Why don’t right wing Americans like free healthcare?

[wishIwasSalludon]

Why

@noobs @cromagnon @ey88

 

[noobs]

tax, the money for healthcare comes from the taxpayer

 

[hattrick]

cuz some obese chick is gonna get healthcare that i paid for via taxes

their body their choice type shit

 

[ey88]

Because they are usually hard workers and get taxed more and have to pay for immigrants to get healthcare, also here in Canada it sucks and it is basically impossible to get a family doctor and wait times are insane

 

[wishIwasSalludon]

Because they are usually hard workers and get taxed more and have to pay for immigrants to get healthcare, also here in Canada it sucks and it is basically impossible to get a family doctor and wait times are insane

So because immigrants will get healthcare Americans shouldn’t?

 

[wishIwasSalludon]

tax, the money for healthcare comes from the taxpayer

The U.S already spends more on healthcare than any country in the world per capita

It’s just the U.S isn’t managing shit correctly

 

[ey88]

So because immigrants will get healthcare Americans shouldn’t?

No I think everyone should get it

 

[noobs]

The U.S already spends more on healthcare than any country in the world per capita

It’s just the U.S isn’t managing shit correctly

it’s better the less the government spends on healthcare and welfare

the us gov doesn’t pay for healthcare

 

[wishIwasSalludon]

No I think everyone should get it

Fuck I can hear a rat crawling around in my walls

 

[cromagnon]

Crossiant

 

[noobs]

The U.S already spends more on healthcare than any country in the world per capita

It’s just the U.S isn’t managing shit correctly

i still don’t want to be forced to pay money for other people

it’s their own responsibility

 

[wishIwasSalludon]

Crossiant

No

 

[wishIwasSalludon]

i still don’t want to be forced to pay money for other people

it’s their own responsibility

You already do, who do u think funds schools, roads, and literally every government service

 

[cromagnon]

I’m

No

i love you bhai

 

[noobs]

You already do, who do u think funds schools, roads, and literally every government service

the purpose for tax is for agreed upon goods that would be impossible through decentralized society

i don’t want to pay for poor people without benefit so i support public schooling but not welfare and healthcare because in schooling niggers are made civilized

i couldn’t give a shit if a nigger broke his leg

 

[looksmaxxed]

because i have to be financially responsible for genetic shit obese subhumans, illegals, and all manner of human detritus. it's a nice system theoretically, but doesn't work in reality. free healthcare for white citizens who own property? maybe

 

[Gaygymmaxx]

cuz some obese chick is gonna get healthcare that i paid for via taxes

their body their choice type shit

Fuentes was right

 

[wishIwasSalludon]

because i have to be financially responsible for genetic shit obese subhumans, illegals, and all manner of human detritus. it's a nice system theoretically, but doesn't work in reality. free healthcare for white citizens who own property? maybe

the purpose for tax is for agreed upon goods that would be impossible through decentralized society

i don’t want to pay for poor people without benefit so i support public schooling but not welfare and healthcare because in schooling niggers are made civilized

i couldn’t give a shit if a nigger broke his leg

Here’s what you’re not understanding

The U.S already pays more in healthcare per capita

It’s just mismanaged because conservatives keep voting to not manage it properly

Theoretically speaking your taxes shouldn’t even increase

 

[noobs]

Here’s what you’re not understanding

The U.S already pays more in healthcare per capita

It’s just mismanaged because conservatives keep voting to not manage it properly

Theoretically speaking your taxes shouldn’t even increase

people should cut the funding to healthcare completely

 

[wishIwasSalludon]

people should cut the funding to healthcare completely

Bruh

 

[MaghrebGator]

Man, those people don't really give a damn about anything, they just want to be part of a social group that is one of the majority and they go on with all that trash swallowing for the sake of that social need.

It's what the human being are made off, we are social creatures and democracy is the system that profits the most of it, which makes it one of the worst of them all. Look at football teams, you see fans from different teams always defending their players even though it's literally the most irrelevant stuff in the world.

