| | | >> The ACA in no way changes your examples.
You're trying to change the subject. We weren't talking about the ACA. We were talking about single payer systems.
>> As to the profits, you do realize that companies, like the pharmaceuticals, typically spend much more on executive bonuses and marketing than they do on R&D?
Marketing is part of the cost of a product, so yes, you spend money on marketing. And marketing costs a lot. That it sometimes costs more than R&D is a totally irrelevant fact; it would hardly make sense to spend, for example, twice as much on R&D than on marketing, only to have a great product expire on the shelf. This is a very fundamental precept in business and marketing, that the world will NOT beat a path to your door just because you built a better mousetrap. Particularly when you're talking about a complex subject where it is essential for technical personnel to visit with physicians and make them aware of the drug, advertise to patients so they ask for it, and so on. These are just more expensive than R&D. I have no idea what you think that has to do with anything at all.
The point to be made is that while you have to have a good product, that is not enough. You also have to create demand for it. Every businessman knows this. I'm sure wherever you work, there are marketing people. And I can tell you that I learned some time ago that you don't stay in business developing software that is fun to write, you develop software that will sell, and they are often not the same things.
In the case of a drug, if the profit potential is reduced, so will be the incentive to develop it. That's why we see an abundance of ED treatments and not enough treatments for more rare ailments.
Like Prozac, all drugs have to go through a cost recovery process (not unlike the latest version of Windows) and after that is done -- a period which is represented by the patent expiration time frame -- and the product goes off-patent, it becomes dirt cheap. That $2/day Prozac is now 21c/day, meaning that even poor, uninsured people can be treated for Depression whereas used to, only those covered by great insurance or who have money could be treated.
>> And there isn't 100s of billions of dollars a year in waste, fraud and abuse in Medicare and Medicaid. That is a myth. Just like there isn't any at all in the private sector.
There is a little in the private sector, but very little. It is rampant in the public sector programs because they're easy targets. We know the official estimate is only $60 Billion a year; obviously, they minimize it. But it is far more.
Harvard's Malcolm Sparrow testified before Congress in 2009 that the total of all waste, fraud, and abuse for Medicare and Medicaid could well amount to 20% of those program's costs. Think about that for a minute.
Defrauding Medicare is trivial; it takes 90 days to set it up then it is easy money; if you were careful you could easily get away with it for a year or two before they'd even know it. And by then, you [if you know what you're doing] will have moved on to a different entity, and started the process over. Were I a criminal I could make far more money defrauding Medicare than I could ever hope to make legally (which is why doctors sometimes do this).
The reason is that CMS doesn't understand or care how to prevent fraud. Medicare tries to prevent through an arduous enrollment process, which does NOTHING. Private insurance companies look at claims and don't pay claims which don't look right unless they get proper documentation or other assurance.
It is but one more case of you spouting off about a subject you know nothing about. |
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