I've got a few coworkers in Montreal and I've never heard bad things. That is of course the problem of anecdotes - you can find horrible examples in any system but it usually isn't terribly informative. One thing I have heard is that the care drops as you age in Canada - but what do I know?:)
Umm... it's not illegal, dumbass. As an example, private health clinics deliver a variety of services in Alberta.
Can you actually pay the doctors at that clinic for service. The website you referenced indicated that private clinics can provide services "under the auspices of the Alberta Health Care Insurance Plan or through contracts with health authorities".
That means that they're just a subcontractor for the national insurance program.
By private I meant a place where if I have $10,000 I can ask for an MRI - even if there is nothing at all wrong with me and I just feel like blowing my cash. You can do that in the US - not that most people would want to.
Moore advocates a single-payer system. Under such a system you AREN'T ALLOWED to pay for medical care. You might be able to get care in the US, but you'd probably get something comparable to something you'd get in Canada anyway.
I think we're just miscommunicating. Your point was that in Canada you still have the option of travelling to the US for care and so you did have that freedom. My point is that if the US becomes the same as Canada then you won't actually have that same freedom. You could travel here, but you wouldn't be able to pay for the best care possible.
Right now a Canadian with a billion dollars cash could walk into any hospital in the US and get immediate service with the best physicians available - without any regard to medical need. A US citizen with a billion dollars could not go to Cananda and do the same - they might be able to get care, but they would be prioritized as any other person. In Canada all care is need-based, while in the US it is based purely on willingness to pay (although insurers add a level of need-based rationing). In Canada it is illegal for a doctor to accept cash to give priority treatment. In the US it is not.
Now, you can argue whether the US system is equitable. On one hand it is - the system treats all people with the same amount of cash to spend equally. On one hand it isn't - the system treats different people with the same problem differently. You can argue pros and cons to each form of equality - they accomplish different things and if you consider both fully I don't think it is necessarily obvious which is the better system.
Your proposal seems fine enough, although the exact terms should be decided upon up-front. Ie, companies shouldn't have to do a full R&D project before they find out what the patent life will be. It can't just be a matter of cost though - otherwise companies will just waste money like Bell Telephone used to (why do you think they had so many Nobel laureates - they got paid for every dollar they spent on anything remotely phone-related).
Most patent extensions are usually a good thing - that is the actual intentional extensions awarded by the FDA for pediatric and orphan drug testing. Now, the patent games that companies play on their own is a different matter - that needs to be punished harshly. However, if it weren't for the pediatric extensions most companies wouldn't bother testing their drugs on children. The drug companies are usually in the best place to actually perform this testing, so the 6 month extension seems sensible. Now, there might be other ways to fund it other than patent extensions. And that might actually be more equitable (using taxes and paying companies in cash rather than patent life puts the cost on taxpayers rather than the sick).
Patent games were in fashion a number of years ago, but I don't think it happens as often now. Only a few companies played the game - some stayed out of it. It was just so obviously unethical that it was a massive PR problem. Patents are a deal between society and a company - we do this for you, and you do this for us. That is fair. Playing games to avoid the intent of the law is not.
Any pay as you go system with a large number of upcoming takes and a smaller pool of givers is going to have some of these problems. But they are ironed out with time and a stable demographic spread.
I think you hit the nail on the head there. If the US demographically looked a LOT more like Cananda I'd think that a single-payer system would be more likely to work. US Cities have HUGE numbers of non-productive or only marginally-productive citizens that would be a large net-tax on health care.
Under a single-payer system the people paying for health care now would pay just as much for it if not more. But, they'd have to wait in line behind others who pay not nearly as much. The only ones who benefit are the ones who aren't paying for it now.
I think that most people would have sympathy for people who are of the same walk of life but just temporarily out of a job. The problem is the many more people who just aren't of the same walk of life - they live marginally and people resent paying a lot of money to care for them, as they don't feel like it will ever be reciprocated.
Oxdung. Most drug research is performed in university labs with government money.
Not true. Most basic biomedical research is performed in university labs with government money, but that isn't the same as "drug research". Once a drug concept is invented, it often goes through a lot of optimization and then it enters development, where the real costs are incurred. The clinical trials are the largest cost, and I don't think the government really funds these at all.
Saying that the government pays for drug R&D is like saying that Maxwell developed the perpendicular-recording technology in modern hard drives - sure, he did describe electromagnetism, and maybe he actually did do the hardest part of the work, but ultimately his was still just one part of the puzzle.
Even if you stipulate that 99% of the creative effort behind drugs is government-funded, the fact is that those multi-hundred-million-dollar clinical trials have to be paid for by somebody.
Drugs are expensive because they have to be marketed to the public because in the US, it's a "free" "market".
It isn't like you HAVE to advertise drugs to sell them in the US - they'd sell just as well as they do in Canada if you didn't. It just pays to advertise them. If you didn't, fewer people would take them, which means you'd make less money, which means that you're less likely to develop a particular new drug.
When drug companies decide what areas to research a basic question is what the market is. Would you spend $500M on a drug that will only cure 5000 people? You'd have to charge $100k to break even and nobody would pay that. If a drug can be marketed to more people, then it is more likely to get funded. In that sense drug marketing helps to fund more drugs, by increasing the size of the market.
In Canada, drug prices are strictly regulated, and for the most part, are not marketed to the public. Not having to market is a tremenduous cost cutter and leaves more money for what little research is done by pharmaceutical labs.
Uh, virtually all R&D money for Canadian pharmaceutical companies comes from their selling products in the US. They'd lose money if they only sold products in Canada. (That is, including R&D outlay.) The lack of marketing isn't the reason for the lower prices - the price controls are.
I can pass a law saying that cars can't be sold for more than $500 to anybody. And you know what - for the next two weeks EVERYBODY would be buying dirt-cheap cars. That is until every car lot sells out (they would be sold, no sense just throwing them away). After that, nobody would ever make a car again. And that is the problem with price controls. If you force the price from $5/pill to $4/pill you might get away with it. But it would never stop there - in Canada the prices are already FAR lower than that.
The only reason companies even sell pills outside the US is that it is still above marginal cost. It is the same reason that airlines sell tickets for $100 to standby flyers. It only works because the plane is flying anyway. If they charged that much for EVERY passenger then there would be no flight.
In the US, pharmaceutical companies spent three time as much for marketing than they did for research.
That is probably true. Although the figures are usually for marketing and other administrative costs. However, if you banned marketing it wouldn't really change the price - the companies would lose money since fewer people would buy the product, and would be worse off despite the "savings" on advertising. If prices could rise they would to help cover the shortfall, but most likely it would just result in fewer life-saving medicines in favor of more lifestyle medicines. For some reason it is immoral to charge $5/pill to cure cancer, but it is OK to charge $5/pill for erectile dysfunction. I guess the message is to invest less in cancer patients...
My "liberty" has never been in question. If I want an operation any faster and it's not an emergency I can always head to the US and pay the same price as any American. If I need the operation, I get it right away.
