Pelosi on Drugs: A Bad Trip?

The Manhattan Institute has gathered dozens of economists and policy analysts to make a signed public statement against the Democratic Party's plans for government negotiating prices for Medicare Part D payments. From their statement:

Under current law, negotiations over prices are conducted between the pharmaceutical producers and private firms administering drug benefit programs for Medicare beneficiaries. With federal spending on pharmaceuticals is projected to grow to about $100 billion in 2007 — over 40 percent of the U.S. total —some policymakers now advocate federal negotiation of prices with the pharmaceutical producers, in order to use the large size and bargaining power of the federal government to achieve sharply lower prices.

Federal price negotiations would represent a policy change carrying significant risks for research and development investment in new and improved medicines. A substantial body of research shows that similar federal drug programs impose prices substantially lower than those negotiated in the private sector, and that such lower prices inevitably will reduce research and investment in new and improved medicines. This slowdown in pharmaceutical innovation will yield highly adverse effects upon future patients in terms of reduced life expectancies.

Manhattan's Ben Zycher has issued a full study on these matters, concluding that:

investment in new drug research and development would decline by approximately $10 billion per year. It estimates as well the effect of reduced pharmaceutical R & D investment on American life expectancies, or expected “life-years”. Specifically, this work projects that federal price negotiations would yield a loss of 5 million expected life-years annually, an adverse effect that can be valued conservatively at about $500 billion per year, an amount far in excess of total annual U.S. spending on pharmaceuticals.

The Democrats' projected move toward government price negotations is a perfect example of Mises's notion that a viable and stable "third way" between capitalism and socialism is very hard to find: government interventions (such as Medicare) begat more government interventions (such as government trying to negotiate drug prices). A similar dynamic drives government efforts to manipulate or manage our private choices about eating, drinking, smoking, etc. if they can be said to lead to increased public expenditures on health care down the line. Health, as my friend Sheldon Richman once told me, has indeed become the health of the state.

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  • ||

    It all depends on what you value. Are you interested in having the best drugs possible and the advancement of science or are you interested in equality? If it were up to me, I would take the drugs and the science. To a lot of people in government, however, equality is more important. They would rather have everyone get the same treatment and big pharma not get rich and not have advances than have inequality and get advances.

  • ||

    Whatever one thinks about the wisdom of government as a middle man for prescription drugs, it's the height of idiocy to think that IF the government is buying $100 billion worth, they should be forbidden from even negotiating a good price.

    Would the market, with the government as a huge customer, favor companies who cut out R & D? Or companies that continued aggressive R & D and trimmed fat elsewhere (say, the fleet of salespeople tasked to legally bribe physicians into prescribing their brand name drugs)?

  • thoreau||

    Whatever one thinks about the wisdom of government as a middle man for prescription drugs, it's the height of idiocy to think that IF the government is buying $100 billion worth, they should be forbidden from even negotiating a good price.

    I was just about to say the same thing.

  • ||

    The VA has been negotiating it's drug prices for decades.

    Not to mention foreign countries.

    R & D by big pharma is great, but why should American patients be forced to susbsidize most of it?

  • Sam Franklin||

    T. and bchurch sed what really needed to be said.

    i would add that if the government wants pharmaceuticals to behave as a maximally competitive market, then the size and number of negotiating entities should be equal to the size and number of pharmaceutical suppliers for a given drug.

    If the drug is patented, then there is one supplier and a single buyer would achieve the greatest negotiational balance between supply side and demand side.

    If the drug has multiple sources, then it is best to have a number of buyers equal in size and number to the respective sizes and numbers of the generic drug makers making that particular drug. It may turn out that all the buyers in the market choose to buy from a single generic drugmaker for a certain drug, but the existence of multiple buyers provides incentive for the generic drugmakers to compete relative to a single buyer system (but each customer would still have decent market power compared to say purchasers purchasing for a single person or a single nuclear family).

  • ||

    "Whatever one thinks about the wisdom of government as a middle man for prescription drugs, it's the height of idiocy to think that IF the government is buying $100 billion worth, they should be forbidden from even negotiating a good price."

    Yes, because they buy so much of it and control such a huge portion of the market, they really don't neglotiate but determine the price. The reality is that allowing the government to negotiate means having price controls. It sounds great in theory to let the government negotiate unti you think it through. If you don't like the fact that the government can't really negotiate, the sollution is to get the government out of the business of buying drugs. The sollution is not to deny reality and pretend that you are doing anything but mandating price controls.

