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Coveny
New Member

USA
8 Posts

Posted - 10/06/2017 :  13:18:25  Show Profile  Visit Coveny's Homepage Send Coveny a Private Message  Reply with Quote
This is going to be a fairly long post about what I believe is the solution to health care in America. I’m going to touch on the scientific reasons, the economic reasons, and also discuss the emotion impact. I’m going to try and give goals for each of my positions, as well as explanations on how this position is going to achieve that goal. As a for the record thing I’m not getting anyone to review this before posting it so it likely will have spelling and grammar errors, and may not be as organized as it should be, and while you are welcome to criticize those parts my hope is that you will look past them and discuss the various points and how valid you feel like they are.

The problem
Our current system is too costly because of regulations which prevent small at home type hospitals from operating, as well as the lawsuits against medical personal. These regulations also prevent new drugs from being brought into market, and increase the time and costs involved to bring the drug to market. On the flip side the patents or copy rights to drugs keep drug prices very high in this country because once a drug is created only that company can legally produce it for many many years. This is all designed through corruption of our state and federal government to benefit the few at the cost of the many.

Universal healthcare cuts back much of company’s corruption, lowers medical and drug costs. It is not without its problems though as it removes much of the incentive to become a doctor, which leads to less doctors, longer wait times, or patients not qualifying for needed treatments. This again remove options of the poor to get healthcare.

The goal
To create a system where everyone can get healthcare, provide an incentive for people to become medical professionals, and lower healthcare costs.

The solution
1) Deregulate medical buildings
2) Lower patent and copy right terms
3) Making being a medical personal easier
4) Regulate the amounts of lawsuits
5) Bringing it all together

1) Deregulate medical buildings
Did you know that in an abortion clinic it’s required to have hallways big enough to fit two gurneys side by side? Did you also know that they don’t use gurneys in an abortion clinic? The point being there are many laws in place that regulate what a medical building must have, and these laws double if not triple the cost require to build these facilities. By removing these regulations, we could have doctors who saw patients out of their homes completely removing the overhead costs of having a hospital at all. Obviously, this opens concerns about infection and hygiene but if we want to lower costs and allow more people to make money in the medical profession we need to be able to treat it like any other profession. If you want to pay the extra money for a nice that is always an option, but for the poor this gives them other options to get the treatment they need. And as with everything else, as the demand in the hospitals drops, the cost of going to the nicer facilities will drop as well. This is what capitalism excels at. Once we’ve done that we can setup classification of facilities by standards.

2) Lower patent and copy right terms
Many drugs are patented and copy righted for life, and they have a monopoly on the market so they can charge through the roof. Other companies have to wait years before they are able to make generic versions of the drugs. Companies spend a LOT more on marketing than they do on research. The government is doing most of the research. “75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding” source: http://www.latimes.com/opinion/op-ed/la-oe-1027-mazzucato-big-pharma-prices-20151027-story.html
Government pay for the research (as with the case of the epi-pen) and then private company buy the patient, regulated all the schools to use it, and then increased the price by 5000%. We need to break the patent/copy right monopoly sooner, and force drug companies to invest into research rather than milking what’s already been created.

3) Making being a medical personal easier
One of the best ways to lower the cost of something is to have a better supply. Currently to be a doctor you need over a decade of school, from which you will exit with a mountain of debt, and there are no half measures here. The closest being a nurse practitioner who is still over a decade in the making. Also let’s be clear, medical malpractice is the 3rd cause of death in this country (at over 200 thousand a year) so it’s not like the people who go through all those classes are providing. So, let’s make it easier to break into the medical profession. Let create tiers like what we do with emergency personal. EMT is the first, paramedic is the second, ER nurse is the third, doctor is the fourth. My suggestion is to have 5 tiers for both general and surgery. The higher the tier the more schooling that’s required, and obviously testing and certification for each of level. I purpose to do the tiers in two year increments so Tier 1 = two-year degree, Tier 2 = four-year degree, Tier 3 = six-year degree, Tier 4 = eight-year degree, and Tier 5 is what we have today. Now this could mean 75% in class and 25% on the job, or whatever the industry feels is best, but the amount of time it takes to get to the point where you can see someone needs to be shortened. Also, the ability to prescribe drugs would be attached to the various levels as well.

