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[s0]

negative side effects of prescription drugs kill 300,000 people a year in the US -- more than cancer and heart disease. so it may average out.

Which begs the question: do doctors earn more from prescribing drugs (effectively selling them) in America than they do in the average country with free healthcare?

[Hangedman]

Without it, my brother would be crippled, I would be having trouble breathing, and my family would be bankrupt just trying to pay for some of our "elective" treatments.

So... don't knock it until you try it.

On a sidenote: this motion produced some of the most hilarious strawman arguments I have ever heard.

EDIT: Prescription kickbacks are practically business as usual in the old US system... maybe the government will be less tolerant of being ripped off by pharmaceutical firms than random people who don't really know what the drugs do.

[ஒழுக்கின்மை (Paul Eres)]

@ drChengele

the source of that figure is here: http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm

i think your rule of thumb is wrong, though, at least worldwide -- http://en.wikipedia.org/wiki/List_of_causes_of_death_by_rate

cardiovascular disease is 29%
infections and parasites are 23%
cancer is 12%
etc.

in the US for 2006 it seems to be:
http://www.cdc.gov/nchs/FASTATS/lcod.htm

Heart disease: 631,636
Cancer: 559,888
Stroke (cerebrovascular diseases): 137,119
Chronic lower respiratory diseases: 124,583
Accidents (unintentional injuries): 121,599
Diabetes: 72,449
Alzheimer's disease: 72,432
Influenza and Pneumonia: 56,326
Nephritis, nephrotic syndrome, and nephrosis: 45,344
Septicemia: 34,234

but keep in mind that's only officially recorded numbers: death by side effects of drugs isn't a category, and wouldn't really be counted together. it'd either be counted as an accident, or attributed to what their original problem that they were taking drugs was (more common), so that number would sort of be hidden.

@ c.a.sinclair: of course. many doctors and dentists in europe specifically move to the US because they earn far more here.

[s0]

@ c.a.sinclair: of course. many doctors and dentists in europe specifically move to the US because they earn far more here.

But in that case it's easy to establish a link between the healthcare system and the drug deaths, i.e. doctors in the US are quicker to prescribe "heavy" drugs even if it's not really needed because it means more profit for them.

Unless that's the point you were trying to make anyway.

[ஒழுக்கின்மை (Paul Eres)]

i'm not trying to make any point, i only brought up the large number of people who die from the medical system to show that it's theoretically possible that modern medicine does more harm than good and reduces lifespan, and that for all we know, for every person it saves, it kills someone else. this would only apply to the US system, but i imagine that people still die as a result of the side effects of drugs in other nations as well; just because there's a greater profit incentive to do something here doesn't mean it doesn't happen elsewhere for other reasons. besides, europe still has pharmaceutical companies, so there's still a far greater profit incentive to treat people via patentable prescriptions rather than finding true cures, even in countries with free health care. it's not the profit incentives of the doctors that really matter here, it's the profit incentives of big pharmaceutical companies.

[drChengele]

the source of that figure is here: http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm

Thanks for that, it will make an interesting read, however:

but keep in mind that's only officially recorded numbers: death by side effects of drugs isn't a category,

Aaaaand there's the problem. Recording a cause of death follows strict protocols. This study declared its own criteria about when a death can be attributed to adverse effects to drugs. They use some pretty loosely defined percentages (unless I am mistaken, any error of dosage followed by death is automatically considered "death by drug reaction"). It's an old pitfall well known in medical statistics that death numbers are skewed - as a critical patient approaches death, he is bounced from one ward to another in a haste, can undergo multiple last-minute procedures, and a lot of different medication can be tried by his doctors. It is not at all uncommon to make at least one dosage mistake in this period. As an example of how tricky these numbers can get: any patient dying of any cause after a, say, kidney transplant, will be counted when compiling the numbers of average post-kidney transplant life expectancy, even if the cause of death has nothing to do with the kidneys. This leads patients (and even worse, doctors!) to conclude that a kidney transplant is linked with a life expectancy of 3-6 years, whereas the truth is a large number of chronic patients with multiple systemic conditions heavily skew this number and a kidney, if "undisturbed", so to speak, can last up to 15 or even 20 years.

Either way, sentences like "It is now evident that the American medical system is the leading cause of death and injury in the US" will definitely need more research than a single study. That is not to say the numbers in that study aren't shocking, to say the least. They put the number of people killed by medical mistakes at ONE MILLION ANNUALLY. That's just insane. However, these are not what we call (don't know the English term, sorry) unambiguously unavoidable deaths. In other words, the real number we should be looking for is how many of these would stay alive if they didn't go to the hospital. I think you would find this a much smaller number than 1 million, even with all the overmedication that goes on in developed countries (and US specifically).

i think your rule of thumb is wrong, though, at least worldwide -- http://en.wikipedia.org/wiki/List_of_causes_of_death_by_rate

In worldwide figures a large number of poor African (and a few other) countries heavily skews the number towards infections (and parasites) due to undeveloped healthcare and poor hygiene, drawing the numbers away from cardiovascular disease. I was using the numbers for developed countries, which have much readier access to antibiotics (and usually have a more temperate climate) and much higher life expectancy, so cardiovascular problems (which accumulate with age) come to the front.

