Free Market
-
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
Who decides how much money is spent on research to make new drugs?
Who determines it today? The governments determines what will be bought, sold, allowed, protected, provided, etc. The government effectively already decides completely. The government is always the answer when a free market connect exist. You can hate governments as much as you want, they are the only possible answer. Work to fix them rather than to break systems for best results.
I completely agree that the government needs to exist for certain things - roads, power, water, sewer, etc. of course those, we pay for water, we pay for electricity, we pay for sewer.
I think the only way to get healthcare to be the way you mention is to make it zero cost with no financial incentives to anyone who is in it.
i.e. Doctors only make at max $100K, government funded research labs also have salary caps, etc. I'm not sure you could even allow privately funded medical research labs, unless you could somehow require that all research is open source and all results must be freely shared with anyone who wants them and are able to product any product that is a result of that research at no fee to the researchers.
I'll agree there are plenty of altruistic people out there, probably the Bill Gates of the world would continue to donate millions to such research facilities, but you need to take the corruption out of it, and you do that (as far as I can see) by taking money out of it - i.e. no one can become rich.
Exactly, what that's what most of the developed world has done. There is very little money in healthcare. You can pay your bills. Being a French doctor lets you have a nice house and live in a nice neighbourhood but it does not make you rich. Healthcare systems that are working today have, by and large, effectively no financial incentives outside of relatively basic and limited ones. Similar to teaching jobs in Finland. They pay well, but there is no way to get rich off of it, it just is what it is.
-
@Dashrender said:
@scottalanmiller said:
@DustinB3403 said:
@scottalanmiller said:
@Dashrender said:
Who determines how much money a doctor is paid?
That depends on the system that you want to use. Nearly always the government in systems that currently work well.
Which also means that the doctor is likely to try and "sell" the most expensive service they can every time.
Just like a car sales man.
Have you used healthcare in countries that have government set doctors pricing? Because this really does not happen there. That most of the developed world works this way, and all the countries with the best healthcare, and this is not a problem in the least suggests that this isn't true.
That the US does the opposite and lets doctors set any price they want AND allows them to sell drugs and results in exactly the situation you describe effectively proves that your theory is backwards.
This isn't some theory that isn't tested. You can witness this in global healthcare every day.
The caveat to that is, if you get some type of rare disease or cancer, etc - you'll probably die before you get treatment. But the general populous is probably more healthy and taken care of.
Nope, not a caveat as those systems don't have those problems to the same degree that those not using those systems have. The issues of having to wait for healthcare are less, not more. Just look at the worst ones like Canada and the UK, still no waits even where the system works the worst.
-
A great example is ebola. You can get ebola treatment for a very life threatening disease faster in west African countries than you can in the US. They both diagnose and treat it faster because their labs respond so much faster.
-
@scottalanmiller said:
@Dashrender said:
@scottalanmiller said:
@DustinB3403 said:
@scottalanmiller said:
@Dashrender said:
Who determines how much money a doctor is paid?
That depends on the system that you want to use. Nearly always the government in systems that currently work well.
Which also means that the doctor is likely to try and "sell" the most expensive service they can every time.
Just like a car sales man.
Have you used healthcare in countries that have government set doctors pricing? Because this really does not happen there. That most of the developed world works this way, and all the countries with the best healthcare, and this is not a problem in the least suggests that this isn't true.
That the US does the opposite and lets doctors set any price they want AND allows them to sell drugs and results in exactly the situation you describe effectively proves that your theory is backwards.
This isn't some theory that isn't tested. You can witness this in global healthcare every day.
The caveat to that is, if you get some type of rare disease or cancer, etc - you'll probably die before you get treatment. But the general populous is probably more healthy and taken care of.
Nope, not a caveat as those systems don't have those problems to the same degree that those not using those systems have. The issues of having to wait for healthcare are less, not more. Just look at the worst ones like Canada and the UK, still no waits even where the system works the worst.
I've heard first hand stories from a few Canadian's who came to the US because of the back log in Canada.
-
How do the doctors in those government provided healthcare places get drug so cheap? Why would they be cheaper there in Europe than in the US? I mean besides we are corrupt?
Why wouldn't the drug companies just say no instead of agreeing to a lower price?
-
@Dashrender said:
@scottalanmiller said:
@Dashrender said:
@scottalanmiller said:
@DustinB3403 said:
@scottalanmiller said:
@Dashrender said:
Who determines how much money a doctor is paid?
That depends on the system that you want to use. Nearly always the government in systems that currently work well.
Which also means that the doctor is likely to try and "sell" the most expensive service they can every time.
Just like a car sales man.
Have you used healthcare in countries that have government set doctors pricing? Because this really does not happen there. That most of the developed world works this way, and all the countries with the best healthcare, and this is not a problem in the least suggests that this isn't true.
That the US does the opposite and lets doctors set any price they want AND allows them to sell drugs and results in exactly the situation you describe effectively proves that your theory is backwards.
This isn't some theory that isn't tested. You can witness this in global healthcare every day.
The caveat to that is, if you get some type of rare disease or cancer, etc - you'll probably die before you get treatment. But the general populous is probably more healthy and taken care of.
Nope, not a caveat as those systems don't have those problems to the same degree that those not using those systems have. The issues of having to wait for healthcare are less, not more. Just look at the worst ones like Canada and the UK, still no waits even where the system works the worst.
I've heard first hand stories from a few Canadian's who came to the US because of the back log in Canada.