4) Regulate the amounts of lawsuits
If we put tiers in place then there needs to be an understanding that the less you spend on a doctor the less you can sue them. This could be regulated based on the tier of the individual who saw you or the amount of money you spent to receive care. For instance, if you saw a tier 1 then you couldn’t sue him for more than 10k, tier 2 30k, tier 3 100k, tier 4 200k, and tier 5 unlimited, or it could be something like 100 times what you spent so that if you had a $20 doctor visit then the most you could sue that doctor for would be $2,000, but if you spent $300 then you could sue for 30k. Accidents are going to happen, and if you want to take a higher risk to save money then the person trying to provide you care needs to have the incentive that one mistake isn’t going to bankrupt him.

5) Bringing it all together
Once we have a system in place where medical care is much cheaper and more available we can cheaply subsidize it. For instance, it wouldn’t be expensive to cover 100% the cost for tier 1 medical professions in a tier 1 building, 80% for 2/2, 60% for 3/3, 40% for 4/4, and nothing for 5/5. Insurance companies could easily adapt to this system, and allow for MUCH more flexibility in healthcare plans that cover the difference, and work on top. Making it affordable to even see tier 3 medical professionals. Doctors have the freedom to build their own practices without having to worry about the regulations of the facilities, and our society would likely even have doctor house calls again. If we can stop trying to remove risk, and stop trying to force people to work for less I think we can easily provide healthcare for everyone.

Developing ForDebating.com that I hope to populate with intelligent critical thinkers. You can follow updates at https://www.facebook.com/fordebating

Dave W.
Info Junkie

USA
25909 Posts

Posted - 10/06/2017 :  21:35:29   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Coveny

1) Deregulate medical buildings
Did you know that in an abortion clinic it’s required to have hallways big enough to fit two gurneys side by side?
No, I did not know that. Perhaps you could cite a source (say, the US Code) that will show this is true.

The point being there are many laws in place that regulate what a medical building must have, and these laws double if not triple the cost require to build these facilities. By removing these regulations, we could have doctors who saw patients out of their homes completely removing the overhead costs of having a hospital at all. Obviously, this opens concerns about infection and hygiene but if we want to lower costs and allow more people to make money in the medical profession we need to be able to treat it like any other profession. If you want to pay the extra money for a nice that is always an option, but for the poor this gives them other options to get the treatment they need.
Apply this logic to any other highly regulated profession. Imagine if you could pay less for a plumber who uses filthy, junkyard pipe to repair your mains? You'd just wind up paying more later to have all of your pipes replaced, on top of the healthcare you'd require to cure the diseases the plumber introduced to your home.

Or maybe you choose a "tier 1" electrician to add a whole new (and complex) circuit for your basement entertainment system. Then you wind up paying out the wazoo later when your home burns down due to the electrical fire.

And as with everything else, as the demand in the hospitals drops, the cost of going to the nicer facilities will drop as well. This is what capitalism excels at.
No, health care is not amenable to market forces. Nobody "shops around" when they are having an emergent crisis like a heart attack. The EMTs will take you to the closest facility that can handle your particular problem, regardless of cost. Besides, how long will the conversation with 911 take when they present your spouse with a list of potential ambulance services, rated by cost and Yelp reviews?

Once we’ve done that we can setup classification of facilities by standards.
As an afterthought? That's horrific.

2) Lower patent and copy right terms
Many drugs are patented and copy righted for life...
Citation absolutely necessary for this claim.

Drugs are not copyrighted. Patents last for 20 years. Most drugs require 8-10 years of development after a patent is awarded, leaving 10-12 years of marketable life for a drug company to recoup its investment and make a profit before the generic manufacturers crank out copies for pennies to the dollar. Don't like the idea of a drug company making profits off the sick? Then why did you praise capitalism earlier?

