Under our umbrella
Those who favor a nationalized healthcare system in the United States frequently point to studies that tout the success of socialized medicine in other developed countries. However, Benjamin Plotinsky at the City Journal points out that these studies do not take into account the “pharmaceutical umbrella,” i.e., the influence American-developed drugs have on helping these systems succeed:
One reason for America’s drug dominance (though far from the only one) is America’s unsocialized medicine. Here, with the exception of a few programs like Medicaid and the VA system, the government doesn’t regulate the price of drugs, so when a company invents something big—the latest miracle cancer drug, say—it strikes it rich, making its executives hunger for more. Take away the profit motive, as government-run medicine often does by forcing drug companies to sell at discounted prices, and innovation will dry up. . . . True, America’s unregulated environment benefits any drug company that sells here, regardless of its nationality—but American companies profit most, since even in today’s global economy, a higher proportion of their sales than of European companies’ sales takes place in America.
So socialist Europe, by using American drugs . . . , is profiting from good old-fashioned American free enterprise.
Earlier in the piece, Plotinsky illustrated his point by comparing the healthcare situation with the days of the Cold War:
[I]magine that it’s 1962, the hottest point of the Cold War, and that you’re reading a report comparing two countries’ strategies for resisting the Soviet menace. The United States, the report points out, spends billions of dollars a year on troops, tanks, warships, and missiles, while France spends a tiny fraction of that. Nevertheless, France and America are both unscathed by Soviet bombs. Therefore, the report concludes, France’s Cold War strategy is far more efficient than America’s. And you snicker at the obvious flaw in the reasoning, since you know that what has kept the Soviets away from France is precisely America’s enormous military budget. If not for the nuclear umbrella that the United States has unfurled over the Continent, Volgas might be cruising down the Champs Elysées.
Read Plotinsky’s article in its entirety here.
(HT: Tim Challies at Challies.com)

















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back to top35 Comments to “Under our umbrella”
Profits don’t discover cures, brains do.
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OK, Scroop, but how do brains get their research done without funding? R&D $ comes from reinvesting the profits made on previous discoveries.
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Sick.
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Tell me just ONE instance where socialized (ie, guvmint controlled) medicine is a success………..
just one!
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Justus:
1) Nobody is advocating government controlled medicine.
2) As for government funded medicine we can start with Medicare which the vast majority of recipients are happy with, then the VA and Medicaid, as well as the medical services provided to federal employees, service members and their families. Not a lot of complaints there, either.
As for the drug companies, these days they seem to spend more time finding “cures” for minor problems, then using intensive advertising (and less savory methods) to convince everybody that these are major problems that they must spend thousands every year to treat. It’s perhaps the ultimate inefficiency in our system.
Most of the tough research on tough diseases, including the cancers is being done by, you guessed it, the government, funneling money through NIH and other agencies to University researchers.
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No, RR, you’ve got it all wrong. All we need is to establish a federal department of cures, with a cures czar, and then the government can create cures for a fraction of what the greedy drug companies charge. I have no doubt the best R&D talent will flock to the government cures department, for much less money, so that their brains get the recognition instead of their salaries.
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#4 A few days back the WSJ Opinionjournal had an interesting anecdote about a woman in Britain. While attempting to insert an arterial access line, it sounds like a major vessel was punctured. She literally died due to the slow arrival time of blood from the blood bank.
Yep, the Euro socialists in the western part of Europe built cushy cradle to grave health delivery systems. They could do that and build super highspeed bullet mass transit trains cuz they’ve never really ponied up that much geld to finance NATO.
Paul Krugman the former Enron advisor/economics columnist for NYT remarked that with the burden and worry of health care lifted from them, Europeans were free to spend more time enjoying their families, vacations etc. Only trouble is gee whiz the Europeans basicly stopped having families! Today the beneficiaries of most of the generous unemploymt paymts and subsidized health care in England, France, the Netherlands etc are all those muslim immigrants and their large families.
How anyone could embrace a religion which deems the west a decadent and evil place YET STILL CHOOSE TO LIVE IN THE WEST instead of a tent in a Saudi sand dune escapes me to be honest.
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I suspect this alleged HIV vaccine will have to be shared or given away to those 3rd world countries where it is so rampant. Yes, maybe a scientist or two will earn a Nobel in medicine. But as far as any financial payback for all those manhours of research to find a vaccine? Fuhgedddaboutit!
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I find it frustrating that Medicare and Medicaid are continually held up as “successes” simply because the recipients of them are happy. Problem is, they aren’t solvent, therefore, NOT successful. I would be real happy if someone else were paying my bills, too. How’s about we set up a new gov’t program by which all you happy tax-payers cover my mortgage each month and I declare it a success because, dag-gone it, I AM happy with it.
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Nobody is proposing a “nationalized healthcare system in the United States.”
It really would be nice if the far-right wing would drop this strawman and deal with the proposals that actually are under discussion, but that seems to be too much to ask.
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“Profits don’t discover cures, brains do.”
