growth of costs. Our system's cost is also growing at the fastest pace in the industrialized world. I think/hope this is partially due to how the non partisan Congressional Budget Office calculates savings and costs of the program.

Pros

So what you are saying is the existing healthcare system has given you every incentive to make a really bad choice, a bad choice for you because you are without insurance for the next 4 years. A bad choice for all of us too, because if you do need services, you will no doubtedly go to a hospital, and the general public will almost certainly have to cover your expenses... Here you are a person who can afford insurance, wants insurance, but is being forced down the worst possible avenue.. Good news is "The Afordable Care Act" eliminates pre-existing conditions.

Corruption is codified into our healthcare system. The entire rational for insurance is that a large group of people pay for "insurance" si they will be taken care off when they need it. Or system doesn't support this model for many consumers. Our system still works if you are with a large enough company or organization which can protect you / itself in case they need to draw on benifits. If you aren't with a large umbrulla organization you can see your rates double, tripple your benifits reduced, and your "protections" evaperate. When that occurs to small businesses it is very dificult to replace the original lower cost insurance, and it's hard to join up with higher priced umbrulla organizations after the fact too. To your other point. Employee's rarely have the "right" to seek their best deal, rather they sometimes they get to pick from a sampling of choices offered by an insuror. Companies don't always have a real choice either. Real choices are severely limited under Mccarran Ferguson (1945) which is designed to restrict competiton. It outlaws competition between states, and legalizes collusion within states between would be compeditors. The net effect is a company will have the "choice" between say 20 policies from 20 different companies... but all those policies come from 2 or even 1 providers operating under different names; and are legally mirrors of each other. You can not have choice without competition, and no company with an existing anti trust exemption such as Mccarran Ferguson experiences competion. That's how you get states which are essentially one insurer monopolies for healthcare. Opponents of a private public plan say that they’re trying to defend market competition, what they’re actually doing is defending lucrative local monopolies.