  • ||

    "R & D by big pharma is great, but why should American patients be forced to susbsidize most of it?"

    Because most other countries are socialists and are free riding off of American wealth. Yeah that sucks, but the alternative is to go socialist ourselves and just not have the research at all. The research is something I will gladly subsidize, especially considering that if we don't do it, no one will.

  • ||

    I may just be a dirty liberal, who can't even make change for an evil dollar bill when someone hands me one to buy a bottle of organic carrot juice down on the co-op, but don't suppliers generally agree to lower per-unit costs when dealing with large, reliable customers? Because they make extra profits on the volume, and because the knowledge of future purchases reduces the risk premium for their production costs?

    Manhatten Institute, huh? What are they, some kind of goo-goo group that researches health care?

  • ||

    "but don't suppliers generally agree to lower per-unit costs when dealing with large, reliable customers?"

    Absolutely they do. In fact if the buyer is big enough and dominate the market enough, he can squeeze about every ounce of profit out of the supplier and leave the supplier with the absolute lowest return on his investment possible without putting him out of business. That is precisely the point Joe. The government would squeeze the market to such a degree that funding for R&D would go to hell. Who is going to invest in the pharmaceutical industry if the government is there ensuring the lowest possible returns on capital? You unwittingly stumbled on precisely the point the Manhattan institute is making.

  • ||

    Why exactly can't Medicare pull the same stunts on GlaxoSmithKline as Wal-Mart does to Rubbermaid?

    As neither the shareholders of Lockheed Martin nor advancement of the "bleeding edge" of aerospace technology do poorly under Federal monopsony, I'm not convinced the world will end under the scenario of Medicare throwing it's weight around.

    If I *have* to pay for the old people, I want good-faith negotiated cost-plus and not one dime more.

  • ||

    "As neither the shareholders of Lockheed Martin nor advancement of the "bleeding edge" of aerospace technology do poorly under Federal monopsony,"

    That is an interesting point. Of course the Pentegon funds the hell out of R&D for defense contractors. In fact, a defense contractor gets his R&D money back in the contract once he sells the government on the new F999 or whatever he is selling. I don't think that is true with medicare.

  • ||

    In fact if the buyer is big enough and dominate the market enough, he can squeeze about every ounce of profit out of the supplier and leave the supplier with the absolute lowest return on his investment possible without putting him out of business.

    This does not follow at all. The supplier can simply say, "No."

    The issue Mises points out really arrives with the next round of legislation from a Congress incensed that Medicare patients don't have access to the latest, most expensive drugs because the suppliers won't sell at the price Medicare will pay. When someone suggests the supplier be forced to sell at that price, that is where freedom must make its stand.

  • ||

    John,

    Negotiating leverage and price controls are not the same thing. Presumably, no drug company is willing to accept a price point at which they would lose money, right?

    And I'm not sure why R & D would be the biggest loser if companies did have to cut overhead in order to win government bids. Successful R & D, because of current patent laws, would still provide a huge payoff. The demand for a cure for cancer isn't going away any time soon.

    The real overhead for pharmacuetical companies comes from their sales and advertising depts. From this article:

    http://www.businessweek.com/magazine/content/05_09/b3922001_mz001.htm

    "Pfizer, for example, now spends twice as much on sales and administrative expenses -- $16.9 billion last year -- as it does on research and development."

    Which includes a sales staff of 38,000 and a $3 billion/year ad budget.

  • ||

    In case my point above wasn't clear, having a giant government contract reduces the need for sales and advertising alot more than the need for new products to sell.

  • ||

    Well, John, I share your concern about monopolies, and their ability to control, rather than respond to, the market. Without at least a modicum of equal bargaining power on each side - generally produced by having buyers and sellers who are able to cut a deal with someone else - you end up with one party able to squeeze the other beyond all reason.

    So I can appreciate your concern about the government having too much power during negotiations, and I trust that your deeply-held principles in this area would lead you to be concerned about the opposite, of the suppliers having too much power over the buyer.

    Right now, the buyer in question cannot walk away from the table. The government is mandated to purchase drugs. The "proper" amount of profit for the suppliers to make would be that they can achieve under market conditions, but since we don't have market conditions - what we have, in fact, is a supplier that is disempowered by the size of the buyer, and a buyer that is disempowered by the law - there has to be some other mechanism for producing the equilibrium that would occur in a normal market.

