|
Your continuous donations keep RPGWatch running!
RPGWatch Forums » General Forums » Politics, Religion & other Controversies » Five Myths About Health Care in the Rest of the World

Default Five Myths About Health Care in the Rest of the World

November 7th, 2013, 20:10
You're not reading it right. The US has 50% of global pharma R&D and similar dominance in device R&D. If you ignore 2nd place Japan (since I'm picking on the holier-than-thou Euros at the moment), the US spends roughly TRIPLE the combination of UK, France, Switzerland, and Germany. That's not a few percentage points. Simply put, they're graciously letting us shoulder the financial burden of biomed R&D and then crowing about how little they spend. I'm not sure how to say it in enlightened-speak, so I'll just try, "Duh!" If you take advantage of things that you don't pay for, your costs will naturally be lower. It's the same game they play with their national defense, crowing about how little they spend on military while enjoying the umbrella supplied by our troops on our dime via NATO agreements.

Not saying that's the whole picture by any stretch (as I mentioned, wolfing hit on another biggie with liability costs), but it's impossible to ignore. Well, unless you've got an agenda…

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#21

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 20:15
Originally Posted by dteowner View Post
Simply put, they're graciously letting us shoulder the financial burden of biomed R&D and then crowing about how little they spend.
Fun fact: it's much easier to get new compounds on the market in Germany than it is in the US.


Glad to be your lab rat and pay for it.

"In Grimwhoah, you can ride on turtles."
Sacred_Path is offline

Sacred_Path

Sacred_Path's Avatar
Basement Horror

#22

Join Date: Nov 2012
Location: Germany
Posts: 918

Default 

November 7th, 2013, 20:26
The U.S. also leads in R&D investment in the medical devices. In the 1990s, it directed an average of 8.3 percent
of its share of sales into R&D.61 In the earlier part of the following decade, R&D expenditures comprised 10 to
13 percent of total sales, compared to about 8 percent in both the EU and Japan.
From your somewhat hard to parse quote… the difference between 10-13 and 8 percent isn't as damning as you are suggesting. US is a much bigger market so the same percentage translates to a lot more absolute bucks. So of course more absolute dollars in R&D is spent in the US. Whether or not that much more actually results in more useful medical advances is what's really important. Size isn't everything ya know.
Last edited by Thrasher; November 7th, 2013 at 20:38.
Thrasher is offline

Thrasher

Thrasher's Avatar
Wheeee!
RPGWatch Donor

#23

Join Date: Aug 2008
Location: Studio City, CA
Posts: 10,108

Default 

November 7th, 2013, 20:30
Originally Posted by Sacred_Path View Post
Fun fact: it's much easier to get new compounds on the market in Germany than it is in the US.


Glad to be your lab rat and pay for it.
And yet, we still spend 5 times what Germany does AND it costs roughly 50% more to do a clinical trial there AND we still do double the clinical trials in the US versus Europe as a whole. If you've got such a strong regulatory advantage, it certainly doesn't show up in the numbers.

By the 1990s, European firms typically held older product lines, while U.S. companies took the lead in producing
wholly innovative “new chemical entities” (NCEs). Germany introduced an average of seven NCEs each year from
1985 to 1989, but that number had fallen to an average of only three per year by 1995-1999. The comparable U.S.
averages for NCEs introduced in those two periods increased from 27 to 34. Germany’s percentage of the global
market dropped from 11.75 percent during 1985-1989 to 3.33 percent in 1995, while the U.S. increased its share
of world sales from 42 percent to 59 percent over the same period.
As of May
2011, the U.S. was far and away the leader in hosting clinical trials, with 54,063 under way. Europe had 27,240
active trials, while Japan had 1,840. Even after normalizing for population, the U.S. held a clear advantage with
174 clinical trials per million residents (Europe had 37 and Japan 15 per million people). In fact, 50.9 percent of
all clinical trials in the world as of this date were being held in the U.S

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#24

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 20:35
Originally Posted by Thrasher View Post
From your somewhat hard to parse quote… the difference between 10-13 and 8 percent is as damning as you are suggesting. US is a much bigger market so the same percentage translates to a lot more absolute bucks. So of course more absolute dollars in R&D is spent in the US. Whether or not that much more actually useful medical advances come out of it, is what's really important. Size isn't everything ya know.
That stat that has you confused is a percentage of revenue being put into R&D. So not only do we do more research than the rest of the world combined, but our evil corporate overlords are putting more money back into advancing medicine while their angelic bastionsof humanity put more money in their pockets. 13% to 8%.

