Get Sick and Die; The State of U.S. Healthcare

The Something Awful Forums > Discussion > Debate & Discussion > Get Sick and Die; The State of U.S. Healthcare

Complications: Jun 19, 2014

BiggerBoat posted:

I mean...

UHC has to happen SOON if for no other reason that there's just no other loving option, right?

RIGHT?

20% of the economy buys a lot of lobbyists, donations, bribes, and advertising. Plus it makes up a ton of investments for the upper class, since the healthcare industry is only going to grow in the coming decades. The upper class which makes up our professional politician class. So no, UHC is not going to happen. Too many powerful people would see a lessening of the growth of their unfathomable fortunes.

# ¿ Aug 7, 2020 22:28

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# ¿ May 9, 2024 04:44

Complications: Jun 19, 2014

BiggerBoat posted:

Sorry TL/DR: I'm having a lot of trouble here and wondering if I'm on an island or something. Seriously weighing doctor visits against my bank account, trying to determine which is worth it. Honestly surprised this thread died on the vine.

Hop on over to CSPAM and into the Goonbucks sticky. You're not alone in dealing with the US's healthcare system and there is help available.

# ¿ Sep 28, 2020 20:49

Complications: Jun 19, 2014

If drug companies actually require more money for R&D instead of shareholder dividends or executive bonuses or for marketing or bribes or whatever we can just give them money.

Like.

As a line item in the budget.

While still having health care that vaguely resembles the standards every other developed country in the world has.

This isn't even hard, just write them loving checks from the goddamn Treasury or some poo poo.

Why is this even a debate.

# ¿ Oct 24, 2020 20:01

Complications: Jun 19, 2014

BougieBitch posted:

Well it's a debate because that's not actually a functional policy. If you say "here have $2 billion for R&D" then they just shift any internal money that was going to R&D over to marketing or CEO salaries and you've effectively just given them free money. You could give them a tax deduction proportional to the amount of R&D they perform, but that could be seen as a protectionist play, since it benefits US pharma corps over ones in other countries.

Basically, the best play if you want to fix it by just throwing a wad of cash is to just straight-up buy the companies, change the stated goals of drug development so that decisions are made based on the number of total years of extended lifespan a drug gives across all patients instead of the amount of money it makes, and continue operations as normal otherwise, but that has its own risks because the next time Republicans get control they can shift the priorities back around to loving the poors or sell the parts to whatever private companies still exist like state and local republicans have done for years with public infrastructure, so ideally we'd come up with a more durable solution if one exists.

That's also not getting into what it would mean in terms of international borders and whatnot, like can the US just buy a company that has real property in China or Russia or whatever without starting a whole debacle? Do we give the international employees US citizenship and move them over here? IDK, so far as I know nationalization hasn't been successful outside of situations where the primary value of the company was physical property like railroads, telecomms, or oil production, but I'm not all that well-read overall so maybe someone else could link a primer

Edit: Let me be clear, in response to the above post- I don't think pharma companies are "good, actually", basically this is an exercise in hostage-taking but it's pretty hard to completely decouple a company from one of its core functions the way you are proposing, which is why you actually need some fiddly policy proposal to handle it instead of just a mission statement. We can't even get a national bill passed to regulate the price of insulin (or just buy whatever operation is responsible for manufacture and do it ourselves), so it's a reasonable thing to be concerned about us doing on a larger scale

Look, the premise is that it's pharma company profit that's funding drug R&D for the world (PS lol), and that doing anything to fix the US's broken loving healthcare will be a loss for everybody everywhere because of ~~~think of the pharma execs' bonuses~~~ all that money that pure hearted pharma CEOs can't spend on their scientists. Rip that rug out from under them, and there's still a perfectly viable source of funding for drug R&D - the motherfucking government. Hell, with the savings of giant dump trucks of money not going to shareholders you can increase grants to universities, just have the government run drug trials, etc.

There are a variety of ways to perform research on drugs ranging from basic to clinical trials that can involve the private sector as much or as little as we like, and simply pointing to a profit sheet going down and lamenting the poor scientists' funding is disingenuous at best.

# ¿ Oct 24, 2020 22:29

Complications: Jun 19, 2014

BougieBitch posted:

christ no one is saying this, the point is that you need to explain how you are doing it, you aren't just loading up a T-shirt gun with wads of cash. There's not any US department or agency that currently does anything like this, the closest we have the the FDA and we would need to multiply their budget by like 16 and establish a bunch of new departments and poo poo, it's not just a handwave. The current FDA budget across all departments is $5.7 billion and half of that is paid for by the industries they regulate, annual pharma R&D is like $150 billion across the industry, with individual companies contributing up to $12b a piece.

That STILL doesn't address the other point, which is that phase 3 trials require like 1000-3000 participants, meaning 3000 people with the disease in question who aren't disqualified for various reasons. How are we going to do all of the necessary testing for any given drug, assuming the trial is for something reasonably specific like "stage 3 leukemia in adolescents" or whatever? Again, RIGHT NOW there are a bunch of companies doing trials for COVID vaccines and for a bunch of practical reasons they have concurrent trials in the U.K., Japan, South Africa, Brazil, etc. https://www.statnews.com/2020/10/23/covid-19-vaccine-trials-from-astrazeneca-johnson-johnson-to-restart/

There are a lot of practical reasons to do that, it's not just a cost-saving measure! If some gene would cause you to have a severe reaction to a drug, you could easily miss it if you are pulling your trial sample from a localized population. There are a lot of genes like this, where the frequency is extremely variable based on geographic location, so trials done only on US participants BY NECESSITY would be potentially deficient.

The numbers do not impress me. $150 billion annually? Chicken feed to a government budget. We already know how to administrate budgets to organizations that are literally an order of magnitude larger than that, I assume that it's entirely possible to build another goddamn administrative wing onto an office building somewhere and build some labs for scientists to work out of.

My answer to "how is the government going to do things that corporations are doing" is fuckin' obvious; the same way the corporations are but without profit motive. And also with government budget backing it.

As for how trials get conducted, frankly, I assume that it's possible for assorted health systems to cooperate and handle it in cooperation with governmental entities (kind of like the WHO, or through the WHO, or hell through another international entity who the gently caress knows or cares) rather than corporations via some arcane means like 'talking to each other.' By all means though, enlighten me on the difference between filling out results forms on corporation vs government letterhead.

# ¿ Oct 24, 2020 23:29

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