...and they have a monopoly on the market so they can charge through the roof.
Yes, because of the patent. But guess what? The drug companies still need to negotiate with pharmacy insurance companies, and that brings the costs down. The best thing that could be done in this day-and-age is to allow the Federal government to become one of the negotiators. The number of customers the Feds could bring to the table through Medicaid and Medicare swamps every other group policy in the country. Prices would drop across the board.

Other companies have to wait years before they are able to make generic versions of the drugs.
Yes, that's what patents are for. Reduce patent protections, and you'll stifle innovation not just in the healthcare field, but in every field.

Companies spend a LOT more on marketing than they do on research. The government is doing most of the research. “75% of so-called new molecular entities with priority rating (the most innovative drugs) trace their existence to NIH funding” source: http://www.latimes.com/opinion/op-ed/la-oe-1027-mazzucato-big-pharma-prices-20151027-story.html
Yes, but do the math. $900 billion over 80 years is a measly $11.25 billion/year, spread out over how many thousands of goverment grants? That's what that story didn't mention: that those NIH grants usually go to universities doing basic research, most of which does not provide useful medications later on. Most of the basic research is dead-end. So some biology department in some college finds, with a tiny $10K NIH grant plus some of the school's own endowment, that some compound has an interesting biological effect on something-or-other. A drug company finds out, and says, "we'll pay you to continue this research." The scientists get continued paychecks (good thing), and the school gets its investment back (good thing). If (and it's a big "if") the research "pays off" in that they've discovered a "blockbuster" drug that saves lives, then the NIH has done its job by ensuring that more citizens continue to be taxpayers for longer.

By the way, I've seen bad anti-big-pharma statistics before, but this really takes the cake. Besides missing the fact that a company (any company) that spends more on R&D than on marketing is generally not going to last very long (my plumber spends $0 on R&D, and much more than that on local advertising, and I wouldn't have it any other way), Johnson & Johnson does the vast majority of its business in over-the-counter products like Band-Aid, Benadryl, Bengay, Cortaid, Desitin, EPT, Efferdent, Imodium, K-Y, Lactaid, Listerine, Luden's, Motrin, Mylanta, Neosporin, Neutrogena, Pediacare, Pepcid, Rembrandt, Rolaids, Splenda, Stayfree, Sufafed, Tucks, and Visine, none of which enjoy patent protection.

Government pay for the research (as with the case of the epi-pen) and then private company buy the patient, regulated all the schools to use it, and then increased the price by 5000%. We need to break the patent/copy right monopoly sooner, and force drug companies to invest into research rather than milking what’s already been created.
Many citations required. The law that Mylan helped craft doesn't say that EpiPens are required in schools, only that school personnel couldn't be sued for using them (Mylan even dropped the prices for schools). They didn't increase the price 5000%, but 500%, and consumers were pretty quick to react negatively to that. Mylan continues to develop the product, and so continues to get new patents for new products (the original EpiPen's patent ran out 20 years ago).

Of course, what's bizarre about this entire anti-capitalist screed of yours is your prior (see above) praise for how well capitalism works. You can't claim that capitalism is awesome and complain about drug companies being capitalists. Except for the recent price-gouging, everything Mylan has done is bog-standard capitalism at its finest: buy rights to a product, build market share, rigorously defend rights against competitors, research and develop new similar products, market the hell out of them, defend those new products against competitors, lobby the government to protect the use of product, discount product for the needy to further build market share, etc. This is capitalism 101, but you seem to hate it when it is successful, and praise applications of it that haven't been tried in hundreds of years (deregulation of the medical profession).

And, of course, the idea that "breaking" patents will drive companies to invest in more R&D is a complete reversal of economic reality.

3) Making being a medical personal easier
One word: quacks.

4) Regulate the amounts of lawsuits
You want medical tort reform. Tort reform in general is a perennial concern among many capitalists, since large lawsuits against producers reduces profit margins. The victims, however, don't give a damn about profit margins, because their lives have been damaged or ruined or ended. Some lawsuits are indeed extraordinarily ridiculous (for example, claiming some average Joe's lifetime earnings had the accident not occurred would be in the hundreds of millions of dollars), but that kind of discretion needs to be left to the justice system, and not mandated by law (see your other thread, which you seem to have dropped despite being an advocate of debates).

