Study Calls for Universal Pharmacare Plan

[Evening Star]

Yeah, I'm also interested in hearing an explanation there. I'm not sure what I think of out-and-out nationalization but I do think the case against it has to be explained more fully than that.

(I'm in strong agreement with SmallC so far and do admire the premiers' leadership.)

[ToadBrother]

Ok, I just don't understand how that's related to Universal Pharmacare. Presumably we'd get the same medicines as would be available privately.

Not if the drug companies refused to sell those drugs here we wouldn't. As much as I think there need to be reforms, nationalization of Big Pharma will not ultimately benefit anyone.

[Bryan]

As the saying goes, if it's been proven, it's medicine. Surely you must see the fallacious nature of your statement.

The problem is, when it comes to public health, you can't trust "proven" either. There are charlatans on both sides, and the incentives are greater on the "evidence based" side because the money involved is so much greater. Things end up being "proven" with fake research to secure the patent rights, while unpatentable natural remedies won't even get researched because there's no profit motive.

[P. McGee]

As the saying goes, if it's been proven, it's medicine. Surely you must see the fallacious nature of your statement.

Which statement is that?

[Moonlight Graham]

If we can save money buy buying drugs in bulk, then just let the gov buy all of Canada's drugs at a discount and let the gov act as a wholesaler to whatever pharmacies/hospitals/docs want to buy from it. No need for a universal plan.

Also how the hell are we going to afford it when the baby boomers hit max drug intake?

Oh, and wouldn't this increase the # of prescriptions written? Yes, yes, just give me the drugs doc the gov is paying for it anyways. May do more hard than good.

Edited September 25, 2010 by Moonlight Graham

[Michael Hardner]

Not if the drug companies refused to sell those drugs here we wouldn't. As much as I think there need to be reforms, nationalization of Big Pharma will not ultimately benefit anyone.

The government would be able to get drugs from somewhere, though.

I don't think the business sector would take to nationalization of the pharma-care sector, and I don't think it will be seriously considered anytime soon.

[nicky10013]

The government would be able to get drugs from somewhere, though.

I don't think the business sector would take to nationalization of the pharma-care sector, and I don't think it will be seriously considered anytime soon.

I disagree. I think the notion that big pharmaceutical companies wouldn't sell to the government is absurd. Certainly the UK and France haven't had problems. Indeed, the fact that the government would be buying on such a large scale would be a pharmaceutical wet dream.

The other side is generic drugs. Canada already gets generic pills much cheaper. What we can't get cheap, we purchase generic. In the end, however, such a programme would be such a moneymaker I don't forsee it being a problem. They'll protest and then meekly take their money.

[ToadBrother]

The government would be able to get drugs from somewhere, though.

I'm sure they would, at whatever price the seller wanted to charge.

I don't think the business sector would take to nationalization of the pharma-care sector, and I don't think it will be seriously considered anytime soon.

I certainly hope not.

[wyly]

I think it's a great idea if the government can can get a better deal for us buying bulk, it needn't cost us anything in taxes...and I don't think the drug companies care who they sell to, profit is always the bottom line..

[Argus]

The point of the study was that we're already paying for it.

Yes. We pay for all these drugs anyway - as a people. If we had the government buy them in bulk and negotiate deals for that bulk purchase things would be more organized and the drugs would presumably be cheaper.

I'm in favour of a national health authority to take over most health care initiatives from the provinces, and pharmacare certainly fits in with that.

[Argus]

Not if the drug companies refused to sell those drugs here we wouldn't.

If the drug companies refuse to sell a given drug here then we simply licence a local generic pharmaceutical company to make it for us.

[Argus]

The government would be able to get drugs from somewhere, though.

I don't think the business sector would take to nationalization of the pharma-care sector, and I don't think it will be seriously considered anytime soon.

All the drugs are already purchased by government, are they not? Don't the provinces negotiate pricing directly with the manufacturers based on the size of their purchases?

