August 11, 2003

Health insurance: no good solutions in sight

Tiger (note that he has changed paths from /blog/tiger-rant.html to /blog in order to debug some Blogrolling issues) posts about health insurance in response to a post by Silver Blue on the same. Money graf: "That's all fine and dandy, but there are some places that profits should not take a front seat. Medicine is one of them."

I agree, I think. But this issue is pretty complicated. Yes, USD100+ is an insane amount of money for a week's supply of medicine. I don't know how much price-gouging goes on, but I do assume that the cost of years of R&D is much higher than the actual cost of the meds once they're refined. The companies have to recoup that somehow, in the form of higher prices. But this causes a dilemma for the insurance companies, who have to charge higher premiums or set less-inclusive requirements. So both insured and (obviously) noninsured people get the short end of the stick.

What do we do about this? I'm suspicious of this whole Canadian importation thing: as far as I can see that's taking advantage of the low cost of meds in Canada, artificially held down by government subsidization. Do we really want the Federal Government okaying what amounts to an additional tax burden on Canadians? That doesn't seem very ethical to me. One might even call it taxation without representation.

Maybe the Government should subsidize certain prescription meds altogether. Or pour even more money into R&D. Or give tax credit for insurance. My fiscally conservative side is not very happy about this, but really we're dealing with a situation above and beyond what the Founding Fathers imagined when they wrote the Constitution. Our ability to extend human life grows greater every year; as a result, the numbers (and thus the expense of things like complex day-long surgeries and high-tech scientific research) go up too. Is it moral to deny a longer or healthier life to those who cannot pay for it? I do not know the answer.

Posted by Tim at August 11, 2003 08:37 AM
Comments

Well said; the only thing is that most of the US's elderly are held together by meds that cost well in excess of the $100 a week, while trying to exist on their meager retirement and/or social security (My grandmother has a widow's pension and social security [she was unable to work due to having to care for a physically and mentally handicapped daughter] and draws $610 a month. That has to pay health insurance, medication, food, and utilities. She owns her house or I do believe she'd be on the street).

Handouts are not the answer; I realize that R&D is expensive, but somewhere there needs to be a line drawn in the sand.

I used to work in a billing office for an emergency room; most of the rates charged were very reasonable, until you came to the person who was in cardiac arrest.

I can't tell you the number of patients who were basically DOA, that the doctor spent less than five minutes with them realizing there was no reason to work on trying to revive them, that were still charged for a Level V service (which is the most expensive). Back in those days, that was $297. The ekg, technicians, er services, etc. were all billed separately. $297 for a doctor to whoosh in, go "they're dead" and whoosh back out. Either the family, the insurance, or the estate would have to pay this overly inflated cost.

Yes, America's healthcare is broken. It needs fixed. But I'm not sure that more government oversight is the way to go.

Posted by: SilverBlue at August 11, 2003 09:00 AM

Call me a capitalist, but don't you think that if we were rid of health insurance entirely that free market forces would resolve the problem? For example, I used to have health insurance and a visit to my doctor cost me 10 bucks. My current job has no bennies whatsoever (not even sick days or vacation) and a visit to my dr costs me $63 bucks (or $93 if she spends more than 5 minutes looking at me). As much as I like her, if she gets much pricier I'm going to start shopping around to find a cheaper physician. If no one had insurance to insulate them from the sticker shock, I really think costs would come down (although a lot of paper pushers in dr.s' offices would be looking for work).

Posted by: Susie at August 11, 2003 11:14 AM

It's hard to say. I think, all in all, the prevalence of health insurance has a negative effect because there's a lot of people who then decide they might as well go to the emergency room for a cold, or stock up on prescription pain-killers whenever they get a headache.

On the other hand, there are other reasons why health care is costly (R&D being a major one) and a lot of people probably couldn't pay full price...

Posted by: dagny at August 11, 2003 01:09 PM

'zactly, dagny. Socialized medicine fails because it's a blank check where mom takes little Billy to the M.D. everytime he gets the sniffles. The access is infinite and the check is blank. Hello Citizen, meet Financial Ruin. Oh, nice to meet you. Can we go home now...?

Posted by: Tuning Spork at August 11, 2003 10:27 PM

A few points:

- All except one major pharmaceutical companies spend twice as much on marketing as they do on R & D. The exception is Eli Lilly, which spends only 1.5 times as much on marketing as R & D. (Source: http://www.namiscc.org/newsletters/July01/DrugPrices.htm)
- Prescription drugs in Canada are not subsidized, except for those with low income. Prescription drug prices in Canada are regulated by the government.

Seeing as drug companies are given 20-year monopolies on new drugs that they create, some price regulation seems only fair. In some cases, drug companies abuse the patent system to delay generic competitors for up to a few years.

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