Medical torts are particularly not amenable to hard, mandated categories, since the practice of medicine involves a ton of judgment calls - turning doctors into script-following robots would be disastrous while there still exist multiple illnesses that present alike except for subtle differences. Medicine is not like the housing market, where builders can defend lawsuits by saying (for example), "the law says we needed to dig down two feet for the foundation, and the independent inspector agrees that we dug down 2.5 feet, so therefore it's not our fault." There do exist standards of practice for medical professionals, but they aren't so cut-and-dried, except in the most obvious of cases (for example, "don't give blood thinners to a patient who is bleeding out").

5) Bringing it all together
Yes, to summarize, you want to:

1) Deregulate medical buildings Make medical care more dangerous in the name of capitalism
2) Lower patent and copy right terms Screw capitalism and by doing so reduce medical innovation
3) Making being a medical personal easier Introduce more quacks to the marketplace
4) Regulate the amounts of lawsuits Screw the victims of those quacks

Are there problems in the field? Yes. As the ancient joke goes, you call the guy who graduated last in his class at medical school "doctor." The solution is not to eliminate the protections we have now, especially since those protections are inadequate when it comes to pre-market drug testing.

Look to Europe and Japan. They have more regulations yet lower health care costs and better results. Oh, wait, you dismissed that before:
Universal healthcare cuts back much of company’s corruption, lowers medical and drug costs. It is not without its problems though as it removes much of the incentive to become a doctor, which leads to less doctors, longer wait times, or patients not qualifying for needed treatments. This again remove options of the poor to get healthcare.
Citations needed for all those claims.

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Coveny
New Member

USA
8 Posts

Posted - 10/07/2017 :  20:33:35   [Permalink]  Show Profile  Visit Coveny's Homepage Send Coveny a Private Message  Reply with Quote
Originally posted by Dave W.

No, I did not know that. Perhaps you could cite a source (say, the US Code) that will show this is true.

http://blog.al.com/wire/2013/04/gov_robert_bentley_signs_bill.html


[Apply this logic to any other highly regulated profession. Imagine if you could pay less for a plumber who uses filthy, junkyard pipe to repair your mains? You'd just wind up paying more later to have all of your pipes replaced, on top of the healthcare you'd require to cure the diseases the plumber introduced to your home.

Or maybe you choose a "tier 1" electrician to add a whole new (and complex) circuit for your basement entertainment system. Then you wind up paying out the wazoo later when your home burns down due to the electrical fire./quote]
There is always going to be risks, and given that medical malpractice is already the 3rd biggest killer, and the US has the most expensive for the least care I don't believe your concerns are valid.



No, health care is not amenable to market forces. Nobody "shops around" when they are having an emergent crisis like a heart attack. The EMTs will take you to the closest facility that can handle your particular problem, regardless of cost. Besides, how long will the conversation with 911 take when they present your spouse with a list of potential ambulance services, rated by cost and Yelp reviews?

You could easily prepare for emergencies in advance and setup care. The refute that it shouldn't be done because it isn't done... isn't valid.


As an afterthought? That's horrific.

I can see you are very emotional about this topic.


Citation absolutely necessary for this claim.

Drugs are not copyrighted. Patents last for 20 years. Most drugs require 8-10 years of development after a patent is awarded, leaving 10-12 years of marketable life for a drug company to recoup its investment and make a profit before the generic manufacturers crank out copies for pennies to the dollar. Don't like the idea of a drug company making profits off the sick? Then why did you praise capitalism earlier?

20 years you say, so the Epipen developed in what the 70s it isn't under patent anymore right? Also you are talking about exclusivity and prevention on generics not the right to the brand name. I have no issues with companies making money, but I want there to be a balance to capitalism as well... as my post has stated.


Yes, because of the patent. But guess what? The drug companies still need to negotiate with pharmacy insurance companies, and that brings the costs down. The best thing that could be done in this day-and-age is to allow the Federal government to become one of the negotiators. The number of customers the Feds could bring to the table through Medicaid and Medicare swamps every other group policy in the country. Prices would drop across the board.

