Quote:You are absolutely correct that my disappointment is my problem.  I am working some doubles, so will have to get into more detail later, but you seem to be in favor of competition and free market solutions, which is good, and I think you (and jj) are in favor of price transparency (which in my opinion is absolutely essential). We also agree that diet and individual responsibility is important. But just to be clear, I am not sure I have ever gotten an opinion on how procedure and drug costs are more expensive for private insurance here versus other countries, even those with private insurance. Did I miss that somewhere?

 

Drugs are more expensive for 3 main reasons:

 

1. Foreign governments set the price there while the market/manufacturer does here. This reduces cost, but in consequence it also limits availability for drugs they decide not to pay for.

 

2. The FDA oversees patent law for drugs which in turn leads to monopolies and 2a. The FDA is always backlogged in approving generic equivalents which reduce the costs by half.

 

3. Some laws, like requiring patient consent before switching from label to generic, make cost control difficult in practice because pharmacies are forced to fill the more expensive name drug unless the patient agrees otherwise.

 

Procedures (and health care in general) are more expensive because of 1. high Administrative Costs (25% of health care spending), 2. defensive medicine, treatment availability and overutilization (CTs, MRIs, and Mammograms for instance), 3. a higher usage rate for physician specialists over primary care doctors, 4. industry wages, and, of course, 5. drug costs. All of these factors drive prices up before we even consider the other social and environmental factors we discussed in other parts of this thread.

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