    Of course, a principled libertarian would be far more concerned about an economic party disempowered by the law than one "disempowered" by having a very large negotiating partner.

    So what's the answer? In the absence of ordinary market dynamics, how do you stop a supplier with a captive customer from engaging in predatory pricing?

  • ||

    Gee, maybe we should have all of the products we buy negotiated for us through 3rd parties like the insurance companies so that the producers capture more profit & put it into new research. Then EVERYTHING would see great advancements in technology & innovation. Think how great the world would be.

    So, instead of buying Doritos for $3 at Wal-Mart, I could just go to the store & pick them up. A month later, I would get a bill from Wal-Mart telling me that my plan allowed a $50 reimbursement for Doritos, that it had paid $25 & that I owed the remaining $25, until my Dorito deductible would be met.

    God, we would have the most awesome Doritos in the world if we did it like that.

  • ||

    In the absence of ordinary market dynamics, how do you stop a supplier with a captive customer from engaging in predatory pricing?

    "Predatory pricing"? You must have a different definition of 'predatory' from mine.

    There is a consumer surplus provided by the drug. The negotiation is nothing but fighting over how to divide the consumer surplus between supplier and consumer. As noted in the article, the consumer surplus on some drugs is phenomenally large, measured in years of enhanced quality of life or actually continued life. It hardly seems "predatory" for the supplier to want some of that.

  • ||

    Some, MikeP.

    Under ordinary market conditions, the drug companies realize some of that value. The customers, through their negotiating power, realize some of it, too.

    What is to prevent the suppliers from demanding the whole enchillada?

    There are those who have decided that this particular industry is worth subsidizing, through the payment of inflated prices by the federal government. Personally, as someone who agrees with John about the wonderfulness of subsidized medical research, I think there are ways of achieving this degree of subsidy that can be better targetted.

  • ||

    MikeP,

    A predatory price is one that a supplier charges, above market value, because his buyer is compelled to buy the product, and cannot avail himself of the ordinary market-based means of negotiating.

    The definition isn't really dependent on whether you disagree with him, and think he's getting his money's worth. It doesn't even depend on whether John decides that society is better off with the over-market-value in the hands of the supplier, rather than the purchaser.

  • ||

    A predatory price is one that a supplier charges, above market value, because his buyer is compelled to buy the product, and cannot avail himself of the ordinary market-based means of negotiating.

    You seem to think this represents some sort of legal restraint on Medicare's "right" to throw its massive weight around. Even if Medicare is allowed to negotiate prices, it is not captive. It can always walk into the supply houses and buy it off the shelf like every other insurer and patient.

    There is a (somewhat) functioning market outside of Medicare and Medicare's negotiations, and Medicare can take advantage of it just like anyone else.

    Now, in the unlikely case that the supplier actually charges the government a price above list price, there might be an issue there. I, of course, would argue that the supplier should be able to do that. The government should respond by fixing whatever idiotic law requires Medicare to buy any drug anyone offers at any price.

  • ||

    MikeP:

    I don't think the problem is even the next round of legislation. I think the bigger problem is that the government is in charge of approving drugs. I think you are very likely to see something along the lines of if you knock a little bit off the cost of this drug your approval process will go much smoother for your next drug, or it could be really bumpy.

    If the parties were really on an equal footing I wouldn't have a problem with the govt. negotiating for prices.

  • ||

    What is to prevent the suppliers from demanding the whole enchillada?

    The same factors that control the division of the consumer surplus in every other market, even monopoly markets. Among these are:

    1. The desire to actually sell something.

    2. The availability of near-substitutes.

    3. Resistance by consumers against being reamed.

    4. General goodwill and reputation.

  • ||

    Obviously the author of this post has never wanted for medication. If he had, it would know how incredibly frustrating and angry it makes you to know there is a drug available to relieve your condition but it is beyond your financial means. Try living with that and let us know how your libertarian position changes.

    Why can't the money come from pharm companies profits, instead of their R&D?

  • ||

    Lots of interesting discussion here on pricing. However, did anybody note the assertions on life expectancy? Apparently, rapid innovation by big pharma increases life expectancy, but a slower rate of innovation will reduce life expectancy? Doesn't follow to me. I guess I would assume that slower innovation would increase life expectancy at a slower rate, rather than killing people off quicker. But then, "slow the rate of increase in average life expectancy" doesn't have the same sense of urgency.

