Now, this is a bit ironic...

[Biggles]

Maxtor2

Interesting, however, you will not be surprised if I take issue with you on a number of points.

With regards drugs - I cannot talk about the US situation as I know little about it. However, surely a cursory glance at the industry would have highlighted major European companies and European activity in this area. Medical research is big business here too. Likewise, these companies must do battle with Chinese and Indian replicants but that does not stop them doing good business in Europe - despite the nature of European Health Systems.

List of European based companies

The above lists most companies operating in Europe, including US firms that have decided to have activities here as well as in the US.

With regards the UN, it looks suspiciously like someone has been watching Faux News (I saw that somewhere and it tickled me). There have been no end of interviews on the ground with UN workers on most TV channels - and likewise similar reports in most of the National newspapers. Is it an International conspiracy to suggest the UN is working when it is not?


UNESCO did have people on the ground as did other UN bodies. You will recall it was UN workers that highlighted problems on the ground with child traffiking and it was a UN plane that hit the water buffalo on the runway in Aceh - one of the very first planes to attempt a landing. There were some who laughed at the UN's misfortune. However, it is having one's cake and eating it to say they goofed and to boot they weren't even there.

To read your post Maxtor we would have to deduce that only US aid got through and it was only delivered by US citizens - is this the case?

Bilateral aid has been an ongoing scourge of Government Aid for many years and the US has been one of the prime exponents. I recall attending a conference at Edinburgh University on Overseas Aid (I nearly moved to that Department) and a gentleman from Africa said there was a pecking order - "get Norwegian or Swedish aid if it is available - they will buy you what you need" he said. "Failing that it is bilateral aid where they give you the money to buy what they want to sell you". Both Britain and the USA were main players in this field. Bilateral Aid can of course also fall into the "what you need" category. (Note this does not apply private giving which tends by nature to be unilateral).

The other myth that should also be nailed is that Europe only gives through State Aid. This is of course madness. Most of the World's best known charitible bodies, from the Red Cross, The Salvation Army, Oxfam, Medicin Sans Frontiers and Christian Aid, originated in Europe, still have their HQs here and are still prominent features of European life. In the UK private donations were double that of the Government. If the US total is $1b then that means that the US people gave double that of the Government. This would suggest that my argument that there is little difference between the two areas is sound and that this entire subject is an enormous red herring. Quite who it serves, or to what purpose, (other than a little ritual UN bashing) is not clear.

The US aid was real and important and undoubtedly saved lives - I share Colin Powell's view that hopefully this will build bridges.

Regardless of the politics in UN HQ and the somewhat unreal atmosphere of the General Council, there are thousands of ordinary aid workers in the UN on the ground and dealing with day to day issues of water, food and health all over the World. By all means lampoon those who play politics in New York but why denigrate the work and dedication of those who are simply trying to make a difference? Note also: Blue Beret peacekeepers are totally separate from ordinary day to day UN aid workers. These fall under the remit of the Security Council and are drawn from full time armed forces around the World. They are separate and distinct from UNESCO etc., and the Byzantine politics the Blue Berets have to work under (or in most cases watch) are as a result of the individual countries that form the World body failing to agree on almost anything. It is not the UN that says they can't act it is partisan politics from individual countries that stymies them (Ban the Veto is my banner )

Meh - not had a good day - as in Camp Granada kindly disregard this letter.

[Maxtor2]

J2k4, I think we're already on the same team, whether we try to make it sound formal or not. But, I don't have any intention of taking a leading role here, as I have neither the experience nor the time to gain the experience of 3,000+ posts.

Vidcc, drug companies have found that they must have a huge bank account to float on in case their drugs are unexpectedly rejected by the FDA, or they must have trusting and generous venture capitalists. Let's get a more complete set of data on Pfizer (I can't find any more statistics from 2002, unfortunately). Yahoo does well. In short, for 2004: 17.61% profit margin, $51.57 billion in revenue, and $18.81 billion in debt. Profit margins can vary quite widely, especially since Pfizer doesn't have a wide variety of products to sell. If these numbers continue, it will take every cent of profit for the next 2 years, 2 months, and a week or so for Pfizer to cover its debts. Henry A. McKinnell, CEO of Pfizer, makes $9.5 million per year. The average CEO salary for his industry is just over $3 million per year. For the work required to lead a company the size of Pfizer, that salary isn't very extravagant. The president of Comair, a real asshole who is almost singly responsible for destroying the airline, got tens of millions per year, and a $20 million severance package, when Comair finally released that they either had to fire him or declare bankruptcy due to the incredible cost of their pilot's strike.
Did you know that aspirin can help prevent heart attacks? Well, many in the medical industry know that, but very few outside of the industry are aware of this fact, even though it has been verified many times over more than a decade. The reason you (probably) didn't know this was because the FDA prohibited companies from advertising this effect of aspirin, as it had not been 'proven' to the FDA's standards. The FDA finally approved the advertisement of this after about a decade. However, an 85 cent (or about that) packet explaining this specific trait of aspirin could be purchased at many pharmacies, but few were actually purchased. I'll agree that many of the commercials may be unnecessary, or could more easily be limited to medical magazines, but they do have some purpose. Besides, I don't want Bowflex to find any more space for those horrible, 2-minute-long commercials. I must admit, the really good commercials were by Bridgestone (which is actually Firestone) and Hagan-Das, which turned icecream advertising into a work of art. On the other hand, Viagra and Levitra need to rethink their advertisements. They should try Trojan's methods: hilarious innuendo that implies everything that the commercial wants to say, but without using the specific words that parents hate.

