Healthcare Reform in the USA

[CaveMum]

Last night President Obama's healthcare bill was passed.

Surely I am not the only person to be shocked at the level of vitriol being aimed at Obama and this Bill in the US?

I cannot get my head round the fact that people seem to think that healthcare for everyone is a bad thing!

I know the NHS is far from perfect, but at least everyone gets treatment. I've heard some of the downright lies being spouted in the US about the NHS : "People over 75 don't get treated" and of course the classic "All Brits have bad teeth", and I am appalled.

I'd be interested to hear how other people feel on this topic.

Welcome to the civilized wod America, we've been waiting for you.

i too am lost as to why they are against it. on the tv this morning was a mother saying she cannot even get a prescription when she's ill. madness.

It's probably a case of "nobody likes change."

So does the us government pay the premium on behalf of every american citizen now? my friend used to pay something like 700 dollars a month she claimed, I can't quite believe that. But would she not have to worry about health insurance any more?

It's part of the American psyche as far as no interference by government in one's private life as the idea is that a faceless bureaucrat will start making decisions about one's health. Why a private insurance company is deemed more acceptable, I don't know.

Had to laugh though when visiting in January and my friend's brother said he didn't want the government interfering in his Medicare.

So pleased when I saw this this morning. I can't remember the reasoning for the Republican party to be so against this bill.

Is there some argument about research or drug companies being affected? Damn my crap memory.

Yeah, apparently ground breaking research is all funded by the high prices of drugs

was that at me?

No, it was at the stupidity of the Republican party and the fact that drug prices are kept artificially high saying that it pays for research. It's a scare tactic. I've heard the argument that genetic research will stop if Obama's Bill goes through and any advances in cancer treatment.

good, that's what I thought.

I've heard that too, yes. It's incredible when you think about it, isn't it. It's so hard to believe that, in a country like the US, that people are developing serious illnesses as a result of prior infections that wouldn't have happened if they'd just had access to antibiotics.

Ok well this is my take on it. The NHS is available for everyone and this is what is good about it, but if you want expensive new drugs for cancer for example they won't be available, this is my direct experience. So the bill will help more people access healthcare in the US which is a good thing, but think about it if you are already covered by top notch health insurance, you won't gain anything, but in fact your coverage and ability to access cutting edge treatment may well become worse why would you want this? Not everyone is so selfless.

And yes ground breaking research is covered by the cost of drugs. I don't know the exact statistics but for every drug that makes it to market 10 or so fail, and the research and testing phase is v.v.v. expensive, it has to be funded from somewhere and these are not charities but companies that need to make a profit. Without this profit motivation new treatments would not be developed.

Not wanting "free at point of use" healthcare for all isn't such a strange mindset.

Our grandparents and parents (well depending on your age) lived at a time when this country didn't have free healthcare. It took the enormous effect of WW2 upon this country to bring us around to a state of mind where we wanted the NHS.

If we hadn't gone through those times then it's reasonably possible that we'd be like America is today with health being provided privately.

"if you are already covered by top notch health insurance, you won't gain anything, but in fact your coverage and ability to access cutting edge treatment may well become worse why would you want this? Not everyone is so selfless."

Well the theory is that if you are so well covered then you're paying through the nose for it. So the rich won't gain anything substantial, where as to more normal incomes the savings on health insure could be immense. Allegedly...

"yes ground breaking research is covered by the cost of drugs. I don't know the exact statistics but for every drug that makes it to market 10 or so fail, and the research and testing phase is v.v.v. expensive, it has to be funded from somewhere"

I think that the statistics are even worse then 1:10. To take a new drug from concept through to availability is very time consuming, very risky and enormously expensive. Right up until the last trials, after years of work and massive expense, the drug could fail.

However Europe does have state provided health care and our drugs industries haven't collapsed.

So state health care clearly doesn't mean the end of research and investment in new medications.

Having lived in the UK and the US, I'm highly disappointed that this bill passed. Healthcare isn't free, this only means that the US healthcare system will take a tumble in level of quality or to keep the level up, money will be taken from somewhere else. It amazes me the number of people who complain about 'the British welfare state' and then think that the NHS is a good thing.

