03 Nov 13
Originally posted by whodeyWhat bothers me tremendously is the unwillingness of self-styled liberals to hold Obama accountable for anything. Obama remains friends with an avowed and unapologetic terrorist. Obama, because of his drug history, could not join the military he disdains and now leads. Michelle's comment that her husband's election was the first time she's ever been proud of her country. Obama's complete incompetence at governance, which, after all, should have been perfectly predictable, given his breathtakingly thin résumé.
You have to understand that pretty much all of Obama's supporters favor crashing a system that they see as fundamentally corrupt. The free market is the devil and they are out to slay that devil under any cost.
It's begun to turn over Obamacare. NBC and CBS are finally reporting - the six day one signups, the act that Obama knew 93 million people would lose their health coverage and his lies to the American people. Hopefully the media will continue to begin doing their jobs. Obama must be praying for a natural disaster right now.
03 Nov 13
Originally posted by KazetNagorraI do not disagree with your points, but, what most people do not realize, and you have minimized in your first statement, is that liability lawsuits have had a major effect on cost due to the insurance premiums paid by all manufacturers of medical equipment. Many of the items used today are inexpensive when in their component form, yet when put together and used for a medical purpose, the cost of purchase is many times higher than the value of the item. And, government rules requiring regular servicing and calibration increase the cost of using the item even more. Every item, whether a pair of scissors or an MRI device, suffers this cost inflation. Overall, this alone increases the cost of medicine by billions of $ per year. And, doctors these days are so fearful of suits of the category "failure to diagnose", that they routinely overtest every presenting complaint. A diffuse abdominal pain requires a CT and Ultrasound, rather than simply being recognized as Dr Leonard McCoy's "acute postprandial discomfort". Certainly, CT's are used to generate income for the hospital, as they have become a routine part of an ER visit. 60 Minutes had a great look at one hospital system (Kaiser) last year, where the doctors were rated by administration on how many expensive tests were ordered and how many admissions were generated. But, overall, our quality of heath care is no better than it was 50 years ago when MD's practiced "by the seat of their pants". Nor, do most physicians even know how to practice sans all these overpriced devices anymore. Insurance costs also add to the price of drugs. But, the drug manufacturers are most of the problem, releasing drugs that are unsafe, (and getting them by the FDA much too easily, but that is another story), and keeping Congress from restricting drug advertising, as Canada has done. Did you know that 33% of the retail price of prescription drugs is the added-on advertising costs, passed directly to consumers? And that Big Pharma uses their financial clout to keep Congress from passing the law that Canada has, because they WANT the TV networks to be reliant on their advertising dollars as a lever in order to keep any adverse info about their products from the public?
Medically related lawsuits, while certainly wasteful, only contribute to a small part of US health care costs. Most of the costs are related to inefficiencies in the way the market is organized, overtreatment due to financial incentives to prescribe drugs and treatment, poor preventive care due to financial incentives not to give any and another major f ...[text shortened]... is quite straightforward to slash costs in half by copying a more efficient health care system.
So many factors involved. So much corruption and greed, that I cannot see any part of the health care system ever improving. Obamacare is created by and for the wealthy corporations, and will only benefit them. Just as the Medicare drug "benefit" only benefits Big Pharma, by allowing them to raise their prices, so will Obamacare do the same for all medical care. Yet, the quality of care will suffer.
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03 Nov 13
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Originally posted by DanTriolaA small nit, only being mentioned because of the strong anti-government bias of many here.
I do not disagree with your points, but, what most people do not realize, and you have minimized in your first statement, is that liability lawsuits have had a major effect on cost due to the insurance premiums paid by all manufacturers of medical equipment. Many of the items used today are inexpensive when in their component form, yet when put together an ...[text shortened]... rices, so will Obamacare do the same for all medical care. Yet, the quality of care will suffer.
"And, government rules requiring regular servicing and calibration increase the cost of using the item even more."
Intrinsic to the design and use of any measurement device is a procedure that assures that it is working correctly and reporting accurately. Service and calibration do not occur only because we have government. In fact, the FDA device GMPs have moved away from testing for compliance with specifications, and toward process and computerized systems validation, which builds assurances into the design and manufacture of the product.
I directed a corporate group that audited our manufacturing operations, including both drugs and devices, against our corporate standards, which were more detailed and strict than government standards. This is because the FDA sees itself as one of several mechanisms of control, among the others are product reputation and tort law, even criminal law remedies such as RICO laws. So the industry does its best to minimize FDA regulation and then, realistically, turns around and applies stricter controls to avoid facing those other mechanisms of control.