Also, Einstein may have revolutionized science, but he didn't send man to the moon. Neither did Newton, whose unmodified equations were used to plot the course of the Apollo spaceships. Federal research certainly made a few discoveries which later scientists used, but those discoveries were few among many, and did comparatively little to reduce the cost or time needed for research.

I'll have to add a second part to this post later, as it's getting well past my bedtime. Oh yeah, Rosewood, I'm not your dad, and I have yet to hear of an actual case in which someone cannot get the medicine they depend on. Rat Faced, any company can make a good profit with a generic variety of a drug. And that hotel was 5-star by Indonesian standard, which means a bit better than a Mariot resort in Atlanta, Georgia (but the price is of a US 5-star hotel). And, the UN bureaucrats want everything delivered at about the same time they finish ordering. Depending on the bureaucrat, food might be pre-made (and wasted if the bureaucrat changes his plans), and the hotel will keep room service workers on the job for every hour of the day. Mind you, this is before thinking about preparing for the one thing the UN claims to do the most: coordinate the actions of other countries. The US, Australia, and other donators seem to be working nicely with each other, even without the interference of the UN (or, more likely, in spite of the interference of the UN). OK, now it's time to go to sleep; I'll try to post again tomorrow, with some more complete replies.

[vidcc]

Maxtor

All of the points you raised have been already taken into account when I formed my opinion on the way the drug industry works in the USA. I do try to look at both sides before I take a stance. The drug industry is just one element of the whole healthcare issue.

Hobbes.

you raised the FDA points which are another element of the problems we have. One thing I would like to raise is generic products.
After the monopoly period is over and generic brands start to hit the market the price does fall....however the price even for generic brands in the USA is far higher than the price of the "original" in many other countries.

I am not entirely sure that FDA standards are stricter, this may well be the case compared to some countries but not all.... one thing I would suggest is that the FDA perhaps works slower than many of its counterparts.

[Everose]

Oh yeah, Rosewood, I'm not your dad, and I have yet to hear of an actual case in which someone cannot get the medicine they depend on.


Maxtor2, I should have been clearer. To mistake you for my Father, due to the amazing amount of logic I felt was in your post is the highest compliment I could pay you.

I have witnessed very many people being unable to purchase the drugs they depend on due to cost in this country. But it is our social services that, when finally made aware of a situation, step in to help.

[vidcc]

there are many who do not qualify for help

[hobbes]

Maxtor



Hobbes.

you raised the FDA points which are another element of the problems we have. One thing I would like to raise is generic products.
After the monopoly period is over and generic brands start to hit the market the price does fall....however the price even for generic brands in the USA is far higher than the price of the "original" in many other countries.

I am not entirely sure that FDA standards are stricter, this may well be the case compared to some countries but not all.... one thing I would suggest is that the FDA perhaps works slower than many of its counterparts.

Now Vidcc, why would you think the FDA works slower? Isn't that just wild speculation. That's not being very nice.

The FDA has a track record of being extra-strict in drugs hitting the market. I imagine this may be a reflection of all the lawyers who look at any adverse drug reaction as a class action law suit.

As for higher prices, elective drugs like "Viagra" and "Levitra", price will be driven by demand. If people are willing to pay, that is what they will charge.

For necessary medication, this is usually through a 3rd party payer and the person doesn't care what it costs. The burden here falls on those paying out of pocket. But I don't know of any case where a patient was allowed to die because they couldn't pay for insulin. The government lets you exhaust your resources, then steps in and covers the cost.

I think, as Maxtor says, that in other countries with a different approach to healthcare, the government tells a company what it will pay for the drug, whereas here, 3rd party insurers don't have this power.

If a hospital bills $50 dollars for a medication to a private insurer, they will get paid $50. If they bill to medicare/medicaid, they usually pay 65%.

[vidcc]

FDA approved doesn't mean a drug is safe or effective though....does it?

[Biggles]

I am somewhat confused by this talk of 5 star hotels. Who stayed in a 5 star hotel? The UN relief workers who were providing medical aid and food in field hospitals and camps? The UN staff that flew out with Kofi Annan when he toured the region and met with the affected countries leaders? As I recall, Colin Powell also toured the region and met the same people. I would be surprised if he stayed in a 2 star self catering apartment, but I am happy to be corrected.

For the record, I would expect Colin Powell and his staff to stay in a decent hotel when tavelling abroad - making him go in a camper van seems harsh (although very egalitarian )

If the argument is that the actual relief workers are not helping those affected by the tsunami but rather are drinking cocktails in Jakarta* I would certainly be interested in the evidence.


*I am not sure there any 5 star International hotels in Aceh.

[hobbes]

FDA approved doesn't mean a drug is safe or effective though....does it?

Specious relevance to the thread. We are talking about factors which may make American drugs more expensive.

Why are the drugs not safe? The FDA shut down the entire production of Urokinase because a couple samples had traces of bacteria.

Why not effective? The drugs do what they say.

Where are you going with this Vidcc? I'm wondering what your point is?

But Dr. Goodman of the F.D.A. defended its policies, saying that they were the "gold standard" for safety worldwide and that if companies could not measure up or chose not to, it might be better for them to pull out.

-from Ruthie's article on vaccine shortage. FDA was causing all kinds of ruckus. They are a pain, but they have really help to set standards that prevent AIDS from getting into our drugs which need cell cultures.

BTW- We now have a SURPLUS of vaccine and people are now bitching about throwing the unused stuff out.

[j2k4]

J2k4, I think we're already on the same team, whether we try to make it sound formal or not. But, I don't have any intention of taking a leading role here, as I have neither the experience nor the time to gain the experience of 3,000+ posts.