Yes, but if you did the same in Canada you and/or your doctor could be arrested for it. If somebody offered private insurance in Canada they would definitely be punished. If the system works so well, then why make it illegal not to use it?
And if Moore gets his way you wouldn't be able to travel to America and pay the same price as any American - at least not in the same way that you can today.
I've heard wildly diverging descriptions of the state of care in Canada. My guess is that the level of care varies significantly - either by location, or maybe by demographic (maybe young working-class people get better care than those who are scheduled for death).
The thing I don't like is the illegal-to-just-pay-for-your-own-care bit. If the system were so great, they wouldn't have to outlaw the competition. If something is really a better product I won't have to be forced to buy it...
Ridiculously low-grade, old-fashioned, ineffective medicines with more side effects than actual effects. Oh, and you have to take 5 of them at a time. They make sure you come back by giving you only a few days of medicine.
Some of that might be due to the not-invented-here syndrome that much of Japan seems to suffer. Most nations set basic quality standards for medicines. Japan has a ton of minutia in their regs that stipulate just about everybody regarding how you make and test your drugs. If it wasn't designed for use in Japan, then it is hard to sell in Japan. For a long time they also wouldn't accept clinical trial data from outside of Japan - after all, non-Japanese just aren't quite the same.
Most of the laws seem to be designed to protect local industry. Most pills get made wherever it makes sense (US and Europe early-on, Asia for cheap manufacturing) and are exported to wherever they are needed. In Japan I'm guessing that most of the pills are made domestically. Pills that would be accepted in ANY nation of the world other than Japan stand a good chance of being rejected by the local regulators.
The only reason companies even bother selling medicines there is because everybody takes pills for ANYTHING, EVERYTHING, and NOTHING. It probably started out with snake-oil, but people in Japan take pills by the bushel. I'm surprised they don't have all kinds of problems as a result... I'm actually a fan of direct-to-consumer marketing, but I question the ethics of not better-educating the market in Japan (it is one thing to ask somebody to talk to their doctor about whatever, it is another thing to KNOW that people are taking your pill just for the placebo effect and not educate them).
Wrong party blamed - correct issue identified...:)
One issue I have is with the number of private standards bodies that are essentially codified in law.
Want to create a college and offer financial aid? Go pay an accredidation bureau.
Want to rewire your house legally? Go fork out $50 for a copy of the National Electric code.
Don't like something in the NEC? Don't bother calling your congressman - they can't change it.
Want to test some pharmaceuticals for purity? Buy your standards from the USP. Want to know how to test them? Go buy a copy of the latest USP and all the updates.
The same applies to ISO, and any number of other standards bodies.
They aren't bad things to have. My objection is that they become officially blessed in law - so you have to follow some standard that isn't government-set, and which you can't even obtain without paying for it.
Imagine being fined $1000 for violating town ordinance 1.343.14. You ask for a copy of the town ordinance and are told that it can't be copied - it is copyrighted. You have to buy the town legal reference series for $1000.
The laws and businesses activities of the government should be public domain. Sure, there is room for exception for national security and personal privacy. However, the rules followed by the government should be available to anybody to read, copy, comment-on, and for elected officials to revise...
The entire utility, and cleverness, of the concept of "capitalism" was to take the evil vice of greed and try to harness it for the good of the society, based on the recognition of the fact that those afflicted by the disease of greed seem, for the most part, uncurable. That is, the idea was to collar the pathologically greedy and force them to pull some useful payload attached to their leash behind them as they struggle, driven despertately by their disease, wheezing and coughing all the way.
Well-said!
The only problem is that I think you just described the ENTIRE human race, and not some sub-class within it. Oh sure, not everybody here would sell their money for cash (although many would if the price was right), the fact is that ALL humans are motivated by greed. That is why capitalism works so well in its inherently-imperfect way.
Just look at what happens in a city when there is no police coverage (LA Riots, Katrina, etc) - everybody and their uncle is looting the local department store. And not for bottled water...
Greed is a universal condition, although it can vary in intensity. One might kill their mother for $1000, but I might only deprive her of a little happiness for $50,000. NOBODY reading this is really immune from selfishness - if you think you are then you are simply deluded. Some might not measure their success in dollars, but that doesn't change the fact that everybody is motivated by greed in some way.
By the way, I'm all for healthcare reform. It is because of greed that we DO in fact need a government responsive to the people to reign in individual excess. However, I'm not convinced that simply offering free health care without limit to everybody equally is going to work. Ultimately those who are paying for it will resent waiting in line behind those who aren't paying for it. And I don't mean the next door neighbor out of a job for three months. The issue is that not all work is equally valuable, and the reward for being a clerk at the local Walmart shouldn't be the same as the reward for managaing a 5000-employee business.
The 9-11 workers were an interesting case. Those who provided aid in the first week or two after the attack should be treated to good care at government expense - whether they were called to the scene or not - as long as they complied with general safety directions at the scene and wore any provided protective equipment.
That might sound a bit over-qualified to some. One person interviewed in Sicko mentioned working as a rescue worker (unsolicited) for several months on the scene. The fact is that NOBODY needed to be rescued after about a week or two - it was just hopeful thinking at that point. The problem is that politically the police couldn't go arrest volunteers for trespassing. Volunteers just weren't needed after the first week or two. The problem is that volunteers feel like it is their right to pitch in, and don't necessarily comply with safety requirements (respirators among other things), and nobody is necessarily funding equipment for people who don't really need to be there.
Don't get me wrong - when there was the possibility of saving lives I'm all for good samaritians stepping in, and if they hurt themselves in the process of saving others in a large-scale disaster then there is cause for some government funding. My issue is that many who worked at ground zero after the initial rescue effort weren't really there to save others - they were there to meet some need in themselves. They themselves needed care of a different sort. It would have been much cheaper to fund psychologists for everyone rather than fund lung operations five years later. But, you can't walk around NYC asking heros to go home without ending up hung on a girder.
Morally there are really only two options - one is for government to pay for care, but then government gets to make sure you take care of yourself (ie tough luck if you want to help out with the rubble pile). The other is that you get to do whatever you want to your own body, but now I get to question whether I should pay for it.
Don't get me wrong - my heart goes out to those suffering from the 9-11 related injuries. I think full funding of care for emergency responders is appropriate, as well as volunteers during the first week or two as long as they complied with any orders being given by those overseeing efforts. And I think those in charge of the scene should have taken more responsibility to safeguard the lives of people who did show up after they were no longer needed - they should have had the courage to turn people away when the project was just a demolition exercise. Perhaps that error means that we should pay for the resulting health care costs - I don't know that I know the answer to that question for sure. However, it isn't an unfair question to ask...
You know all those pages and pages of terms and conditions that came with your policy, that you didn't really study carefully? As soon as you want any money, they're going to go over every line with a fine-tooth comb, and if you forgot to dot an 'i' or cross a 't', they won't pay.