  • ||

    John wrote:
    > The reality is that allowing the
    > government to negotiate means having
    > price controls.

    Baloney. Capitalism works both ways. The drug company will not be forced to sell their drugs at the asked-for price--they can refuse, and take their chances in other domestic and foreign markets. That's called the free market, in case you need a refresher.

  • ||

    So, when are you guys gonna stop dropping Sheldon Richman's name and hire him. When that happens, do we call it the Liberty-ification of Reason?

  • thoreau||

    Why can't the money come from pharm companies profits, instead of their R&D?

    Because the profit motive is what makes things happen?

  • ||

    Mike P,

    1 and 3 do not apply, because the government is required by law to buy the drugs. Even if the government feels it is being reamed, it is forbidden from negotiating.

    #2 would seem to relevant in some cases, but not others.

    Number 4 doesn't seem to apply, either, since the government is compelled to keep up the purchases, regardless of the suppliers' reputation.

    Nor is the "right" of Medicaire to go somewhere else and pay an even higher price a terribly compelling argument.

  • ||

    Kevin:

    Why can't the money come from pharm companies profits, instead of their R&D?

    Why can't the money come from the people using the currently available pharmaceuticals?

    Life has a 100% mortality rate...one's inability to afford the output of other people's work is sad and depressing...but it's still an individual's situation. There are groups, including the Pharma industry, who make 'humanitarian' contributions of drugs to those without the means...but that is a free choice on their part, not a government mandated act of capital redistribution.

  • ||

    "Who is going to invest in the pharmaceutical industry if the government is there ensuring the lowest possible returns on capital? You unwittingly stumbled on precisely the point the Manhattan institute is making."

    And the EXACT same thing is true about "big oil" (whose return on capital is about 10%).

  • ||

    "Baloney. Capitalism works both ways. The drug company will not be forced to sell their drugs at the asked-for price--they can refuse, and take their chances in other domestic and foreign markets."

    It is not that they will refuse to sell or that the government will destroy the pharmaceutical companies. It is that they will make a such a small profit on existing drugs that their will be no incentive to spend to get new ones. Most drugs fail and cost the drug companies billions and return nothing. The ony reason drug companies are willing to spend that kind of money is the fact that they can make huge profits when a drug works. Take away the huge profits on existing drugs and there will not be near as much emphasis to risk money developing future drugs.

  • ||

    There are other options.

    The government could buy at the average price of the X lowest contracted amounts that other consumers (Wal-Mart, Walgreens, etc). This would allow the government to take advantage of the market pricing without having a way to shakedown the companies, no?>

  • ||

    "I guess I would assume that slower innovation would increase life expectancy at a slower rate, rather than killing people off quicker."

    And if a brand new epidemic -- something akin to AIDS -- who would pay for new research?

  • ||

    Obviously the author of this post has never wanted for medication. If he had, it would know how incredibly frustrating and angry it makes you to know there is a drug available to relieve your condition but it is beyond your financial means.

    I take a prescription medication that costs $10 a dose. I mostly can't afford it, but when I can I am supremely grateful it exists. I suppose I could take the view that I am entitled to the thought and labor of all those folks who conspire to create and produce the thing, but mostly I'm just grateful to be able to have some relief from time to time.

    Try living with that and let us know how your libertarian position changes.

    Satisfied?

    Why can't the money come from pharm companies profits, instead of their R&D?

    There are lots of practical reasons, but ultimately, it's because it's their product to do with as thy please. If it's worth it you'll cough up the cash. If not, well, it's not yours to take as you please. I guess it looks less like a smash and grab mob when it's done through the feds, huh?

  • ||

    joe,

    1. The government can't go buy it off the shelf at list price, thus leveraging the rest of the market that is not captive to some idiotic law?

    2. The government can't change the idiotic law?

    3. The government really, really can't say no to any drug under this idiotic law?

    4. Why aren't companies charging the government $1,000,000/patient-year for exclusive drugs right now?

  • ||

    "The government could buy at the average price of the X lowest contracted amounts that other consumers (Wal-Mart, Walgreens, etc). This would allow the government to take advantage of the market pricing without having a way to shakedown the companies, no?>"

    I can't see why that is not a good idea and wouldn't work.

  • ||

    "I guess I would assume that slower innovation would increase life expectancy at a slower rate, rather than killing people off quicker."