Do you really think the average hillbilly from Gary, Indiana doesn’t want free healthcare because of some deep economical analysis and conclusions?? Like come on man.

Any rational unbiased person in the world would reduce a sad and cumstained 5% the US military budget (Which is like 4 times China who is second in that spending in the world) for the sake of the best free healthcare you can imagine, an utopia. They just believe the TV propaganda trash coming from the elites that "Dude social healthcare, social, SOCIALISM DUDE, IT''S THE SOVIETS ALL OVER AGAIN", and since they want to feel part of that group (Right wing americans) who also happens to be defined by the elites, they don't mind to not only accept it but defend it to the teeth.

That's why they hate any other ideology outside their "Democratic" parties, because they are shaped by outside factors. That's why they have been fighting Islam and even other ideologies for decades, because they are outside of their reach, contradict capitalism which relies mainly on interest to enhance a specific extremely small elite that will enslave the world without moving a finger, and the people that follow them reach the billions because they just have to pick up a book and start reading it and easily pledge allegiance to it so they are very accesible.

 

[incel-at-heart]

Why

@noobs @cromagnon @ey88

It isn't free

 

[Jason Voorhees]

tax, the money for healthcare comes from the taxpayer

I don't think people realize that they get what they pay for. The US doctors are some of the best in the world, most of the hospitals are equipped with state of the art equipments, the services are quick, effective and all the patients are attended to on time. Just ask the eurocels on the forum how shitty their muh free Healthcare is in their country.


Long waits that make you question if you're there for a doctor's appointment or a vacation, doctors who seem like they're just counting down the seconds until they can punch out, aand dogshit facilities and equipments. It's like, when there's no money to be made, the service tends to suck.
That's where the whole capitalism thing comes into play. Competition always drives quality up.

 

[Scarface756]

Tbh, I never understood why Right Wingers in Merica think universal healthcare is some sort of Commie propaganda when it's pretty much standards all over the world including in more conservative countries that aren't remotely woke.

That's just an L not matter how much you dice it.

The fact that you niggas don't think the billionaire class who runs this country can help us get universal healthcare which will save us lots of money in the long haul is honestly hilarious and sad at the same time.

Even fucking Nationalist parties in Europe and Asia support universal healthcare. Fucking insane how much billionaires and elites have paid off both parties to push the meme that it's "commie" or "woke" to want it.

 

[Jason Voorhees]

I don't think people realize that they get what they pay for. The US doctors are some of the best in the world, most of the hospitals are equipped with state of the art equipments, the services are quick, effective and all the patients are attended to on time. Just ask the eurocels on the forum how shitty their muh free Healthcare is in their country.


Long waits that make you question if you're there for a doctor's appointment or a vacation, doctors who seem like they're just counting down the seconds until they can punch out, aand dogshit facilities and equipments. It's like, when there's no money to be made, the service tends to suck.
That's where the whole capitalism thing comes into play. Competition always drives quality up.

Read this

Tbh, I never understood why Right Wingers in Merica think universal healthcare is some sort of Commie propaganda when it's pretty much standards all over the world including in more conservative countries that aren't remotely woke.

That's just an L not matter how much you dice it.

The fact that you niggas don't think the billionaire class who runs this country can help us get universal healthcare which will save us lots of money in the long haul is honestly hilarious and sad at the same time.

Even fucking Nationalist parties in Europe and Asia support universal healthcare. Fucking insane how much billionaires and elites have paid off both parties to push the meme that it's "commie" or "woke" to want it.

 

[Aypo129]

Because US healthcare system is perfect pretty much from top to middle and there is leeway already present in the lower end of income
It's the same story as US Drug price


Alot of people complain about the prices of Drugs in USA the same as healthcare compared to other countries
However since price comparisons over a small set of drugs cannot establish overall comparative prices, the best approach is to calculate price indices limited to those drugs sold in different countries. This is the approach taken in a recent report, “International Prescription Drug Price Comparisons,” produced by the RAND Corporation, a highly regarded research organization. Observed prices are weighted (multiplied) by their reported quantities in one of the two comparator countries. Since our attention is focused on U.S. prices, the RAND study appropriately employs U.S. quantity weights. Furthermore, since the pharmaceutical sector produces and sells more than a thousand medicinal molecules, the RAND authors are correct that the best approach is to calculate price indices for the existing set of overlapping products.