That actually isn't equally true for all insurers, and the same thing happens in other industries as well. Usually the cheapest companies tend to be the stingiest. When you hear an ad about saving a heap on your car insurance make sure you look into whether they actually settle claims - it is really easy to offer cheap insurance if you don't actually insure anything.
One solution to this problem might be to require insurers to publicize some kind of metrics on how often they pay out for various conditions, and what percentage of premiums get paid back out.
I've had my health insurance pay out tens of thousands of dollars for major surgery (the unnegotiated rate was in the hundreds of thousands), and while I've had a billing mistake or two along the way I've gotten them fixed by sending them a note on their website the few times that it has happened. The difference is that my insurance probably costs quite a bit more than some of the plans featured in Moore's film.
I'm all for nailing insurance companies that don't pay out on claims to the wall, but that doesn't fundamentally make the concept a bad one.
Moore has some valid points in his film, but many of his points aren't valid. For example he spends quite a bit of time complaining about denials for pre-existing conditions. That is only true if you go from no insurance to buying insurance. If you just switch jobs/plans/etc you're fully covered. The reason this policy exists is because of what would happen if it didn't - people would just not buy insurance AT ALL and insurance brokers would sell it to you while you were waiting in the ER waiting room. Why pay for insurance before you actually need it if you don't have to? People shouldn't wait until they are diagnosed with a serious disease before buying insurance. Now, the quibbling over technicalities and yeast infections is a whole different matter.
Don't get me wrong - the system needs reform. But, unsurprisingly Moore is offering sound bites and ignoring the serious issues. It works good as an attention-getter, and we should be paying more attention to the problem. But, the solution isn't a dreamland where you work 35 hours/week with 10 weeks of vacation, have unlimited sick time, and if you just aren't feeling up to work you can take off three months to visit the south of France with pay. Sounds great - but it doesn't really work that way (just ask an unemployed Frenchman - they make up 8.7% of the population).
And while we're at it, let's reform the patent system for drugs. Maybe if the taxpayers pay for it, don't give a patent, or give it for shorter terms, and certainly don't EXTEND the patent beyond the original terms (even if the taxpayers didn't pay for it, because then the taxpayers pay for it).
The problem is that the taxpayers don't generally pay for drug R&D. They certainly pay for very early blue-sky research, but most of the costs come in at a much later stage.
It is kind of like saying that a state-of-the-art hard drive technology should be unpatented because Maxwell figured out magnetism a long time ago. While there is no question that without Maxwell's laws that nobody would be building hard drives, it isn't the whole picture.
I'm actually in favor of the NIH doing some beginning-to-end drug development as an experiment. They could even subcontract to big pharma if it made sense economically, while retaining all patent rights. The resulting products would be licensed royalty-free to any US manufacturer (only fair since the US taxpayers funded it, not that it would stop others from copying it anyway). The resulting pills would be very cheap - as cheap as anything available over-the-counter. Of course, you would pay for it in your taxes. People could see firsthand whether it made sense economically. However, I don't think it would significantly reduce the costs of medicines - just how they are paid for. You could probably get the same effect by just making all drugs free and having government pay the $5/pill to some big pharma company. But, if the publicly-funded system works out really well then it will take off as people will want to fund it further. And if it bombs you haven't put the whole pharma industry out of business.
Of course, this model still doesn't deal with the fact that US citizens fund drug R&D for the entire world. But US citizens already pay for the defense costs of half the world as well - at least they'd get to pick what drugs get researched under this model...
When the profits of a few CEOs are more important than the lives of the citizenry you know the system is fucked.
Actually, the tradeoff was with the viability of the entire pharma R&D industry. Sure, a few CEOs make off very well, but the fundamental issue is that drug R&D costs hundreds of millions of dollars, and somebody has to pay for it otherwise it just won't happen. The biggest cost is clinical trials (picture paying thousands of MDs to test tens of thousands of volunteers), which for new drugs are basically funded entirely by industry.
Sure, there are other ways to do it than charging $5-500 per pill. Government could fund the trials or they could lower the costs in other ways. However, you can't simply set a price limit of drugs - if you did people would simply stop developing them. Sure, academia would still do blue-sky R&D as they currently do, but nobody would actually scale up the processes, perform clinical trials, and then defend a marketing application. Academically the problem got boring as soon as you successfully cured the first rat.
People who think that price controls will work with no other changes simply aren't aware of the costs of drug R&D.
And putting limits on drug marketing won't save any money either - drug companies wouldn't be doing it if they didn't think it would increase revenue. All reduced marketing does is lower the number of people taking a drug - which decreases the likelihood of it getting developed in the first place. Which isn't to say that reforms on marketing aren't possible or proper - just that it won't actually save any money. What you lose on the bottom line you'll more than make up for on the top line. And the argument over marketing costs just ignores the fundamental issue of the fact that R&D costs STILL have to be paid.
What I've always advocated is leaving the drug industry as it is, and on the side starting a competitive publicly-funded soup-to-nuts R&D program run out of the NIH. They might subcontract some of the development work to Pharma if it was cost-competitive, but they would retain all patents and offer royalty-free licenses to any manufacturer so that the final product is very cheap. Then taxpayers can look at the total bill after a few years and see if they like the end-result. Taxpayers could still buy expensive privately-funded drugs if the public ones turn out not-so-good, but you'd still have state-of-the-art R&D available to benefit those who can't afford expensive meds. If the public effort works really well the pharma industry will just turn into a subcontractor as they won't be able to compete. If it fizzles we haven't lost anything.
I've never liked government plans where step 1 is to ban all competition. That basically just means that you won't have anybody to compare them to. Just look at where its gotten us with the local cable companies...:)
Actually, the companies don't tend to do it. I knew somebody who worked on subborigation. They tend to use arbitration and industry guidelines, since big insurance companies are just as likely to end up on either side of a claim it is in their interest to just set out guidelines and not litigate.
It is the individual claimants that file suit. They only receive claims, they never pay them out, so it is in their interest for claims to be as large as possible...
One issue with healthcare is the who-pays problem. If government offered free health care to anybody who paid at least $5000/year in Federal taxes there would probably not be an objection - most likely the level of care would end up being pretty high, and since so few people pay that much in taxes it wouldn't lead to a huge competition for treatment facilities.
The problem is that universal care means taking care of the 95% of the population who pay little to no taxes (comparatively).
The people who pay for health care now will still pay for health care under the new system (just in taxes). The difference is that they'll have to stand in line behind people who aren't paying much of anything. So what incentive do they have to want the new system? They pay the same, but get less in service.
So, ultimately, those with money and power are going to oppose universal health care. If it happens it will be the result of voters who don't pay much in taxes (which would be most of them).
The problem is that you can't make the cost of universal care go away simply by putting a zero-dollar pricetag on it. Somebody ends up paying. Unintended consequences tend to cause nasty problems if you don't think things out.
