Health Care Passes in House 220-215

[Gewehr98]

As part of a drug/bio-therapeutic company (Ikaria/INO), I, too am puzzled by the sweeping generalizations offered by Shootingstudent.  I get monthly breakdowns on R&D, growth, expenditures, etc from our CEO.  That's something I don't think SS is privy to, but I could be wrong. 

[AZRedhawk44]

G98:

Being part of one of the "evil" drug companies, do you know if people in your company sometimes speculate on what would happen if your company simply chose to not do business in countries where it is not profitable to do so?

For example:  Your company creates drug "X" in a US based R&D lab.  From inception to FDA approval, it takes 10 years and 75 million dollars to accomplish this feat.  Production cost per pill is $0.10 now that the R&D is completed, but you have a $75 million deficit before it makes financial sense for your company to exist, so you decide to resell the drug to pharmacies at $0.50 per pill, and the pharmacy sells it to the end user at $1 per pill.

The number of medically affected people who need "X" (or any targeted new prescription) isn't very high, but "X" has a respectable target audience.  Let's say there are 500,000 people in the US diagnosed with that condition, and 3 million total in western countries.  "X" is to be prescribed daily, indefinitely.

If half of those 500k take "X" then you have 250k * 365 pills sold per year.  That's a gross revenue of $45.6 million in the US market once half of all diagnosed patients are on your prescription.  Net revenue (subtract $0.10 per pill) is closer to $36 million.

Now... to sell abroad to price-controlled medical economies, you can only sell the pills to pharmacies at $0.15 per pill.  Revenue to that remaining 2.5 million non-US market would be a gross of 13.7 million with a pill manufacturing cost of about 9.1 million, for a net around 4.5 million.  That 4.5 million would probably be consumed in dealing with the myriad of international laws involved, since your 2.5 million target user base is spread out among 20 different countries.  Remember, your $0.10 per pill is just for domestic production costs and does not include the legal wranglings involved in international trade.

Is it even "worth" it to manufacture for the foreign market, in comparison to the investment involved of deliberately withholding the product for several years to try and change legislation in those countries?

Are there US-based laws that would prohibit such an action?  What recourse would another country have against a US-based pharmaceutical that simply decided to shut down operations elsewhere?

Is the foreign drug market that bad yet, or is it merely not as good as the US?

[FTA84]

Countries which induce price controls on simple farming end up with famine.  Now food is a more basic a necessity than medical care; it is also infinitely more simple in terms of development and distribution.  

How does anyone think that government controls on health care won't lead to less health care when it can't even apply to farming?

Reducing ability to profit IS reducing incentive to produce.

[Headless Thompson Gunner]

HTG, I'm struggling to see where I said there should be no charge for development. 

You've said over and over again that there should be less R&D.  You say it every time you say government should make medicine cheaper.

Either of two things must happen if you artificially reduce prices below their natural level.  Either you have less revenue to cover costs, or you have less revenue to generate profits. 

This means either you have less capability to invest in new research, or you have less reason to invest in new research.  Either way, you get less research.

It is no coincidence that the nation that allows the most profit potential for medical providers is also the nation that produces the most medical research and development.

Every time you say medical costs should be forced down by government fiat, what you're actually saying is that you want less research.  Whether you understand it or not, whether you admit it or not, you're saying there should be less research.

[makattak]

You've said over and over again that there should be less R&D.  You say it every time you say government should make medicine cheaper.

Either of two things must happen if you artificially reduce prices below their natural level.  Either you have less revenue to cover costs, or you have less revenue to generate profits. 

This means either you have less capability to invest in new research, or you have less reason to invest in new research.  Either way, you get less research.

It is no coincidence that the nation that allows the most profit potential for medical providers is also the nation that produces the most medical research and development.

Every time you say medical costs should be forced down by government fiat, what you're actually saying is that you want less research.  Whether you understand it or not, whether you admit it or not, you're saying there should be less research.

Unfortunately, those on the left have a total inability to look beyond first causes. The economic reasoning that looks to the effects of a policy beyond the intentions of a policy are generally dismissed as fantasy and mean-spirited attacks.

[Gewehr98]

AZRH44, we're trying darn hard to expand our drug's presence in Mexico, Japan, and Australia.

You would not believe the investment required in legal counsel and regulatory research just to get a foothold in one of the foreign markets, let alone three.

Dealing with the FDA is but one hoop we have to jump through, and that's just the domestic market. 

We seem to be having the best luck with Japan. 

Mexico, quite honestly, cannot really afford INOmax, save for some private hospitals around Mexico City. Hopefully, those hospitals will make our expansion into that market at least marginally successful, otherwise we're throwing good money after bad.   

[RocketMan]

All the talking heads and pundits have been reporting that the Senate version of the health care bill might not even come up for a vote before Christmas, if at all this year.
The WSJ is reporting that it is scheduled for a vote at 8:00 PM Saturday after only ten hours of debate.
Looks like the fat lady is warming up her pipes.

[sanglant]

i can't keep quite anymore, i looked up INOmax. and now i just have to say.




