Archive link. https://archive.is/N4Rqj

Some personal editorializing: This is a pretty remarkable first because of how captive we Americans are to pharma prices. Famously, when Medicare Part D was brought into existence by law it restricted the federal government from negotiating Part D drug prices. To me, shopping for drugs in Canada is tackling the symptom and ignores the cause. I wonder if this gets more traction with more states how it might affect drug prices in Canada, too.

The real solution to all this, of course, would be nationalize the healthcare industry in all aspects and to create a single payer healthcare system.

  • @sugar_in_your_tea
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    -26 months ago

    I disagree with nationalizing any of it. Instead, we should have some important reforms:

    • reduce patent duration - this is the major hurdle in generics replacing name brand, which keeps prices high
    • transparent care costs - journalists and individuals can’t easily compare routine/planned costs because prices are only known with a quote (very hard to get), and there’s usually no guarantee that the price is good
    • ambulance prices are ridiculous, and it’s not something you can easily opt out of - I think these should be 100% publicly funded, provided the paramedics recommend the ambulance (you could choose to pay for it yourself if they don’t)
    • simplify insurance - ideally make it more similar to auto insurance, as in you get coverage after some deductible, no networks or other nonsense (you pick your caregivers, procedures, etc); you could pick a more comprehensive plan if you know you’ll have more fixed costs
    • reduce restrictions on medications - e.g. with insulin, the US only allows the more expensive options, which have replaced less expensive options (they were a little less effective, but still solved the problem, and way cheaper)

    I personally don’t trust our government to put together a decent healthcare system. The one we have is heavily regulated, with lots of cronyism to ensure things stay expensive. A national program just makes it a political problem, I want it to be transparent so that public can vet it. We can have government health care systems (e.g. Medicare), but the focus should be on making the system more transparent and auditable, not just hide the problem in the tax system.

    • @[email protected]
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      fedilink
      26 months ago

      My friend takes insulin. He used to be on MediCal. They only covered the cheap insulin, and he had so many problems with it. Then he got a job with decent coverage and gets the good stuff now. No more problems.

      Pharma should be at least partially nationalized. Guarantee them a set profitability through a government contract, then all treatments developed are provided at cost. We pay a lump sum in taxes, but then the medication is nearly free. This is going to be a huge benefit when customized mRNA cancer treatments become common.

      Totally agree we need to do something about the crazy price of an ambulance ride. People risk their lives and the lives of others when they forego an ambulance and try to transport themselves after a serious injury. My former roommate cut off some fingers in a chop saw, then drove to the emergency room with his hand wrapped in a towel and his severed fingers in a sandwich bag. Said he wasn’t paying $5000 to go 3 miles.

      I was actually happiest with my medical when I was in the service. If socialized medicine could be like that, I’d be 100% behind it. Note that I am not talking about the VA medical, which can be horrible. “Yep, you’ve got cancer. We can get you in for surgery in 6 months…” - “Well, your cancer metasticized and spread - if only we got to it 3 months earlier…”

      • @sugar_in_your_tea
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        16 months ago

        I really hate that insurance picks and chooses drugs to cover, it should merely be a dollar amount they cover with some deductible. My wife needed to change birth control for some reason, and the doctor picked one that wasn’t covered (would’ve been hundreds) and they called the doctor to switch it to a much cheaper one (became free). That’s just ridiculous.

        However, just because the “cheap stuff” doesn’t work as well for your friend doesn’t mean it should be banned, it should just not be recommended. If you choose to save some cash or your body is just fine with a cheaper alternative, you should be free to use it.

        Pharma… partially nationalized

        That’s a hard no from me. We should either go all the way one way or the other, this halfway nonsense is where corruption thrives.

        Shorter patent durations should be enough to both provide profit and promote competition. Right now, pharmaceutical companies milk a profitable drug until the patent runs out, and patents last 20 years from the filing date. I’m thinking we cut patents to 7 years from filing or 5 years from entry in the market, whichever is longer, with an option to renew for 5 years more years based on need (e.g. medication for a niche condition will take longer to recoup costs) and only if the product actually exists.

        I’m also fine with the US directly owning a pharmaceutical research lab. But it shouldn’t be funding a private pharma company, that’s just too sketchy.

        in the service

        Yeah, socialized medicine is going to look more like the VA situation and less like medical care in the service despite what politicians will claim.

        The military gets some of the best care in the country (and for good reason), despite all the flak it gets for handling stuff like burn pits (that was for vets AFAIK). There’s absolutely no way that level of care is getting rolled out to 300+ million Americans, there just aren’t enough care providers to go around if they tried, and there certainly is not enough money.