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Thread: Does Drug Development Require Profit?

  1. Top | #21
    Cyborg with a Tiara
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    I don’t think we need to close down all drug companies, just advocating to make the budget include a government funded lab as a player in the game.

  2. Top | #22
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    Quote Originally Posted by untermensche View Post
    Quote Originally Posted by Loren Pechtel View Post

    The left loves to claim this, but there are multiple factors involved:

    1) No sales costs.
    A plus. Also no money taken out called profit
    The point is that it's not a fair comparison.

    2) Bill payment is outsourced to the IRS and thus not on the books.
    A plus.
    You work for Enron???

    3) They force facilities to accept lower reimbursements.
    A plus.
    It results in more and more doctors completely refusing to deal with Medicare. It's gotten bad enough we have a hospital chain here that got sufficiently fed up with it that they decided they are better off not going along--even though that means that if they end up with a Medicare patient they simply write it off.

    4) And despite this they clearly aren't doing it the cheapest--observe the medicare advantage plans. That's private industry providing medicare for less than the government can.
    Medicare replacement plans are not Medicare.

    Allowing the replacement plans makes Medicare worse. I agree.
    The point is that the Medicare Advantage plans are offering a service which many find superior and they're doing it cheaper. Thinking they shouldn't exist doesn't change this.

  3. Top | #23
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    Quote Originally Posted by Rhea View Post
    Quote Originally Posted by Loren Pechtel View Post
    4) And despite this they clearly aren't doing it the cheapest--observe the medicare advantage plans. That's private industry providing medicare for less than the government can.
    I don’t think that is accurate.

    Advantage plans are a plan to get extra benefits, and the Medicare program pays Medicare Advantage insurers a monthly fee per enrollee to cover the cost of carrying their beneficiaries.

    Medicare advantage is an add-on upgrade made necessary by the Republican sandbagging of the Medicare system.
    Many such plans have a $0 premium. Thus they're doing basically the same thing as the government--but they're offering extras. That means they're doing it cheaper than the government.

  4. Top | #24
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    Quote Originally Posted by Rhea View Post
    I don’t think we need to close down all drug companies, just advocating to make the budget include a government funded lab as a player in the game.
    I'd have no problem with that. In fact, I think it would be a good idea to have a government lab that works on the stuff that is of value but not so profitable. (For example, new antibiotics.)

  5. Top | #25
    Loony Running The Asylum ZiprHead's Avatar
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    Quote Originally Posted by Loren Pechtel View Post

    The point is that it's not a fair comparison.

    2) Bill payment is outsourced to the IRS and thus not on the books.
    A plus.
    You work for Enron???
    Is the IRS not the collections agent for the US government? How much do you think it costs to have a programmer create code to automatically send the Medicare portion of the tax collection to the Medicare budget account? You always bring up your programming experience so, c'mon, tell us how much that would cost, especially in comparison to private insurance plans?
    When conservatives realize they cannot win democratically, they will not abandon conservatism. They will abandon democracy.

    Poverty exists not because we cannot feed the poor but because we can't satisfy the rich.

  6. Top | #26
    Loony Running The Asylum ZiprHead's Avatar
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    Quote Originally Posted by Loren Pechtel View Post
    Quote Originally Posted by Rhea View Post
    Quote Originally Posted by Loren Pechtel View Post
    4) And despite this they clearly aren't doing it the cheapest--observe the medicare advantage plans. That's private industry providing medicare for less than the government can.
    I don’t think that is accurate.

    Advantage plans are a plan to get extra benefits, and the Medicare program pays Medicare Advantage insurers a monthly fee per enrollee to cover the cost of carrying their beneficiaries.

    Medicare advantage is an add-on upgrade made necessary by the Republican sandbagging of the Medicare system.
    Many such plans have a $0 premium. Thus they're doing basically the same thing as the government--but they're offering extras. That means they're doing it cheaper than the government.
    Still, while many offer $0 premiums, the devil is in the details. You will find that most have unexpected out-of-pocket expenses when you get sick, and what they pay can differ depending upon your overall health.2 Here's a look at some of the disadvantages of Medicare Advantage Plans.