Also, having worked for a large drug company, I know how much it cost just to run and operate the plant where the drugs were made, not including the research that it took to get the drugs into production, and it's not cheap. The only reason that generics are cheap is b/c they have taken all the work already done by the big companies (research and production set-up) and copied it. If big drug companies fail, no one will be doing the research.

Well our European drug industries have a large market in the US, strangely! A large number of new cancer drugs are either not funded by the NHS or are delayed for years by NICE (not so nice). If there is no market for these drugs they won't be developed.

Those on good insurance with normal incomes may win financially but will their access to medicine improve?

I do think everyone should be able to access healthcare, but my experience of the NHS, dirty neglected wards, denial of cancer medication to a family member has really changed my views.

Riven, that's so madening!

How is there such a huge difference in the cost of drugs? $2300 a vial compared with £105?

'Happens to the insured in the US all the time. The company refuses to pay for what the doctor recommends and suggests a cheaper one or just flat out says no.
And the uninsured don't even get that far!'

Absolutely true!

Watch the local news every night. Hardly a week goes by when someone isn't featured trying to raise money to pay for a medical procedure their child needs but their insurer won't cover.

And the cost! Even for 'good' insurance.

My sister and BIL pay $1400/month for a family of 4, not including vision and dental. Their co-pays are $30 and a $1000 deductible.

And they're lucky! Many, many employers don't offer insurance at all, offer it and you have to pay the entire premium or don't extend coverage to dependents.

The research and developoment costs argument about drugs prices is a bit misleading. Yes it costs a lot to bring a drug to market. Many, many fall by the wayside without getting approval. However, as an industry, pharmacutical companies spend almost twice as much on marketing drugs as they do on developing them.

Well it's becuase a lot of people were happy with the current system and do not want government control of their health care. He's receiving a lot of virtriol because instead of accepting that these were peoples honestly held views he treated them as though they just didn't understand what he was trying to do and forced the bill through anyway.
Hopefully this will seal his fate as a one term president.

"pharmacutical companies spend almost twice as much on marketing drugs as they do on developing them."

Nonsense, utter nonsense.

Perhaps when looking at each drug they market the cost of developing it was exceeded by the cost of marketing it.

However the vast majority of drugs never get as far as being marketed yet still consume vast amounts of R&D funds.

For example in 2006 Glaxo spent $2.5 billion on marketing.

However there R&D expenditure was nearly £3.5 billion.

And yes those are in different currencies, so it's probably fair to say that the R&D budget is more than twice that of the marketing budget ($2.5 billion is about £1.6 billion).

The figures are here:
www.gsk.com/investors/reps06/annual-report-2006.pdf
www.fiercepharma.com/speci al-reports/glaxosmithkline-top-13-advertising-budgets

Drugs companies are certainly not saints and they don't need to be attacked with fabricated figures.

I found this breakdown of the cost of having a baby in the USA for one family in Texas with no maternity insurance:

1. 1st Doctor Appointment (Dec, 08): $528.00
2. Pregnancy Blood Tests (Dec, 08): $320.50
3. 2nd Doctor Appointment (Jan, 09): $528.00
4. 3rd Doctor Appointment (Feb, 09): $528.00
5. A surprise bill from Quest Diag. (Feb, 09): PENDING (Still!)
6. Ultrasound ? It?s A Boy! (Feb, 09): $804.64
7. 4th Doctor Appointment (March, 09): $528.00

1. More blood work (March, 09): $37.00
2. 5th Doctor Appointment (April, 09): $528.00

10. Ultrasound again (April, 09): $763.00

11. 6th Doctor Appointment (end of April, 09): $528.00

12. Bloodwork for Glucose test (April, 09): $48.00

13. Lab for possible UTI (May, 09) : $22.00

14. $%#@! Hospital stay for vaginal delivery (May, 09): $3,300.00

15. Epidural for vaginal delivery (May, 09): $1,200.00

16. Tylenol for Tarzan to deal with the above: $2.25

17. Circumcision paid upfront (May, 09): $250.00

18. Cost for another Dr. to read April Ultrasound (June, 09): $171.50

19. Blood tests (again! July, 09): $59.00

20. Blood tests @ hospital (July, 09): $34.40

21. Doctor bill @ hospital (July, 09): $242.00

22. Blood tests @ hospital (July, 09): 98.80

The Total Cost To Have A Baby Without
Maternity Insurance : $10,521.09

Makes you grateful for the NHS that bit more!