The U.S. Pharmaceutical Sector

Before reviewing the RAND report’s drug price comparisons, we must consider some distinct features of the U.S. pharmaceutical supply structure, many of which are fundamentally different from those found elsewhere. As Tom Rice points out in his 2021 book Health Insurance Systems: An International Comparison, “nearly all of the countries [included in his discussion] either set pharmaceutical price levels or engage in explicit negotiations with manufacturers.” However, “none of these activities are carried out by the U.S. federal government.” Instead, “current U.S. policy … prohibits government negotiation and relies instead on competition.”

That U.S. policy of relying on competition is correct and longstanding. As far back as the passage of the Hatch–Waxman Act in 1984, this policy direction was established. Unlike other countries, U.S. policymakers emphasize the societal gains from pharmaceutical innovation, fostering a rapid pace of new product introductions as well as those from securing low, competitive prices. The Hatch–Waxman framers recognized the conflict between these two policy objectives.

With both objectives in mind, the Hatch–Waxman framers created a second distinct pharmaceutical industry that had not previously existed. Indeed, this law was the most striking exercise of industrial policy, carried out through regulatory reform, in U.S. economic history. And it happened because a conservative Republican senator from Utah, Orrin Hatch, and a liberal Democratic congressman from West Los Angeles, Henry Waxman, worked together. By changing the regulatory structure enforced by the Food and Drug Administration, the law effectively created the U.S. generic pharmaceutical industry.

Because of the legislation, the United States has two distinct pharmaceutical industries, designed to achieve very different objectives. The branded industry, comprised of the “Big Pharma” drug companies and — later — innovator startups, was tasked with promoting a rapid pace of new product introductions intended to serve the health needs of the country and the world. (See “Why Punish the Drug Industry that’s Combating COVID?” p. 4.) The Hatch–Waxman framers acknowledged that high prices might be charged for new therapeutic agents, but they would be limited more effectively to the duration of the associated drug patents. As those patents expired, the law would allow and even encourage generic companies to enter the market with competing low-priced formulations of the established drug.

Under the Hatch–Waxman Act, potential entrants do not need to demonstrate anew by costly and socially wasteful duplicative testing the safety and efficacy of already existing pharmaceuticals, as had previously been the case. To receive FDA marketing approval, a competitor need only demonstrate bioequivalence, meaning that its version of the drug produces a biochemical response similar to that of the patented drug. This provision sharply reduced the cost of entry. While Big Pharma firms can set high prices for new drugs during their products’ patent lives, the Hatch–Waxman framers anticipated sharply lower prices once generic entrants appeared and price competition became effective.

The then-fledgling generic industry was designed to assure low prices for drugs for which patent protection had expired. This objective would be achieved not through price regulation or government intervention into the price-setting process, but through competition. Where branded prices exceeded production costs, the framers believed, a bevy of new firms would flock to the industry, attracted by the prospect of undercutting the high prices charged for therapeutically effective pharmaceuticals. If there were profits to be made, the Hatch–Waxman framers presumed that generic producers would appear.

For this scheme to work, physicians and patients would need to view generic pharmaceuticals as comparable in quality to their branded alternatives. At the time the legislation was being debated, arguments were made that “knock off” drugs would not be trusted despite FDA certification of their bioequivalence. Overall, there were serious questions as to whether the new policy of two distinct U.S. drug industries, not found anywhere else in the world, would actually work. But that was 37 years ago, and now we have the answers.

Table 1, which reports data for 2019, tells the story. When the Hatch–Waxman Act was passed in 1984, generic prescriptions accounted for merely 14% of total prescriptions. By 2019, they dominated the pharmaceutical sector and represented fully 90% of all dispensed prescriptions. Generics achieved that result by continually reducing prices such that they now represent only 29% of total spending on pharmaceuticals after accounting for discounts, rebates, and other price concessions.

