The unsung price of universal healthcare
By 
Shan-ul-Hai •
July 21, 2008
Make no mistake; I am a staunch supporter of a universal healthcare plan for Americans. It’s about time that we caught up with the rest of the developed world (and much of the developing world) in providing health coverage to our population, particularly to children who would otherwise go without receiving care for problems that need medical attention. But there is one very important cost that hasn’t been mentioned by policymakers.
Right now, the US is the international hub for biomedical research despite the fact that countries like France and Russia give (arguably) a higher social value to scientists. This is because we’re the only developed country where pharmaceutical companies are able to make enough of a profit to pay for clinical trials and drug development; in turn, more money is available to pay (and to train) biomedical scientists, which produces more research, which produces more money, which produces more research…
In other countries, it’s far more difficult to get money for biomedical research. That leads to more frugality in the lab, but one of the effects is to make it much harder for graduate students to get scholarships and stipends (reducing the incentive for students to pursue advanced degrees). Then less research is conducted, and then less revenue is generated, and then less money is available for students, and then less people go to graduate school, and then less research is conducted, and so on to infinity.
If we instituted a universal healthcare plan, it would require reduced drug prices similar to what we see in other countries (and also similar to Medicare/Medicaid requirements). That would reduce drug company revenue, which would start the cycle that would eventually lead to less biomedical research. The only way that free healthcare would be successful is if we also institute a way to fund research. We would need to throw in a research tax (which I would support)… I’d like to see one of the candidates mention that eventually.
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1. There’s quite a bit of research going on in the UK and Canada, isn’t there?
2. I don’t think most of the money generated by academic centers through clinical trials ends up paying for graduate student education and basic science labs. That money comes mostly from the NIH. Profits from clinical trials, whether government or industry-sponsored, end up going toward new clinical facilities, technology, etc., I believe.
3. Drug companies already spend twice as much on marketing and advertising than they do on R&D. If they believed universal healthcare would result in a decrease in profits that would significantly affect their business, they could do some cost-cutting in other areas such as marketing, I would think.
There is little evidence that more profit translate into more R&D investment. On the contrary, during the last 10 years R&D has never been so low.
Today’s Big Pharma returns come from evergreening (extending a patent life) frivolous patenting (patenting an existing product for another trivial application) marketing and selling generics at very expensive prices and a few other tricks of the trade.
What is sure is that much more is invested into marketting activities. Universal care as well as compulsory licensing is not going to reduce their margin.
So your saying that you would support more taxes in these hard times to provide universal healthcare? Why not just privatize in all and create competition, that would lower down the prices right too, and with competion you would have the race for better medicine, better doctors, etc.?
I don’t agree with universal healthcare, the government has to much control over people now, and I don’t want my healthcare to be next too. Not only that, I don’t like the idea of more taxes being put on us, it is that last thing we need right now.
There is some research in Canada/UK/Australia/France and other countries, but not as much. Any American medical scientist can tell you that most of the publications they run into are American publications.
The money for drug trials doesn’t go directly to grad student education… it’s a much more indirect thing. It goes to the university and to the professors’ salary, which in turn helps bring in better professors and better funding, etc. It’s a big cycle that eventually leads to the status of what we have today.
Sure, they spend a lot on marketing… and that’s what will go away with universal healthcare. The government will reduce drug prices and severely cut into their profits; the reason why drug companies do all of their research/clinical trials in the US is because they don’t have any profit margins elsewhere.
What do you mean when you say “these hard times”? Is it more important to have a big house than to have good healthcare? Yes, I’d support a higher tax, but it would replace the cost of health insurance.
If you think the government has too much control, that’s a separate issue… I honestly don’t see why government control is a problem. As long as they’re helping us (for instance, by taking care of our health), then why is it a problem that they’re getting involved in our lives?
“There is some research in Canada/UK/Australia/France and other countries, but not as much. Any American medical scientist can tell you that most of the publications they run into are American publications.”
Huh? The US has 5x the population of France and the UK, 9x the population of Canada, and 14x the population of Australia. Obviously more publications will come out of the US. On a per capita basis, however, the difference would probably be negligible.
“It goes to the university and to the professors’ salary, which in turn helps bring in better professors and better funding, etc. It’s a big cycle that eventually leads to the status of what we have today.”
Most of it goes to the hospital or institution for clinical activities and paying the staff and overhead required to conduct trials. It only partly goes to a professor’s salary…and that professor will most likely be a clinician who has nothing to do with training graduate students.
“the reason why drug companies do all of their research/clinical trials in the US is because they don’t have any profit margins elsewhere.”
This does not seem logical to me. It would actually be cheaper to perform the trials in another country, e.g., Poland. The company would have to pay less to the hospital/institution. Look at clinicaltrials.gov. There are 4741 listed open industry-sponsored trials in the US, 893 in Canada, 441 in Australia, and 695 in the UK. Given the difference in population of the countries, the numbers are not weighted heavily towards the US, especially given that there are probably more small trials which are not listed being performed abroad than in the US. Even Poland has 403 trials.
Americans spend an exorbitant amount on healthcare which is partly why you see more trials in the US. Many patients in the US are willing to spend the time and money to undergo treatment in the setting of severe Parkinsons or epilepsy or end stage lung cancer or whatever, despite their prognosis. Also, there are probably a lot of people ready to try a new drug that may have severe unknown adverse events for things like restless legs syndrome, anxiety, or ED in the US than abroad, as well.
I am a firm believer in universal health care for America. There are over 50 million people in this country who don’t have health insurance, and therefore can’t get medical care when they need it. Heck, it’s hard to pay for medical care WITH health insurance.
I think the simple solution would be that extra tax. I wouldn’t mind paying it one bit.
The pharmaceutical companies in this country make more than enough money, and I agree with ‘mama’(above) that the drug companies currently spend far more money advertising than on r&d.
If you’ve ever been without health insurance, you would understand the plight of the people who can’t afford it. I’ve been there, spent countless hours in the ER with my child, only to be given inadequate care and sent home. Thank God I have insurance now. And everyone needs it.
As someone who is watching her mother pay through the teeth on medicaire for her pharmaceutical needs due to a nasty coverage gap, I fully agree with universal healthcare. We need to do something to make healthcare available to all reasonably.
Taxes will be raised regardless so why not pay a little towards something beneficial rather than for some of the more ridiculous things we are subject to pay for.
Did you see the Bunk study stating 2/3 of doctors in America want National Health Care. The doctors who did this study also conducted one in 2002 and found that the majority of doctors did not want national health care, the problem with this is that the 2 question surveys drastically differ in there 2nd question. I found this article, 60% of Physicians Surveyed Oppose Switching to a National Health Care Plan, It’s worth a read.