Forgive this stupid question, but...

[SDMuscleBuddy]

Originally Posted by amtharin

This is what a lot of people dont understand about drug companies. It take about a billion dollars, and 10 years to bring a drug to the market. What company is going to put that much time and money into something without expecting some type of payback (profit)??

Were do you think most of the research funding comes from?

[amtharin]

Originally Posted by SDMuscleBuddy

Were do you think most of the research funding comes from?

Most of it comes from private investers.

Im still waiting on you to answer my question about why dont you take issue with other industries that provide things that people need??

[neonhypoxia]

As for health care on the whole I don't have the stats infront of me so I won't comment on that. However I do work for a pharmacuetical company and I will comment on that as some of the information posted here is incorrect.

To begin with when it comes to a drug that's still under patent the company that produces it can simply charge whatever they want. In most industries if the price for something is too high you simply wouldn't buy it but this isn't the case for pharma. Instead your choice is either pay what the company is asking for it or suffer the health effects and in many cases potentialy die. Once a drug goes generic and other companies begin production of it then competition does come into play however there are issues with this as well. While it is illegal for companies to work together and price fix it still happens in the industry quite often. Also for a reason I have never understood some doctors and some people will only purchase the name brand drug once its gone generic despite the generic being exactly the same drug and still being manufactured by major pharma corporations. It would seem like the solution to this would be to remove patent rights when it comes to pharma however that would simply bring R&D to a grinding halt as no company is going to pay to do the R&D if they can't make a profit off of it.

As for the price of R&D much of what has been stated is incorrect. Alot of that investment can be used as a tax write off so essentialy the company doesn't really pay for much of it. Much of the price is also double counted when it comes to taxes and to figures posted for the public. It will be counted once in the general R&D budget and then counted again for the R&D of that specific drug. This means that often the company gets a much larger tax break for the R&D of a specific drug than what they actually should.

When it comes to taxes I should also note that most pharma companies get major breaks in general on income and property taxes. Things like construction of new labs and purchase of new equipment is also usually written off.

Don't be confused by how much R&D looks like it cost and then use that to justify the prices for drugs. Generally alot of profit is made, we definetly aren't worried about going out of business.

[SDMuscleBuddy]

Originally Posted by amtharin

Most of it comes from private investers.

Im still waiting on you to answer my question about why dont you take issue with other industries that provide things that people need??

A little more than half is most, that's correct. Still the American people spend 40 billion on research every year. Pharmaceutical research relies heavily on public funding, and all we get in return are new higher priced patented drugs that are marginally better than those already on the market. I agree with Dean Baker that we should fund research 100% and eliminate monopoly pricing.

http://www.paecon.net/PAEReview/issue32/Baker32.htm

I addressed your non-point earlier.

[cavymeister]

Originally Posted by SDMuscleBuddy

A little more than half is most, that's correct. Still the American people spend 40 billion on research every year. Pharmaceutical research relies heavily on public funding, and all we get in return are new higher priced patented drugs that are marginally better than those already on the market. I agree with Dean Baker that we should fund research 100% and eliminate monopoly pricing.

http://www.paecon.net/PAEReview/issue32/Baker32.htm

I addressed your non-point earlier.

Which would you rather, a pharma that is driven by profits to create better and more effective drugs, or one that is a social program?

[SDMuscleBuddy]

Originally Posted by cavymeister

Which would you rather, a pharma that is driven by profits to create better and more effective drugs, or one that is a social program?

You don't see any possibilities in between?

[cavymeister]

Originally Posted by SDMuscleBuddy

You don't see any possibilities in between?

Please explain in between please? Because it looked like your post was saying for them to be funded 100% and the currently it is a little less then 50%. (I may have misread your post, but that's what I gather..)

I don't feel that a social program, or one that has regulatory limits placed on it's profits will excel as well as a company that is allowed to flourish in the market. If it wasn't for the market and health care system we have, we would not have the advancements that we currently enjoy.

[amtharin]

SDMuscleBuddy, answer the question. Say you have..

Family A: Eats filet mignon every night for dinner.

Family B: Cant afford filet mignon and has to eat spam sandwitches.

What make you think it's okay for the government to say to Family A, "Hey, we're are going to have to take some of you filet mignon and give it to Family B so everything will be fair. It not right that you guys can eat nice meals every night and they have to eat spam".

[neonhypoxia]

Originally Posted by cavymeister

Which would you rather, a pharma that is driven by profits to create better and more effective drugs, or one that is a social program?

