The return of the jungle

US prosecutors to seek death penalty for Luigi Mangione, Bondi says

From an European perspective, the US system health insurance system is so ■■■■■■ up and unfair towards the insured that I’m honestly surprised there isn’t more Luigis gunning down executives.

He should get whatever the usual penalty for his crime is. The same rules apply to everyone.

It might not be a bad idea for the President to add prescription drug prices to his tariff calculations.
I know drug prices have been discussed here in the past and, just as the US pays the lion’s share of defending Europe, the US pays the lion’s share of the cost of developing drugs, so that US consumers are subsidizing European/Canadian/Asian/African/Australian/etc healthcare.
There’s got to be a way to fix that, and somehow the Europeans/Canadians/etc are going to have to pay their fair share of drug development costs. There’s probably some smart ideas in the old threads.

And get rid of Obamacare. I’m not a fan of “dirigiste” capitalism.

One reason for this is that European countries, Canada, Australia etc, buy medicine in massive, massive bulk (due to universal healthcare systems) and can negotiate or even dictate prices with pharmaceutical companies. In the US the end users essentially have very little negotiation power. This leads to a situation where the average Joe in America essentially pays whatever is asked and subsidizes foreign consumers because those margins need to come from somewhere.

In health care, market principles alone don’t work like in other sectors. Consumers can’t shop around mid-heart attack. And since information asymmetry is huge (your doctor knows more than you ever will), true free-market efficiency is almost impossible. That’s why every developed country other than the U.S. has some form of centralized negotiation or price control—and why, paradoxically, they often spend less and get more.

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If it’s being done by the European/Canadian/etc governments, then it can be regarded as a kind of non-tariff barrier. The governments won’t allow the sale in their countries unless you agree to their price.
In some countries that have both public and private healthcare, if you don’t agree to the government price for the public system, you’re not allowed to sell to the private system either. I believe that’s the case in the UK, where the rule is that if a drug is available then it’s available on the NHS, and if you flip that around, that means that private (non-NHS patients) can’t buy a drug unless the drug companies accept the NHS price. That’s definitely a non-tariff barrier.
And in some cases, the drug companies don’t play ball. The NHS refuses to pay for some orphan drugs (for rare cancers for example) which means those drugs are simply not available in the UK, even to private patients. Patients who need those drugs have a choice between going overseas for treatment (usually to the US) or dying. The Brits try and raise money to pay for that treatment using things like GoFundMe.

Isn’t begging for help a pretty standard procedure in the US, especially in the lower echelons of the society where insurance coverage is low or inadequate? It doesn’t really matter if the drug exists in the US when you have no way of getting it.

Something probably has to change. Statistically Americans pay double the price for lower quality healthcare than Canadian, Australian and European counterparts. If I were American, I’d start wondering why and how is the US the only developed economy that has decided to go for the hardcore neoliberal approach for such basic necessity as healthcare.

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These things are all tied together. When people discuss the US paying to defend Europe/Canada/etc, they often make the point that those other countries spend on healthcare that money they save by not paying for their own defense.
If I ever had cancer or any other life-threatening disease, I would far rather be treated in the US than Europe or Canada. The UK for example has a metric QALY (Quality-Adjusted Life Years), with a cut-off of for treatment of between £20,000 and £30,000 per additional QALY gained. One QALY represents one year of life in full health. One year at less than full health would be less than one QALY, and they have formulae to calculate the discount. Until recently it was even worse with the Liverpool Care Pathway where hospitals and doctors were incentivized to terminate patients to save money. An intrinsic problem with state-run medicine is that at some point, doctors cease to regard themselves as your doctor and instead regard themselves as working for the government.

