A friend of mine who was a research scientist for Bristol Meyers-Squibb before going to law school tells me that a lot of rationale for higher costs in the USA are simply fabricated (I've heard the same thing about gas prices from a former oil company attorney - funny, isn't it?). Also, if Americans want drugs to be more effective, they should stop exposing themselves to all sorts of drugs and chemicals all the time. We have antimicrobial this, sterile that, drugs in our meat, chemicals in our produce, etc. etc. The United States consumes the most drugs in the world, both illegal and legal, and that's not per capita. So not only do we pay the most, but we also buy the most. This is why people in the US are developing "immune" strains of Strep throat whereas you bring a bottle of penicillin to any poor or indigenous village in the third world and you'll see almost miraculous results. And it's why the pharmaceutical drug companies lobby so hard for no price controls, because the US is a gold mine for them.
And HMOs are a completely different factor when you're talking about the practice of medicine v. the bottom line. At the end of December a story came out in LA about a girl who died of leukemia because her HMO denied her a liver transplant that had a 65% chance of saving her life. Only after the family staged a protest did the HMO finally fold, and then it was too late. The girl died a few hours after the HMO finally agreed to cover the cost, after weeks of denying coverage and ignoring her doctors when they informed the company of the need of the procedure to save her life. Also, some states, such as NY, make HMOs litigation-proof from denial of such coverage. So we have private sector health care, which in the private sector in the US everything is driven by profit motive, versus a system run by the government.
And let's talk about those people who can't work. My mother died at the age of 48. From the ages of 38-45, she suffered 4 heart attacks and a stroke. She also had several degenerating discs in her spine, two in her lumbar and one in her neck. For someone who is functionally immobile, work isn't really an option. So she had medicaid/medicare/whatever. I recently saw something on TV where an MMA fighter - one of the most physically demanding occupations on the planet - had a degenerating disc. They put a small plastic block in his back and within 24 months he was back fighting again. Now my mother, on the other hand, because she didn't have private insurance, would have to go the emergency room virtually every week for pain management, get treated like a drug seeker, be subject to rudimentary surgical procedures that did almost nothing in the long run to resolve her pain, get denied further surgical procedures to correct problems and complications she'd develop after her original surgeries, and then spent the last 3 or so years of her life virtually crippled, having to get around with a cane or a walker. I can't help but think that if she had private insurance or hadn't had to rely on public health coverage, that she would've been treated better, would've got the care and been able to at least been eligible for treatments that would've actually improved her life, instead of leaving her dead before the age of 50. That's what I think about every time talk of Universal Health Care is talked about. Do I necessarily think it will work? No. Does what we have now work? No. HMOs suddenly popped up in the 70s and were given all the power in the world by Congress and eventually snaked their way into every decision hospitals, primary care physicians, and specialists make. I think it's silly to argue that a government run system would be any more driven by the "bottom line" than the current system, where private companies are allowed to play shell games and place Vegas odds on our lives. So we either go the Ron Paul route and get the power away from HMOs and give people tax breaks for health coverage expenses, so that people can start to afford health care without having to implement universal health care, or we start to move towards a more socialist system. If it's truly about people, then in a field such as medicine, people should come before profit. That's why I don't completely believe that a market (read: profit) driven system in medicine necessarily works.
By the way, you guys who talk about lack of research or whatever... Consider that the socialist French researched and discovered the HIV virus and the test for HIV contemporaneously with American researchers. We're not the only country in the world that performs medical research. Whether it's through corporate profit motive or government grant, medical research will still get done.
Last edited by PJL; 01-05-2008 at 10:35 AM..