[Smallc]

I'm in favour of a national health authority to take over most health care initiatives from the provinces, and pharmacare certainly fits in with that.

I'm not. I want the provinces to work out their own deal, all contributing to an authority they pay for.

[Michael Hardner]

All the drugs are already purchased by government, are they not? Don't the provinces negotiate pricing directly with the manufacturers based on the size of their purchases?

The first sentence could be interpreted to mean:

1 ) "100% of drugs are already purchased by the government"

or

2 ) "Every drug on the market is bought, in some quantity, by the government"

The answers are 1 ) No and 2 ) Yes. At least as far as I know.

Universal Pharmacare would mean that we transitioned to 1 ) - 100% of drugs bought by the government.

[Argus]

The first sentence could be interpreted to mean:

1 ) "100% of drugs are already purchased by the government"

or

2 ) "Every drug on the market is bought, in some quantity, by the government"

The answers are 1 ) No and 2 ) Yes. At least as far as I know.

Universal Pharmacare would mean that we transitioned to 1 ) - 100% of drugs bought by the government.

Well the drugs the provinces do buy are purchased at often enormous discounts due to their purchasing power. Presumably, letting them buy all the drugs would result in even higher discounts which they could pass along to us.

[Michael Hardner]

Well the drugs the provinces do buy are purchased at often enormous discounts due to their purchasing power. Presumably, letting them buy all the drugs would result in even higher discounts which they could pass along to us.

Yes, true. But we`d have another government institution to deal with (see what Pliny thinks and I would like to see the government get better at delivering services.

[ReeferMadness]

A universal plan will lower the overall cost of drugs to Canadians by two means:

1. Governments are in a much stronger position to negotiate with the drug companies

2. Lower overall administration costs through centralization of paper work from the insurance companies

However, the real problem isn't the costs, it's the underlying economics of health care. The drug companies are making so much money treating disease and conditions, there is no motivation to discover cures.

And governments provide pathetically little funding to researchers so that cures may be found.

[Smallc]

However, the real problem isn't the costs, it's the underlying economics of health care. The drug companies are making so much money treating disease and conditions, there is no motivation to discover cures.

That isn't true. cures, vaccines, and better treatments are invented all of the time. Some of the research is publicly funded, and some is privately funded.

[Michael Hardner]

That isn't true. cures, vaccines, and better treatments are invented all of the time. Some of the research is publicly funded, and some is privately funded.

Thank you for that post. I can't abide by the attitude that huge companies are conspiring to destroy the planet. When they act to harm the planet, they do it in full view of all of us.

[ReeferMadness]

That isn't true. cures, vaccines, and better treatments are invented all of the time. Some of the research is publicly funded, and some is privately funded.

Really.

"Better treatment" is a code word for new drugs that can be patented, ensuring that the big pharmas continue to generate fat profits. Treatment generates continued cash flow. Cure kills the golden goose.

New vaccines are just a continuation of a concept that was discovered decades ago. And many vaccines (like the flu vaccines) need to be constantly redeveloped, ensuring continued cash flow to big pharmas.

Cures. The only one that comes to mind is the discovery that most ulcers are caused by infectious agents. Why don't you list all of the cures you know of?

I can tell you that it's been nearly 40 years since Richard Nixon declared that finding a cure for cancer was a "national goal". Since then, progress has been spotty at best. Two of the main treatments (radiation and chemotherapy) are both carcinogenic themselves. Review the literature and you will find plenty of enormously costly drugs that increase life span by a few months or less.

Since Nixon's declaration about $200 billion has been spent on research. This is the sum total spent over 40 years on the second leading cause of premature death. Compare that to a half trillion dollar "defence" budget in one year alone. And how much of that $200 billion was spent on cures instead of just "treatments" that go to improving cash flow but make little difference to the patient?

The cancer industry got tired of bad press so they solved the problem by calling people "survivors" if they were still alive after 5 years. How many 45 year-olds do you know that are satisfied to live 5 years, a lot of it puking as a result of the "treatment"?