And now you too blame the patents...


Yes, but do the math. $900 billion over 80 years is a measly $11.25 billion/year, spread out over how many thousands of goverment grants? That's what that story didn't mention: that those NIH grants usually go to universities doing basic research, most of which does not provide useful medications later on. Most of the basic research is dead-end. So some biology department in some college finds, with a tiny $10K NIH grant plus some of the school's own endowment, that some compound has an interesting biological effect on something-or-other. A drug company finds out, and says, "we'll pay you to continue this research." The scientists get continued paychecks (good thing), and the school gets its investment back (good thing). If (and it's a big "if") the research "pays off" in that they've discovered a "blockbuster" drug that saves lives, then the NIH has done its job by ensuring that more citizens continue to be taxpayers for longer.

So taxpayers are subsidizing the research, but we aren't making any money off the end product.


By the way, I've seen bad anti-big-pharma statistics before, but this really takes the cake. Besides missing the fact that a company (any company) that spends more on R&D than on marketing is generally not going to last very long (my plumber spends $0 on R&D, and much more than that on local advertising, and I wouldn't have it any other way), Johnson & Johnson does the vast majority of its business in over-the-counter products like Band-Aid, Benadryl, Bengay, Cortaid, Desitin, EPT, Efferdent, Imodium, K-Y, Lactaid, Listerine, Luden's, Motrin, Mylanta, Neosporin, Neutrogena, Pediacare, Pepcid, Rembrandt, Rolaids, Splenda, Stayfree, Sufafed, Tucks, and Visine, none of which enjoy patent protection.

You misunderstand. If they don't spend the money on to research the patent they shouldn't enjoy the spoils of it.

Many citations required. The law that Mylan helped craft doesn't say that EpiPens are required in schools, only that school personnel couldn't be sued for using them (Mylan even dropped the prices for schools). They didn't increase the price 5000%, but 500%, and consumers were pretty quick to react negatively to that. Mylan continues to develop the product, and so continues to get new patents for new products (the original EpiPen's patent ran out 20 years ago).

Of course, what's bizarre about this entire anti-capitalist screed of yours is your prior (see above) praise for how well capitalism works. You can't claim that capitalism is awesome and complain about drug companies being capitalists. Except for the recent price-gouging, everything Mylan has done is bog-standard capitalism at its finest: buy rights to a product, build market share, rigorously defend rights against competitors, research and develop new similar products, market the hell out of them, defend those new products against competitors, lobby the government to protect the use of product, discount product for the needy to further build market share, etc. This is capitalism 101, but you seem to hate it when it is successful, and praise applications of it that haven't been tried in hundreds of years (deregulation of the medical profession).

And, of course, the idea that "breaking" patents will drive companies to invest in more R&D is a complete reversal of economic reality.

Ah so you are familiar with the ways to bypass the 20 patent to make it lifetime. Regulations such as patent and copyright laws are against free market. Wanting to remove them isn't a case of me being against capitalism at all, but I will concede I believe it has as many problems as socialism has.


One word: quacks.

Because 250 thousand people dead a year isn't a quack? https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

You want medical tort reform. Tort reform in general is a perennial concern among many capitalists, since large lawsuits against producers reduces profit margins. The victims, however, don't give a damn about profit margins, because their lives have been damaged or ruined or ended. Some lawsuits are indeed extraordinarily ridiculous (for example, claiming some average Joe's lifetime earnings had the accident not occurred would be in the hundreds of millions of dollars), but that kind of discretion needs to be left to the justice system, and not mandated by law (see your other thread, which you seem to have dropped despite being an advocate of debates).

It needs to? Why? It can be left open at the top end sure, but having it open on the bottom end bankrupts someone who's trying to me a discount medical profession and help others.


Medical torts are particularly not amenable to hard, mandated categories, since the practice of medicine involves a ton of judgment calls - turning doctors into script-following robots would be disastrous while there still exist multiple illnesses that present alike except for subtle differences. Medicine is not like the housing market, where builders can defend lawsuits by saying (for example), "the law says we needed to dig down two feet for the foundation, and the independent inspector agrees that we dug down 2.5 feet, so therefore it's not our fault." There do exist standards of practice for medical professionals, but they aren't so cut-and-dried, except in the most obvious of cases (for example, "don't give blood thinners to a patient who is bleeding out").

