in some part of europe, we have national healthcare so basically people don't think they are paying their medications, like there was some magic money.
in that case, you don't care if you drug cost 10€ or 2000€ because you aren't spending a single € from your own wallet, at least if you don't factor in taxes.
Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get it paid by their own insurance but it cost them directly a lot of money.
I would think that americans would be much more vigilant about what medication they take, the price it cost, and so would have much lower pricing. That's just how free market work, and technically there are many medication manufacturer and many customer.
Is it the proof that a true unregulated free market doesn't work ? if left unsupervised, big companies are going to buy smaller companies until they are monopoly or make secret, behind the door, deal to keep price up.
It's what the USA is made on, the idea of freedom and free market. i believe the idea of unregulated market is more recent, think the 70's, but surely in the 50 years since then american would have pushed back against it and not elected people like Trump who are all in.
> I would think that americans would be much more vigilant about what medication they take
This is why I always check to make sure it's fiscally responsible before I start chemotherapy, or before buying that emergency inhaler for asthma, or before accepting paralytics and anesthesia when undergoing surgery. How fortunate that in America diabetics have the freedom to die rather than take overpriced insulin. Let the free market decide which child with leukemia deserves a bone marrow transplant and which deserves a casket! That's a much more responsible market than just having everybody chip in a small amount so that nobody needs to worry about the cost of the medications they need to live. Sure, in America millions will die or be bankrupted by healthcare costs every year, but that's better than spending a single $ from your own wallet if even a tiny fraction of it might help pay for someone else's medications right?
> Sure, in America millions will die or be bankrupted by healthcare costs every year, but that's better than spending a single $ from your own wallet if even a tiny fraction of it might help pay for someone else's medications right?
I do believe your question is false, we don't spend a tiny amount of our money on healthcare.
Around 20% of our revenue, in France, goes to the universal healthcare.
And yes, I would rather manage that money myself because I believe I am better at doing so that my government. Isn't that one the core beliefs of Americans ?
The issue is that there must an actual free market, enforced by government, and not some kind of oligarchy where drug price are kept artificially high amongst reseller.
> Around 20% of our revenue, in France, goes to the universal healthcare.
I wish we only had to pay 20%!
For those of us who are lucky enough to have health insurance 27% of our paychecks go to it which still doesn't pay for much of what we need. People with insurance commonly need to pay around $30 for every visit to a doctor. That's just the cost to walk in the door and doesn't cover many of the services/treatment your doctor will give you beyond a check up and common types of lab work.
Our poor healthcare system results in a lot of illness and over 60% of Americans need to take prescription drugs every day. Most of the people taking drugs are taking 4 or more. The insurance that takes almost 30% of our income doesn't fully cover those either. Each drug that is covered by your insurance will typically require you pay $10-$20 each month when you pick them up at the pharmacy. It's common for Americans to have to spend $40-$80 for their medications every month. A third of Americans can't afford to fill their prescriptions and are forced to suffer and get sicker. A quarter of Americans report having to put off medical treatment for serious conditions because it is unaffordable.
People without insurance have it much much worse.
That doesn't even include the costs of things like eye care (glasses), dental care, emergencies, specialized treatments, surgeries, ambulance rides, etc. The single greatest cause of finical ruin in America is the cost of healthcare. If people only ever had to pay 20% no one would go bankrupt, or lose their home, or die because of healthcare costs.
Having to pay only 20% of your income to medical expenses would be a dream come true in the US. Please trust me as an American, your system is better by far. Or don't trust me and listen to the countless experts who will tell you that our healthcare system is garbage and that yours is better.
That doesn't make your system ideal by any means, but don't envy us or look to us as an example.
> I would rather manage that money myself because I believe I am better at doing so that my government. Isn't that one the core beliefs of Americans?
Not really? Things at a certain scale are impossible for individuals to manage alone. Healthcare expenses are one of those things. Maybe you could shave some percentage points off of your own healthcare spending, but that would cause you to end up in a situation like we have where large numbers of people can't get the care they need at all and are ruined by the expense. For the nation, that's much worse. Even for you it would be worse because having a bunch of sick people living in poverty all around you has far reaching effects. Your odds of getting sick increase. Homelessness increases. Crime increases. Living in a society where people are healthy and taken care of is well worth the extra 5% or even 10% you'd save.
A "free market" is one that exists without any enforcement/interference by the government. I agree that government should intervene to stop the greedy oligarchs from keeping drug prices high, but that would be the literal opposite of a free market. You don't want a free market, you just want better regulation of the healthcare industry and I don't blame you. I do too.
I mean you're joking but there are maybe ~20 brands who produce and sell inhalers. Maybe I need the inhaler but I also have a certain amount of choice, and presumably some are more expensive than others. Insulin is a famous example, because you can buy a vial for ~$30 or a nicer one for $300. They all effectively do the same thing but there is a quality difference between them, usually in regards to release time and how often you'd have to take it.
There are some market pressures in healthcare when multiple companies can compete, although it's so heavily regulated it can be hard to see the market pressures in practice. Consumers often do have some amount of choice though
I just checked insulin price in France, we have SANOFI 100 UI/ml 15ML for the price of 20€.
How is it possible to have 300$ Vial ? Sanofi ain't exactly a charity and they are doing extremely well financially, 300$ is obscene. If they sell it at 300$, there must be people buying it. Who are they ?