The reality is that every nation practices capitalism. The only thing that changes is the form of the currency. Iran is a capitalist nation that trades in religious fervor. The USSA was a capitalist nation that traded in political power-brokering. The day that an MP in a socialized nation waits the same time for a hospital procedure as some guy out on the streets is the day that I recognize that they are in fact socialized. They might not pay for health care in dollars, but those with power still get preferential treatment...
Uh, where do insurance companies compete to give out bigger payouts?
It is difficult to compare auto insurance rates in the US with those just about anywhere. And the reason for this is the US civil court system, which costs a fortune and routinely gives out big rewards. In most nations a fender-bender won't result in hundreds of thousands of dollars in claims just about ever.
Then again, if the government insured everybody they would just stipulate the claims and there probably wouldn't be anything you could do about it - sovereign immunity and all that...
Keep in mind one purpose for the veto-power bit was to prevent all-out war. Picture this scenario:
1. Russia and US get in some kind of dispute over some 3rd-world backwater. 2. UN votes in favor of US (or Russian) position. 3. UN sends in troops. 4. UN votes to continue to escalate conflict. 5. Nuclear weapons begin being employed.
This couldn't happen under the UN system as if either the US or Russia cared greatly about the issue they'd just veto all action. Sure, nothing happens, but then again you don't have nuclear winter either.
The system was designed to just lock up rather than leading into open conflict between the nuclear-armed members.
Has it always worked out well - no. But, no body of this nature can ever be perfect. I mean, what is the point in a UN council where 300 nations that have no army but hold >50% of the population vote for some change that isn't supported by the world's largest powers? It would be nothing more than a symbolic gesture, since nobody is going to force the big nations to budge. The large nations didn't set up the UN so that they could be told what to do - they set it up as a negotiating tool amongst themselves.
I know people on/. tend to think about the absurdity of software patents, but medical patents can be far more deadly and really need a review when they're used to prevent delivery of medication to people too poor to pay for medicine.
Well, most of those nations that are in need of these medications don't have drug patents anyway - or at least they don't follow them. Perhaps that is part of the reason that nobody bothers to R&D cures for these diseases?
If the problem is that diseases are being cured but nobody can afford the cure, then maybe some kind of patent reform might help - but beware of unintended consequences. If the problem is that a disease isn't cured at all then how will lowering the financial payoff for curing it help?
I'm all for publicly-funded R&D for the sake of the common good. Perhaps the NIH should undertake orphan-drug funding. They might offer bounties (serious ones), or subsidize clinical trial costs (the biggest expense in drug R&D). They might even take the lead role in R&D and maybe contract out the development services to a big pharma while retaining the patent rights (to offer royalty-free licenses).
Right now about the only public role in R&D is blue-sky research, with maybe a lead compound here or there. However, most of the R&D expense comes in after this point, so government bodies don't have much bargaining power regarding patent licensing (short of changing patent law). Rather than use the club of denying patents, why not just have the public fund key drug developments and offer the resulting products royalty-free? Lots of companies would step in to do the manufacturing.
The real problem is that politicians don't want to actually spend money on R&D. They just want to pretend that by changing the rules others will spend money on R&D and the drugs will be cheap. Real life just doesn't work that way...
Actually, juries are permitted to use their own judgement as to the truthfulness of any testimony they hear, based on their own intuition. If a guy sounds like a liar a juror is completely within their rights to consider that the witness might be lying.
Now, an evasive answer doesn't automatically equate to lying, and I don't think anybody is saying that. However, if somebody asks a defendant "did you shoot your wife" and the defendant goes on about how people should have a right to own a gun, I'll start wondering why they didn't just answer the question. Now, if somebody asked the defendant why they owned a gun that might be a perfectly reasonable response, but if it looks like they're trying not to answer a straightforward question that goes to the heart of the case I'm going to assume they're hiding SOMETHING. Now, maybe it isn't what I think they're hiding, but it is one more piece to the puzzle.
People make a big deal out of cases where they don't have a body, a gun, a bullet in the body, ballistics linking the gun to the bullet, DNA and fingerprints on the gun, a witness saying the defendant talked about shooting the victim, and an eyewitness seeing the defendant in the vicinity of the crime scene. Most cases are not that open-and-shut. And if they were they'd NEVER make it to a jury - that defendant would take any plea bargain they could get.
Circumstantial cases are very common, and people are frequently convicted on circumstantial evidence. The standard is reasonable doubt. I've heard the comparison made to large financial decisions - like buying a house. Suppose you did a lot of research and were about to buy a house. Then a random guy walks up to you and says that the house is haunted. Would that in itself change your mind to buy it? If not, the "reasonable doubt" standard hasn't been met. If you're as sure of a defendant's guilt as you would be about a large financial decision, then even if you aren't 100% certain you still can convict. And I got that from a judge's instructions...
Nothing in life can be proven with certainty - but that isn't the standard used in courts. If 12 people unanimously agree somebody is probably guilty without reasonable doubt then they go to jail. I don't know all the facts in this case, and a lot more might come out in a trial than is known now, but it takes more than an alternative theory to acquit you...
"Tonight on Lost, sponsored by Coca-Cola, Jack and Kate have more awkward sexual tension, while Hurley tries to cheer everyone up, Sawyer acts rudely, and Sayid kills someone with his feet."
Sorry - I'm interested in episode descriptions - not generic show descriptions that apply to the whole series. Oh wait...
No sense backing off too much on the acceleration - as soon as you hit the air you're going to probably have 100Gs of deceleration for a brief time until you're out of the lower atmosphere. Even a very streamlined vehicle hitting 1ATM air at orbital velocity is going to have MASSIVE drag. You'd need a massive heat shield as well (which probably would be gone (and no longer needed) a second into flight).
Yes, but if they followed standards of just about any sort it would work fine - because somebody would take the time to write some software to make it work.
I don't run amd64 so as to NOT be able to find software. I run it because it has certain advantages, and most mainstream open-standards-based software works fine on it - particularly FOSS.
I was just pointing out that flash isn't some kind of panacea to obtaining compatibility. In fact, in some cases it is less compatible than just posting a link to the video. I'm not quite sure why they can't just do both (I have no objection to the flash content being there - I don't even see it anyway). It isn't like it actually makes it harder to download the actual video data...
For the amd64 Linux/Konqueror user, youtube is one of those sites that NEVER works. Now, pages that just provide a link to an avi/mpg file work just fine.
Flash videos are just incredibly annoying. Inevitably I just figure out the url for the flv file and download it so that it can be played with mplayer.
Video shouldn't require a plug-in to work. And if it does they could at least make it more widely available...
Well, it works fine if you're open to other nations with similar standards.
Kind of like most forms of insurance in the US. If you have insurance and want to switch providers, generally they can't exclude you for pre-existing conditions if the coverages are comparable. On the other hand, if you have no insurance and want to buy life insurance the day after you're diagnosed with cancer that is likely to be terminal in two months, then nobody has to sell it to you. The goal is to foster competition between companies, without defeating the whole purpose of insurance (where you pay in without knowing whether you will actually need it).