In contrast, the branded industry receives more than 70% of aggregate net revenues even while providing only 10% of dispensed prescriptions. This disconnect is striking and associated, of course, with major differences in the average price per prescription between the two industries: over $600 for branded drugs but only $26.89 for generics. Based on these data, an appropriate response to the question of whether average U.S. drug prices are high or low is both. By regulatory design, there are two pharmaceutical industries: one with high prices and the other with low ones. And this result is just what the Hatch–Waxman framers had in mind.

International Price Comparisons and the RAND Report

The RAND authors were tasked by the U.S. Department of Health and Human Services with “understanding the extent to which drug prices are higher in the United States than in other countries.” To this end, they explain and then derive “price indices as a tool to compare drug prices between countries.” However, the authors pay little attention to the presence of two distinct U.S. pharmaceutical industries. In effect, they compute a “fruit” index containing “apples” and “oranges” with little concern paid to the striking price differences between them.

In the discussion that follows, I largely ignore the authors’ overall index, which mixes together the prices of branded and generic drugs. I focus, instead, on their separate price indices for branded and generic pharmaceuticals, which is where they make their most important contributions. And rather than deal with their full sample of 32 comparator countries, I consider only Japan, Germany, and the United Kingdom, which are the three largest consumers by volume of pharmaceuticals after the United States. As indicated in the first part of Table 2, U.S. sales of combined branded and generic drugs are much greater than those found in any of the next largest countries.

The data presented in the second part of Table 2 describe the different compositions of U.S. pharmaceutical sales as compared with its largest rivals. Consistent with the data presented earlier on prescriptions, the physical volume of U.S. generic sales was 84% of the country’s total in 2018, although its sales revenue was only 12% of the total. The next largest countries all had smaller shares of physical units accounted for by unbranded generics but larger shares of sales revenue. These data indicate the very different pharmaceutical supply structures in the United States and elsewhere.

Table 3 reports the RAND report’s major findings. Consistent with the data provided earlier, and after making the appropriate net price correction, U.S. branded drug prices are more than double their foreign counterparts in Japan and the UK and just under that level in Germany. However, these averages apply to only 16% of the pharmaceutical physical units sold in the United States.

In contrast, as also indicated in Table 3, the RAND report finds that U.S. average generic drug prices are much lower than those reported for the three large comparator counties: only 43% for Japan, 62% for Germany, and 68% for the UK. And these averages apply to fully 84% of the pharmaceutical standard units sold in the United States. To a far greater extent than elsewhere, U.S. pharmaceutical prices diverge between the branded and generic markets. Competition determines price outcomes in generic markets but not so much for those supplied by branded pharmaceuticals, which remain largely the province of patent-protected product monopolies.

While the RAND report provides a useful discussion of price index economics and also valuable price indices concerning U.S. pharmaceuticals, it suffers from a lack of connection to the underlying market conditions. Its concluding statement makes that disconnect clear:

We found that 2018 drug prices in the United States were substantially higher than those in other countries. The magnitude of this difference between prices in the United States and other countries was substantial.… Only unbranded generics had lower prices than in most comparator countries.

What is missing from the statement is that, by their own reported data, fully 84% of total pharmaceutical quantities are represented by unbranded generics. That category of pharmaceuticals hardly represents an exception to a larger conclusion put forth in the report.

Policy Conclusions

The RAND report confirms the common notion that U.S. consumers pay high branded drug prices as compared to other developed nations. It also confirms the less recognized fact that U.S. consumers pay lower generic prices than elsewhere. This division reflects U.S. policymakers' dual goals of promoting pharmaceutical innovation while also reducing the prices of long-established drugs. To gain the benefits of therapeutically advanced new drugs, the Hatch–Waxman policymakers willingly tolerated high branded prices. Whether those prices are excessive or not turns on whether they exceed levels required to achieve the drug innovation policy objective and not on whether they are higher than elsewhere.