04 Nov 13
Originally posted by JS357Again, I do not argue your nit.
A small nit, only being mentioned because of the strong anti-government bias of many here.
... So the industry does its best to minimize FDA regulation and then, realistically, turns around and applies stricter controls to avoid facing those other mechanisms of control.
I know that last statement only too well, having made that point on numerous occasions myself. Mostly in re-assuring my wife that: even though the medication is past its expiration date, it is still good! Every standard has a built in "fudge factor". Mostly applied by the company's legal department, in order to say: "We even set the bar higher." in case of a suit.
It applies to every warning put by the FDA in the PDR as well. I suspect it is always a multiple of the real data, not a %age. But, nonetheless, speaking from a background in analytical chemistry, I understand calibration, and yet, it does add to the overall cost. More significant in cost is the drive to constantly upgrade equipment. As encouraged by the Federal tax codes on depreciation. Or perhaps, that tendency arises from the innate planned obsolescence that all products are now designed with!
After all, I am old enough to remember re-usable hypodermic needles! Now, most of the surgical equipment used is all disposable. Plastics! Except for drapes and towels. Paper. They used to be cloth, but economics dictate a reduction in human labor, so now, no laundries. But the contaminated waste disposal business is burgeoning. And expensive for the client. All factors in medical costs rising. The truckloads of disposable gloves alone probably add a billion/year. All due to AIDS, and hepatitis. Which is all from IV drug use. And, who is really responsible for the almost exponential increase in drug use?
That's another story.
(I do tend to digress.)
Anyway, I am curious. In what business are you?
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04 Nov 13
Originally posted by DanTriolaI am retired from the health care industry.
Again, I do not argue your nit.
I know that last statement only too well, having made that point on numerous occasions myself. Mostly in re-assuring my wife that: even though the medication is past its expiration date, it is still good! Every standard has a built in "fudge factor". Mostly applied by the company's legal department, in order to say: "We eve ...[text shortened]... hat's another story.
(I do tend to digress.)
Anyway, I am curious. In what business are you?
Some of our early products were marketed, in part, on the basis of their long shelf life. Retain samples were taken of every batch. We tested retain samples on a schedule throughout their lifetime (not every batch, but if a problem were detected, neighboring batch retains would be tested.) We actually shortened the expiration date of rock-solid drugs only to save on having to test for so long. So you are right. Store in cool darkness, they are OK.
04 Nov 13
Originally posted by JS357The problem is that nits are real, and a billion here and a million there, pretty soon you're talking about real money. Doctors practicing defensive medicine. Cost of devise remaining high beyond the normal time of recouping R&D by amortization.
I am retired from the health care industry.
Some of our early products were marketed, in part, on the basis of their long shelf life. Retain samples were taken of every batch. We tested retain samples on a schedule throughout their lifetime (not every batch, but if a problem were detected, neighboring batch retains would be tested.) We actually shortened th ...[text shortened]... ly to save on having to test for so long. So you are right. Store in cool darkness, they are OK.
In sectors which are highly regulated like education and medicine. technical progress doesn't tend to reduce cost and spread benefits the way it happens in other high tech sectors. Much of the reason is the regulation and the subsidies. The subsidies reach the industry, but not the consumer.
Industrial MRIs don't have the regulations and subsidies of the medical ones. The cost of the medical technology remains high, while the same technology in industry, moves in a more unaffected curve.
04 Nov 13
Originally posted by normbenignExactly. 3D TV's? Wait a few years. They will be a lot cheaper. MRI's? Next model will cost twice as much.
The problem is that nits are real, and a billion here and a million there, pretty soon you're talking about real money. ... The cost of the medical technology remains high, while the same technology in industry, moves in a more unaffected curve.
I used NMR analysis in college chemistry. As I remember, the machine cost the department ~ $20k, in 60's money. My car cost $1300 (Corvair)
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04 Nov 13
Originally posted by normbenignI can't speak to gov't subsidies on MRIs.
The problem is that nits are real, and a billion here and a million there, pretty soon you're talking about real money. Doctors practicing defensive medicine. Cost of devise remaining high beyond the normal time of recouping R&D by amortization.
In sectors which are highly regulated like education and medicine. technical progress doesn't tend to re ...[text shortened]... echnology remains high, while the same technology in industry, moves in a more unaffected curve.
My main point was that drug/device companies control their product efficacy/safety/quality, more than the FDA requires, due to two other factors: company/product reputation, and tort/criminal liability.
But we are far afield from Obamacare glitches. I can cede that point.