    And if a brand new epidemic -- something akin to AIDS -- who would pay for new research?

  • ||

    Are the server squirrels back???

  • Robert||

    So let's see...putting contracts out to bid is supposed to save taxpayers money, and is certainly not anti-liberty. But when it comes to drugs, this is somehow different? The only difference is the form of auction: proposing a price rather than taking the lowest bid.

    What's not clear is what happens when no price is agreed to. Does the contract go unfilled?

  • ||

    ChicagoTom's suggestion is what I was trying to get at. Something comoparable to how Fair Market Value is determined when the government pays out a property claim. If we can recognize a problem with Party A getting too good a deal out of a captive-purchase, then we should recognize a problem with Party B getting too good a deal out of a captive-purchase.

    Mike P,

    1. The shelf price is even higher, and the suppliers would make even more of a profit.

    2. The government could chance the law and not have a program to provide prescription drugs, sure, but the question at hand is how to handle the situation we're facing now, where the government is buying prescription drugs for seniors.

    3. The government has to purchase the drugs Medicaire patients need, by law.

    4. Because a screwing that large would cause a hue and cry, resulting in reforms that kill the goose that laid the golden egg.

  • ||

    joe,

    I am not arguing against the contention that Medicare is overcharged today. I am arguing that the legal requirements on Medicare do not imply in any way that the suppliers can get "the whole enchilada" of the consumer surplus. They can get list price, a price that is constrained by other consumers who are not shackled by the legal requirements on Medicare.

  • ||

    The government could buy at the average price of the X lowest contracted amounts that other consumers (Wal-Mart, Walgreens, etc). This would allow the government to take advantage of the market pricing without having a way to shakedown the companies, no?

    That's basically what happens now. There are standardized prices for drugs, and various buyers get various discounts. What the discount the big buyers get is quite well known.

  • ||

    Why not simply pull a chavez and simply nationalize the drug industry?

    BTW I seem to recall Chavez wanting to set a price floor of $50.00/BBL a few months ago. The current free-falling oil price must have him shitting his fatigues!

  • ||

    gaijin wrote:
    > Life has a 100% mortality rate...one's
    > inability to afford the output of other
    > people's work is sad and depressing...but
    > it's still an individual's situation.

    In every industrialized country in the world except the US, health care is a right, not a privilege. They recognize that a human being's health is not something to be bartered on the free market, but a fundamental right of civilized existence in a civilized state. The entire purpose of pursueing wealth is to better the quality of existence. That applies to nation-states just as much as it applies to individuals.

  • ||

    pigwiggle wrote:
    > I take a prescription medication that costs
    > $10 a dose. I mostly can't afford it, but
    > when I can I am supremely grateful it exists. > I suppose I could take the view that I am
    > entitled to the thought and labor of all
    > those folks who conspire to create and
    > produce the thing, but mostly I'm just
    > grateful to be able to have some relief from > time to time.

    Then you are accepting far less than you deserve. The goverment to which you pay taxes has given the pharmaceutical companies massive tax breaks, tax credits, research grants, and access to fundamental research which the government has paid for. Why should these corporations not be required to pay back (in the form of lower prices and medication for the poor) in exchange for the copious benefits they have received from government?

  • ||

    In other words, why do all profits belong to corporations when all expenses do not?

  • ||

    And let us not forget laws that are extremely favorable and beneficial to startups and corporations, such as Bayh-Dole.

  • ||

    "Why should these corporations not be required to pay back (in the form of lower prices and medication for the poor) in exchange for the copious benefits they have received from government?"

    Because it'll produce lay-offs

  • ||

    Mr. Sane wrote:
    >> "Why should these corporations not be required >> to pay back (in the form of lower prices and >> medication for the poor) in exchange for the >> copious benefits they have received from
    >> government?"

    > Because it'll produce lay-offs

    Oh baloney. By that logic any expense a corporation undergoes produces layoffs. Should we enact policies to eliminate all their expenses as well? Should we subsidize 100% of their R&D expenses?

  • ||

    Then you are accepting far less than you deserve. The goverment to which you pay taxes has given the pharmaceutical companies massive tax breaks.

    Huh, I deserve that which I have earned, period. Property rights are an inseparable part of fundamental liberty. My wife is a physician. Does she owe you some bit of her time? Healthcare is a civilized right, correct? If you need healthcare presumably you have a right to her labor. I'm a chemist. What do I owe you? Maybe 5 hours of lab-time working on Kevin's drug, for whatever Kevin has. We have the brightest and best working in healthcare because it's such a desirable, and therefore profitable product. Remove the profit and you'll have your hands full of dim but caring healthcare professionals.