It's very easy as I just outlined.

Yes, to summarize, you want to:

1) Deregulate medical buildings Make medical care more dangerous in the name of capitalism
2) Lower patent and copy right terms Screw capitalism and by doing so reduce medical innovation
3) Making being a medical personal easier Introduce more quacks to the marketplace
4) Regulate the amounts of lawsuits Screw the victims of those quacks

And to summarize, you want to
1) Let people die outside of shinny buildings
2) Let companies profit off taxpayer dollars
3) Let people die outside of doctors offices
4) Let the victims die because they couldn't get in at all


Are there problems in the field? Yes. As the ancient joke goes, you call the guy who graduated last in his class at medical school "doctor." The solution is not to eliminate the protections we have now, especially since those protections are inadequate when it comes to pre-market drug testing.

For someone who asks for a lot of citation you sure don't like to use them.


Look to Europe and Japan. They have more regulations yet lower health care costs and better results. Oh, wait, you dismissed that before:[quote]Universal healthcare cuts back much of company’s corruption, lowers medical and drug costs. It is not without its problems though as it removes much of the incentive to become a doctor, which leads to less doctors, longer wait times, or patients not qualifying for needed treatments. This again remove options of the poor to get healthcare.Citations needed for all those claims.

Again no citations, but most universal type health care system I've looked into has major problems on incentivizing doctors and patents getting healthcare, or getting timely health care.

Developing ForDebating.com that I hope to populate with intelligent critical thinkers. You can follow updates at https://www.facebook.com/fordebating
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Dave W.
Info Junkie

USA
25909 Posts

Posted - 10/08/2017 :  00:48:22   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Coveny

http://blog.al.com/wire/2013/04/gov_robert_bentley_signs_bill.html
So one state has the gurney rule. Why did you say it in your OP as if it were policy across the nation?

There is always going to be risks, and given that medical malpractice is already the 3rd biggest killer, and the US has the most expensive for the least care I don't believe your concerns are valid.
There will always be risks, so we shouldn't demand that the risks be lower? I strongly disagree.

By the way, do you also advocate for the repeal of seat-belt laws? Driving will always have risks, after all. Shouldn't someone be allowed to buy a cheaper ("tier 1"?) car without seat belts and airbags and the like? (Should that someone be required to inform their passengers that safety equipment is not present before they get in the car?)

You could easily prepare for emergencies in advance and setup care. The refute that it shouldn't be done because it isn't done... isn't valid.
No, you can't "easily prepare" for these things. There are hundreds, if not thousands, of possible different emergency-care scenarios, and you'd need to specify a hospital (or even a particular doctor) for each. And that's all you'd be doing, since doctors move around and prices change as market forces work on them, so you'd be needing to constantly update your preferences (and backups, if your primary choice isn't available at the particular time you have a problem). And this doesn't even address the fact that most people are medically ignorant, and so would need a substantial medical education before being able to make informed decisions about which services to select for which conditions.

Do you know what level of care and from what facility you would want to get for a haital hernia? How about a transient ischemic attack? How about paronychia? How much of your spare time are you willing to spend to map it all out in some sort of standard document that the EMTs can read quickly? How much of an increase in taxes are you willing to subject yourself to for the creation of that Federal document and the instructions you will use to fill it out (because we can't have people living close to a city, county or state border getting screwed because "foreign" EMTs couldn't figure out their medical directives when all their local EMTs were busy with a mass casualty event) and maintained electronically (because nobody wants your handwriting to get in the way of the treatment of your heart attack) securely (because nobody wants another Equifax)?

It's not that it shouldn't be done because it isn't done - it's that it shouldn't be done, period. It's impractical for an average citizen to create advance health care directives for any/every possible situation. Even current advance directives tend to be pretty simple. "My wife gets to make my medical decisions if I am incapable," for example. And/or, "don't use 'heroic' measures to keep me alive." But even such simple directives are legal documents that cost actual money to produce, and there's little reason to think that they wouldn't be in your ideal America, so you're saying that poor people don't deserve such advanced preparations.