It's much easier to see in the pdf with all the pretty pictures. Between the crappy formatting, missing graphs, and mid-quote topic shift, it's admittedly hard to follow.

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#25

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 20:37
Originally Posted by dteowner View Post
AND it costs roughly 50% more to do a clinical trial there
There are fewer legal obstacles to getting a compound released here. I assumed that also means it's cheaper. Even if not, I think you're neglecting the effect of getting to the market faster.

"In Grimwhoah, you can ride on turtles."
Sacred_Path is offline

Sacred_Path

Sacred_Path's Avatar
Basement Horror

#26

Join Date: Nov 2012
Location: Germany
Posts: 918

Default 

November 7th, 2013, 20:40
OK, I'll read the source.
Thrasher is offline

Thrasher

Thrasher's Avatar
Wheeee!
RPGWatch Donor

#27

Join Date: Aug 2008
Location: Studio City, CA
Posts: 10,108

Default 

November 7th, 2013, 20:43
Since the markets for pharma and healthcare products is global, and since R&D (has to) pay for itself through the developed products, everyone pays for it. It doesn't matter where you live, nor where the company is located that did the R&D - it's a global market and most of the notable companies are global players themselves.
GhanBuriGhan is offline

GhanBuriGhan

GhanBuriGhan's Avatar
Wose extraordinaire

#28

Join Date: Oct 2006
Posts: 3,486

Default 

November 7th, 2013, 20:51
Originally Posted by GhanBuriGhan View Post
Since the markets for pharma and healthcare products is global, and since R&D (has to) pay for itself through the developed products, everyone pays for it. It doesn't matter where you live, nor where the company is located that did the R&D - it's a global market and most of the notable companies are global players themselves.
That's only true if global prices are the same. They are not, as you Euros love to point out. Our costs are higher, so we are, effectively, subsidizing you. Using an overly-simple summary, they're selling to you at cost and making their money on us because that's what the global system forces.

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#29

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 20:53
Originally Posted by Thrasher View Post
OK, I'll read the source.
That's an undertaking. I recommend skimming thru to whatever charts catch your eye and reading a few paragraphs before and after. Then you can go back for specifics (such as the quotes I dug out for sacred) as needed.

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#30

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 20:59
Hmm, yes. What I am really looking for is per capita numbers. That's the right statistic to be comparing, otherwise the population size of the US dominates.
Thrasher is offline

Thrasher

Thrasher's Avatar
Wheeee!
RPGWatch Donor

#31

Join Date: Aug 2008
Location: Studio City, CA
Posts: 10,108

Default 

November 7th, 2013, 21:04
The prices are what the market allows. It has nothing to do with where the R&D is located. You may "effectively" subsidize other parts of the world, but that's because your market conditions allow these high prices, not because of your contribution to R&D. So it's your onw choice. Your market is set up in a way to allow these high prices.

Now, the revenue made may be a good thing, as it allows Big Pharma a big profit, which can be invested in R&D - howver R&D is usually only a small % of the budget. And still, as long as you get a product approved for the US, a foreign company will have the same advantage in your market as your own companies. In the end it comes down to this - in the US, Big Pharma has a much bigger lobby than in other countries, where the system enforces that health insurance companies have a large weight (although big pharma is a heavyweight wherever they are).
GhanBuriGhan is offline

GhanBuriGhan

GhanBuriGhan's Avatar
Wose extraordinaire

#32

Join Date: Oct 2006
Posts: 3,486

Default 

November 7th, 2013, 21:11
Originally Posted by GhanBuriGhan View Post
The prices are what the market allows. It has nothing to do with where the R&D is located. You may "effectively" subsidize other parts of the world, but that's because your market conditions allow these high prices, not because of your contribution to R&D. So it's your onw choice. Your market is set up in a way to allow these high prices.
Somebody's got to pay for R&D, or it simply doesn't happen. Y'all sure aren't stepping up. I'd chalk it up to an unfortunate reality and yet another part of America's Burden, but I find it rather insulting to put up with chirping from the very folks benefiting most from the situation.
Originally Posted by GhanBuriGhan View Post
Now, the revenue made may be a good thing, as it allows Big Pharma a big profit, which can be invested in R&D - howver R&D is usually only a small % of the budget.
Yeah 10-13% of sales here, but sadly only 8% of sales over there. Awfully miserly for bastions of humanity, me thinks.

