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because of the ACA the cost has went up since insurance companies know you're required to buy it ...

The facts: The ACA puts a hard limit on profits the insurance companies may make by requiring them to spend 80% of premiums on medical care. If they fall under that line, they have to refund the difference to their customers.

In 2011, that refund totaled 1.1 billion dollars. In 2012, as insurers began to moderate their prices to align more closely with costs, 504 million was refunded. In 2011, they got even closer, and refunds due to excessive margins dropped to 332 million.

But this only reflects the overcharges made according to the new ACA rule. The estimate of what consumers saved due to insurance companies being hard limited is much higher - according to HHS, that amount exceeded 4 billion dollars in 2013 alone.

Refunds cite

So no, the ACA has not enabled insurance companies to gouge you via your insurance premiums. The truth is exactly the opposite.

We spend ~$30billion a year on research in the U.S. on the NIH, so a partial solution is already in place.

Thats fine, except for covering testing costs as well. How many millions does it take just to get the FDA to allow? Well lets see what I found out from Google:

$802 million

No joke.

Oh really?

Nonsense, is it?

Nonsense?

Nonsense?

What about clear violation of their very policies on SAFETY? Nonsense?

But if you worked in "health insurance industry", you'd never want FDA to stop doing what they do, after all, any government involvement is beneficial for large corporations, who gain monopoly/oligopoly power by restricting access of small competitors, by forcing any innovator to seek sponsorship of large pharma company, by having government money in insurance, which is the reason that insurance premiums are as high as they are and climbing, having insurance attached to people's jobs, which is the reason there is a problem of "preexisting-conditions" in the first place, because once you change your job and if you have a "condition", it's that much harder to get coverage again.

In a free market an American would have been able to buy health insurance privately from any provider from ANYWHERE in the world.

Why can't an American buy health insurance from Singapore?

AFAIC, I don't actually care whether his treatment is fake or not, I really do not care. He seems to have gotten the FDA Trial Phase I and Phase II approvals. So the stuff is safe for consumption, that's all that is actually important to know.

At that point I don't want government being anywhere near the treatments. There are plenty of cases where FDA involvement does one thing only: increase the cost of drugs or worse. If FDA even has to exist, it's role should be limited to questions concerning safety and nothing more, as it's useless in most important cases anyway.

http://en.wikipedia.org/wiki/Mifepristone#FDA_controversy

http://www.youtube.com/watch?v=9QqIN9EfQwM

Given the existence of the placebo effect, in what way do you suppose that the market -- consisting of individuals who operate on limited information -- will be able to tell the difference in efficacy between a non-steroidal anti-inflammatory and acupuncture?

- ha ha, the way it was always done, by doctors sharing information among each other, learning what works and what doesn't - the only real way things are found to be useful or not.

Especially given that so-called "alternative medicines" such as Zicam can effectively compete against science-based medicine even with FDA regulations in place? Do you propose we go back to the patent medicine era?

- I am against all patents altogether. There should be no gov't creating artificial barriers to entry against individuals and for monopolies and there should be no special treatment provided to monopolies, like in case with this, falsifying the results to help out some friends in giant pharma. However FDA routinely denies people in US access to drugs, that are used all over the world, for example the drug RU 386, which was used in Europe and was banned in US by FDA.

Why the fuck should some piece of shit government organization deny you access to drugs, any drugs if you wish so and especially drugs that are known to be effective and are in use in the rest of the world?

The reason we have the regulations we have by the FDA is because we tried working without them and, unsurprisingly, people died and a lot of unscrupulous hucksters made a lot of money.

- no, the reason you have FDA being what it is, is because it has enormous power, which translates into dollars for monopolies, who kill off the small competitors and make sure prices never fall.

We have the same thing going on now with homeopathic medicine.

- there is no reason for FDA to get involved into this homeopathic stuff, especially since it is just placebo.

What we need are good, functional, and smarter regulations, not merely fewer or more regulations.

- seriously? You truly believe that? You truly want government to regulate your life? To tell you, probably a grown ass man, what you can and cannot use in your life as drugs? To ensure that only monopolies can sell you drugs? To make sure you have to pay a small fortune for any real treatment?

Please check your facts before posting; this took me all of a minute with a search engine to find in PLoS.

- I'll give you some facts.

Here is one. A drug that before FDA approval only cost $10/shot (ten dollars), once approved by FDA was immediately repriced at $1500 dollars a shot (one thousand five hundred dollars), as FDA granted a monopoly to the producer company, so nobody could compete with them. This is for a drug that people need to take 20 times, so that's $30,000 for the 20 times instead of $200 as it was prior to FDA 'approval' - in reality granting a monopoly. The orders of magnitude, by which FDA raises costs to the end users are similar with this drug.

And yes, it only takes an Internet search.

Also, do you have a citation?

Sure, plenty.

But yeah, denying claims makes overhead higher, as a percentage.

Anyway, I did happen to come across the first Google result for “medicare overhead rates” (since you didn’t give any citation for your claim, I looked it up myself). Some points:

the public health insurance system has an overhead cost which is about 2% of claims, while the private sector has administrative costs between 20%-25% of claims

taking into account extra legal costs from Medicare adjudication and CMS salaries, the administrative cost ratio increases to 5.2% ... [for private insurance,] If we exclude taxes and profits, as well as sales commissions, then the total administrative costs decrease to 8.9% overall and 8.0% for large group policies

Medicare incorrectly counts its cost of capital as 0. The true cost would take into account the direct cost of hiring IRS workers to collect the taxes which pay for Medicare as well as taking into account the distortionary effects of income taxation on workers labor supply decisions.