You are making the assumption that newer drugs are always more effective and are safer, this is often not the case. Alot of the times newer drugs are developed and brought to market simply because the patents expired on an older one and a company can no longer make as much money on it. Depakote would be a good example of this. It is newer than phenobarbital yet for most people phenobarbital works slightly better and has far fewer side effects. So you have a newer drug which is slightly less effective and more dangerous by quite a bit compared to the older drug, which one do you think doctors are more likely to prescribe? If you guessed phenobarbital you are wrong; in the U.S. depakote is prescribed more often. So why would doctors do this? Abbott, the company that makes depakote, is known for heavily using drug reps to influence doctors with free items, dinners, vacations, all sorts of things. As long as the doctor keeps prescribing depakote Abbott keeps buying them off.

This isn't some sort of lone example either. Every pharma firm uses policies like this for most of the drugs they put out, many of which are inferior to older drugs or OTC treatments. So while some newer drugs are better many are not. Instead they are prescribed because for the doctor has essentially been bought.

[cavymeister]

Originally Posted by neonhypoxia

You are making the assumption that newer drugs are always more effective and are safer, this is often not the case. Alot of the times newer drugs are developed and brought to market simply because the patents expired on an older one and a company can no longer make as much money on it. Depakote would be a good example of this. It is newer than phenobarbital yet for most people phenobarbital works slightly better and has far fewer side effects. So you have a newer drug which is slightly less effective and more dangerous by quite a bit compared to the older drug, which one do you think doctors are more likely to prescribe? If you guessed phenobarbital you are wrong; in the U.S. depakote is prescribed more often. So why would doctors do this? Abbott, the company that makes depakote, is known for heavily using drug reps to influence doctors with free items, dinners, vacations, all sorts of things. As long as the doctor keeps prescribing depakote Abbott keeps buying them off.

This isn't some sort of lone example either. Every pharma firm uses policies like this for most of the drugs they put out, many of which are inferior to older drugs or OTC treatments. So while some newer drugs are better many are not. Instead they are prescribed because for the doctor has essentially been bought.

So, are you saying that we shouldn't agressively pursue newer drugs and treatment options?

[SDMuscleBuddy]

Originally Posted by cavymeister

Please explain in between please? Because it looked like your post was saying for them to be funded 100% and the currently it is a little less then 50%. (I may have misread your post, but that's what I gather..)

I don't feel that a social program, or one that has regulatory limits placed on it's profits will excel as well as a company that is allowed to flourish in the market. If it wasn't for the market and health care system we have, we would not have the advancements that we currently enjoy.

Yes, I like the idea that we fund medical research 100%, then any number of companies can bring each new drug to market at competitive prices. Those that offer the best combination of quality and price will be making a nice profit. Nothing wrong with that.

[SDMuscleBuddy]

Originally Posted by amtharin

SDMuscleBuddy, answer the question. Say you have..

Family A: Eats filet mignon every night for dinner.

Family B: Cant afford filet mignon and has to eat spam sandwitches.

What make you think it's okay for the government to say to Family A, "Hey, we're are going to have to take some of you filet mignon and give it to Family B so everything will be fair. It not right that you guys can eat nice meals every night and they have to eat spam".

Weak analogy. It's not about who can afford what. It's about a middleman who does nothing but shuttle cash from me to my doctor while doing everything they can to keep as much for themselves as possible after they've already taken some to buy advertising, pay sales commissions, and nice bonuses for the executives.

I know all of you would object to this as a business model at the grocery store. Why is it so vaunted a model for the health care industry in the eyes of you obstructionists?

Reforming this link in the chain is the easiest and fastest way to reduce costs, thus making health care affordable for more people.

[neonhypoxia]

Originally Posted by cavymeister

So, are you saying that we shouldn't agressively pursue newer drugs and treatment options?

Not at all, I never said that. Just pointing out that it seemed like you were trying to state that newer drugs are always better and that is blatantly wrong. You never bother to correct me on that and state it was not what you were meaning so I have to assume it is. The fact is that sometimes never drugs are better but often they aren't. However regardless of that fact the companies that make them and the doctors that are getting kick backs relentlessly pimp them out because they are more profitable. A point that you never even bothered to address.

[cavymeister]

Originally Posted by neonhypoxia

Not at all, I never said that. Just pointing out that it seemed like you were trying to state that newer drugs are always better and that is blatantly wrong. You never bother to correct me on that and state it was not what you were meaning so I have to assume it is. The fact is that sometimes never drugs are better but often they aren't. However regardless of that fact the companies that make them and the doctors that are getting kick backs relentlessly pimp them out because they are more profitable. A point that you never even bothered to address.