    KEY TAKEAWAYS
    A Medicare Advantage (MA) Plan, known as Medicare Part C, provides Part A and B benefits, and sometimes Part D (prescription) and other benefits.1
    All Medicare Advantage providers must accept Medicare-eligible enrollees.3
    Sick participants may find that medical care costs skyrocket under a Medicare Advantage plan due to copayments and out-of-pocket expenses.2
    Medicare Advantage customers can switch back to Original Medicare during an annual enrollment period.3
    Prospective Medicare Advantage customers should research plans, copays, out-of-pocket costs, and eligible providers.
    Disadvantages of Medicare Advantage Plans
    In general, Medicare Advantage Plans do not offer the same level of choice as a Medicare plus Medigap combination. Most plans require you to go to their network of doctors and health providers.1 Since Medicare Advantage Plans can’t pick their customers (they must accept any Medicare-eligible participant), they discourage people who are sick by the way they structure their copays and deductibles.

    Author Wendell Potter explains how many Medicare Advantage enrollees don’t find out about the limitations of their Medicare Advantage plans until they get sick:

    “Although Mom saw her MA premiums increase significantly over the years, she didn’t have any real motivation to disenroll until after she broke her hip and required skilled care in a nursing facility. After a few days, the nursing home administrator told her that if she stayed there, she would have to pay for everything out of her own pocket. Why? Because a utilization review nurse at her MA plan, who had never seen or examined her, decided that the care she was receiving was no longer ‘medically necessary.’ Because there are no commonly used criteria as to what constitutes medical necessity, insurers have wide discretion in determining what they will pay for and when they will stop paying for services like skilled nursing care by decreeing it ‘custodial.’”
    https://www.investopedia.com/article...tage-plans.asp
    When conservatives realize they cannot win democratically, they will not abandon conservatism. They will abandon democracy.

    Poverty exists not because we cannot feed the poor but because we can't satisfy the rich.

  7. Top | #27
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    Quote Originally Posted by ZiprHead View Post
    Quote Originally Posted by Loren Pechtel View Post

    The point is that it's not a fair comparison.



    You work for Enron???
    Is the IRS not the collections agent for the US government? How much do you think it costs to have a programmer create code to automatically send the Medicare portion of the tax collection to the Medicare budget account? You always bring up your programming experience so, c'mon, tell us how much that would cost, especially in comparison to private insurance plans?
    You utterly missed the point.

    Of course what you describe is trivial. What's not trivial is getting the money in in the first place. My point about Enron was keeping costs off the books, which is what you're trying to do here.

  8. Top | #28
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    Quote Originally Posted by ZiprHead View Post
    Quote Originally Posted by Loren Pechtel View Post

    Many such plans have a $0 premium. Thus they're doing basically the same thing as the government--but they're offering extras. That means they're doing it cheaper than the government.
    Still, while many offer $0 premiums, the devil is in the details. You will find that most have unexpected out-of-pocket expenses when you get sick, and what they pay can differ depending upon your overall health.2 Here's a look at some of the disadvantages of Medicare Advantage Plans.

    KEY TAKEAWAYS
    A Medicare Advantage (MA) Plan, known as Medicare Part C, provides Part A and B benefits, and sometimes Part D (prescription) and other benefits.1
    All Medicare Advantage providers must accept Medicare-eligible enrollees.3
    Sick participants may find that medical care costs skyrocket under a Medicare Advantage plan due to copayments and out-of-pocket expenses.2
    Medicare Advantage customers can switch back to Original Medicare during an annual enrollment period.3
    Prospective Medicare Advantage customers should research plans, copays, out-of-pocket costs, and eligible providers.
    Disadvantages of Medicare Advantage Plans
    In general, Medicare Advantage Plans do not offer the same level of choice as a Medicare plus Medigap combination. Most plans require you to go to their network of doctors and health providers.1 Since Medicare Advantage Plans can’t pick their customers (they must accept any Medicare-eligible participant), they discourage people who are sick by the way they structure their copays and deductibles.

