Friday, October 27, 2006

Silver Bullet to help the manufacturing economy in Southern Illinois.

If we don't want to lose all manufacturing in Southern Illinois and the USA, we should go to a nationalized health care system.

Cool fact that I bet you didn't know, the number one country to take manufacturing jobs from the USA is clearly China. But the number 2 country is Canada. There isn't much difference between Canada and the USA beyond their much cheaper health care costs.

Think about it, all those 10,000 square foot doctor houses and record profits for the drug companies must be coming from somewhere.

7 comments:

Jonathan Bean said...

Canada will come up on almost any top economic rival list because of its proximity and trade importance.

Why is our medical third-party insurance system screwed up? WWII -- wage controls led to tax-deductible health insurance. There's no reason why jobs and health insurance must be tied but vested interests...

Record profits from the drug companies in the USA....because Canada and ther est of the world are stealing (yes, stealing) the value of our patented medicines through price caps. Note: The US policy on generics is very permissive and the cost is virtually nothing when made in Bangladesh. That's why Wal-Mart can give away $4 generics and not lose money.

So, we are the health (and drug) provider of last resort. Who will play that role when we don't?

Another note about Canada: It's productivity is very close to the USA's, while Euro nations (West Euro) trail behind by 25-30%. So, again, it's not surprising that they are more competitive than, say, the British (don't get me going on their NHI).

Peter in Carbondale said...

I agree with everything here almost, but there is one little detail that you are overlooking. The USA is the richest country in the history of the world. For 50 years we have had the best science, innovation, most effective economy, and the most money. Of course, we are the go to place for health care. The USA has earned that right. It isn't clear in anyway that changing the way we pay doctors will stop us from being the best place to receive health care in the world. I don't agree that the cause and effect is clearly there.

If you started to do anything, maybe educating the doctors on costs would be helpful? Maybe closing the paybacks to doctors for prescribing expensive drugs? For example, some drug my Mother has been taking for years came off patent. Price per month is $20 or so. The doctor gave her a prescription for the companies new drug at $250 per month. You only take it once a day instead of 4 times. This kind of decision making is killing us. The Republican Congress and "W" gave up the right to get better rates on prescription drugs in the new laws, don't tell me this isn't about political givebacks and greed.

It is clear that the amount of money we are putting into paying for doctors process insurance claims can't get more expensive by going to a single payer system isn't it?

The doctors, drug companies and the health insurance industry have 15% of our GNP and rising 15% or more per year. They are going to kill the goose that lays the golden eggs if they don't watch it.

I think the real cost to our society is in the emergency intervention situations being so expensive and driven by lack of health care. A simple $4 antibiotic from Walmart would save a multiple day hospital stay for many people, but they can't afford to see a doctor to the the script.

It is possible to control health care costs and profits without killing all profit in the system. It doesn't have to be one way or the other does it?

Keeping me on my toes.

Jonathan Bean said...

Canada will come up on almost any top economic rival list because of its proximity and trade importance.

Why is our medical third-party insurance system screwed up? WWII -- wage controls led to tax-deductible health insurance. There's no reason why jobs and health insurance must be tied but vested interests...

Record profits from the drug companies in the USA....because Canada and ther est of the world are stealing (yes, stealing) the value of our patented medicines through price caps. Note: The US policy on generics is very permissive and the cost is virtually nothing when made in Bangladesh. That's why Wal-Mart can give away $4 generics and not lose money.

So, we are the health (and drug) provider of last resort. Who will play that role when we don't?

Another note about Canada: It's productivity is very close to the USA's, while Euro nations (West Euro) trail behind by 25-30%. So, again, it's not surprising that they are more competitive than, say, the British (don't get me going on their NHI).

Jonathan Bean said...

Regarding the brain drain and "it's-not-in-my-job-description" bureaucrats:

Reminds you of SIU and patents, no?

Jonathan Bean said...

Regarding "emergency interventions" -- a boneheaded federal law from the '80s backdoored national health insurance -- if you had an emergency. ERs became a sewer of riff raff, drunks, nonemergencies (kids with the sniffles, etc.). Meanwhile, states like Illinois started Kiddie Care (or whatever they call it) and require all state and federal employees to ask whether mothers on any type of aid would sign up their kids. My wife does this for her job but the mothers don't want to take the time to fill out two pages. Participation rate is too low. But now they are forcing kids to have not only vaccinations but dental visits every year -- I researched and found this IL state law was passed by a) a dentist-legislator; and b) a legislator who used to be a lobbyist for dentists! "First, do no harm" and get the government out of the medical business.