    Look, If you want to argue the corporate welfare angle, well, let's just get rid of that. But in the end I don't think the parma companies add all that to the bottom line. Presumably competitive pressures should force them to some nominally sustainable return. However, since you seem to be so concerned about profits, why not cap profits? What profit would be acceptable? The average return of the S&P 500? 100? How much of the value a company creates should it and it's investors get to keep?

  • ||

    pigwiggle write:
    > Look, If you want to argue the corporate
    > welfare angle, well, let's just get rid of
    > that.

    This is the best argument you have?? Come on. We both know that corporate welfare is not going to end, ever. By now it's built in to the system, and corporations lobby extremely hard to keep it. We must therefore deal with it as it is and proceed accordingly. Since these pharmaceutical companies receive massive tax breaks, credits, R&D grants, Bayh-Dole advantages, and access to decades of fundamental research paid for by the government, they owe something in return. Something substantial (as has been their gift).

    THE EXPENSES WERE NOT ALL THEIRS AND SO THEIR PROFITS ARE NOT ALL THEIRS.

    I'm surprised I have to explain this to a purported libertarian free marketer. Dude, your companies are sucking at the public teat. They owe compensation.

    As for your wife: I don't know the details of her situation. Did she receive subsidized student loans? Grants? Did her medical school? Does her practice? If so, then yes, she owes something back to the public above and beyond the ordinary level of taxation for someone of her income. It's elementary fairness. We pay, and then they pay. Why is that not fair?

  • ||

    This is the best argument you have?

    No, but I guess you though it was the weakest, apparently primed for cherry picking. It seems your beef is the subsidies, so let stop them. Seems simple, simple enough for a paste eater like yourself. What don't you get.

    But I doubt subsidies have that much effect on the actual price (if they are uniform). Lets say you and I had dueling adjacent car washes, mostly the same. The town decided that car washing was a general good appropriate for the investment of public funds. You pad your bottom line in the way you accuse the pharma companies of doing. I give all my car dryers breast augmentation and tight lycra shorts. You get no business and I get it all. Or you could invest and offer a better product to the public. This is the idea behind the public R&D investment. Not that drugs will be cheaper, but better drugs will come to market (and also that otherwise non-profitable drugs will too). It isn't needed, though. There are plenty of folks willing to invest in pharma companies (absent the federal stick). But we have the 'heatlhcare' is a human right' crowd fucking it up for the rest of us. The same bleeding hearts that dreamed up the R&D subsidies to begin with. Oh, and subsidies student loans also. The idea th

    Look, just answer this. If healthcare is a right, then you have the right to another's thoughts and labor, right? This is the most galling bit. The pharma argument is trite compared to that gem. Lets hash that one out.

  • ||

    Since these pharmaceutical companies receive massive tax breaks, credits, R&D grants, Bayh-Dole advantages, and access to decades of fundamental research paid for by the government, they owe something in return.

    No, they don't.

    The government's putative reason for this "investment" is the improvement of the public weal: It is presumed that products will be available to the people that otherwise would not be.

    I am entirely against this form of social engineering, of having government redistribute money to pharma in hopes that it will produce a better society than that produced by keeping the wealth in the hands of free people.

    Nonetheless, it is the government that chooses to do it. You can't change the implicit conditions after the fact to make the direct recipients of the subsidies be responsible for the subsidies.

  • ||

    "In every industrialized country in the world except the US, health care is a right, not a privilege." - Kevin

    And in every country where health care is a "right", it is also rationed by the government. A lot of drugs in such countries are avilable cheaper than Americans can get them, but many other drugs are not even available, because the government health care services have deemed them too expensive to be in their plans. The drug you require now may be economically out of reach, but it is not unavailable by government fiat.

    With these plans also comes massive taxation, the costs of health care are more hidden to the individual, not removed. As others have pointed out, removing profit motive reduces incentive for brightest, and most ambitious people from pursuing careers as doctors and biochemists, leaving the field intellectually poorer.

    The perfect world of health care you are looking for does not exist.

