[stochastician]

Comments like this always make me sad. Not just because I disagree with them (I do!) or that I think they are claiming certainty about facts in dispute (I think they are ! [1, 2] ) but because they make no mention of trade-offs. We can vehemently disagree about these things, get our information from different sources, and advocate for different policies, but hopefully we can all agree that there _would_ be tradeoffs? What might be the downsides to the proposed approach ? Do we think this would result in reduced innovation? In fewer potential cures?

[1] https://blogs.sciencemag.org/pipeline/archives/2019/05/28/wh... [2] https://blogs.sciencemag.org/pipeline/archives/2014/11/11/ma...

[throwlaplace]

whenever anyone casts doubt on the idea that healthcare (or pharma) could be cheaper (and implicitly that the tradeoffs would be worth it) my simple response is: then please tell me how does every other western nation accomplish it? overall healthcare goals are met and for less money (in aggregate and individually) all around the world. in which way is america exceptional except insofar as exactly that here business tries to extract as much as value as physically possible. invariably someone will say something like "wait times" but it never pans out (just yesterday i was looking for data on this and it's simply inconclusive).

[bluGill]

I for one am not casting any doubt on the idea that health care in the US could be much cheaper without any cost to research. I'm casting doubt on the proposals I've seen because the root cause (in my opinion) is not being addressed. When I have to buy the insurance my boss selects for me it is impossible for me to improve the system. (in theory I can buy elsewhere, but I lose the large subsidy my boss provides)

[shpongled]

Every other western nation can accomplish it because the US is paying for, and performing the vast majority of drug discovery research (publicly and privately funded). US citizens are subsidizing the healthcare of all of those other countries.

[balfirevic]

> in which way is america exceptional except insofar as exactly that here business tries to extract as much as value as physically possible

Apparently, it's exceptionality comes from high levels of obesity, homicide, car accidents and drug abuse, of which only the last one has any link to businessy nature of healthcare.

https://randomcriticalanalysis.com/2019/11/07/a-tale-of-two-...

[Mirioron]

If you are rich, get cancer and can pick any country to get treatment in, which country do you go to? Obviously it would depend on the specific cancer, but I think the US would be the best bet in aggregate.

[harryh]

Correct. Cancer survival rates in the US are generally the highest in the world (it varies a bit by cancer type).

https://www.cdc.gov/cancer/dcpc/research/articles/concord-2....

[Someone1234]

And if you're not rich, and get cancer, which country do you go to? I bet in aggregate it is never the US.

[Mirioron]

Well, it depends on what citizenship you have. The point is that if it's expensive in the US now then perhaps in the future it will be cheaper and available elsewhere.

[claudeganon]

The purchasing and marking up of expired drugs/patents and blocking of transition to generic status seem the obvious counterexamples here...

https://hbr.org/2017/04/how-pharma-companies-game-the-system...

[craftinator]

100% agree. If we didn't have data about any of these other Western country's healthcare systems, then arguments like "maybe that's just how much it costs" or "there are tradeoffs between market driven and government driven" are plausible. However, that is simply not the case. The money goes >somewhere<, to >someone<, and with wealth inequality being quite high in the US, I imagine you can identify where a large amount of that money is going. Extremely rich pharma Bros are a great example of how the market has failed in the pharma industry.

[_dw7s]

Considering you brought in feelings into the equation, I want to express the reason I'm sad. I'm sad that antibiotics are not profitable enough to be researched and we're slowly but steadily heading into antibiotic-resistance hell as we're losing the arms race with bacteria thanks to capitalist healthcare.