If highly-socialized nations had completely open borders with anybody, then anybody in the world with an expensive medical condition would just move there, until the tax base completely erodes.
On the other hand, highly-socialized nations have no issues opening borders with each other for the most part - nobody has a real incentive to immigrate en-masse with expensive conditions, and any immigration is likely to be bilateral.
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I've got a few coworkers in Montreal and I've never heard bad things. That is of course the problem of anecdotes - you can find horrible examples in any system but it usually isn't terribly informative. One thing I have heard is that the care drops as you age in Canada - but what do I know? :)
Umm... it's not illegal, dumbass. As an example, private health clinics deliver a variety of services in Alberta.
Can you actually pay the doctors at that clinic for service. The website you referenced indicated that private clinics can provide services "under the auspices of the Alberta Health Care Insurance Plan or through contracts with health authorities".
That means that they're just a subcontractor for the national insurance program.
By private I meant a place where if I have $10,000 I can ask for an MRI - even if there is nothing at all wrong with me and I just feel like blowing my cash. You can do that in the US - not that most people would want to.
Moore advocates a single-payer system. Under such a system you AREN'T ALLOWED to pay for medical care. You might be able to get care in the US, but you'd probably get something comparable to something you'd get in Canada anyway.
I think we're just miscommunicating. Your point was that in Canada you still have the option of travelling to the US for care and so you did have that freedom. My point is that if the US becomes the same as Canada then you won't actually have that same freedom. You could travel here, but you wouldn't be able to pay for the best care possible.
Right now a Canadian with a billion dollars cash could walk into any hospital in the US and get immediate service with the best physicians available - without any regard to medical need. A US citizen with a billion dollars could not go to Cananda and do the same - they might be able to get care, but they would be prioritized as any other person. In Canada all care is need-based, while in the US it is based purely on willingness to pay (although insurers add a level of need-based rationing). In Canada it is illegal for a doctor to accept cash to give priority treatment. In the US it is not.
Now, you can argue whether the US system is equitable. On one hand it is - the system treats all people with the same amount of cash to spend equally. On one hand it isn't - the system treats different people with the same problem differently. You can argue pros and cons to each form of equality - they accomplish different things and if you consider both fully I don't think it is necessarily obvious which is the better system.
Your proposal seems fine enough, although the exact terms should be decided upon up-front. Ie, companies shouldn't have to do a full R&D project before they find out what the patent life will be. It can't just be a matter of cost though - otherwise companies will just waste money like Bell Telephone used to (why do you think they had so many Nobel laureates - they got paid for every dollar they spent on anything remotely phone-related).
Most patent extensions are usually a good thing - that is the actual intentional extensions awarded by the FDA for pediatric and orphan drug testing. Now, the patent games that companies play on their own is a different matter - that needs to be punished harshly. However, if it weren't for the pediatric extensions most companies wouldn't bother testing their drugs on children. The drug companies are usually in the best place to actually perform this testing, so the 6 month extension seems sensible. Now, there might be other ways to fund it other than patent extensions. And that might actually be more equitable (using taxes and paying companies in cash rather than patent life puts the cost on taxpayers rather than the sick).
Patent games were in fashion a number of years ago, but I don't think it happens as often now. Only a few companies played the game - some stayed out of it. It was just so obviously unethical that it was a massive PR problem. Patents are a deal between society and a company - we do this for you, and you do this for us. That is fair. Playing games to avoid the intent of the law is not.
Any pay as you go system with a large number of upcoming takes and a smaller pool of givers is going to have some of these problems. But they are ironed out with time and a stable demographic spread.
I think you hit the nail on the head there. If the US demographically looked a LOT more like Cananda I'd think that a single-payer system would be more likely to work. US Cities have HUGE numbers of non-productive or only marginally-productive citizens that would be a large net-tax on health care.
Under a single-payer system the people paying for health care now would pay just as much for it if not more. But, they'd have to wait in line behind others who pay not nearly as much. The only ones who benefit are the ones who aren't paying for it now.
I think that most people would have sympathy for people who are of the same walk of life but just temporarily out of a job. The problem is the many more people who just aren't of the same walk of life - they live marginally and people resent paying a lot of money to care for them, as they don't feel like it will ever be reciprocated.
Oxdung. Most drug research is performed in university labs with government money.
Not true. Most basic biomedical research is performed in university labs with government money, but that isn't the same as "drug research". Once a drug concept is invented, it often goes through a lot of optimization and then it enters development, where the real costs are incurred. The clinical trials are the largest cost, and I don't think the government really funds these at all.
Saying that the government pays for drug R&D is like saying that Maxwell developed the perpendicular-recording technology in modern hard drives - sure, he did describe electromagnetism, and maybe he actually did do the hardest part of the work, but ultimately his was still just one part of the puzzle.
Even if you stipulate that 99% of the creative effort behind drugs is government-funded, the fact is that those multi-hundred-million-dollar clinical trials have to be paid for by somebody.
Drugs are expensive because they have to be marketed to the public because in the US, it's a "free" "market".
It isn't like you HAVE to advertise drugs to sell them in the US - they'd sell just as well as they do in Canada if you didn't. It just pays to advertise them. If you didn't, fewer people would take them, which means you'd make less money, which means that you're less likely to develop a particular new drug.
When drug companies decide what areas to research a basic question is what the market is. Would you spend $500M on a drug that will only cure 5000 people? You'd have to charge $100k to break even and nobody would pay that. If a drug can be marketed to more people, then it is more likely to get funded. In that sense drug marketing helps to fund more drugs, by increasing the size of the market.
In Canada, drug prices are strictly regulated, and for the most part, are not marketed to the public. Not having to market is a tremenduous cost cutter and leaves more money for what little research is done by pharmaceutical labs.
Uh, virtually all R&D money for Canadian pharmaceutical companies comes from their selling products in the US. They'd lose money if they only sold products in Canada. (That is, including R&D outlay.) The lack of marketing isn't the reason for the lower prices - the price controls are.
I can pass a law saying that cars can't be sold for more than $500 to anybody. And you know what - for the next two weeks EVERYBODY would be buying dirt-cheap cars. That is until every car lot sells out (they would be sold, no sense just throwing them away). After that, nobody would ever make a car again. And that is the problem with price controls. If you force the price from $5/pill to $4/pill you might get away with it. But it would never stop there - in Canada the prices are already FAR lower than that.
The only reason companies even sell pills outside the US is that it is still above marginal cost. It is the same reason that airlines sell tickets for $100 to standby flyers. It only works because the plane is flying anyway. If they charged that much for EVERY passenger then there would be no flight.
In the US, pharmaceutical companies spent three time as much for marketing than they did for research.