There is empirical evidence in a study by F.M. Scherer that drug companies' net revenues are an important predictor of pharmaceutical company ratios of research and development expenditures to sales. There is also evidence that larger therapeutic markets, which promise greater revenues, directly entice the entry of new medications and new molecular entities. The point here is that pharmaceutical innovation is an economic activity that is pursued, like other economic activities, for financial gain.

Even when new pharmaceuticals build upon basic scientific discoveries made in government and university facilities, company resources are required. On this point, an empirical study by Andrew Toole estimated that for every public dollar allocated to basic biopharmaceutical research, an additional $8.38 is spent on pharmaceutical R&D. In a recent report, the Congressional Budget Office emphasized

the complementary relationship between public and private R&D spending [which] arises mainly because NIH funding focuses on basic research that leads to the discovery of new drugs, whereas private spending focuses on applications of such research.

A major factor in private R&D spending is the cost of the extensive clinical trials required before the Food and Drug Administration grants marketing approval. These trials can cost upward of $100 million per drug according to estimates by Joseph DiMasi and colleagues. The point here is not to diminish the importance of public research but rather to note its complementarity to industry research in circumstances where both efforts are essential.

To be sure, pharmaceutical R&D is inherently uncertain. While not all research programs lead to therapeutically important new drugs, many do. A striking example is the development of pharmaceutical treatments to combat the virulent AIDS epidemic. An empirical study by Tomas Philipson and Anupam Jena of the comparative aggregate treatment costs and social benefits reported that the survival gains associated with the new AIDS treatments were conservatively valued at 20 times the observed treatment costs.

While the AIDS example may be atypical, Philipson and Jena also noted that for a larger sample of 200 branded pharmaceuticals, societal values exceed treatment costs by as much as 10 times. Moreover, for new drugs that are no better than existing ones, these pharmaceuticals are generally priced at about the same level as their established rivals, according to my research with John Lu. For the most part, and with some exceptions, the prices charged for branded drugs lie well below the social value of their therapeutic contributions, as explained in a forthcoming paper by Mark Pauly et al.

Between 1990 and 2015, U.S. life expectancy increased by 3.3 years, and a recent study by Jason Buxbaum et al. apportioned that improvement among leading contributory factors. The authors emphasized that the 12 most significant factors together contributed 85% (2.9 years) of the aggregate gain. Among those factors, pharmaceuticals was the second most important, after public health measures. Drugs represented 44% of the aggregate improvement in mortality rates, although partly offset by a survival deterioration of 9% associated largely with the opioid crisis. Still, the net gain from pharmaceuticals was 35% of the total. These findings, the authors point out, "underscore the central role of medications in explaining reduced mortality."

Another report by the Congressional Budget Office examined the connection between pharmaceutical prices and innovation. When bills are offered or passed in either chamber of Congress, they are commonly "scored" by this impartial office to describe the implications of the proposed legislation. For the most part, the CBO provides budgetary implications but sometimes also offers additional non-budgetary effects. The CBO "scored" the 2019 Cummings legislation mentioned earlier.

The bill's objective was to reduce drug prices by instructing the secretary of health and human services to negotiate the prices of "selected drugs" so they do not exceed 120% of their average price charged in a specified group of countries. In such circumstances, the CBO estimated that government spending would fall by $456 billion over a 10-year period. The CBO also estimated that, because of the diminished revenue for newly patented drugs, eight fewer drugs would be introduced over the 2020–2029 period, and 30 fewer drugs over the subsequent decade. A subsequent CBO staff report reduced those figures to two fewer drugs in the current decade and 23 fewer in the next decade, but also estimated there would be 34 fewer drugs in the following decade. The report explained, "The change would be small for the first few years … [but] would increase substantially as decisions in earlier phases of development affect later phases."

The evident tradeoff between prices and innovation raises the policy question of why other developed nations have enforced far lower prices despite having similar menus of advanced pharmaceuticals. Wouldn't their lower revenues yield fewer new drugs? The answer lies in the reality that the tradeoff between branded prices and innovation does not affect other countries nearly as much as it does the United States.