Brains recognize that profits motivate comapanies to do the research that leads to cures.
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Mommy: I find it frustrating that Medicare and Medicaid are continually held up as “successes” simply because the recipients of them are happy. Problem is, they aren’t solvent, therefore, NOT successful
Maybe, but they also aren’t comparable to what’s being proposed. Medicare, and Social Security too, were intended to be paid for by taxes from current wage-earners, with benefits going to retirees. That works fine as long as the working population continues to grow faster than the retiree population. But, with the baby-boom generation reaching retirement age and people living longer on average, that equation has been upset. Those programs are at risk because there are comparatively fewer people working and more eligible for benefits.
The public-option part of the health care reform would not work like that. It would be paid for by premiums paid by current members — a much more business-like funding structure. Citing problems with Medicare funding as an argument against the public option fails because it’s not a fair comparison.
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Ken: Brains recognize that profits motivate comapanies to do the research that leads to cures.
But as Arcadia correctly pointed out: Most of the tough research on tough diseases, including the cancers is being done by, you guessed it, the government, funneling money through NIH and other agencies to University researchers.
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“Most of the tough research on tough diseases”
Really? Two significant fallacies there.
First, NIH, WHO, and universities are doing research, and no one is denying that. You, however, seem to be pretending that the pharma companies aren’t developing all sorts of things, including the drugs that entities like WHO depend on: http://tinyurl.com/ybbxx63
Second, all medical research ultimately depends on somebody somewhere making a profit. Either pharma companies themselves have some money left over (after manufacturing the medicines they’ve already developed) that they can funnel back into the lab for the next go-round, or the government funds research based on taxes it confiscates from wages and corporate profits.
Developing cures for cancer may be the equivalent of rocket science, but understanding the basic economics of who pays for all the test tubes should not be.
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#14 Cant speak for other universities, but at the UT school of pharmacy in Austin you see plaque after plaque acknowledging a hefty underwriting for research by Merck, Astra-Zeneca, Glaxco etc. I knew a chem grad student who also got funding from a drug company.
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SteveG
You are mildly humorous.
You hold up Medicare as a successful program in support of the healthcare bill. Then, you say “they aren’t comparable.”
You severely criticize opponents of the healthcare bill for predicting that many factors will “upset the equation” and then you use that as an excuse as to why Medicare isn’t working as intended.
But only mildly.
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I’m as pro-business as the next guy, but let’s face it, Somalia has given the world zero NCE’s, despite having no government and less gun control.
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Lets see here! All research must be funded by someone . Do I have that correct, or is there an organiszation somewhere that gets research scientist to work free. The ’someone’ is the person who is purchesing the drug who pays a percentage of the cost for research, either to the drug company or through governmentfunding IE taxes. May I remind us all that the government does not pay anyone anything, they simply direct the taxpayers money as they will. Most of the time for good, often not.
Blessings
Roger
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Man, this is a Tokarev discussion (or at least one where “Reader” should chime in).
There is a pricing problem at work: discounts do have to be compensated or subsidized somewhere else. So lower prices for drugs overseas in turn pushes up their cost here.
Second, there is also the problem of the market supplying what people will pay for, as opposed to what will actually help people. The result is that we get plentiful supply of viagara and the like, but have difficulty finding suppliers for rare diseases, or for vaccinations. Given the health consequences, pure market pricing may not be the most just way of allocating production; an intervening or mediating body is necessary to secure overall health.
Last, market pricing tends to underfund research. Again, if that can be given to other agencies (universities, government labs like NIH) this frees the pharmaceutical company of certain costs. A a public good, we probably want that, insofar as pure research becomes part of common knowledge, rather than sequestered behind drug company walls: we want to build on discoveries and let the commercial companies then create the applications.
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This is a response to Arcadia – you state in your response that there are no complaints to Medicare or VA or military doctors? HAVE YOU EVER BEEN TO A MILITARY DOCTOR? I HAVE and let me tell you there is a huge difference between military and non-military. And do you receive medicare? I am sure that would be a BIG NO. Didn’t you listen to the news about the huge issues happening at the VA this past summer to all the military guys who were wounded? You don’t know what the heck you are talking about so maybe it is time for you to be quiet and check your facts. Government Healthcare IS a HUGE mistake for this country. There are fewer advancements in technology because of the HUGE loss of revenue. Don’t kid yourself this won’t solve anything but create a nightmare. Get a clue…
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Government decisions on funding is mostly political.
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My favorite new drug for something that I didn’t know was a problem until I was educated by an ad featuring Brooke Shields
Latisse
Who knew she had an eyelash problem? They were hidden by her eyebrows!!
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Mommy: You hold up Medicare as a successful program in support of the healthcare bill. Then, you say “they aren’t comparable.”
No I didn’t. Please don’t confuse me with others.
I might hold up the VA system as an example, because it’s more comparable, but I have never said that about Medicare.
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For SteveG:
http://online.worldmag.com/2009/09/09/no-more-scare-tactics/#comments
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Pardon, SteveG, meant to also say to look at comment 119 on that thread.