As for doctors and costs, why not break up the medical cartel through the licensing laws? For years, the AMA had a stranglehold on the total number of med school students until the Reagan DOJ forced them to settle in an antitrust suit. Still, there is an oligarchic "wink-wink" limit on the numbers. And you wonder why so many of our doctors are foreign? That's fine with me -- just make sure you keep the immigration door open (I'm an open borders libertarian). However, we need to get our own medical house in order.

No, it's not because we are the richest -- after 50 years, there would be comparative advantages in different fields of pharmacy and medical devices. Indeed, many of the top pharmaceuticals and medical mfgers are foreign-based but they sell for a profit here, not there. Why? Because bureaucrats say they can't make money. This, in turn, contributes to the brain drain from Europe and Canada because the bright academic entrepreneur with a new medical device can't get the socialistic bureaucrats to allow him to patent, etc. I've participated in international forums with such people (from Germany) and they just gave up and came here.

As for rising costs, Europe and Japan (which relies very heavily on pills, BTW) are facing a far worse crisis: The Birth Dearth. The birth rate is down to 1.3 and going lower. Their population will contract in half, be really old and too few young workers to pay their way. We have this problem on a much smaller scale. Imagine the native-born depopulation (through low birth rates, outmigration) of Europe in 50 years. It won't be pretty. Their social insurance is already getting hit with a demographic tsunami (forgive the hyperbole, this is a blog, right?).

Besides, as my Labor Leftie graduate student found out when he faced losing his back to herniated disks, that isn't "life-threatening" in Britain so he was "immediately" put on the queue for an operation scheduled 18 months in the future (the Brits have had artificial back disks for 25 years but NHI doesn't cover them). The result: He would end up in a wheelchair but otherwise very healthy, he was told! He ate crow, went to his Tory father-in-law for a loan and went OUTSIDE the system for an artificial disk. Now, after 40 years of increasing back pain, he has no pain at all! As a victim of retractable back pain, this sent chills down my spine. (FYI: Our FDA just approved artificial disks in this country; they are great but expensive. Wheelchairs are cheaper).

I know you are rich, Peter, and you or your's could always go outside the system. For the rest of us: "let us eat pills?!"

Anyway, we are slouching toward our own unique patchwork NHI. Medicaid, Medicare, kiddie care. And you wonder why health costs are rising? Other people are paying...

Recommended reading: Splendid satirical critique of Medicare (national health insurance for old people):

"Medicare Meets Mephistopheles." By Cato Institute. It explains the economics of medicare from the pen of "Underling Demon 666 in Charge of North American Recruitment." Even if you disagree, it's a great read with chapter titles after the 7 deadly sins. LOL

Peter in Carbondale said...

OK, I'm kind of with you. But, riddle me this. The government isn't getting out of health care, there is to many campaign contributions to be made.

If you apply free market ideas to the government as the biggest buyer of drugs in the country, they should have the cheapest or at least nearly the cheapest drugs. Instead our buddies the Republican Congress voted in paying the highest amount possible for drugs.

I guess in some theoretical way it is possible to keep the government out of legal drugs. In reality there is so much money in prescription drugs, that every politician would trade their soul for a crack at it.

The devil is in the details.

Jonathan Bean said...

Agreed. The GOP Congress, with a GOP president, has been total corporate welfare (one reason NOT to use NHI to bail out "manufacturing" -- of course, the big corporate contributors, i.e., bastards, want a free lunch). The best that will happen is the GOP loses the House (hopefully not the Senate because the only thing keeping movement conservatives going to the polls is "judges, judges, judges." Peggy Noonan said this in a recent WSJ and this is what real fiscal conservatives are thinking.

BTW, I just figured out that two of my five drugs are on Wal-Mart's $4 list. Instead of paying $60 (two $10 copays X 3months), I'm going to have my M.D. write a script for 90 fill and then get the price down to $1.33/month per drug. Not bad. No insurance, just cheap generics. Americans spend a lot, but do they spend wisely? (OK, Peter, you know I'm a Yankee skinflint, I'll confess...).