> I would think that americans would be much more vigilant about what medication they take, the price it cost, and so would have much lower pricing.
> Is it the proof that a true unregulated free market doesn't work ?
The market is heavily regulated (frequently crazily) by the FDA, and the actual amount anything costs is heavily obscured from the eyes of any consumers by the fog of bureaucracy and insurance.
Many people have 3-4 tiers of fixed copays that the insurance company makes up - some pharmacies won't even tell you when there is a cash price or a "coupon" that would be cheaper than your insurance copay! And pharmacies don't publish a plain list of what the cash prices are, and it would be hard for most people to even produce the tier formulary, it's buried as a PDF in some obscure page of a horrible website. So we just go to the pharmacy and see what it'll cost us.
Also, one major insurer owns a major pharmacy benefits manager and one of the big 2 pharmacy chains, so they use that to put their thumb on the scale however they can, while the other insurers and PBMs play games to lock consumers into restrictive exclusive deals that are to their detriment.
Anyway we don't have a market at all when it comes to healthcare, because the majority of price information is withheld from consumers until the opportunity to make any choice, if it even existed, is well past.
> Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get it paid by their own insurance but it cost them directly a lot of money.
That's the idea, but in practice there are so many layers of indirect government incentives, disincentives, and direct interventions that market is no longer effective for this purpose.
It's virtually impossible to find out how much a medical procedure actually costs. Most hospitals and clinics refuse to even estimate as a policy, which has led to the creation of things like pre-paid services for labor and delivery. Those are quite rare.
I'm 100% in favor of allowing the market to work - but at this point, we have the worst of both worlds and the best of neither. Either extreme would be better than what we have.
> It's virtually impossible to find out how much a medical procedure actually costs. Most hospitals and clinics refuse to even estimate as a policy, which has led to the creation of things like pre-paid services for labor and delivery. Those are quite rare.
That's absolutely incredible. Yeah if you can't even get a pricing,i don't see how you could make any decision whatsoever.
Part of the problem is that the way our healthcare system is setup, it's not even a remotely free market. It's pretty much a worst of all worlds situation.
Americans pay multiples more per capita, and receive worse healthcare based on outcomes compared to European nations. The UK on average has better oral health than the USA, but Americans love to joke about British teeth... I think the US believes it's own "free market" propaganda too much. Clearly socialised universal healthcare (which every G20 nation does outside the US) is a better system.
You're painting with a fairly broad brush. Opinions in the US are diverse, and generally more in support of socialized healthcare than against.
We're not far from half the US population having what amounts to universal healthcare already, even without making it official. I sometimes wonder how high it will get before people come to the realization that we're already close enough to that point and going the rest of the way is viable.
It does not work that way, though, because as a practical matter, the majority of routine medications in the US are generics now and quite cheap, maybe $25 out of pocket (and frequently zero) with even basic insurance. The crazy prices happen for the edge cases. Things that happen often enough that you may know someone affected by it, but are still a minority of most people's experience.
> I would think that americans would be much more vigilant about what medication they take, the price it cost, and so would have much lower pricing. That's just how free market work, and technically there are many medication manufacturer and many customer.
(Not american) This assumes they have a choice, no? Do these medications have real alternatives?
> in some part of europe, we have national healthcare so basically people don't think they are paying their medications, like there was some magic money.
Europe is a big place, buddy. Which particular part are "we" from today?
NHS England has NICE (National Institute for Health and Care Excellence), which does the cost-benefit analysis for all medicines prescribed, nationally. It frequently decides medicines aren't worth the money. If you, as a private citizen, want that particular medicine, you can waste your own money on it. NHS England does not have a moral hazard problem.
The NHS also spends money trying to convince people to exercise, eat well, lose weight, not smoke, look for early signs of cancer, etc., because they find that relatively tiny amounts of money on these campaigns results in massive, massive savings from not having to treat so much preventable disease later in life.
i think healthcare is one market where capitalism just doesn't work well at all. for those areas, it actually makes sense to introduce hard or soft price ceilings.
> Contrary to the USA where it's a much more responsible market,
This is satire? I can’t tell anymore.
I mean the USA is the only country where someone can allegedly murder a healthcare executive for denying treatment and popular culture is engaged in drooling about how well the alleged killer fills out a tailored shirt.
Right, but it's not more responsible is it? It's plainly kafkaesque with lots of impositions that always serve only to benefit the gatekeepers. Which is why they hated Obamacare, because it is less bad.
in that case, you don't care if you drug cost 10€ or 2000€ because you aren't spending a single € from your own wallet, at least if you don't factor in taxes.
Contrary to the USA where it's a much more responsible market, people do pay for the medications or they get it paid by their own insurance but it cost them directly a lot of money.
I would think that americans would be much more vigilant about what medication they take, the price it cost, and so would have much lower pricing. That's just how free market work, and technically there are many medication manufacturer and many customer.
Is it the proof that a true unregulated free market doesn't work ? if left unsupervised, big companies are going to buy smaller companies until they are monopoly or make secret, behind the door, deal to keep price up.
It's what the USA is made on, the idea of freedom and free market. i believe the idea of unregulated market is more recent, think the 70's, but surely in the 50 years since then american would have pushed back against it and not elected people like Trump who are all in.