I don't think that advances in technology are going to always be better then some of the older things. There's proof in almost every facit of manufacturing and industry. I'm not arguing with you on that.

Onto the issue of the doctors getting kick backs from the drug companies... If they were able to make enough money with normal patients and every day things, they wouldn't need those kick backs. They wouldn't need to squeeze in as many patients as possible durring the day either. If they weren't paying mega bucks for malpractice insurance and getting paid pennies for medicare and medicade they would be able to treat the patient better and not worry about money as much.

I remember, not too long ago, when it was popular to be a doctor because you'll make a lot of money and be able to help people...

Originally Posted by SDMuscleBuddy

Yes, I like the idea that we fund medical research 100%, then any number of companies can bring each new drug to market at competitive prices. Those that offer the best combination of quality and price will be making a nice profit. Nothing wrong with that.

So no private investor funding of drug companies then?

Edit:
To clarify, do you feel that by lowering every company to the same level by only allowing public funding that the same high level of R & D? If not, are you OK with lesser advancements in medical technology in leiu of less profits for the drug companies?

[neonhypoxia]

Originally Posted by cavymeister

I don't think that advances in technology are going to always be better then some of the older things. There's proof in almost every facit of manufacturing and industry. I'm not arguing with you on that.

Onto the issue of the doctors getting kick backs from the drug companies... If they were able to make enough money with normal patients and every day things, they wouldn't need those kick backs. They wouldn't need to squeeze in as many patients as possible durring the day either. If they weren't paying mega bucks for malpractice insurance and getting paid pennies for medicare and medicade they would be able to treat the patient better and not worry about money as much.

I remember, not too long ago, when it was popular to be a doctor because you'll make a lot of money and be able to help people...

Malpractice insurance is definetely an issue and a major one at that but it isn't the only one. Additionaly the cost of their education and trying to pay off their student loans from it is also an an issue, but again there is more to it. You seem to be thinking that the only reason doctors accept kickbacks is because they don't have enough money to make ends meet, this is simply ridiculous. People who are in debt are not the only ones who take money, goods, services, whatever under the table. Usually people seem take them because of greed and self interest and not because they simply owe money.

[amtharin]

Originally Posted by SDMuscleBuddy

Weak analogy. It's not about who can afford what. It's about a middleman who does nothing but shuttle cash from me to my doctor while doing everything they can to keep as much for themselves as possible after they've already taken some to buy advertising, pay sales commissions, and nice bonuses for the executives.

I know all of you would object to this as a business model at the grocery store. Why is it so vaunted a model for the health care industry in the eyes of you obstructionists?

Reforming this link in the chain is the easiest and fastest way to reduce costs, thus making health care affordable for more people.

Im not talking about 3rd payers. You are the one that keep bringing that up. Im talking about your utopian idea of equality.

[cavymeister]

Originally Posted by neonhypoxia

Malpractice insurance is definetely an issue and a major one at that but it isn't the only one. Additionaly the cost of their education and trying to pay off their student loans from it is also an an issue, but again there is more to it. You seem to be thinking that the only reason doctors accept kickbacks is because they don't have enough money to make ends meet, this is simply ridiculous. People who are in debt are not the only ones who take money, goods, services, whatever under the table. Usually people seem take them because of greed and self interest and not because they simply owe money.

I understand that people take kick backs, but if it becomes less appealing and more immoral they do it less. I hold doctors to a higher level then I would a used car salesman, or a congressman.

Then what do propose to fix that issue though for the sake of debate?

[SDMuscleBuddy]

Originally Posted by cavymeister

I don't think that advances in technology are going to always be better then some of the older things. There's proof in almost every facit of manufacturing and industry. I'm not arguing with you on that.

Onto the issue of the doctors getting kick backs from the drug companies... If they were able to make enough money with normal patients and every day things, they wouldn't need those kick backs. They wouldn't need to squeeze in as many patients as possible durring the day either. If they weren't paying mega bucks for malpractice insurance and getting paid pennies for medicare and medicade they would be able to treat the patient better and not worry about money as much.

I remember, not too long ago, when it was popular to be a doctor because you'll make a lot of money and be able to help people...



So no private investor funding of drug companies then?

Edit:
To clarify, do you feel that by lowering every company to the same level by only allowing public funding that the same high level of R & D? If not, are you OK with lesser advancements in medical technology in leiu of less profits for the drug companies?

I don't believe that will happen. Need is the driver for innovation, more so than profit.

[SDMuscleBuddy]

Originally Posted by amtharin

Im not talking about 3rd payers. You are the one that keep bringing that up. Im talking about your utopian idea of equality.

