[asking]

Tom, You are really wrong about this. I don't want to be rude, but this is actually something I know a lot about, thanks to a close friend whose non profit funds biomedical research. The private sector primarily puts into production ideas that are developed in labs funded by the government. Sure, you can name a few exceptions, but government funded basic research is the overwhelming pattern. You can mention a few private foundations, and there are more of them now then there were in the days of the polio vaccine. But their research portfolios pale in comparison to the research generated by federal funds.

Basic research is just too risky for most businesses. The irony is that by avoiding risk and following excessively conservative business practices, big pharma has hurt itself. For what they spend, they have shockingly little to show. Fortunately, they've been able to overcome their lack of novel product with just phenomenal marketing skill. One reason they need novel products of course is that the patent only lasts 17 years and it takes a big chunk of that just to get a drug through clinical trials.

I think drug companies' behavior should be reincentivized, but in exchange, they should get much longer patents than they now do. 17 years just isn't enough. On the other hand, my heart isn't bleeding for them, either.

[asking]

Which is EXACTLY why nationalized medicine will not work.

What?

Government-funded biomedical research has been working spectacularly for 50 years. Every country in the world admires our ability to do scientific research and, indeed, other countries began emulating us, and this successful model is now commonplace throughout the world--BECAUSE IT WORKS!

Is it perfect? Of course not! Can you find things you disagree with? Of course.
But the overall model for funding science has been stunningly effective.

We wouldn't have the internet, annual flu vaccine, effective treatments for heart attack and stroke, or prostate, PAP, and mammogram screenings without it. The list is just endless.

[inthebox]

https://www.askmehelpdesk.com/curren...ml#post2089399

Mamograms are one thing:

The fact is, screening in women yearly under 40 DOES SAVE LIVES - 15% reduction in mortality - 6800 lives ACOG's own statement.
They have to compare similar endpoints - in this case death. You cannot honestly compare that to anxiety over a false positive mamogram or an un-neede biopsy.

That same organization ACOG is for the new pap smear recommendations

First Cervical Cancer Screening Delayed Until Age 21 Less Frequent Pap Tests Recommended

"A review of the evidence to date shows that screening at less frequent intervals prevents cervical cancer just as well, has decreased costs, and avoids unnecessary interventions that could be harmful."

I have yet to see the data, the evidence, that getting mamograms every other year in women 40-49 reduces death "just as well" as yearly mamograms.

Also ACOG [ pap ] and the USPTF [ mamogram ] are independent organizations, so to attribute these changes to Obama is not reasonable.


G&P

[NeedKarma]

Which is EXACTLY why nationalized medicine will not work.

Apparently only in your country.

BTW you do realize that Obama has basically rejected the report of the OP, right?

[George_1950]

Apparently only in your country.

BTW you do realize that Obama has basically rejected the report of the OP, right?

Of course: he would like to be more like 'me' in his public persona, but the cat is out of the bag.

[asking]

I have yet to see the data, the evidence, that getting mamograms every other year in women 40-49 reduces death "just as well" as yearly mamograms.

Here's the source.

http://www.ahrq.gov/clinic/uspstf09/...er/brcanup.htm

I have not read it.

Have fun!

[George_1950]

https://www.askmehelpdesk.com/curren...ml#post2089399

Also ACOG [ pap ] and the USPTF [ mamogram ] are independent organizations, so to attribute these changes to Obama is not reasonable.


G&P

You make many good points; but on this last, you are clearly wrong. You must understand, Obama is a puppet - a very small man in a very large office.

He is president at a time when powerful historical/philosophical forces are moving through this nation. Of course, Obama is not acting alone; the progressives have large majorities in both houses of Congress. Progressive beliefs are rampant, similar to what Nazism was in early 1930's Germany - some folk see how the political winds are blowing and jump on board (i.e. AARP); there are many believers, and numerous others just climb on board.