Now let's get back on track...

that modern medicine does more harm than good and reduces lifespan, and that for all we know, for every person it saves, it kills someone else. this would only apply to the US system, but i imagine that people still die as a result of the side effects of drugs in other nations as well;

US numbers definitely seem to indicate that their funding is not as efficient in prolonging people's lives as in other countries and this might be a cause, yes.

[s0]

it's not the profit incentives of the doctors that really matter here, it's the profit incentives of big pharmaceutical companies.

Those are linked though. I read in a book about healthcare and medicine in Germany that doctors routinely get "bribed" by pharma companies to prescribe certain drugs over others, and since those are multinational corporations like Pfizer and Roche, I imagine their policies aren't different in the US.

[Sam]

I live in Britain which has a national health system, and it is good.  We pay income tax which is %0 if you're on less than $10,000; 20% for up to $31,000; 40% for more than that (roughly converted to US dollars).  Healthcare is free!  If you like you can also have private health insurance, which basically means you get non-emergency treatment faster and cable TV if you stay in hospital.

The only disadvantage I have seen is that someone has to decide what treatments should be offered by the free healthcare, and one might not always agree with their decisions.  I suppose that is mirrored in the U.S. system with insurance companies deciding what treatments to pay out for, but at least then you potentially have a choice of insurer.

I think that those of us with this kind of free healthcare system can have a hard time appreciating just how good it is not having to worry about how to afford grandfather's cancer treatment.

Our health service also spends a fair amount on education (been trying to find a useful figure, but failed) which is of course hugely important.  To be extra cynical for a moment: In a system such as this it pays to prevent disease; in a system governed by those that sell treatments and insurance companies that can drop people once they're ill, prevention is bad for business.

[Soulliard]

And a big congratulation on your survival! I'm really, really happy for you!

Thanks, but Crohn's disease isn't deadly (at least not in the developed world). Its symptoms do have a huge impact on the quality of life, though.

Fortunately, my current treatments work very well, so Crohn's disease doesn't have much of an impact on my life anymore. As long as I can continue to get treatment, I'll be fine.

Soulliard, there is one thing that perplexes me:

I can't afford to miss even a single Remicade infusion. If I did, my body could build up an allergic reaction to it, and I would not be able to get the treatment again.

This is not how allergies work. Perhaps it was explained to you in a bad way? Either way I wanted you to be aware of this fact because I wouldn't want someone in your position to be uninformed: You CANNOT become allergic to a drug (or, in this case, a monoclonal antibody) by suddenly stopping taking it. It's preposterous and if a medical worker did tell you this he deserves to be shot.

Sorry, I made the wrong choice of words there. Basically, if I don't get regular Remicade infusions, my body will build up antibodies against it. So any future treatments would be ineffective.

[Richard Kain]

Which begs the question: do doctors earn more from prescribing drugs (effectively selling them) in America than they do in the average country with free healthcare?

No, they don't. In fact, most doctors don't sell drugs themselves. And the pharmacies that do sell drugs do not pay doctors for their presecriptions, they just check with them to insure that the prescriptions are legitimate.

Pharmaceutical companies do send representatives to try to persuade doctors to use their products. But they do not pay doctors money to prescribe their drugs. In fact, I'm pretty sure that such practices are illegal here in the U.S. On top of that, such actions would be useless in the long run. When a doctor prescribes a name-brand drug, the patient is not actually required to buy that specific name-brand. They can request a list of generic alternatives from their pharmacist, and the pharmacist is required to tell them if any exist. Since the exclusivity patent on most drugs is limited to only a few years, numerous generic alternatives exist for almost every drug in circulation. Even if doctors prescribe a specific brand of drug, any savvy patient can acquire a much cheaper chemically identical alternative just by asking for it.

[BinaryMind]

I live in the part of Canada that has had Health Care for almost 50 years. Everyone hated it when it first happened, now the whole country has it and well, it saved me $10,000 on a surgery. I think it turned out pretty well.

[gunmaggot]

the main thing i think the gov should do is 1) stop subsidizing certain foods and agricultural companies (for instance, the gov pays people to make corn), and 2) stop taxing imports at an unfair rate just to protect US companies (for instance, it costs far more to use sugar than hfcs in the US, because most sugar is made in south america and heavily taxed if imported, whereas most HFCS is made in the US and subsidized) -- so i feel it's gov involvement that creates the problem in diet in the first place.