That is probably true. Although the figures are usually for marketing and other administrative costs. However, if you banned marketing it wouldn't really change the price - the companies would lose money since fewer people would buy the product, and would be worse off despite the "savings" on advertising. If prices could rise they would to help cover the shortfall, but most likely it would just result in fewer life-saving medicines in favor of more lifestyle medicines. For some reason it is immoral to charge $5/pill to cure cancer, but it is OK to charge $5/pill for erectile dysfunction. I guess the message is to invest less in cancer patients...
My "liberty" has never been in question. If I want an operation any faster and it's not an emergency I can always head to the US and pay the same price as any American. If I need the operation, I get it right away.
Yes, but if you did the same in Canada you and/or your doctor could be arrested for it. If somebody offered private insurance in Canada they would definitely be punished. If the system works so well, then why make it illegal not to use it?
And if Moore gets his way you wouldn't be able to travel to America and pay the same price as any American - at least not in the same way that you can today.
I've heard wildly diverging descriptions of the state of care in Canada. My guess is that the level of care varies significantly - either by location, or maybe by demographic (maybe young working-class people get better care than those who are scheduled for death).
The thing I don't like is the illegal-to-just-pay-for-your-own-care bit. If the system were so great, they wouldn't have to outlaw the competition. If something is really a better product I won't have to be forced to buy it...
Ridiculously low-grade, old-fashioned, ineffective medicines with more side effects than actual effects. Oh, and you have to take 5 of them at a time. They make sure you come back by giving you only a few days of medicine.
Some of that might be due to the not-invented-here syndrome that much of Japan seems to suffer. Most nations set basic quality standards for medicines. Japan has a ton of minutia in their regs that stipulate just about everybody regarding how you make and test your drugs. If it wasn't designed for use in Japan, then it is hard to sell in Japan. For a long time they also wouldn't accept clinical trial data from outside of Japan - after all, non-Japanese just aren't quite the same.
Most of the laws seem to be designed to protect local industry. Most pills get made wherever it makes sense (US and Europe early-on, Asia for cheap manufacturing) and are exported to wherever they are needed. In Japan I'm guessing that most of the pills are made domestically. Pills that would be accepted in ANY nation of the world other than Japan stand a good chance of being rejected by the local regulators.
The only reason companies even bother selling medicines there is because everybody takes pills for ANYTHING, EVERYTHING, and NOTHING. It probably started out with snake-oil, but people in Japan take pills by the bushel. I'm surprised they don't have all kinds of problems as a result... I'm actually a fan of direct-to-consumer marketing, but I question the ethics of not better-educating the market in Japan (it is one thing to ask somebody to talk to their doctor about whatever, it is another thing to KNOW that people are taking your pill just for the placebo effect and not educate them).
Wrong party blamed - correct issue identified... :)
One issue I have is with the number of private standards bodies that are essentially codified in law.
Want to create a college and offer financial aid? Go pay an accredidation bureau.
Want to rewire your house legally? Go fork out $50 for a copy of the National Electric code.
Don't like something in the NEC? Don't bother calling your congressman - they can't change it.
Want to test some pharmaceuticals for purity? Buy your standards from the USP. Want to know how to test them? Go buy a copy of the latest USP and all the updates.
The same applies to ISO, and any number of other standards bodies.
They aren't bad things to have. My objection is that they become officially blessed in law - so you have to follow some standard that isn't government-set, and which you can't even obtain without paying for it.
Imagine being fined $1000 for violating town ordinance 1.343.14. You ask for a copy of the town ordinance and are told that it can't be copied - it is copyrighted. You have to buy the town legal reference series for $1000.
The laws and businesses activities of the government should be public domain. Sure, there is room for exception for national security and personal privacy. However, the rules followed by the government should be available to anybody to read, copy, comment-on, and for elected officials to revise...
Well-said!
The only problem is that I think you just described the ENTIRE human race, and not some sub-class within it. Oh sure, not everybody here would sell their money for cash (although many would if the price was right), the fact is that ALL humans are motivated by greed. That is why capitalism works so well in its inherently-imperfect way.
Just look at what happens in a city when there is no police coverage (LA Riots, Katrina, etc) - everybody and their uncle is looting the local department store. And not for bottled water...
Greed is a universal condition, although it can vary in intensity. One might kill their mother for $1000, but I might only deprive her of a little happiness for $50,000. NOBODY reading this is really immune from selfishness - if you think you are then you are simply deluded. Some might not measure their success in dollars, but that doesn't change the fact that everybody is motivated by greed in some way.
By the way, I'm all for healthcare reform. It is because of greed that we DO in fact need a government responsive to the people to reign in individual excess. However, I'm not convinced that simply offering free health care without limit to everybody equally is going to work. Ultimately those who are paying for it will resent waiting in line behind those who aren't paying for it. And I don't mean the next door neighbor out of a job for three months. The issue is that not all work is equally valuable, and the reward for being a clerk at the local Walmart shouldn't be the same as the reward for managaing a 5000-employee business.
The 9-11 workers were an interesting case. Those who provided aid in the first week or two after the attack should be treated to good care at government expense - whether they were called to the scene or not - as long as they complied with general safety directions at the scene and wore any provided protective equipment.
That might sound a bit over-qualified to some. One person interviewed in Sicko mentioned working as a rescue worker (unsolicited) for several months on the scene. The fact is that NOBODY needed to be rescued after about a week or two - it was just hopeful thinking at that point. The problem is that politically the police couldn't go arrest volunteers for trespassing. Volunteers just weren't needed after the first week or two. The problem is that volunteers feel like it is their right to pitch in, and don't necessarily comply with safety requirements (respirators among other things), and nobody is necessarily funding equipment for people who don't really need to be there.
Don't get me wrong - when there was the possibility of saving lives I'm all for good samaritians stepping in, and if they hurt themselves in the process of saving others in a large-scale disaster then there is cause for some government funding. My issue is that many who worked at ground zero after the initial rescue effort weren't really there to save others - they were there to meet some need in themselves. They themselves needed care of a different sort. It would have been much cheaper to fund psychologists for everyone rather than fund lung operations five years later. But, you can't walk around NYC asking heros to go home without ending up hung on a girder.
Morally there are really only two options - one is for government to pay for care, but then government gets to make sure you take care of yourself (ie tough luck if you want to help out with the rubble pile). The other is that you get to do whatever you want to your own body, but now I get to question whether I should pay for it.
Don't get me wrong - my heart goes out to those suffering from the 9-11 related injuries. I think full funding of care for emergency responders is appropriate, as well as volunteers during the first week or two as long as they complied with any orders being given by those overseeing efforts. And I think those in charge of the scene should have taken more responsibility to safeguard the lives of people who did show up after they were no longer needed - they should have had the courage to turn people away when the project was just a demolition exercise. Perhaps that error means that we should pay for the resulting health care costs - I don't know that I know the answer to that question for sure. However, it isn't an unfair question to ask...
You know all those pages and pages of terms and conditions that came with your policy, that you didn't really study carefully? As soon as you want any money, they're going to go over every line with a fine-tooth comb, and if you forgot to dot an 'i' or cross a 't', they won't pay.