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#33

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 21:14
Originally Posted by Thrasher View Post
Hmm, yes. What I am really looking for is per capita numbers. That's the right statistic to be comparing, otherwise the population size of the US dominates.
I did see several per capita numbers, but I don't know if I saw the specific one you want. That said, since we're comparing the US to all of Europe, the population size angle might actually favor us.

edit- per wiki, "Western Europe" actually has more people than the US as of 2009, 371mil to 310mil. Assuming we throw out a portion of Europe for purposes of this discussion (there probably isn't much R&D going on in Portugal), it's probably safe to call the "per capita" argument roughly a wash.

Sorry. No pearls of wisdom in this oyster.
Dallas Cowboys: Still afraid to hope / / Detroit Red Wings: Another rollercoaster season?
Last edited by dteowner; November 7th, 2013 at 22:15.
dteowner is offline

dteowner

dteowner's Avatar
Shoegazer

#34

Join Date: Oct 2006
Location: Indiana, USA
Posts: 11,340

Default 

November 7th, 2013, 23:11
As usual, no mention of Australia where medical R&D in some areas actually leads the world. Our system isn't perfect, especially the LONG waiting lists for elective surgery, but at least most is either affordable or 'free'!!

If God said it, then that settles it!!

Editor@RPGWatch
Corwin is offline

Corwin

Corwin's Avatar
On The Razorblade of Life
RPGWatch Team

#35

Join Date: Aug 2006
Location: Australia
Posts: 10,551
Send a message via Skype™ to Corwin

Default 

November 7th, 2013, 23:18
Originally Posted by dteowner View Post
I did see several per capita numbers, but I don't know if I saw the specific one you want. That said, since we're comparing the US to all of Europe, the population size angle might actually favor us.

edit- per wiki, "Western Europe" actually has more people than the US as of 2009, 371mil to 310mil. Assuming we throw out a portion of Europe for purposes of this discussion (there probably isn't much R&D going on in Portugal), it's probably safe to call the "per capita" argument roughly a wash.
Also be careful not to take credit for international corporations that do most of biomedical research. They really can't be considered US anymore.
Thrasher is offline

Thrasher

Thrasher's Avatar
Wheeee!
RPGWatch Donor

#36

Join Date: Aug 2008
Location: Studio City, CA
Posts: 10,108

Default 

November 9th, 2013, 15:54
Originally Posted by Thrasher View Post
Also be careful not to take credit for international corporations that do most of biomedical research. They really can't be considered US anymore.
This is correct. International pharma usually needs to have research in all three major markets (the US, the EU and Japan) in order to pass regulatory hurdles that in some cases are thinly veiled protectionism. My wife used to work in pharma research and her company had a US site that they couldnt gut for that reason. I am sure the American companies have suboptimal facilities in Europe and Japan for the same reason.

Originally Posted by dteowner View Post
That's only true if global prices are the same. They are not, as you Euros love to point out. Our costs are higher, so we are, effectively, subsidizing you. Using an overly-simple summary, they're selling to you at cost and making their money on us because that's what the global system forces.
R&D costs are a relatively minor cause of the discrepancy between US and ROTW medical costs.

The main factors are that healthcare simply is more accessible to Americans (which is good for the individual patient but costly), that your medical sector has incentive systems that encourage expensive examinations and treatments (you'll have to work much harder to get a CAT scan in Europe), that your incentive system encourages overmedication, lifestyle differences causing health issues (obesity etc, but we are catching up there), and the lawsuits you mentioned.

That said your system is probably the best in the world in terms of accessibility for the insured. It is probably not among the more cost efficient. There are always tradeoffs. You could probably save money without sacrificing health outcomes by being a bit more restrictive with drug usage and being more restrictive with access to specialist care, but that would be a hard sell to people who are used to getting some kind of treatment quickly.

EDIT: Even if the difference in costs were entirely due to R&D it'd be dishonest to call it a subsidy of the rest of the world. After all the R&D tends to result in profitable products for the (US in this case) industry…
Last edited by Zaleukos; November 9th, 2013 at 16:08.
Zaleukos is offline

Zaleukos

Zaleukos's Avatar
Bum

#37

Join Date: Nov 2006
Posts: 1,869
RPGWatch Forums » General Forums » Politics, Religion & other Controversies » Five Myths About Health Care in the Rest of the World
Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

All times are GMT +2. The time now is 17:56.
Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
Copyright by RPGWatch