Added: Satisfaction with NHS collapses despite Labour vow to fix service

21% satisfied, 59% dissatisfied

Really difficult to assess the systemic differences based on one type of disease. The cancer survival rates are high in the US, but not higher than in European countries like Sweden, Norway, or Germany. The aggregate statistics say that the bang for the buck in the US is much lower than in Europe, despite the doctors that terminate patients at will :smiley:

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This seems to depend which dataset you use.
Jan 2024: UK has some of worst cancer survival rates in developed world, report says

Analysis of international data by the Less Survivable Cancers Taskforce found that five-year survival
rates for lung, liver, brain, oesophageal, pancreatic and stomach cancers in the UK are worse than in
most comparable countries. On average, just 16% of UK patients live for five years with these
cancers.

Out of 33 countries of comparable wealth and income levels, the UK ranks as low as 28th for five-
year survival of both stomach and lung cancer, 26th for pancreatic cancer, 25th for brain cancer and > 21st and 16th for liver and oesophageal cancers respectively.

For each of the 6 cancers, which together account for nearly half of all common cancer deaths in the UK, they ranked the 33 countries and gave 1 point for 1st, 2 for 2nd, and so on, then calculated each country’s mean rank
The US does very well using that data:
1: S.Korea
2: Belgium
3: USA

Some of the remarks in the article linked at the top of this post are scary

In the UK, seven in 10 patients receive no treatment at all for pancreatic cancer and of the 10,000
people diagnosed annually, just 10% receive surgery. Similarly, in England only 65% of people with a
cancerous brain tumour are treated by surgery, radiotherapy and/or chemotherapy – the main
potential treatments – in comparison with 85% of breast cancer patients.

In a new book, top Biden aide describes ‘out of it’ president before Trump debate | Books | The Guardian

“According to Klain, it turned out that Biden “didn’t know what Trump had been saying and couldn’t grasp what the back and forth was”; left preparation and fell asleep by the pool; obsessed about foreign leaders, saying “these guys say I’m doing a great job as president so I must be a great president”; “didn’t really understand what his argument was on inflation”; and “had nothing to say about a second term other than finish the job”.”

HOW is it possible that the Dems couldn’t come up with a better candidate and let Sleepy Joe go for it?

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I mean lol Fdt. I woulda preferred this senile man. Trump doing too much.

This just in The New England Journal of Medicine

https://www.nejm.org/doi/10.1056/NEJMsa2408259

Another family man who dindu nuffin shot by the Bad Blue Man

This just in The New England Journal of Medicine
Not even wealth is saving Americans from dying at rates seen among some of…
Experts said a new study of wealth and mortality in middle-aged and older adults points to deep-rooted
health risks in the U.S.

You sound just like the President and Secretary Kennedy. MAHA!

13 Feb 2025: Executive Order 14212—Establishing the President’s Make America Healthy Again Commission

The NEJM article was simply rehashing the concerns the President had already expressed in his Executive Order establishing the MAHA Commission.
The gist of the Executive Order is that the medical/pharmaceutical industry sucks trillions of dollars a year out of the economy and yet has objectively failed to achieve improvements in Americans’ health.
Which is why Bobby Kennedy is HHS Secretary and tasked with the Herculean task of setting this right and Making America Healthy Again.
While President Trump is slaying the Deep State and the Military Industrial State, the Welfare-Warfare State, Secretary Kennedy will be doing battle with the Pharma Industrial State.

From the Executive Order

To fully address the growing health crisis in America, we must re-direct our national focus, in the public and private sectors, toward understanding and drastically lowering chronic disease rates and ending childhood chronic disease. This includes fresh thinking on nutrition, physical activity, healthy lifestyles, over-reliance on medication and treatments, the effects of new technological habits, environmental impacts, and food and drug quality and safety…*

Therefore, the Commission shall:

(a) study the scope of the childhood chronic disease crisis and any potential contributing causes, including the American diet, absorption of toxic material, medical treatments, lifestyle, environmental factors, Government policies, food production techniques, electromagnetic radiation, and corporate influence or cronyism.”

Some words I never thought I’d say: Godspeed Mr Kennedy. MAHA!