  • pigwiggle||

    Ouch, server squirrels. My point about subsidized student loans was redacted. Here it is again. Like R&D, money for pharma research, the government invests in education to increase the supply of something folks need. It isn't some pre-purchasing scheme. You seem to think that the government has bought for you some share of future drugs or the labor of some graduate. You don't need a bunch of libertarians to point this out. Go to any lefty board and they'll be say the same thing, of course they will be for it while we are again it.

    Look, I've heard lots of folks say we need to invest in more science teachers because we need more scientists, not that we need to invest in science to ensure ownership of future science labor. But let's not conflate the two bits at hand. One, you feel like you have purchased a stake in something and are being ripped off. You are wrong, but that isn't so interesting. The second, that healthcare is a right. Thats what I want to talk about.

  • ||

    Why are R&D and increased life expectancy a good thing? In a socialist state, the fewer years of retirement avialable to a person the better off everyone else is. The government has a vested interest in killing off the baby boomers ASAP.

  • ||

    MJ wrote:
    > And in every country where health care is a
    > "right", it is also rationed by the
    > government.

    As if health care isn't rationed in the US. Try living without health insurance some time, and then tell me about rationing.

    In any case, despite such rationing, studies show that citizens of industrialized countries with single payer health insurance have significantly *better* health than do US citizens. Longer live expectancy, lower infant mortality rates, and much lower costs. Their system is better in every objective way.


    > A lot of drugs in such countries are avilable > cheaper than Americans can get them,

    ...because their governments care enough to negotiate bulk pricing. The US government does not.

    > but many other drugs are not even available, > because the government health care services
    > have deemed them too expensive to be in their > plans.

    And yet these countries have significantly better health than Americans at significantly lower cost. Sounds to me like these foreign governments know what they're doing and that they have not restricted any drug to the point where it affects health.

    > With these plans also comes massive taxation,

    Wrong. In fact, foreign health plans are significantly *cheaper* than US plans. They cover more people with better coverage at a lower price.

    > In the costs of health care are more hidden
    > to the individual, not removed. As others
    > have pointed out, removing profit motive
    > reduces incentive for brightest, and most
    > ambitious people from pursuing careers as
    > doctors and biochemists, leaving the field
    > intellectually poorer.

    And yet foreign citizens enjoy a higher level of health than do Americans.



    The perfect world of health care you are looking for does not exist.

  • ||

    pigwiggle wrote:
    > If healthcare is a right, then you have the
    > right to another's thoughts and labor, right?

    This is such an absurd, immature, illogical statement that it's not even worth my time to discuss.

  • ||

    This is such an absurd, immature, illogical statement that it's not even worth my time to discuss.

    Look Kevin, I get it. You are bent. So you didn't know I was a physical chemist when you tried to bullshit me with that garbage about Arrhenius; the father of physical chemistry himself. A bit of advice; There are many folks, probably most, that are smarter than you. Just don't talk out of your ass and you'll save yourself the embarrassment. Now get over it.

    So, come on. I'm sure you are very important, but if your time was so valuable you wouldn't be frittering it away here. Take a shot. If it's really so absurd you could quickly dispatch it and get back to whatever you do. Deep breaths ... you can do it.

  • ||

    Pigwiggle, I see that you are still incapable of intelligent discourse without obscenities and ad hominem remarks. You really must work on that.

    If you are a physical chemist, you are a poor one indeed not to know that Arrhenius calculated the climate sensitivity of the earth's atmosphere in 1896.

    Health care as a human right no more gives rights to "another's thoughts and labor" than does the US human right to an education. No one in the education sector loses their thoughts or labor because all children have the right to a basic education. In fact, this human right has proven to serve our society well. It is the same with health care.

  • ||

    Health care as a human right no more gives rights to "another's thoughts and labor" than does the US human right to an education.

    Which is also not a right.

    Could you find a different word, please? Calling these things "rights" rather than "entitlements", "privileges", or, to ruin some other word instead, "porcupines" merely dilutes people's understanding of actual rights, such as the right not to have one's property stolen to pay for someone else's health care or education.

  • ||

    MikeP wrote:
    > Could you find a different word,
    > please? Calling these things "rights"
    > rather than "entitlements", "privileges", or,

    I will keep the word "right." Our society has progressed beyond the point where an elementary education was a privilege, and it is such a fundamental "entitlement" that it is properly called a "right."

    > merely dilutes people's understanding of
    > actual rights, such as the right not to have > one's property stolen to pay for someone
    > else's health care or education.