And vice versa. It's not that they never have a back log. It is that they have less of one. Many Americans go to Central America for services too. Doesn't mean that the US is terribly backlogged.
Were those emergency services in Canada or optional ones?
-
@Dashrender said:
How do the doctors in those government provided healthcare places get drug so cheap?
Doctors don't get them. They are just for sale. The idea that doctors gate drugs in an Americanism.
-
@Dashrender said:
Why would they be cheaper there in Europe than in the US? I mean besides we are corrupt?
That's the only reason. There is no system for raising the prices like there is in the US. In the US there is an unlimited ability to make things expensive due to the lack of open market. In most of the world drugs are sold openly (outside of a few extreme examples) like any normal market product. The question isn't what makes them cheap everywhere else, it is what makes them expensive in the US?
-
@Dashrender said:
Why wouldn't the drug companies just say no instead of agreeing to a lower price?
Because someone else will make them and make all of the money from them. -
@scottalanmiller said:
Here is a thought experiment...
What if a single rich person could hire every doctor that there is - this doesn't just give them access to all existing legal healthcare but the right to control the creation of more (only doctors can make more doctors legally.) The market is not free, someone new is not allowed to just become a doctor by knowing doctor stuff, you have to have other doctors and political groups approve you. It's a gated thing. So, in theory, access to healthcare can be controlled by a single person without the ability to have competitors.
In a free market, that situation cannot arise. Someone could always invest the time, effort or money to compete. But in the current framework, it is completely possible although totally impractical, to literally buy up all healthcare and with non-competes literally shut down the healthcare systems totally if one so desired.
We may be closer to that reality than people realize. Around here The Cleveland Clinic owns and runs 90% of the healthcare facilities and has the same amount of doctors under contract. My wife was in their main facility before she passed, and it is larger than most mid-sized cities. Just a small idea of the size, the window in her room looked out over the helicopter landing pads, all 4 of them. To get to her room from the parking lot, you walked 3/4 mile.
-
Rochester is like that, UofR owns nearly all of the hospitals in the area.
-
This Phallac Martin Shkreli's attorney raises his rates by 5000%.
Hell yeah.... !
-
@DustinB3403 said:
This Phallac Martin Shkreli's attorney raises his rates by 5000%.
Hell yeah.... !
I don't believe I'm saying this, but nice move lawyer, nice move.
-
Another important thing to remember when pharma is given free reign to do whatever they want - the incentive, and it is enormous, is to make people sick or keep people sick and make them need to buy as many drugs as possible. This isn't a little amount of money, it is one of the world's biggest industries and affects every doctor, nurse, pharmacists, hospital, pharmaceutical, pharmacy, doctor's office and every person who works in a support role for those industries. The number of people who are paid based on this need and economic force makes it one of the biggest employers out there - every single employee of which is financially incentivized to make you and keep you sick.
Not that everyone gives into the temptation. But anyone who tries to make you healthy does so against their own self interest and the interests of every person they work with, for and around, most of the people that they likely know and all of their families.
-
@scottalanmiller For sure. The OBGYN I used to help out with the office computers for was a big advocate for avoiding C-sections. They almost always cause more complications down the road that also need to be managed properly. She actually dropped the contract with one of the local hospitals when the board decided they wanted a 100% C-section rate, just so they could fully book the birthing ward.
-
It's amazing how often business people, and not medical staff, direct medical procedures. I know of a local kid that his own father, being the doctor, was going to let expire because his manager didn't want the necessary appendectomy done. His mother, not a doctor, secretly took the boy to a different hospital when the father was at work and they did an emergency surgery and saved him. Even his own father and attending doctor cared more about a crappy job than the life of his own kid. Imagine how little they cared about random patients!
It was recently (last ten years or less) discovered that a standard knee surgery that is done had no valid purpose and even caused slight damage versus doing no surgery at all but was considered benign "enough" that it was worth putting patients at risk to do this made up surgery that it had become completely standard and was done all over the country as "standard." Now they know that it was fake but it was to the point where many doctors doing it were not even aware it was a fake surgery as it was so standard - just none of them knew why they did it or why it should be done yet they kept doing it because none of them thought that knowing what they were doing was relevant!!
-
@scottalanmiller said:
It's amazing how often business people, and not medical staff, direct medical procedures. I know of a local kid that his own father, being the doctor, was going to let expire because his manager didn't want the necessary appendectomy done. His mother, not a doctor, secretly took the boy to a different hospital when the father was at work and they did an emergency surgery and saved him. Even his own father and attending doctor cared more about a crappy job than the life of his own kid. Imagine how little they cared about random patients!
It was recently (last ten years or less) discovered that a standard knee surgery that is done had no valid purpose and even caused slight damage versus doing no surgery at all but was considered benign "enough" that it was worth putting patients at risk to do this made up surgery that it had become completely standard and was done all over the country as "standard." Now they know that it was fake but it was to the point where many doctors doing it were not even aware it was a fake surgery as it was so standard - just none of them knew why they did it or why it should be done yet they kept doing it because none of them thought that knowing what they were doing was relevant!!
Do you have a link to the situation you're talking about?
-
@Dashrender no, they would not have put it in the paper!
-
By local kid, I literally meant my home town and someone that my family actually knew. Not someone I learned about through news channels or something.
Just as it didn't make the news when the local hospital refused to treat me for appendicitis and let me appendix rupture. Medical things like doctors refusing treatment are neither newsworthy nor something that can go into the news.
-
My best friend interviewed with that company. They wanted him to build their server and network infrastructure from scratch. He turned down the job to work somewhere else.