Check this: "Dems' slick fix: $210 billion of fiscal restraint" - "Something unusual and largely unnoticed happened last week as Democrats pushed the national health care bill through the House. In a complicated, late-night maneuver, on a party-line vote, the House Rules Committee used the health bill to pave the way for a $210 billion increase in Medicare payments to doctors, without any money budgeted to pay for it. Congress then combined that $210 billion with a measure that would force lawmakers to exercise fiscal discipline -- except when it came to the $210 billion...More importantly, they threw a very big bone to several physicians organizations, which badly want the increased doctor payments and to whom Democrats are deeply indebted for support of health care legislation." Dems' slick fix: $210 billion of fiscal restraint | San Francisco Examiner

[asking]

You should know that progressives like me feel totally betrayed by this health care "reform" bill. It's so bad now, I'd can it and start over. But the politicians on both sides of the aisle are doing what they do best, trade favors. This bill is NOT what progressives wanted.

[George_1950]

Similarly, "What does it take to get a wavering senator to vote for health care reform?

"Here's a case study.

"On page 432 of the Reid bill, there is a section increasing federal Medicaid subsidies for “certain states recovering from a major disaster.”

"The section spends two pages defining which “states” would qualify, saying, among other things, that it would be states that “during the preceding 7 fiscal years” have been declared a “major disaster area.”

"I am told the section applies to exactly one state: Louisiana, the home of moderate Democrat Mary Landrieu, who has been playing hard to get on the health care bill."
The $100 Million Health Care Vote? - The Note

Corruption is the name of the game: GOP, Democrat, Nazi, Commie, doesn't matter when this stuff is going on.

[asking]

George, I agree, although I'm not sure where pork barreling ends and corruption begins. They all do it because they have to please their constituents to get reelected.

I don't know of any easy solutions to that, although there may be some election reform that would help. It's discouraging.

[tomder55]

Last I checked American Pharmceutical companies spent almost $60 billion in private research in 2008 . This is what the CBO said about it.
“The pharmaceutical industry is one of the most research-intensive industries in the United States. Pharmaceutical firms invest as much as five times more in research and development, relative to their sales, than the average U.S. manufacturing firm.”..... "Many examples exist of major therapeutic gains achieved by the industry in recent years.... [A]necdotal and statistical evidence suggests that the rapid increases that have been observed in drug-related R&D spending have been accompanied by major therapeutic gains in available drug treatments.”

This at a time where R&D in other industries is being cut.
I agree that extending patent exclusivity' time frame would unleash even more innovation .
However losing the exclusivity is also a motivating factor for those big evil pharmaceutical companies to press on in the R&D .

[asking]

But most of their "innovation" is altering drugs slightly and repatenting the same drug with an added methyl group or similar. I have also read that their R&D costs are puffed up with expenses that are really marketing. But I confess I don't have time to track this down and prove it to you right now. Pretty sure it's true though.

I've also covered some private meetings run by pharmaceutical executives and they do things like get a drug approved as an orphan drug (which has fewer restrictions and a quicker FDA approval process), then persuade doctors to prescribe if off label for a much more common disease. In neither case (orphan or common disease) is the drug significantly better than generics that are already available, but it costs a LOT more. It may be 10% better for half of patients, or something like that.

The other thing is that pharma is primarily interested in treating chronic diseases, not in curing people. That's not in the public interest OR in the interests of individual patients. It's just a more effective way for a business to make money. That is their job, of course. But what's good for Pfeizer and Merck isn't necessarily what's good for America.

[George_1950]

George, I agree, although I'm not sure where pork barreling ends and corruption begins. They all do it because they have to please their constituents to get reelected.

They are not doing the health care takeover and destruction bill because 'constituents' want it; let us be clear about that.

[NeedKarma]

They are not doing the health care takeover and destruction bill because 'constituents' want it; let us be clear about that.

I believe that was a large part of Obama's election platform, it's part of what the people voted for.

[tomder55]

I submit that the Pharmaceutical industry would've been confined to the dustbin long ago if all they did was tinker with existing products. Your bias against the industry is showing I think .I did some checking and the FDA approved about 80 new drugs just this year. All of them are retreads ? I don't think so.

[inthebox]

You make many good points; but on this last, you are clearly wrong. You must understand, Obama is a puppet - a very small man in a very large office.

He is president at a time when powerful historical/philosophical forces are moving through this nation. Of course, Obama is not acting alone; the progressives have large majorities in both houses of Congress. Progressive beliefs are rampant, similar to what Nazism was in early 1930's Germany - some folk see how the political winds are blowing and jump on board (i.e. AARP); there are many believers, and numerous others just climb on board.