That actually isn't equally true for all insurers, and the same thing happens in other industries as well. Usually the cheapest companies tend to be the stingiest. When you hear an ad about saving a heap on your car insurance make sure you look into whether they actually settle claims - it is really easy to offer cheap insurance if you don't actually insure anything.
One solution to this problem might be to require insurers to publicize some kind of metrics on how often they pay out for various conditions, and what percentage of premiums get paid back out.
I've had my health insurance pay out tens of thousands of dollars for major surgery (the unnegotiated rate was in the hundreds of thousands), and while I've had a billing mistake or two along the way I've gotten them fixed by sending them a note on their website the few times that it has happened. The difference is that my insurance probably costs quite a bit more than some of the plans featured in Moore's film.
I'm all for nailing insurance companies that don't pay out on claims to the wall, but that doesn't fundamentally make the concept a bad one.
Moore has some valid points in his film, but many of his points aren't valid. For example he spends quite a bit of time complaining about denials for pre-existing conditions. That is only true if you go from no insurance to buying insurance. If you just switch jobs/plans/etc you're fully covered. The reason this policy exists is because of what would happen if it didn't - people would just not buy insurance AT ALL and insurance brokers would sell it to you while you were waiting in the ER waiting room. Why pay for insurance before you actually need it if you don't have to? People shouldn't wait until they are diagnosed with a serious disease before buying insurance. Now, the quibbling over technicalities and yeast infections is a whole different matter.
Don't get me wrong - the system needs reform. But, unsurprisingly Moore is offering sound bites and ignoring the serious issues. It works good as an attention-getter, and we should be paying more attention to the problem. But, the solution isn't a dreamland where you work 35 hours/week with 10 weeks of vacation, have unlimited sick time, and if you just aren't feeling up to work you can take off three months to visit the south of France with pay. Sounds great - but it doesn't really work that way (just ask an unemployed Frenchman - they make up 8.7% of the population).
The problem is that the taxpayers don't generally pay for drug R&D. They certainly pay for very early blue-sky research, but most of the costs come in at a much later stage.
It is kind of like saying that a state-of-the-art hard drive technology should be unpatented because Maxwell figured out magnetism a long time ago. While there is no question that without Maxwell's laws that nobody would be building hard drives, it isn't the whole picture.
I'm actually in favor of the NIH doing some beginning-to-end drug development as an experiment. They could even subcontract to big pharma if it made sense economically, while retaining all patent rights. The resulting products would be licensed royalty-free to any US manufacturer (only fair since the US taxpayers funded it, not that it would stop others from copying it anyway). The resulting pills would be very cheap - as cheap as anything available over-the-counter. Of course, you would pay for it in your taxes. People could see firsthand whether it made sense economically. However, I don't think it would significantly reduce the costs of medicines - just how they are paid for. You could probably get the same effect by just making all drugs free and having government pay the $5/pill to some big pharma company. But, if the publicly-funded system works out really well then it will take off as people will want to fund it further. And if it bombs you haven't put the whole pharma industry out of business.
Of course, this model still doesn't deal with the fact that US citizens fund drug R&D for the entire world. But US citizens already pay for the defense costs of half the world as well - at least they'd get to pick what drugs get researched under this model...
When the profits of a few CEOs are more important than the lives of the citizenry you know the system is fucked.
:)
Actually, the tradeoff was with the viability of the entire pharma R&D industry. Sure, a few CEOs make off very well, but the fundamental issue is that drug R&D costs hundreds of millions of dollars, and somebody has to pay for it otherwise it just won't happen. The biggest cost is clinical trials (picture paying thousands of MDs to test tens of thousands of volunteers), which for new drugs are basically funded entirely by industry.
Sure, there are other ways to do it than charging $5-500 per pill. Government could fund the trials or they could lower the costs in other ways. However, you can't simply set a price limit of drugs - if you did people would simply stop developing them. Sure, academia would still do blue-sky R&D as they currently do, but nobody would actually scale up the processes, perform clinical trials, and then defend a marketing application. Academically the problem got boring as soon as you successfully cured the first rat.
People who think that price controls will work with no other changes simply aren't aware of the costs of drug R&D.
And putting limits on drug marketing won't save any money either - drug companies wouldn't be doing it if they didn't think it would increase revenue. All reduced marketing does is lower the number of people taking a drug - which decreases the likelihood of it getting developed in the first place. Which isn't to say that reforms on marketing aren't possible or proper - just that it won't actually save any money. What you lose on the bottom line you'll more than make up for on the top line. And the argument over marketing costs just ignores the fundamental issue of the fact that R&D costs STILL have to be paid.
What I've always advocated is leaving the drug industry as it is, and on the side starting a competitive publicly-funded soup-to-nuts R&D program run out of the NIH. They might subcontract some of the development work to Pharma if it was cost-competitive, but they would retain all patents and offer royalty-free licenses to any manufacturer so that the final product is very cheap. Then taxpayers can look at the total bill after a few years and see if they like the end-result. Taxpayers could still buy expensive privately-funded drugs if the public ones turn out not-so-good, but you'd still have state-of-the-art R&D available to benefit those who can't afford expensive meds. If the public effort works really well the pharma industry will just turn into a subcontractor as they won't be able to compete. If it fizzles we haven't lost anything.
I've never liked government plans where step 1 is to ban all competition. That basically just means that you won't have anybody to compare them to. Just look at where its gotten us with the local cable companies...
Actually, the companies don't tend to do it. I knew somebody who worked on subborigation. They tend to use arbitration and industry guidelines, since big insurance companies are just as likely to end up on either side of a claim it is in their interest to just set out guidelines and not litigate.
It is the individual claimants that file suit. They only receive claims, they never pay them out, so it is in their interest for claims to be as large as possible...
One issue with healthcare is the who-pays problem. If government offered free health care to anybody who paid at least $5000/year in Federal taxes there would probably not be an objection - most likely the level of care would end up being pretty high, and since so few people pay that much in taxes it wouldn't lead to a huge competition for treatment facilities.
The problem is that universal care means taking care of the 95% of the population who pay little to no taxes (comparatively).
The people who pay for health care now will still pay for health care under the new system (just in taxes). The difference is that they'll have to stand in line behind people who aren't paying much of anything. So what incentive do they have to want the new system? They pay the same, but get less in service.
So, ultimately, those with money and power are going to oppose universal health care. If it happens it will be the result of voters who don't pay much in taxes (which would be most of them).
The problem is that you can't make the cost of universal care go away simply by putting a zero-dollar pricetag on it. Somebody ends up paying. Unintended consequences tend to cause nasty problems if you don't think things out.
The reality is that every nation practices capitalism. The only thing that changes is the form of the currency. Iran is a capitalist nation that trades in religious fervor. The USSA was a capitalist nation that traded in political power-brokering. The day that an MP in a socialized nation waits the same time for a hospital procedure as some guy out on the streets is the day that I recognize that they are in fact socialized. They might not pay for health care in dollars, but those with power still get preferential treatment...