WHIPPETS???


  no harm ment it just needed said

[Hutch]

The WSJ is reporting that it is scheduled for a vote at 8:00 PM Saturday after only ten hours of debate.

BOHICA.  The irony of it is, I have to decide TODAY whether to establish an MSA and HDHP (savings account and hi-deductible insurance) or stay with my EPO coverage.  Wish I could get a delay until next week...

[Gewehr98]

Sanglant, we deliver Nitric Oxide.

Not Nitrous Oxide.

There is a difference.   

[charby]

All the talking heads and pundits have been reporting that the Senate version of the health care bill might not even come up for a vote before Christmas, if at all this year.
The WSJ is reporting that it is scheduled for a vote at 8:00 PM Saturday after only ten hours of debate.
Looks like the fat lady is warming up her pipes.

I have a slight inkling that this won't pass in the Senate.

[grey54956]

If it does pass the Senate, we'll all need prescription strength Preparation-H.  Will gov't cover that?

[RocketMan]

I have a slight inkling that this won't pass in the Senate.

Remember, there were doubts about it passing in the House.  Pelosi's crew managed to whip enough folks into line to pass their version.
Personally, I think all the "doubts" being expressed by those in Congress are a smoke screen meant to deflect constituent concern so they can pass this damn thing.

[grey54956]

So, assuming that this abomination passes, gets reconciled and signed, how do we go about turning back the clock.  Is it possible to attack the constitutionality of such laws?  Would it be better to pursue legislation to disassemble this and other entitlement programs?  Can such a thing be done?  Maybe we need a third party whose only focus is to disassemble the majority of gov't programs going back to the 30's, with the beneift of vastly reduced taxes and improved freedoms.

[RocketMan]

I do not know of any entitlement program that has ever been rolled back, unconstitutional or otherwise.  Once it's in, we're probably stuck with it.

[MicroBalrog]

I do not know of any entitlement program that has ever been rolled back, unconstitutional or otherwise.  Once it's in, we're probably stuck with it.

Actually, if I recall correctly, there was a vast healthcare entitlement passed in the late 1980's/early 1990's that was then repealed.

[makattak]

I do not know of any entitlement program that has ever been rolled back, unconstitutional or otherwise.  Once it's in, we're probably stuck with it.

Of note, the entitlement part doesn't begin until 2013. The paying for it part starts immediately.

If Obama is defeated in 2012, we will have that chance to repeal it then. Otherwise, I, too, am doubtful it could be repealed (prior to a total collapse of the economy from the combined effects of said healthcare, Medicare, and Social Security).

[longeyes]

There are many ways to "repeal" something.  The stakes just have to be high enough.

In the past in America they weren't; but times change.  

If we are forced to choose between past contracts and survival, we might surprise ourselves by choosing survival.  Maybe some of us will just choose to not play the game any more.

I don't think the "rules" in the future will resemble those we have counted on in prior times.  Nothing about our current situation matches up with past crises; we are in a new and far more dangerous place.

***

I always find this strange, this assumption that we are just going to march lemming-like into complete serfdom because what more and more consider a rogue government makes deals against the best interests of our nation.  Societies do not just grind on unless they are in relative isolation and their populations are completely impotent.  Things today are very fluid.

[Headless Thompson Gunner]

The bulk of our success as a society is due to our peculiar set of rules, and our willing adherence to them.

You ought not be so cavalier about throwing those rules away.

[longeyes]

Dear "Headless:"

Kindly note that I AM NOT THE ONE THROWING THE RULES AWAY.

You have a lot of people in high places, especially ones pledged to represent us, who are doing that.

There is no "rule" that says I must go along with oppression and insanity.  The Founding Fathers would agree with me, I believe, on that one.

You're a smart guy--I read your posts--and you know perfectly well that the American people are getting shafted right and left by people who don't give a fig for what we think, much less our best interests.  They stopped playing by the rules a long, long time ago.  If we're smart we'll do what we need to do to get back on our feet and re-take our country.  I continue to believe that co-existence with the Left in America is a dangerous delusion.  That means separation, hopefully amicable.  While it's possible that we can again achieve a political majority in America, I think the odds, unfortunately, are against that.  If that's the case what do you propose, just sitting back and becoming a slave?

[Gewehr98]

Kindly note that I AM NOT THE ONE THROWING THE RULES AWAY.

You have a lot of people in high places, especially ones pledged to represent us, who are doing that.

There is no "rule" that says I must go along with oppression and insanity.  The Founding Fathers would agree with me, I believe, on that one.

You're a smart guy--I read your posts--and you know perfectly well that the American people are getting shafted right and left by people who don't give a fig for what we think, much less our best interests.  They stopped playing by the rules a long, long time ago.  If we're smart we'll do what we need to do to get back on our feet and re-take our country.  I continue to believe that co-existence with the Left in America is a dangerous delusion.  That means separation, hopefully amicable.  While it's possible that we can again achieve a political majority in America, I think the odds, unfortunately, are against that.  If that's the case what do you propose, just sitting back and becoming a slave?

Oh, boy.

Well, folks, we made it to 6 pages at least.  That's pretty good, all things considered.