As an afterthought? That's horrific.
I can see you are very emotional about this topic.
Yes, people's lives are on the line, and you're advocating for more of them to die. Why shouldn't I be emotional about it? You're clearly emotional, as well. Is this an "okay for me, but not for thee" situation?

20 years you say, so the Epipen developed in what the 70s it isn't under patent anymore right?
Couldn't keep reading before answering, huh? The original EpiPen is most assuredly not under patent protection any longer. Guess what? It's been improved. If you want the old, less reliable technology, nobody can stop you from using it.

Also you are talking about exclusivity and prevention on generics not the right to the brand name.
I'm having trouble parsing this statement. Why should anyone have any rights to anyone else's brand name? Did you get copyrights and trademarks mixed up in your OP?

I have no issues with companies making money, but I want there to be a balance to capitalism as well... as my post has stated.
Where did you state that?

And now you too blame the patents...
Are you kidding me? I clearly stated that the current system has problems. Patents drive up the cost to consumers in general (not just in medicine), and collective bargaining drives the costs down (ditto). This is economics 101. If all medical research were 100% government funded, there'd be no need for medical patents, and nobody would make a profit from the resultant drugs. Wouldn't that be awesome?

So taxpayers are subsidizing the research, but we aren't making any money off the end product.
Taxpayers aren't spending multiple millions of dollars on any single particular drug to get it ready to market, the drug companies are. And an increase in the tax base (by saving lives) will reduce the deficit, which is about the only way that the taxpayers can get recompensed these days.

You misunderstand. If they don't spend the money on to research the patent they shouldn't enjoy the spoils of it.
No, you don't understand. The marketing-to-R&D ratios in the article from which you got your information are meaningless if they include marketing on products that don't enjoy patent protection, like the ones I listed for you, which said article must have done, since drug companies don't break down their marketing budgets on a product-by-product basis in their annual reports.

Plus, the big biotech companies patent the drugs before they enter the multi-million-dollar clinical trials required to get FDA approval. They do so because applying to start such trials requires them to disclose what they are doing, publicly. Do you need a primer on the drug development process? NIH grants go to step 1 and some step 2 stuff. Step 3 is the most expensive step, and requires disclosure, and so requires patent protection.

Ah so you are familiar with the ways to bypass the 20 patent to make it lifetime.
No, it doesn't "bypass" anything. As above: if you want to try to market 40-year-old technologies, you are free to do so. Nobody can force you to not make EpiPens as they were built in the '80s, nor can they stop you from trying to get consumers to buy them. You'd have to do so under a different name (since "EpiPen" is surely trademarked, and trademarks can last forever), but the name doesn't matter, it's the results that count, right?

Regulations such as patent and copyright laws are against free market.
Yes, and we're better for them. The free market is a hypothetical entity that doesn't actually exist, and even if it did, it could not possibly be the solution to all our woes, especially our medical woes. It is far too easy to be a bad actor that kills people slowly in the medical field that the idea of a "free" medical market is utterly ludicrous. For example, if you want to fleece cancer victims, just tell them they need vitamin B-17 and they'll give you money and then later die from their cancer or by poisoning themselves with apricot pits, but there will be so much time between their payment to you and their death that their survivors will have a hard time proving in court that you were responsible. Cha-ching!

Wanting to remove them isn't a case of me being against capitalism at all...
If you remove patent protection, you remove one of the primary drivers of innovation. So you're not opposed to capitalism, just new stuff?

...but I will concede I believe it has as many problems as socialism has.
I don't think you understand economics very well if you think that those are the only available options.

