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October 28, 2003

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Mithras

Also, much of the "new drug" development is done by companies whose patents on old medications are about to expire. Even though the new drug is not more efficacious than the old drug, they can market it and docs will prescribe it. A government-run system could avoid those costs.

Having said that, I don't think single-payer healthcare will ever happen in the United States. The propaganda is so vile against any kind of government solution that people would sooner let their kids die than vote for single-payer.

Jane Finch

Although it sounds good to those who don't want to consider that maybe drug companies are price gouging when and where they can, I'm not convinced that Canadians are free-riding. To my mind, it's the same as a really large corporation negotiating a health deal for its employees...only in this instance, it's the government. Further, I haven't seen the part where the companies are obligated to sell a thing to Canadians, or in Canada.

The Kid

The Canucks are hitching a free ride -- they know that they can demand a discount for newer drugs because their market is so small and because they carefully select what new drugs they will offer to the public and restrict the rest. Drug companies will play these games to reap the marginal income and ensure that all their drugs have a fighting chance for approval up north.

Physicians face a similar conundrum -- most docs are not government employees, but are in private practice and to some extent compete against each other in their specialties. But the governments put an annual cap on the amounts paid for physician services. This system has worked for decades, but is collapsing with the aging population that needs more medical care than current budgets can provide.

The caps are one reason that Canada has far fewer MRI and CATScan systems per capita than in the US, and why the waiting times for these diagnostic devices are insane. As near as I can figure, the devices end up being treated as current expenses, i.e., they are not capitalized [and depreciated] over time.

But back to drugs. “Free” drugs allow folks to avoid hard choices. Most folks would rather sit on a couch than walk or work out, eat tasty fat than bland fiber, etc. Cholesterol-reducing, hypertension management, and other optional (in most cases) drugs therefore become mandatory because it’s easier to pop pills than follow a rigorous regimen if someone (or everyone) else is footing the bill. Please pass the Cheetos and the remote. Drug costs will only soar under single-payer and even under our employer-paid system because the beneficiaries perceive the costs as negligible or nonexistent.

But it was orneriness and pride, not altruism, that made me forego the subsidized $29 monthly cost of hypertension and cholesterol medication. I now hang out in bars and beat up people who try to argue for single-payer health insurance. I am getting a workout and changing the world, one weenie at a time.

Jane Finch

Kid, you haven't explained a thing. Why do drug companies need "marginal profits" at all? Why would the puny Canadian market mean a damn thing to drug companies, and why would they care so much that their drugs were approved or indeed sold in Canada?

And as for a cap on physician services, au contraire. My province pays a fee for service that is negotiated with the College of Physicians and Surgeons and doctors do fine. As for equipment and certain elective procedures, yes they is rationed...that's the chief feature of a universal system. Unlike the insane no-limits seniors bribery that characterizes US Medicare, in other countries government medical services have to be rationed or they go broke. And who determines wait lists? Not the government...doctors.

Patricia Downing

Were you aware that genetic drugs in Canada run much higher than generic drugs in the US?

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