Why does my medication cost $8000 in the US and $20 in Mexico?

That was about consolidation of the market leading to monopoly power and pricing. Every company has to at least cover costs and make a bit of profit to exist. That's not just true of capitalism. A Chinese company that doesn't make money will not exist for long either. Either way the problem isn't due explicitly to capitalism, and when it comes to healthcare in the USA at least, everything revolves around the government from the pricing to the reimbursement to sometimes even the cost structure for some of the supplies. It's heavily regulated, and you will immediately fail if you don't jump through the myriad of hoops required to get reimbursed by the biggest and yet most unreliable payor, Medicare and Medicaid. Having worked in healthcare the past 2 decades, the easiest way I know if someone doesn't work in or know much about healthcare is if they blame it's ills specifically on capitalism. That's someone who hates capitalism starting with the conclusion and then trying to find evidence and clues to prove the hypothesis they arrived with.

I won't pretend to say the opposite though that healthcare needs to be more free market. I don't know what the solution is, but I don't think people have thought through a lot of the solutions they've put forward. 30%+ of physicians are either within a couple years of retirement age (65) or over that. A move to single payor or universal healthcare would mean an immediate physician shortage, because many of these guys in private practice already don't take anymore medicare patients due to not being able to make any money on them at all. When a payor pays you only 15 cents to every dollar you charge them, it's hard to break even on your costs, let alone make any money. So if all payors turned to Medicare, a giant chunk of these doctors would say fuck it and go golfing. No reason to do for no money what they've been doing for 6 figures anymore. Many hospitals would fail outright because as it is, if you have too high a percentage of medicare/medicaid patients the government gives you lump sum payments at the end of the year basically admitting that yes, they don't pay enough so here's a little extra so you don't go under. Do that writ large across the entire system and I don't believe it will go well.

Also, given we do subsidize most of the world, I don't think people realize the dominos that would drop if we try to adopt the same model. If everyone price fixes for medication then they don't make any money anywhere, and prices everywhere rise, or more likely medication shortages happen everywhere. Pharmaceutical companies would just stop manufacturing expensive life saving drugs and pare back to those drug lines that are profitable. They'd cut back heavily on R&D unless the government takes up that spending also. At this point the government is paying all insurance, paying to keep hospitals from closing, and then probably paying to keep R&D flowing and pharmaceutical companies afloat. Taxes would have to rise on everyone significantly to afford all of this, or we'd have to see rationing of care like in other Countries and given the most expensive time for healthcare is closer to death, inevitably we would have to go the route of Canada and push euthanasia to keep the system viable.

I expect this outcome fully within the next 20 years, but I'll pretend to be shocked it didn't turn out like expected.

/r/healthcare Thread Parent