HFCS is cheaper than regular sugar, subsidies or not - that's why it was taken up by food manufacturers in the first place as an alternative to sugar (the subsidies and tariffs came later).  It's misleading to suggest that govt subsidies/import tariffs are what keeps corn production so dominant - the subsidies were introduced in the first place to keep the US corn industry competitive with countries whose corn/sugar production isn't subsidised but instead exploits cheap labour.  The 'unfair' taxes were introduced to allow the local manufacturers to compete with 'unfair' production practices in China, Mexico, India, Brazil etc.  You might as well argue that it's the minimum wage laws in the US that made it necessary to subsidise the industry, so they should be scrapped instead.

[ஒழுக்கின்மை (Paul Eres)]

@ drChengele - yeah, i've similar criticism of that number. i think it's inflated (it's probably more like 300k, which was what i originally remembered it as, than 1m), but it's still a big problem, even if it doesn't kill as many people as heart disease, cancer, or even car crashes. it certainly does kill some people. my sister was almost killed by an allergic reaction to a drug, and had to be hospitalized for her reaction for six months. if individuals who are saved by modern medicine are examples of it extending lifespan, than logically aren't individuals who are killed by modern medicine examples of it not extending lifespan?

@ richard kain - they aren't paid directly for those drugs, but they are often informally paid "bribes" by drug companies for prescribing certain drugs, as someone mentioned earlier.

@ gunmaggot - it makes no sense to me to say that it's cheaper. if it were cheaper, it'd be used worldwide, instead of just in the US (where we have subsidies and taxes on sugar). in mexico and in most other countries, soft drinks use sugar, not hfcs. if hfcs really were cheaper, why wouldn't companies in mexico (a relatively poor country) use it instead of sugar? you could say that they don't export hfcs, and that's true, but they also don't export sugar -- they import both. obviously it's more profitable for coca cola to use sugar in most countries, and more profitable for them to use hfcs here.

also, things can't just be 'cheaper' in a vaccum. to say that hfcs would be cheaper even without corn subsidies and taxes on sugar imports makes no sense to me. how could you know that? is it just cheaper to grow corn than sugar cane or beets? do you get more sweetener per hectare with corn? not sure what you mean

[gunmaggot]

The tariffs on imported sugar - to protect the US sugar industry from cheaper foreign stuff - is what caused the food manufacturers to switch to HFCS in the first place, which was cheaper than using local sugar (all else being equal HFCS is cheaper to produce than sugar, drop for drop, because it's sweeter and easier to transport - but it does greatly depend on what is being grown regionally).  So, yeah, they never would have switched to HFCS in the first place without sugar tariffs.  Subsidies came along and made it worse.  So I basically agree with what you are saying - but it goes further than that.
The US is partly so dominant in corn because of the subsidies, but there's a good chance the rest of the world would ramp up corn production to exploit it, and you'd see more of it everywhere, like how palm oil is slowly taking over the role of traditional oils in foods.  Sugar has been used as a sweetener much, much longer so its roots are deeper and wider so to speak.
The corn subsidies/tariffs have definitely exacerbated the problem in terms of how much HFCS makes it into food and stuff, no question - so I agree with that.  Additionally, there are quotas in Europe that limit how much HFCS can be imported, which goes some way to explaining how it hasn't exploded there, so that's the other side of the coin.

[Mar]

I live in the part of Canada that has had Health Care for almost 50 years. Everyone hated it when it first happened, now the whole country has it and well, it saved me $10,000 on a surgery. I think it turned out pretty well.

hawaii has had it for..forever! and they're like the happiest place on earth. i think it's a good investment for out nation.

[Movius]

I was wondering how long it would take BIG PHARMA conspiracies to enter into this thread.

Also...

Norway has had free healthcare for ages and just happens to have one of the highest standards of living in the whole world...

wins non-sequitur of the thread. Perhaps the USA should adopt conscription and a state religion too?

[Hangedman]

There sure are a lot of people who still want to pay huge bills for things they have no control over. 

[gunmaggot]

Norway has had free healthcare for ages and just happens to have one of the highest standards of living in the whole world...

wins non-sequitur of the thread. Perhaps the USA should adopt conscription and a state religion too?

Neither of those things have anything to do with high standards of living, though.

[team_q]

I was wondering how long it would take BIG PHARMA conspiracies to enter into this thread.

I'm still waiting for you to post a long boring blog article about how people think about this subject wrong.

[Movius]

Perhaps I didn't highlight BIG PHARMA enough.

The thread is a like a clown car crash. I mean it's all entertaining as it is, the gnashing of republicans upset that Obama has embraced a new kind of socialism instead of the old one arguing with assorted idiot leftist trash lecturing on how to be generous with other peoples money.

Then you have the paranoid conspiracists crashing into the debate at full speed in their all natural bio-identical Volkswagen Type 2 powered by homeopathic moon crystals