Because 250 thousand people dead a year isn't a quack?
Errors are not necessarily either malpractice or quakery. These words have particular meanings in this context. So when you said, above, "medical malpractice is the 3rd cause of death in this country," you are factually incorrect. From your link:
The researchers caution that most medical errors aren't due to inherently bad doctors, and that reporting these errors shouldn't be addressed by punishment or legal action. Rather, they say, most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.
Note the use of the word "most". Here's the definition of malpractice: "improper, illegal, or negligent professional activity or treatment..." Congress once ran a study in which quacks were "Anyone who promotes medical schemes or remedies known to be false, or which are unproven, for a profit." Neither definition covers what your own citation says causes "most" medical errors. Therefore, 200+ thousand people a year do not die from "malpractice" or from "quacks". They die from errors, as your own reference states.

It needs to? Why? It can be left open at the top end sure, but having it open on the bottom end bankrupts someone who's trying to me a discount medical profession and help others.
It won't bankrupt you if you get a "tier 1" lawyer to help for cheap, right? Right?!

Seriously, see my post in this thread (that you dropped) for a high-level overview of why judicial discretion is necessary. At any level.

And if you want to provide discounted (or even free) medical care, you can do so within the field as it currently exists, just follow these steps:
  • 1 - Become so rich that you don't need to work
  • 2 - Go to medical school, nursing school or EMT training
  • 3 - Graduate
  • 4 - Provide free or discounted medical care, using the money you generated in step 1
Easy peasy.

It's very easy as I just outlined.
Nobody is ever going to implement your "tiered" doctoring system, for the reasons I've already explained, so your tort reform ideas will have to play in the market as it exists.

And to summarize, you want to
1) Let people die outside of shinny buildings
Wow, you seem pretty emotional about this issue. No, you haven't asked me what I would do to reform the system, nor have I offered much in the way of hints. I've primarily explained why your ideas will make things worse than they already are. Are you sure you should be starting a debating web site when you're attacking straw men like this?

Of course, I shouldn't have to note (but I will) that Federal law as it stands requires that hospitals provide emergency care regardless of the ability of the patient to repay the costs. So no, people don't "die outside of shiny buildings." That's just emotional hyperbole.

2) Let companies profit off taxpayer dollars
So I take it that you think all government contracts should be not-for-profit? I agree that the profiteering of the companies that provide military hardware can be a bit extreme. But how about the individual workers for those contracting companies? How will you explain to them that they aren't allowed to profit from working for the government? What will that do to their paychecks?

3) Let people die outside of doctors offices
4) Let the victims die because they couldn't get in at all
See the point about how telling you that you are wrong isn't the same thing as advocating for the status quo.

For someone who asks for a lot of citation you sure don't like to use them.
In my prior post, where did I make a claim that required a citation? Do you really need a citation for the fact that drugs do not enjoy copyright protection? Maybe you do. You apparently required citations for terms like "malpractice" and "quack," and seem to lack some basic knowledge of economics, so maybe you really do require the most fundamental facts of these fields to be explained to you. Perhaps you shouldn't be advocating for sweeping changes to the single largest sector of our economy without learning at least the bare minimum needed to make a sound argument?

Some have argued that your good intentions should be ignored if the results of your advocacy turn out to be harmful. I would suggest that offering advice while demonstrating ignorance of basic facts is grounds for ignoring intent altogether.

Again no citations...
Yes, I asked you for citations for your claims, but you only provided a single link, and it didn't even support the claim you made.

...but most universal type health care system I've looked into has major problems on incentivizing doctors and patents getting healthcare, or getting timely health care.
Citations still required.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
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ThorGoLucky
Snuggle Wolf

USA
1414 Posts

Posted - 10/09/2017 :  13:27:18   [Permalink]  Show Profile  Visit ThorGoLucky's Homepage Send ThorGoLucky a Private Message  Reply with Quote
The gurney rule was a disingenuous restriction against women and their constitutional right to not be forced to give birth against their will.
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Dave W.
Info Junkie

USA
25909 Posts

Posted - 10/09/2017 :  20:01:50   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by ThorGoLucky

The gurney rule was a disingenuous restriction against women and their constitutional right to not be forced to give birth against their will.
All abortion restrictions seek to punish women for having sex. How do we know this? Because along with trying to outlaw abortion, they also won't do anything to make contraception cheaper or more convenient. But cheap, easy contraception would reduce the need for abortion drastically.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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