Frontline did a good piece about this. “Sick around the world.” The author does a review of 6 countries including the US, UK, Japan, Germany, Taiwan and Switzerland. He compares them on a couple of things described in the graphic below, as well as a bunch of others, but these are some of the main ones. All the other countries have universal healthcare, based off of different systems. There are some systemic problems in the different countries, like japan being in deficits. Taiwan kinda did a study based off of similar principles when they designed their own system, and its kinda underfunded, but thatd probably be solved if they put 8% of gdp into it. They seem to tout taiwan and switzerland as being the best options.
If youre asking what the specific causes are, I think its some combination of malpractice insurance, excessively high administrative costs (particularly relating to insurance), no standard set pricing for different procedures or care, artificial restrictions on the number of people that can become clinicians (for example only 4 nps allowed per md in california), higher quality in access to treatment that isnt available in other places, and a pricing scheme that involves insurance companies, medical professionals and govt reimbursements that leads to overpricing that is hardly ever followed in practice.
I’ve studied a bit of pharma and I’m aware of shit like what shkreli did being rampant. There are a bunch of firms that do the same thing, as well as the big companies.
It does seem that more drugs get developed here, but that seems to be more of a function of research done by groups funded by the NIH or VC’s rather than big pharma. I am a bit skeptical though of this graph given that I am aware of what is considered a “new drug” in the US, given that they can just reformulate it slightly or get it approved for a new purpose and bam patent extension. I suspect that this may be overinflating the numbers for the USA. I dont know enough about the subject to make a really good statement.
btw even shithole coutnries are able to negotiate it down.
r&d model < acquire/partnership model
that is why health exec and researchers are having an exodus. you dont get your full worth unless you work for a start up.
sure you take the risk that your shit fails, but on the off chance you succeed, you will get a buyout and be a real baller, and if you fail, you will still likely get an agreement with milestones that is still higher than your would be salary in big health.
the ones that acquire are the ones that have had early success and are flush with cash to buy these companies. or they take on huge debts and charge hgiher prices to consumer to make the diff. Faqin aholes!
i remember reading somewhere awhile back saying how healthcare companies drugs charged based on the opp cost of an alternate treatment. same theory but with a different twist - maybe they are charging us more because our lives are more productive and therefore more valuable, hence a higher opp cost. eh!