    This is not a right at all. In fact, every goverment in the world taxes (not "steals") a portion of every person's property in order to fund thinks like health care and education. It is no more theft than private property is a theft from the commons. In fact, the concept of private property is more of a theft than is any tax. But this is getting far afield.

    Education is a right in the United States. (So is a telephone line.)

  • pigwiggle||

    Kevin-

    "Arrhenius calculated the climate sensitivity of the earth's atmosphere in 1896."

    I'm supremely grateful to hear it. I'll let those jokers working on the next IPCC assessment know. They can quit clogging the computer queues, get out of my way, and let the rest of us get on with some science that wasn't settled last century.

    "Pigwiggle, I see that you are still incapable of intelligent discourse without obscenities and ad hominem remarks. You really must work on that."

    Drop the shrinking violet act. It's silly.

    "In fact, the concept of private property is more of a theft than is any tax. But this is getting far afield. "

    Hardly far afield. In fact, this is really the heart of it. Folks here value individual liberty. In fact, (and I don't want to speak for everyone) most here don't recognize society as having 'rights' in a way an individual does. Society is just an artifact, an emergent phenomena that results from a collection of individuals. It doesn't have rights, or wants, or standing, or obligation. It's a mirage.

    I understand you don't see it that way. It just all comes down to a matter of values, and we have different ones. However, the beauty of my value system is that you and your socialist ilk can get together and do what you please. Buy each other's kids school books, set up institutions to take each other's money, mandate affluence and tranquility. Whatever silly whim you happen to get, just leave me be. But in your value system, the force and violence of the state is a reasonable and authentic means for today's pet project. Dress up the mob rule in the guise of legitimacy through a (transient) majority. People like you frighten me. You are creepy and evil.

  • ||

    If you are a physical chemist, you are a poor one indeed not to know that Arrhenius calculated the climate sensitivity of the earth's atmosphere in 1896.

    Forgot to mention in my last post (you threw me with that private property bit), I had the original manuscript pulled, and again, you are full of shit. Funny thing, Arrhenius thought that a mean increase in atmospheric temperature would be beneficial. Save us from the 'tyranny' of a coming ice age. He thought a warmer planet could sustain more plant life and have more temperate weather. Bit of irony, there.

  • ||

    pigwiggle wrote:
    > Forgot to mention in my last post (you threw > me with that private property bit), I had the > original manuscript pulled, and again, you
    > are full of shit.

    You have a strange way of arguing--you merely call someone names and obscenities, yet fail to offer countering evidence or an argument of your own. There is more to debate than refutation.

    And I was a little wrong about Arrhenius: he calculated the climate sensitivity of the earth's atmosphere to be *5* C.
    http://en.wikipedia.org/wiki/Arrhenius#Greenhouse_effect_as_cause_for_ice_ages

    > Funny thing, Arrhenius thought that a mean
    > increase in atmospheric temperature would be > beneficial. Save us from the 'tyranny' of a
    > coming ice age. He thought a warmer planet
    > could sustain more plant life and have more
    > temperate weather. Bit of irony, there.

    Yes, scientists have learned a great deal about the planet since Arrhenius's day, and must better understand the consequences of global warming. As you would expect from a science that had progressed 110 years.

  • ||

    Pigwiggle, you wrote you had Arrhenius's original manuscript "pulled," which I somewhat doubt since it was published in 1896. It is available, however, on the Web:
    http://web.lemoyne.edu/~giunta/Arrhenius.html

    See in particular the table labeled "Carbonic Acid=2.0". The right-hand column shows the calculated temperature increases as a function of latitude, viz. the climate sensitivity.

  • ||

    pigwiggle wrote:
    >> "Arrhenius calculated the climate
    >> sensitivity of the earth's
    >> atmosphere in 1896."

    > I'm supremely grateful to hear it. I'll let
    > those jokers working on the next IPCC
    > assessment know. They can quit clogging the
    > computer queues, get out of my way, and let
    > the rest of us get on with some science that > wasn't settled last century.

    Pigwiggle, if you knew even the slightest thing about climate science you'd know that Arrhenius's calculation was a first-order calculation (CO2 only), whereas modern calculations on which the IPCC is based take into account other GHGs, orbital, solar, and volcanic factors, aerosols, and more. See IPCC TAR v 1 ch 6.11.1.2 Fig 6.6 http://www.grida.no/climate/ipcc_tar/wg1/245.htm#fig66

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