I don't know what that means. What is "my" utopian idea of equality?

[SDMuscleBuddy]

Originally Posted by neonhypoxia

Malpractice insurance is definetely an issue and a major one at that but it isn't the only one. Additionaly the cost of their education and trying to pay off their student loans from it is also an an issue, but again there is more to it. You seem to be thinking that the only reason doctors accept kickbacks is because they don't have enough money to make ends meet, this is simply ridiculous. People who are in debt are not the only ones who take money, goods, services, whatever under the table. Usually people seem take them because of greed and self interest and not because they simply owe money.

The total cost of malpractice - insurance, legal fees, and awards - is only about 5% of the total cost of health care in this country. It's not a "major" issue, though I agree that there are reforms that should be made, just not as part of health care reform legislation.

[cavymeister]

Originally Posted by SDMuscleBuddy

I don't believe that will happen. Need is the driver for innovation, more so than profit.

We NEED to get homeless people off the street, but there is no profit in it. Why don't we have more places for them to stay? We NEED jobs in America right now, but where there's no, or little profit, there will not be business.

[neonhypoxia]

Originally Posted by cavymeister

I understand that people take kick backs, but if it becomes less appealing and more immoral they do it less. I hold doctors to a higher level then I would a used car salesman, or a congressman.

Then what do propose to fix that issue though for the sake of debate?

Actually I hold congressmen to a higher standard than I would a doctor mainly because each one of them is able to impact many more people's lives than a single doctor does. But that's a discussion for another time and I'll simply leave it at the fact that I'm extremely disappointed with them as well.

I would call perscribing someone a drug that is less effective or more dangerous than another drug as being pretty immoral to begin with. Frankly I'm not really sure of a good way to fix it. I recognize the problem, but don't really see a good way to bring about a solution. Having the practice frowned upon to an extreme degree by the medical community should be a very effective method but I have no clue how to accomplish that. Really all I have is tightening legislation and the enforcement of said legistlation when it comes to doctors recieving anything at all from drug manufactures or any other group that could potentialy profit off of a patient recieiving inferior care in one way or another.

[amtharin]

Originally Posted by SDMuscleBuddy

I don't know what that means. What is "my" utopian idea of equality?

Your idea that everyone should be equal, no one should profit, the government should be in control, etc.

[neonhypoxia]

Originally Posted by SDMuscleBuddy

The total cost of malpractice - insurance, legal fees, and awards - is only about 5% of the total cost of health care in this country. It's not a "major" issue, though I agree that there are reforms that should be made, just not as part of health care reform legislation.

Total cost of heath care being the key part there. Yes, it looks like a small percentage but when you factor in how much of the cost goes to insurance, equipement, medication, ect and look at what percentage a doctor is actually making malpractice becomes a very big issue.

Keep in mind I'm not suggeting we do away with malpractice. If a doctor or anyone else does infact make a mistake I'm all for sticking it to them. However there are alot of frivalous lawsuits as well that simply drive up the cost of malpractice insurance. This I have a major issue with.

By the way I'm not at all argueing against you on this subject. For the most part it looks like we hold the same position. However it seems like we are coming from very different directions on alot of it. I'de like to see alot of issues in the health care industry cleaned up.

[cavymeister]

Originally Posted by neonhypoxia

Actually I hold congressmen to a higher standard than I would a doctor mainly because each one of them is able to impact many more people's lives than a single doctor does. But that's a discussion for another time and I'll simply leave it at the fact that I'm extremely disappointed with them as well.

I would call perscribing someone a drug that is less effective or more dangerous than another drug as being pretty immoral to begin with. Frankly I'm not really sure of a good way to fix it. I recognize the problem, but don't really see a good way to bring about a solution. Having the practice frowned upon to an extreme degree by the medical community should be a very effective method but I have no clue how to accomplish that. Really all I have is tightening legislation and the enforcement of said legistlation when it comes to doctors recieving anything at all from drug manufactures or any other group that could potentialy profit off of a patient recieiving inferior care in one way or another.

By higher level, I meant that they have my interests in mind versus the other. I don't have confidence that most Congressmen are looking out for me, while I do feel that Dr's do.

I'm not confident that tighter legislation, more regulation, and more government oversight will fix that issue personally. Increasing the awareness to the public would be great if the general populas gave a ****, but they really don't care. It's a tough call, that's for sure.

[SDMuscleBuddy]

Originally Posted by amtharin

Your idea that everyone should be equal, no one should profit, the government should be in control, etc.

How you got this out of my posts, I'll never know. This is probably why the national dialog is so heated. Nobody's listening. They're all talking.