@ stefan: thanks for the interesting info. I’ll try to look it up

@Brian & Joseph

I presented an economic argument as seen from the pharmaceutical industry’s point of view of pure profit. I admit that a couple of sentences cannot be but superficial. They are based on professional market reports like EMS and ResearchandMarkets.com.

The Germans have not privatised their health care system; they have delegated pharmaceutical sourcing and distribution to private insurance funds. It is in the interest of these companies to source the cheapest medicines by tender as the system is built in such a way that their profits are realised by cannabalising the pharmaceutical industry’s margins. No government will ever reach their efficiency levels on this point.

I do not have enough knowledge of America’s healthcare system so I cannot rebut that point.

The quoted articles are both political. Call me a cynic, but I rarely attribute credibility to emotionally charged political statements. I prefer cold hard numbers.

We are probably better off agreeing to disagree since we approach this topic from opposite ends.

@ Stefan Vella

a quote from the World Socialist (gasp!) WebSite quoting the Süddeutsche Zeitung:

Commenting on the trend in German taxation, Peter Bofinger, a member of the German Council of Economic Experts, wrote in the Süddeutsche Zeitung, “If we had the tax rates that were in place in 1998, we would have 75 billion euros more revenue per year.”

Now you know what the real problem is… the gap between rich and poor is superseding the barbaric times before 1930’s crash and the resultant social backlash. The real story is that the middle class is evaporating. We’re at the end of a golden age that will take a long time to come again. On a better note though many poor countries might get a shot at lifting themselves out of abject poverty.

@ Stefan Vella, how will the germans manage to make it work when privatised health care in the US is an immoral broken mess that is costing double per patient what it costs in the most expensive socialised systems?

Here’s a cringe worthy snippet from an article written by an ER specialist in San Francisco. The rest is available on Harper’s website…subscribers only unfortunately.

——————-

I spent my early childhood in a trailer in Texas, so I thought I knew something about barriers to health-care access, and maybe even something about poverty. Then I became an emergency physician in Oakland.

…

The county hospital E.D. is where those with no insurance and no money go. The elderly and disabled who qualify for Medicare and Medicaid may also go there, but they often take the insurance elsewhere.

…

Not infrequently, the primary reason for a visit to the hospital is listed as “Lost Insurance” or “Lost Kaiser” (one of the country’s largest health-maintenance organizations); once the form just said “Lost,” but we all knew what it meant. Every week we see patients with decompensated chronic disease who say, “I was doing fine until I lost my job and couldn’t get my meds.”

…

There are those who have lives so complicated—by three jobs, or six children—that a 3 a.m. emergency visit is all they can manage. They come to the county E.D. because we are always open, and refuse care to no one.

…

The failure of preventive primary care creates emergencies that should never have been. The county hospital sees diseases that have become the worst versions of themselves: what should have been simple diabetes, requiring oral medication and diet change, presents as diabetic ketoacidosis, a life-threatening condition of acid in the blood. We see severe infections that are treatable only with amputation but that once were simple cellulitis, requiring antibiotics; and numerous strokes, which could have been prevented through blood-pressure control. Although the E.D. tries to give patients what they need, it cannot offer them a phone number they can call for refills or the chance to see the same doctor year after year.

…

The triage nurse passed me a handwritten note from a patient in the waiting room. It read:

Please help me. My jaw has been broken and I am in a lot of pain. I’ve been here over an hour and am still bleeding. My hands and feet are numb and I’m starting to shake. I need some care. I have insurance.

The engineer who wrote the note was in his mid-thirties. He had been prescribed cough medicine with codeine for a viral illness and had passed out in his bathroom, breaking his jaw and several teeth on the sink as he fell. His injuries were no more and no less painful than some of those resulting from violence in Oakland. What was striking was that a highly educated young man could think that his pain, bleeding, and shaking might not get him care in one of the best hospitals in the country but that his insurance would; he could assume that the brief wait before he was seen was due not to the stroke and heart-attack patients who had come in just before him but to our suspicion that he did not have insurance. When even the privileged feel their access to care is so vulnerable, it becomes hard to argue that the system is working for anyone.

—–

Anybody thinking that a private system will make things automatically better most probably believes in fairy tales as well… obviously loads of money and connections will get you anywhere, even in the US of A.

Iro , isn’t the ‘choice’ of medicines strictly the pharmacist’s job?

If, for example, I have a headache the doctor should prescribe paracetamol and write down his diagnoses, the pharmacist who knows his subject more thoroughly than a GP would recommend to me a certain brand because there is this chemical which would make me feel better in my condition. This was the procedure forty years ago.

My personal doctor knows that I know what’s going on, so he just writes down the prescription and explains which is the active ingredient I need, but mishaps most probably happen on weekends we have to go to a health centre or a hospital , there’s no choice there.

Yet again, you are confusing two separate issues: 1. the price of medicines and 2. the unnecessary prescription of medicines like antibiotics.

Honest people in this business don’t resort to such tactics (1&2), greedy and unscrupulous ones do give doctors perks and commissions so that they prescribe importer’s overpriced products. That’s why these are not separate issues.

[Daphne – Ho-hum. The usual tarring of everyone with the same brush. You might as well take you argument all the way back to the manufacturer, and refuse to buy any medicine at all on the grounds that too much of the price represents profit, CEO’s salaries, jollies for doctors at international conferences, unnecessary research expenses, etc. And then you can drop dead or suffer your illness purely on a point of principle. And see where that gets you.]

@Stefan Vella

Flip your coin and you shall see differently.

’29th June, Germany’s government moved on Tuesday to break drug makers’ grip on prices with a bill aimed at saving the creaking health care system about €2 billion a year.’

‘7th July, The centre-right government’s health reform plan was blasted Wednesday by opposition parties, unions and insurers as a failure to tackle the deep problems with the health system that would burden the poorest.’

I ask you this, who will be carrying the greatest burden? Pharmaceutical companies, the government, insurance companies or the poor sod in the street?

Watch out for the smoke and mirrors.

But enough of this as we are going out of context.