Check this: "Dems' slick fix: $210 billion of fiscal restraint" - "Something unusual and largely unnoticed happened last week as Democrats pushed the national health care bill through the House. In a complicated, late-night maneuver, on a party-line vote, the House Rules Committee used the health bill to pave the way for a $210 billion increase in Medicare payments to doctors, without any money budgeted to pay for it. Congress then combined that $210 billion with a measure that would force lawmakers to exercise fiscal discipline -- except when it came to the $210 billion...More importantly, they threw a very big bone to several physicians organizations, which badly want the increased doctor payments and to whom Democrats are deeply indebted for support of health care legislation." Dems' slick fix: $210 billion of fiscal restraint | San Francisco Examiner

From your link

The bill reverses scheduled cuts in Medicare payments to physicians. For years Congress has vowed to make gradual cuts, and for years it has put them off. All those unmade cuts would add up to a 21 percent reduction next year, unless Congress put them off again

Cuts in payments to doctors for care of patients under the government system, medicare,
Have been delayed. This is NOT a pay increase, but rather prevention of a pay decrease.
Remember doctors are business owners or employees of business owners. A 21% cut in revenue to a business with generally over 50% overhead, means a 44% cut in pay. When current medicare payments are barely covering the cost of doing business, a 44% cut will force plenty of doctors to limit, or not see any medicare patients. Go ask any doctor how many medicare patients will they see if reimbursement is cut 21%?


G&P

[inthebox]

Here's the source.

Screening for Breast Cancer: An Update for the U.S. Preventive Services Task Force

I have not read it.

Have fun!

From table 1 of your link:

The risk reduction of breast cancer death for women 39-49 is the SAME, roughly 15%, as it is for women 50-59 years old.

The NNT, the number needed to treat, that is how many mamograms does it take to prevent a breast cancer death, may be 1 in 1907 in the 39-49 age group and 1 in 1339 in the 50-59 age group, but at what arbitrary number do you decide that a technique to prevent breast cancer death is not needed?

2 counterpoints:

1] The recommendations were based on a collation of multiple trials, Britain and Sweeden were mentioned. How can you compare British and Sweedish women to American women? I am not being facetious here. You have to compare melons to melons - sorry I could not resist. This is what I mean, in the US, breast cancer mortality differs on such factors as race. To extrapolate data from non-American women and apply it to American women is intellectuallly wrong.

CDC - Breast Cancer Rates by Race and Ethnicity

2] Where is the evidence from American trials that every other year mamogram in women 39-49 is just as effective in reducing breast cancer death as yearly mamograms?


Remember in the mid 1980s when airbags were supposedly better than just seatbelts? It was mandated, then after a year or so it was found that airbags can kill or harm small people [ women and children ]. You have to look at the data, is it good? How is it used? And are the conclusions drawn from the data correct? In this case airbag data was from 160 pond males. Tragically that data did not apply to smaller people.


G&P

[Fr_Chuck]

What americans believe they want is free health care ( no one pays for it) and to a better standard than they have now.

What they are finding out they may get is something worst than medicare that they are going to have to pay for if they have income. Or perhaps lower pay since their work place will have to pay for it.

Remember America has felt that Medicare was good enough for that group of Americans, why would we expect better

[NeedKarma]

What americans beleive they want is free health care ( no one pays for it)

Everyone who has universal health care is aware that it comes as part of our taxes. To tell people that it's "free" health care is intellectually dishonest.

[asking]

Airbags save more people than they kill.
Mammograms also have a risk, namely radiation.

In fact, treatment for breast cancer has a risk. My sister was treated for breast cancer with radiation 20 years ago. She received 5000 rads, enough to trigger another case of cancer in 20 years. It looks like that may in fact have happened. But she got another 20 years. I hope she gets another 20, but the fact remains that radiation exposure has a CUMULATIVE effect on cancer risk. So it's totally reasonable to weight that risk against the benefits of all kinds of screenings, not just mammograms. I just turned down an MRI for that reason.

Lets' be sensible.