Hacker News new | ask | show | jobs
by BerislavLopac 4819 days ago
Actually, the problem in the US is in the lack of the balance between the producers and customers of medicine. In Canada, as you point out, there is a state monopoly on the purchasing side, but there is a similar monopoly on the selling side, in the form of medical patents. In India, there isn't a monopoly on either side.

In the US, you have no monopoly on the healthcare side, but the drug companies have a monopoly on the drugs they produce. I'm not saying neither that you should drop the patents nor that you should introduce social healthcare -- but you should restore the balance in some way.

Personally, I'm for dropping or drastically reducing the patents on new drugs. I know that the argument against it is that it will discourage the research, but I don't believe it -- actually, it would enable further research on already existing drugs, improving them, and finding new uses and applications (think Viagra). But that's my personal opinion, and I'm not even a US citizen; you should find the right solution for yourselves.
1 comments
objclxt 4819 days ago
> In the US, you have no monopoly on the healthcare side, but the drug companies have a monopoly on the drugs they produce.

In a way there is a monopoly on the healthcare side in the US, but it only impacts a certain segment of the population. Medicare is able to negotiate significant discounts on the cost of healthcare compared to private insurers precisely because for so many people it is the de facto provider.

There was a really interesting Planet Money podcast a month or so ago about healthcare costs in the US which covered why the difference between private insurers and Medicare is so great: http://www.npr.org/blogs/money/2013/02/26/172996963/episode-...

link
rdl 4819 days ago
Medicare/Medicaid are specifically not allowed to bargain on drug prices, though. They are a monopsony for hospital/doctor services, with full pricing power, for the old and poor, but pay market prices for drugs by law.
link
refurb 4819 days ago
More accurately, Medicare is not allowed to negotiate for drug prices, however, the don't pay more than the average selling price for a drug (ASP).

Medicaid is certainly allowed to negotiate over drug prices. Medicaid gets an automatic 23% off the drug price and if the states can get an even bigger discount, they often get to keep it.

link