As disclosed in the RAND report, the United States accounts for 58% of total pharmaceutical sales revenue among nations in the Organisation for Economic Co-Operation and Development, whereas the second and third highest counties, Japan and Germany, are 9% and 5% respectively. Moreover, because U.S. branded prices are higher than elsewhere, the United States accounts for approximately 78% of worldwide industry profits. All other countries, in aggregate, account for less than one-third of that amount. Put simply, U.S. profits incentivize global innovation.

Whether this striking imbalance resulting from high U.S. branded drug prices is "excessive" or not depends on policy objectives pertaining specifically to the branded industry. As emphasized in a 2018 report by the President's Council of Economic Advisers, "worldwide profits drive innovation incentives," which in turn depend at least partially on the prices paid by government health insurance programs. The report continues, "Providing innovative returns is a global public goods problem that leads to classic under-provision through government free-riding." Because advanced new pharmaceuticals benefit all countries, each has an incentive to free ride off the high prices and resulting incentive effects of others. While this incentive applies particularly to smaller countries that contribute little to overall innovative returns, it is least applicable to the United States, which in effect has no one to free ride on. In a sense, the United States is captive to its overwhelming position in the worldwide pharmaceutical marketplace.

Fundamentally, the reason why U.S. branded drug prices are so high is that the societal gains from therapeutically advanced new products are embodied in the prices that informed collective buyers are willing to pay. While most other countries can presume that pharmaceutical innovation is largely unaffected by its pricing decisions, the United States cannot. There are advantages to this heady role, including that advanced new d

Since price comparisons over a small set of drugs cannot establish overall comparative prices, the best approach is to calculate price indices limited to those drugs sold in different countries. This is the approach taken in a recent report, “International Prescription Drug Price Comparisons,” produced by the RAND Corporation, a highly regarded research organization. Observed prices are weighted (multiplied) by their reported quantities in one of the two comparator countries. Since our attention is focused on U.S. prices, the RAND study appropriately employs U.S. quantity weights. Furthermore, since the pharmaceutical sector produces and sells more than a thousand medicinal molecules, the RAND authors are correct that the best approach is to calculate price indices for the existing set of overlapping products.

The U.S. Pharmaceutical Sector

Before reviewing the RAND report’s drug price comparisons, we must consider some distinct features of the U.S. pharmaceutical supply structure, many of which are fundamentally different from those found elsewhere. As Tom Rice points out in his 2021 book Health Insurance Systems: An International Comparison, “nearly all of the countries [included in his discussion] either set pharmaceutical price levels or engage in explicit negotiations with manufacturers.” However, “none of these activities are carried out by the U.S. federal government.” Instead, “current U.S. policy … prohibits government negotiation and relies instead on competition.”

That U.S. policy of relying on competition is correct and longstanding. As far back as the passage of the Hatch–Waxman Act in 1984, this policy direction was established. Unlike other countries, U.S. policymakers emphasize the societal gains from pharmaceutical innovation, fostering a rapid pace of new product introductions as well as those from securing low, competitive prices. The Hatch–Waxman framers recognized the conflict between these two policy objectives.

With both objectives in mind, the Hatch–Waxman framers created a second distinct pharmaceutical industry that had not previously existed. Indeed, this law was the most striking exercise of industrial policy, carried out through regulatory reform, in U.S. economic history. And it happened because a conservative Republican senator from Utah, Orrin Hatch, and a liberal Democratic congressman from West Los Angeles, Henry Waxman, worked together. By changing the regulatory structure enforced by the Food and Drug Administration, the law effectively created the U.S. generic pharmaceutical industry.

Because of the legislation, the United States has two distinct pharmaceutical industries, designed to achieve very different objectives. The branded industry, comprised of the “Big Pharma” drug companies and — later — innovator startups, was tasked with promoting a rapid pace of new product introductions intended to serve the health needs of the country and the world. The Hatch–Waxman framers acknowledged that high prices might be charged for new therapeutic agents, but they would be limited more effectively to the duration of the associated drug patents. As those patents expired, the law would allow and even encourage generic companies to enter the market with competing low-priced formulations of the established drug.