Uh, where do insurance companies compete to give out bigger payouts?
It is difficult to compare auto insurance rates in the US with those just about anywhere. And the reason for this is the US civil court system, which costs a fortune and routinely gives out big rewards. In most nations a fender-bender won't result in hundreds of thousands of dollars in claims just about ever.
Then again, if the government insured everybody they would just stipulate the claims and there probably wouldn't be anything you could do about it - sovereign immunity and all that...
Keep in mind one purpose for the veto-power bit was to prevent all-out war. Picture this scenario:
1. Russia and US get in some kind of dispute over some 3rd-world backwater.
2. UN votes in favor of US (or Russian) position.
3. UN sends in troops.
4. UN votes to continue to escalate conflict.
5. Nuclear weapons begin being employed.
This couldn't happen under the UN system as if either the US or Russia cared greatly about the issue they'd just veto all action. Sure, nothing happens, but then again you don't have nuclear winter either.
The system was designed to just lock up rather than leading into open conflict between the nuclear-armed members.
Has it always worked out well - no. But, no body of this nature can ever be perfect. I mean, what is the point in a UN council where 300 nations that have no army but hold >50% of the population vote for some change that isn't supported by the world's largest powers? It would be nothing more than a symbolic gesture, since nobody is going to force the big nations to budge. The large nations didn't set up the UN so that they could be told what to do - they set it up as a negotiating tool amongst themselves.
I know people on /. tend to think about the absurdity of software patents, but medical patents can be far more deadly and really need a review when they're used to prevent delivery of medication to people too poor to pay for medicine.
Well, most of those nations that are in need of these medications don't have drug patents anyway - or at least they don't follow them. Perhaps that is part of the reason that nobody bothers to R&D cures for these diseases?
If the problem is that diseases are being cured but nobody can afford the cure, then maybe some kind of patent reform might help - but beware of unintended consequences. If the problem is that a disease isn't cured at all then how will lowering the financial payoff for curing it help?
I'm all for publicly-funded R&D for the sake of the common good. Perhaps the NIH should undertake orphan-drug funding. They might offer bounties (serious ones), or subsidize clinical trial costs (the biggest expense in drug R&D). They might even take the lead role in R&D and maybe contract out the development services to a big pharma while retaining the patent rights (to offer royalty-free licenses).
Right now about the only public role in R&D is blue-sky research, with maybe a lead compound here or there. However, most of the R&D expense comes in after this point, so government bodies don't have much bargaining power regarding patent licensing (short of changing patent law). Rather than use the club of denying patents, why not just have the public fund key drug developments and offer the resulting products royalty-free? Lots of companies would step in to do the manufacturing.
The real problem is that politicians don't want to actually spend money on R&D. They just want to pretend that by changing the rules others will spend money on R&D and the drugs will be cheap. Real life just doesn't work that way...
Actually, juries are permitted to use their own judgement as to the truthfulness of any testimony they hear, based on their own intuition. If a guy sounds like a liar a juror is completely within their rights to consider that the witness might be lying.
Now, an evasive answer doesn't automatically equate to lying, and I don't think anybody is saying that. However, if somebody asks a defendant "did you shoot your wife" and the defendant goes on about how people should have a right to own a gun, I'll start wondering why they didn't just answer the question. Now, if somebody asked the defendant why they owned a gun that might be a perfectly reasonable response, but if it looks like they're trying not to answer a straightforward question that goes to the heart of the case I'm going to assume they're hiding SOMETHING. Now, maybe it isn't what I think they're hiding, but it is one more piece to the puzzle.
People make a big deal out of cases where they don't have a body, a gun, a bullet in the body, ballistics linking the gun to the bullet, DNA and fingerprints on the gun, a witness saying the defendant talked about shooting the victim, and an eyewitness seeing the defendant in the vicinity of the crime scene. Most cases are not that open-and-shut. And if they were they'd NEVER make it to a jury - that defendant would take any plea bargain they could get.
Circumstantial cases are very common, and people are frequently convicted on circumstantial evidence. The standard is reasonable doubt. I've heard the comparison made to large financial decisions - like buying a house. Suppose you did a lot of research and were about to buy a house. Then a random guy walks up to you and says that the house is haunted. Would that in itself change your mind to buy it? If not, the "reasonable doubt" standard hasn't been met. If you're as sure of a defendant's guilt as you would be about a large financial decision, then even if you aren't 100% certain you still can convict. And I got that from a judge's instructions...
Nothing in life can be proven with certainty - but that isn't the standard used in courts. If 12 people unanimously agree somebody is probably guilty without reasonable doubt then they go to jail. I don't know all the facts in this case, and a lot more might come out in a trial than is known now, but it takes more than an alternative theory to acquit you...
Sorry - I'm interested in episode descriptions - not generic show descriptions that apply to the whole series. Oh wait...
No sense backing off too much on the acceleration - as soon as you hit the air you're going to probably have 100Gs of deceleration for a brief time until you're out of the lower atmosphere. Even a very streamlined vehicle hitting 1ATM air at orbital velocity is going to have MASSIVE drag. You'd need a massive heat shield as well (which probably would be gone (and no longer needed) a second into flight).
Yes, but if they followed standards of just about any sort it would work fine - because somebody would take the time to write some software to make it work.
I don't run amd64 so as to NOT be able to find software. I run it because it has certain advantages, and most mainstream open-standards-based software works fine on it - particularly FOSS.
I was just pointing out that flash isn't some kind of panacea to obtaining compatibility. In fact, in some cases it is less compatible than just posting a link to the video. I'm not quite sure why they can't just do both (I have no objection to the flash content being there - I don't even see it anyway). It isn't like it actually makes it harder to download the actual video data...
For the amd64 Linux/Konqueror user, youtube is one of those sites that NEVER works. Now, pages that just provide a link to an avi/mpg file work just fine.
Flash videos are just incredibly annoying. Inevitably I just figure out the url for the flv file and download it so that it can be played with mplayer.
Video shouldn't require a plug-in to work. And if it does they could at least make it more widely available...
Well, it works fine if you're open to other nations with similar standards.
Kind of like most forms of insurance in the US. If you have insurance and want to switch providers, generally they can't exclude you for pre-existing conditions if the coverages are comparable. On the other hand, if you have no insurance and want to buy life insurance the day after you're diagnosed with cancer that is likely to be terminal in two months, then nobody has to sell it to you. The goal is to foster competition between companies, without defeating the whole purpose of insurance (where you pay in without knowing whether you will actually need it).
If highly-socialized nations had completely open borders with anybody, then anybody in the world with an expensive medical condition would just move there, until the tax base completely erodes.
On the other hand, highly-socialized nations have no issues opening borders with each other for the most part - nobody has a real incentive to immigrate en-masse with expensive conditions, and any immigration is likely to be bilateral.