I can readily name plenty of diseases and conditions that we "treat" (in many cases with little success and lots of side effects). They're gold mines for the medical and pharmaceutical industries Here is a short list.

• 
  alzheimers
  schizophrenia
  asthma
  allergies
  gout
  arthritis
  parkinsons disease
  MS
  cancers (bloody near all of them)
  diabetes
  herpes
  

Come down with any one of these and there is a little "ka-ching" sound in the offices of health ministries, pharmaceutical giants and doctors. Because you're going to be using their drugs and services for a long time, maybe for as long as you live.

[Smallc]

I'm not sure you're understanding how difficult medical research and finding so called cures are. We can cure more now than we could be for, and we can treat pretty much everything better. We're on the cusp when it comes to other things. You mention cancer. Well, we're better at that than we've ever been. Fewer people who get cancer die, and those that do live longer. It isn't as easy as you seem to think. Some day, diseases of all types will be curable. We get closer to that every day.

These were the top three breakthroughs just last year:

http://www.time.com/time/health/article/0,8599,1946291,00.html

We get closer and closer with so many thing every day.

[Smallc]

The idea that dedicated medical researchers are not working to actually cure disease is actually nonsensical.

Here's the 2008 list. Notice #10.

2008 List

Edited September 26, 2010 by Smallc

[ReeferMadness]

Thank you for that post. I can't abide by the attitude that huge companies are conspiring to destroy the planet. When they act to harm the planet, they do it in full view of all of us.

Let's get something straight. I don't think there is a conspiracy. There is no need for a conspiracy. It's simply the way the system works.

Let's say you're an executive for a big pharmaceutical companies and you are presented with 2 proposals for treatment for a disease. Each proposal requires an outlay of $50 million.

Proposal 1 represents a radical departure from current thinking and a small chance that the result would be an all-out cure for the disease. The projections indicate that there is a 10% chance that there would be a significant improvement in life expectancy which would profit your company $40 million annually for the lifetime of the patent. Additionally, there is a 1% chance of an all-out cure which would profit your company a windfall $500 million during the first year but just $5 million per year thereafter until the patent expires.

Proposal 2 represents an improvement on conventional treatment. It will produce a drug that will modestly increase the life expectancy and reduce the side effects of the currently available treatments. Since patients with this disease are desperate, even modest improvements will produce a signficant demand. The projections indicate that there is a 50% chance that the research will succeed and if it does, your company will generate a profit of $25 million annually for the life of the patent.

You are legally obligated to make the best choice for your shareholders, not for the general public so you pick option 2. The system sucks, guys. Wake up and smell the coffee.

[Michael Hardner]

Let's get something straight. I don't think there is a conspiracy. There is no need for a conspiracy. It's simply the way the system works.

...

You are legally obligated to make the best choice for your shareholders, not for the general public so you pick option 2. The system sucks, guys. Wake up and smell the coffee.

But how do we know the two options you have laid out are reasonable representations of how the industry works ? And therefore how can we say that, as you put it:

"The drug companies are making so much money treating disease and conditions, there is no motivation to discover cures."

[ReeferMadness]

smallc, you keep telling me that we can cure diseases but I'm still waiting for the list of those that have been cured recently. I looked at your links. One is broken. The other lists the top ten medical breakthroughs, none of which are cures. They're just more ways the medical industry can generate profits.

Read this article. It's long but worth the read. It describes how the 40 year war on cancer has produced lots of basic research, some treatment improvements but no cures.

Here's an excerpt that supports my premise about the type of research that actually gets funded:

Indeed, there is no more common refrain among critics of how the war on cancer has been waged: that innovative ideas, ideas that might be grand slams but carry the risk of striking out, are rejected by NCI in favor of projects that promise singles. "We ask the scientists all the time why aren't we further along," says Visco. "Part of the answer is that the infrastructure of cancer is to keep things moving along as they have been and to reward people doing safe research. Exciting new ideas haven't fared well."