[ExI] Health care in the USA

[Mirco Romanato]

Stathis Papaioannou ha scritto:
> 2009/6/28 Max More <max at maxmore.com>:
> 
>> The relentless criticism of the US system should not be allowed to obscure
>> the real ways in which it leads the world. Parts of the system are world
>> class, including its best hospitals. The US has been the leader in medical
>> innovation. Waiting times are lower (for the insured and others who can
>> pay)--see below. Cutting-edge drugs and treatments are available earlier.
>> According to Robert Goldberg of the Manhattan Institute's Center for Medical
>> Progress, the pharmaceutical and biotechnology industries of the USA has
>> developed more cancer drugs than all those in Europe, Canada, and Japan
>> combined. Pharmaceutical R&D has increasingly been focused in the United
>> States due to price controls elsewhere. Goldberg points out that it is in
>> the US that 75 percent of all new drugs are discovered and first used.
>> (Examples being coated stents for treating narrowing heart arteries and
>> LASIK surgery for correcting vision problems.) I would argue that these
>> remarkable results are due to the private aspects of the system.
> 
> There is no doubt that the US leads in medical research, and
> scientific research in general. But almost all of the basic research
> is either government funded or funded by not for profit organisations.
> Pharmaceutical companies pick and choose from this "free" research to
> decide what drug candidates they are going to pursue.

So?
What matter to the consumer is that new, better drugs arrive to the
shelf to be sold. How they arrive is not their concern.
How many new drugs went in commerce with government funded or no-prodit
funded research? I would say none in the last few years or decades. The
reason is simple, no government and no no-profit organization is willing
to pay around 1 billion of US$ for a single drugs to hit the shelves and
wait 10 years for a result.

Surely the cost is too high, but this is mainly due to the extra layers
of bureaucracy and government interference. With these costs it is
economically impossible to market any new drugs that is targeted to a
niche of the market. This because the prices needed to make up for the
costs, the time and the risks would be out of the reach of too many
people and entrepreneurs interested in the new drugs.

If the cost and the time needed to market a new drug will be reduced,
say 50%, we would be able to see an explosion of new research project as
many project that now don't make economic sense would become profitable.

I want remember that the EU pharmaceutical industries were more advanced
of the US pharmaceutical industries until a couple of decades ago. Then
they fall back, moved many research centre in the US and started to
channel investment from research to buy generic producers, because the
bigger buyers (the NHSes) were more interested in cheap drugs now than
to better drugs tomorrow.

Mirco