Medicare serves the elderly population and thus has a high cost per enrollee. In 2003, the average medical cost for Medicare was $6,600 per person per year, while the same figure for private insurance was $2,700.

you'd have thought the moderate and progressive populations of the country

There are moderate and progressive populations in this country? The most progressive president in my lifetime is advocating for a health care policy not unlike Nixon's. There are two parties in America, the right, and the far right.

High unemployment (average of double digit unemployment over the past 20 years or so). High taxes, including a 20% VAT, 40% income tax, 12% social tax, just to name a few. Higher crime rates (with a source). I could go on.

And what if I want to work more than 35 hours a week (I do)? Who are you to tell me I should legally not be allowed to?
What if I want to work more than 47 weeks a year (I do)? Who are you to tell me I should legally not be allowed to?
Your definition of free is sorely mistaken (see taxes above, large copayments (10-40%), and >90% with private insurance).

It has its flaws, as any large institution does, but these are flaws that are siezed upon by opponents and used as propaganda (check out the raft of TV commercials on US TV during Clinton's attempt to get a national system running in the US - "you can't choose your own doctor! you won't have access to cutting edge treatments! the doctors don't get paid a decent wage! you'll have to wait years for lifesaving surgeries!)

And what part of that is not true in different health care systems around the world? More importantly, what part of that was not true with Hillary care that was being pushed in 1993?

Now, in a system like the UK NHS you do have long wait times for certain things if the system is busy, and if there's one major criticism to be levelled at it, it's that it is a behemoth organisation with a lot of bloat in it, soaking up money like a sponge, yet still requiring huge investment with a lot of faults. It is still recovering from 15 years of neglect from a Tory government in the 80s, but it is coming around gradually.

If by coming around you mean providing substandard treatments, denying treatment to anyone they can justify, and killing treatment for anyone who wants to pay the difference for better treatment, then I guess your right.

Even with the horror stories that the newspapers and private healthcare shills love to jump on (I waited 4 hours in the ER when I broke my leg!), these are totally atypical of the experience, and even with these issues that arise (which do need to be addressed), it is still vastly superior to the US system which exists solely to make drug companies, senators, congressmen and other select individuals very rich and has nothing to do with actual health care, other than as a side effect.

Read some of the links I provided above. This isn't a 4 hour wait for a broken leg. It's a refusal to provide effective treatment, long wait times for things like MRI scans and medically necessary procedures and so on in the various different health care systems.

And yes, it's so bad in Canada that it's economically viable for insurance companies to offer wait list insurance that will take you to another country is necessary to get treatment. Try taking a look at medical tourism where a lot of brits seem to be going to India and parts Asia if not just others parts of Europe for cheap medical coverage that they already have in the UK.

The reality is that most of the "savings" would come from not having to pay to do large scale testing with expensive labs, scientists, and medical personnel.

Want to explain how you spend $800 million on clinical tests?

It doesn't cost anything like that to go through the approval process in France, Germany, Japan, etc.

-jcr

http://healthcare-economist.com/2006/07/27/medicares-true-administrative-costs/

I'll summarize: Medicare "administrative costs" are within about 3-4% absolute points of private insurance administrative costs.

Additionally, fraud is rampant in Medicare, which ultimately costs more than a little bit of administrative overhead.

Finally, benefits for Medicare have been growing at an unsustainable rate since it's inception. I do not think you want a program that grows 3x faster than the rate of inflation as your benchmark program for long term medical costs reduction.

Here's an article: http://healthcare-economist.com/2007/10/02/health-care-system-grudge-match-canada-vs-us/ There are others if you go searching.

Pharma research takes anything promising from publicly funded basic research and runs the last mile to a commericial product. (I'm not saying that last mile is 'cheap', but its not more expensive than the basic research they are building on.)

I find that difficult to believe. Multiple sources cite a figure of around 800 Million dollars for bringing a drug from Phase I trials to approval. Trials involve paying doctors to check up on patients who are often getting paid for being in the trial, free drugs for all those in the trial and then multiple trials to screen for rare but possibly deadly side effects.

If a possible side effect is discovered, then further studies must be done to figure out if these side effects are real or just an aberration due to a poorly chosen study population. If the side effects are real, and they cause someone permanent damage, then that person gets free treatment for that damage for life.

Assume one hundred "basic researchers" only find one "promising" lead a year. That makes them at least an order of magnitude more efficient than the "last mile" which drug companies must perform.

http://healthcare-economist.com/2006/04/29/802m/

> So socialized medicine, which has been proven to work far better than
> privatized medicine in the entire rest of the developed world [...]

I think you need to recheck your facts here. Many of the countries with
socialized medicine are currently working on revising it as it has failed
in many ways. I don't have a list of all the countries currently working
on changing, but you can look at one that already has.

A couple of years ago Netherlands privatized their health care system and
from all reports it has been a great success. It is not a pure private
system, it has some strict regulations, but it is definitely not
socialized.

After a quick google, here are a couple references.

http://healthcare-economist.com/2007/09/07/wsj-on-the-dutch-health-care-system/
http://www.medicalnewstoday.com/articles/82785.php

"What mammoth R&D investments?"

http://healthcare-economist.com/2006/04/29/802m/

$802 million. I don't know about you but that seems 'mammoth'-ey to me.

While without patents you would still likely have "scientists" puttering around in their basements accidentally discovering that some fungus that grows in forgotten beer bottles can cure baldness, but without any financial incentive I doubt you've find many people performing extensive safety trials or doing expensive gene splicing/stem cell research/etc just out of the kindness of their hearts. Do you have any idea how much it costs to bring a new drug to market today? By this estimate http://healthcare-economist.com/2006/04/29/802m/, it takes 90.3 months and $802 million. So unless you're not particularly interested in curing cancer, perhaps you can explain how this will happen absent any financial incentive.