    Author Wendell Potter explains how many Medicare Advantage enrollees don’t find out about the limitations of their Medicare Advantage plans until they get sick:

    “Although Mom saw her MA premiums increase significantly over the years, she didn’t have any real motivation to disenroll until after she broke her hip and required skilled care in a nursing facility. After a few days, the nursing home administrator told her that if she stayed there, she would have to pay for everything out of her own pocket. Why? Because a utilization review nurse at her MA plan, who had never seen or examined her, decided that the care she was receiving was no longer ‘medically necessary.’ Because there are no commonly used criteria as to what constitutes medical necessity, insurers have wide discretion in determining what they will pay for and when they will stop paying for services like skilled nursing care by decreeing it ‘custodial.’”
    https://www.investopedia.com/article...tage-plans.asp
    You do get limited docs. And you think Medicare itself is very good about paying for cases like you describe??

  9. Top | #29
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    The latest Atlantic has a dismal, frightening article about the drug southernhybrid mentioned.
    Earlier this week, the Food and Drug Administration overruled—to much criticism—its own scientific advisory committee and approved the Alzheimer’s treatment Aduhelm. The agency made this decision despite thin evidence of the drug’s clinical efficacy and despite its serious side effects, including brain swelling and bleeding. As a result, a serious risk now exists that millions of people will be prescribed a drug that does more harm than good.

    Less appreciated is how the drug’s approval could trigger hundreds of billions of dollars of new government spending, all without a vote in Congress or indeed any public debate over the drug’s value. Aduhelm’s manufacturer, Biogen, announced on Monday that it would price the drug at an average of $56,000 a year per patient, a figure that doesn’t include the additional imaging and scans needed to diagnose patients or to monitor them for serious side effects.

    The federal government will bear the brunt of the new spending. The overwhelming majority of people with Alzheimer’s disease are eligible for Medicare, the federally run insurance program for elderly and disabled Americans. If even one-third of the estimated 6 million people with Alzheimer’s in the United States receives the new treatment, health-care spending could swell by $112 billion annually.

    To put that figure in perspective, in 2020, Medicare spent about $90 billion on prescription drugs for 46 million Americans through the Part D program, which covers prescription medication that you pick up at your local pharmacy. We could wind up spending more than that for Aduhelm alone.

    Most of the costs will be borne by taxpayers. But Medicare beneficiaries will take an additional hit. Because Aduhelm is an infusion drug that will be administered in doctors’ offices and clinics, not taken at home, it will be covered by Medicare Part B—not Part D. Under Part B, beneficiaries pay 20 percent of the costs of their care, which, for a single year of Aduhelm treatment, will be at least $11,200. Although most seniors have supplemental plans to cover these out-of-pocket expenses, prices for those plans are sure to spike, whether they’re on Aduhelm or not. That would be quite hard on seniors, many of whom live on fixed incomes.

  10. Top | #30
    Loony Running The Asylum ZiprHead's Avatar
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    Quote Originally Posted by Loren Pechtel View Post
    Quote Originally Posted by ZiprHead View Post
    Quote Originally Posted by Loren Pechtel View Post

    The point is that it's not a fair comparison.



    You work for Enron???
    Is the IRS not the collections agent for the US government? How much do you think it costs to have a programmer create code to automatically send the Medicare portion of the tax collection to the Medicare budget account? You always bring up your programming experience so, c'mon, tell us how much that would cost, especially in comparison to private insurance plans?
    You utterly missed the point.

    Of course what you describe is trivial. What's not trivial is getting the money in in the first place. My point about Enron was keeping costs off the books, which is what you're trying to do here.
    Utter bollocks. The Medicare budget is published yearly. The IRS budget is published yearly. You admit the cost is trivial yet you continue to make a mountain out of this molehill.
    When conservatives realize they cannot win democratically, they will not abandon conservatism. They will abandon democracy.

    Poverty exists not because we cannot feed the poor but because we can't satisfy the rich.

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