Quote: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.

I am not sure how price negotiations limits availability in an absolute manner like a ban, but I could certainly see how it could favor some drugs over others. I am OK with this as long as the drugs are available on the market.


 

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.

While the problem might be overstated (see
here
) , I am a huge fan of generics. One concern is where the FDA allows testing to be done and how (like that Indian company that had iffy test procedures). One other huge problem is in biological patent law. That needs to be cleaned up to allow more of a path to generics.


 

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.

Seems easily fixable if you shift the cost of the difference to the patient unless a doctor explicitly says the generic doesn't work and backs it up.


 

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.

Admin costs are huge and probably the main driver of the difference between us and other major countries. While I don't think defensive medicine is anywhere near as big a deal, we agree it should be addressed, maybe with a waiver of liability like some other countries use if following standard practices in the absence of gross negligence. Not only higher usage but more specialists here, as it is more lucrative than GP. Agree on wages, but in my mind is less important than admin costs and transparency. But none of this addresses the fact that procedures simply
cost more
 here. In my mind this is because of the lack of price transparency and any true free market. I am very interested in the Australian plan mentioned earlier where the government 'keeps private companies honest' by competing with them, but the private market isn't phased out like in a Beveridge plan.