Aretae

The virtue of excellence

Tuesday, May 1, 2012

Factoid oTD

Here.

Phase 3 trials for FDA approval of new drugs constitute 90% of the cost of new drugs.  With drugs being the primary method of advance of health...we can safely say that the FDA is trying to compete with the communists in terms of deaths-caused by prohibiting already-known-to-be-safe drugs from entering the market.

As per my normal...most of the cost issue in the US medical industry is government-granted monopoly.  FDA for drugs.  AMA for doctors.  Kill those monopolies, and even the most idiotic system of health-care ever built: (employer-provided first-Dollar insurance -- the US standard) would nearly be cost-effective.  But it's hard to be cost effective when the government is doing everything in it's power to keep the cost of medical care high.
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3 comments:

Anonymous said...

Doctor's are a hard group to attack politically. Believe me, I spend all day trying to convince legislators that it's the only way. They are too popular polically.

Drug makers are not popular, but the FDA is popular.

One thing that is weird in politics is how things get done for reasons other then their purpose. For instance, ACA established medical loss ratios. These things are retarded, but I try to remind myself they don't exist because they are smart. They exist to prove to the public that the reason health costs are going up isn't "greedy" insurance companies making a big profit. Thus, when ACA is reformed (I give it less then 10 years) you have more of a platform for shifting the blame to doctors and going after them.

May 2, 2012 at 6:14 AM
Aretae said...

Anon,

I am aware of the political difficulties, though less than you it seems.

If I were plotting a course of attack for sane healthcare policy, I'd hit the insurance companies first... but instead of hitting the companies the way the Dems do, I'd hit the companies as selling a product that's bad. But I've also been working in health insurance a lot in the last few years.

The US system has 2 problems:

1. Monopoly profits from docs and drug companies
2. First dollar insurance.

Either problem, addressed, reaps huge value.

What are current odds on ACA being upheld?

May 2, 2012 at 8:29 AM
Anonymous said...

People like first dollar insurance coverage. They wish everyone had it and it was free. That is the default result in a democracy. Single payer is simply the most efficient way to do it. If you believe first dollar coverage is a political inevitability, you have no choice but to choose the most efficient form of it.

All of the non-first dollar coverage countries are either:
1) Not democracies in some key way
2) Severally regulate the prices of health services.

Singapore for instance does both #1 and #2, and thus can avoid first dollar insurance because people don't need it.

People will slam down on the prices drug companies can charge, but they aren't getting rid of the FDA. So just less drugs will get made.

Doctors is a total non starter. Doctor wages will be curtailed by decree in a government price control regime once healthcare becomes too big as a % of GDP. The AMA will never ever be attacked, period.

50/50 on upheld vs upheld with mandate struck down. Low odds on total striking it down, IMO.

Upheld with mandate struck down is the worst outcome, but they will plow ahead with it if its all they got.

May 2, 2012 at 8:53 AM

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