Under the Hatch–Waxman Act, potential entrants do not need to demonstrate anew by costly and socially wasteful duplicative testing the safety and efficacy of already existing pharmaceuticals, as had previously been the case. To receive FDA marketing approval, a competitor need only demonstrate bioequivalence, meaning that its version of the drug produces a biochemical response similar to that of the patented drug. This provision sharply reduced the cost of entry. While Big Pharma firms can set high prices for new drugs during their products’ patent lives, the Hatch–Waxman framers anticipated sharply lower prices once generic entrants appeared and price competition became effective.

The then-fledgling generic industry was designed to assure low prices for drugs for which patent protection had expired. This objective would be achieved not through price regulation or government intervention into the price-setting process, but through competition. Where branded prices exceeded production costs, the framers believed, a bevy of new firms would flock to the industry, attracted by the prospect of undercutting the high prices charged for therapeutically effective pharmaceuticals. If there were profits to be made, the Hatch–Waxman framers presumed that generic producers would appear.

For this scheme to work, physicians and patients would need to view generic pharmaceuticals as comparable in quality to their branded alternatives. At the time the legislation was being debated, arguments were made that “knock off” drugs would not be trusted despite FDA certification of their bioequivalence. Overall, there were serious questions as to whether the new policy of two distinct U.S. drug industries, not found anywhere else in the world, would actually work. But that was 37 years ago, and now we have the answers.

Table 1, which reports data for 2019, tells the story. When the Hatch–Waxman Act was passed in 1984, generic prescriptions accounted for merely 14% of total prescriptions. By 2019, they dominated the pharmaceutical sector and represented fully 90% of all dispensed prescriptions. Generics achieved that result by continually reducing prices such that they now represent only 29% of total spending on pharmaceuticals after accounting for discounts, rebates, and other price concessions.



In contrast, the branded industry receives more than 70% of aggregate net revenues even while providing only 10% of dispensed prescriptions. This disconnect is striking and associated, of course, with major differences in the average price per prescription between the two industries: over $600 for branded drugs but only $26.89 for generics. Based on these data, an appropriate response to the question of whether average U.S. drug prices are high or low is both. By regulatory design, there are two pharmaceutical industries: one with high prices and the other with low ones. And this result is just what the Hatch–Waxman framers had in mind.

International Price Comparisons and the RAND Report

The RAND authors were tasked by the U.S. Department of Health and Human Services with “understanding the extent to which drug prices are higher in the United States than in other countries.” To this end, they explain and then derive “price indices as a tool to compare drug prices between countries.” However, the authors pay little attention to the presence of two distinct U.S. pharmaceutical industries. In effect, they compute a “fruit” index containing “apples” and “oranges” with little concern paid to the striking price differences between them.

In the discussion that follows, I largely ignore the authors’ overall index, which mixes together the prices of branded and generic drugs. I focus, instead, on their separate price indices for branded and generic pharmaceuticals, which is where they make their most important contributions. And rather than deal with their full sample of 32 comparator countries, I consider only Japan, Germany, and the United Kingdom, which are the three largest consumers by volume of pharmaceuticals after the United States. As indicated in the first part of Table 2, U.S. sales of combined branded and generic drugs are much greater than those found in any of the next largest countries.

The data presented in the second part of Table 2 describe the different compositions of U.S. pharmaceutical sales as compared with its largest rivals. Consistent with the data presented earlier on prescriptions, the physical volume of U.S. generic sales was 84% of the country’s total in 2018, although its sales revenue was only 12% of the total. The next largest countries all had smaller shares of physical units accounted for by unbranded generics but larger shares of sales revenue. These data indicate the very different pharmaceutical supply structures in the United States and elsewhere.

Table 3 reports the RAND report’s major findings. Consistent with the data provided earlier, and after making the appropriate net price correction, U.S. branded drug prices are more than double their foreign counterparts in Japan and the UK and just under that level in Germany. However, these averages apply to only 16% of the pharmaceutical physical units sold in the United States.