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Steve and Arcadia are doing a better job on this than I can, so I will let this thread go. Still looking for a really dumb comment to deconstruct.
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Mommy: Fair enough. Although, all I was saying there is that Medicare isn’t the abject failure it was being portrayed as.
There are very real differences in the funding structure between Medicare and the proposed public option. If we’re talking details, not generalities, and if we’re being honest, those differences have to be part of the context.
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Agreed, but if we’re being honest, we also have to admit that there will be many factors that will “upset the equation” of the proposed solution. That is the basis of what we’ve been trying to say for weeks and it seems to be falling on deaf ears.
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Random: Try RR at 49. His argument could be used to completely de-fund ALL government activities. How does “small enough to drown it in a Dixie Cup” sound?
Harris nailed the central problem with the drug companies. Their primary motive is profit, not health. They are interested in any project that can make money, whether it is good for society as a whole or not.
Sawgunner: Those research grants to UT may be for helpful or just profit-making research. And yes, there can be a cross-over. And, most research universities, thanks to a gigantic government giveaway passed by Republicans in the Bush era do get to keep the patents on the inventions that were funded by tax dollars.
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Most of us will get sick; all of us will eventually die.
It’s like the old joke about the guy who asks a girl he is dancing with, “Will you go to bed with me for a million dollars?”
“Yes,” she says.
“Will you go to bed with me for ten dollars?” he then asks.
“No!” she exclaims, offended. “What kind of woman do you think I am?”
“We’ve already established that,” he says. “Now we’re just dickering over the price.”
As far as health care goes, there is an infinite demand and a limited supply. Now we are just dickering over whether private insurance companies or some public option will decide who is likely to live for a while and who is going to die, and who will whitewash the system we end up with.
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There are several points that the article seems to miss.
1. The premise relies on data that merely look at the number of NCEs from a given country. Because the US has the largest population of any developed country, that factor alone stacks the deck in the US’s favor. When one looks at per capita development of NCE’s, the US fares no better than other developed countries. Thus, there is no correlation between NCE innovation and a country’s method of regulating health-care insurance.
2. The article fails to mention that much of drug company profits depend on non-patent exclusivity. Once a drug is approved, no generic version will come onto the market for about 6.5 years, even if the patents covering the drug are clearly invalid. Who provides brand drug companies with this 6.5 years of unmerited exclusivity? The government.
The US is a profitable market for drug sales because the US makes it harder than any other country for generic drug companies to knock out invalid patents and bring their products to market. This occurs because of government intervention on behalf of Big Pharma.
Besides, drug companies spend far more money on marketing than they do on R&D. Furthermore, a large percentage of Big Pharma R&D is directed to the development of life-cycle extensions (e.g., extended release tablets, etc.).
Conservatives seem to be perfectly happy with big government…as long as it redistributes money to those who are viewed as deserving (in their eyes).
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#31
Excellent.
The pharmaceutical industry is the template for irresistible for meets immovable object.
The force is the profit motive does indeed drive innovation and creation of newer and better drugs.*
The object is that in the urge to maximize profit (an essential part of capitalism) causes the cost of many essential drugs to be far too expensive for many people who desperately need them.
Drugs for treating HIV-AIDS in third world countries is perhaps the most spectacular example. If you allow countries such as India with high tech and large populations of poor people to create their own “knock-off” copies of such drugs and distribute them you have unleashed the demon of socialism and undermined capitalism. Either you destroy (or at least undermine) capitalism or you allow many people to die.
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* Footnote to the previous comment. I don’t hate capitalism and I am quite serious that it is a driving force for innovation and solving problems.
However, those who worship free enterprise (rather than evaluating it rationally in terms of its benefits and flaws) like to overlook the many problems it brings to medicine. Whole books have been written on this topic.
Just a few small points in the interest of brevity.
Drug companies often turn their innovative energy and talents to gaming the system. Marketing drugs that are tiny variations of ones that already do a reasonable job. Bypassing the general role of the medical doctor as the guide and gatekeeper for the patient by mass market advertising, high-pressure selling, and so on.
As far as I can see, 90% of the conversation on worldmagblog on this topic is sloganeering and ideology instead of rational discussion and analysis.
Civilization is doomed. News at 2011.
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While I realize one instance does not mean that it will happen gain, this is what will happen if we get a public option. there is one big difference, the US government will raise taxes and borrow more money and print even more money to pay for nationalized health care.
It will happen.
Bears poop in the woods.
Dogs have fleas.
If we get a public option we will get nationalized health care.
It will happen!
Nationalized health care will be subject to politics.
Research funded by the US government to find the cure for diseases is subject to politics. Are research funds allocated in proportion to the numbers of cases? No, they are funded according to who has the most political pull.
I don’t want my medical care to be subject to Dem vs Rep politics. I don’t want nationalized health care.
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Oops!
I forgot to put this in #34.
http://www.foxnews.com/story/0,2933,440561,00.html
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