In contrast, as also indicated in Table 3, the RAND report finds that U.S. average generic drug prices are much lower than those reported for the three large comparator counties: only 43% for Japan, 62% for Germany, and 68% for the UK. And these averages apply to fully 84% of the pharmaceutical standard units sold in the United States. To a far greater extent than elsewhere, U.S. pharmaceutical prices diverge between the branded and generic markets. Competition determines price outcomes in generic markets but not so much for those supplied by branded pharmaceuticals, which remain largely the province of patent-protected product monopolies.



While the RAND report provides a useful discussion of price index economics and also valuable price indices concerning U.S. pharmaceuticals, it suffers from a lack of connection to the underlying market conditions. Its concluding statement makes that disconnect clear:

We found that 2018 drug prices in the United States were substantially higher than those in other countries. The magnitude of this difference between prices in the United States and other countries was substantial.… Only unbranded generics had lower prices than in most comparator countries.

What is missing from the statement is that, by their own reported data, fully 84% of total pharmaceutical quantities are represented by unbranded generics. That category of pharmaceuticals hardly represents an exception to a larger conclusion put forth in the report.

Policy Conclusions

The RAND report confirms the common notion that U.S. consumers pay high branded drug prices as compared to other developed nations. It also confirms the less recognized fact that U.S. consumers pay lower generic prices than elsewhere. This division reflects U.S. policymakers' dual goals of promoting pharmaceutical innovation while also reducing the prices of long-established drugs. To gain the benefits of therapeutically advanced new drugs, the Hatch–Waxman policymakers willingly tolerated high branded prices. Whether those prices are excessive or not turns on whether they exceed levels required to achieve the drug innovation policy objective and not on whether they are higher than elsewhere.

There is empirical evidence in a study by F.M. Scherer that drug companies' net revenues are an important predictor of pharmaceutical company ratios of research and development expenditures to sales. There is also evidence that larger therapeutic markets, which promise greater revenues, directly entice the entry of new medications and new molecular entities. The point here is that pharmaceutical innovation is an economic activity that is pursued, like other economic activities, for financial gain.

Even when new pharmaceuticals build upon basic scientific discoveries made in government and university facilities, company resources are required. On this point, an erugs are typically introduced first in the United States. But there are obvious disadvantages as well, and among them is that policymakers such as the Hatch–Waxman framers cannot avoid accounting for effects on new product introduction when setting policies affecting prices. The compromise solution contained in that striking piece of legislation will not be duplicated elsewhere.


TLDR there was a lot of thought put into it
@Jason Voorhees got it right

 

[TheBiggestIncelEver]

Why

@noobs @cromagnon @ey88

Because we need to give it to Israel

 

[Unhuman]

Republicans are retarded this is why they don't like free healthcare.

 

[looksmaxxed]

Tbh, I never understood why Right Wingers in Merica think universal healthcare is some sort of Commie propaganda when it's pretty much standards all over the world including in more conservative countries that aren't remotely woke.

That's just an L not matter how much you dice it.

The fact that you niggas don't think the billionaire class who runs this country can help us get universal healthcare which will save us lots of money in the long haul is honestly hilarious and sad at the same time.

Even fucking Nationalist parties in Europe and Asia support universal healthcare. Fucking insane how much billionaires and elites have paid off both parties to push the meme that it's "commie" or "woke" to want it.

the difference is, in those countries, it's still 90% whites, i suspect things will change once the freeloaders explode in population via karlergi

free anything only works when it's applied to people who share your interests. people who pay taxes and think the same way you do.

 

[Aypo129]

There is also very biased way of measuring how good a healthcare is and I can write another essay but I would lay it to rest.
Us healthcare is pretty superior

 

[looksmaxxed]

anyway, nothing is free, it always comes at a cost, the only people who benefit from free medical, are the least productive, least capable, and most subhuman category of society, and the rest have to bear the cost of subsidizing their existence.. societies needs more darwinian selection and less universal suffrage. most people shouldn't have any say in society. when the bill of rights was written, it was written with high iq white chads who owned slaves and property in mind, it wasn't written on behalf of a bunch of low iq black and brown freedmen who smoke crack and sit on a porch collecting wellfare all day