01 July 2009

Dumb, Fat, Unhappy, Poor, Old .... and Sick

By now most folks should know that the Red/South states come in last in terms of education, jobs, income, and smarts by any measure. Now, we find out what that means.

It means that not only ain't they Dumb, Fat, and Happy, they are Dumb, Fat, Poor, Old..... and Sick. While being a Keynesian is orthogonal to Social Darwinism, this story inevitably leads to some pondering. How should we spend our health care dollars? If we spend like the Europeans do, we all live longer and healthier lives. If we continue the way we are, we end up funneling most of our health care dollars into the pockets of HMO's, Big Pharma, and BioTechs. I've been spending some time looking at BioTech/Pharma, and what I see is lots of money going into the pockets of Management in pursuit of multi-kilo buck life extending drugs (broadly defined).

What seems to be the norm is that some scientist or doctor does come up with a novel entity, but aimed at a really small segment of the unwell. The aim is to get as much money into the hands of management (million dollar payments are not uncommon), typically not the founders, scientists, or doctors. Then the FDA process goes on for some years. If the entity is blessed, then the kilo-buck payments begin. Whether any of that gets to the original investors...

The BioPharma traders are scared crapless of Obama. And well they should; the gravy train may well be over. What is not remembered is that, up until the 1970's (or thereabouts), most research was done on the public dime, and the compounds thus discovered were available to all. BigPharma didn't like that, so now we have massive expenditures on trivial (from a public health point of view) drugs in the hope of getting a massive payoff. From public funds, of course; MediCare and MediCaid. For-profit health insurers won't pay for this stuff.

So, we the intelligent and healthy will be stuck paying the bill to keep these self-abusing knuckleheads alive for a few more months. Is this anyway to run a railroad?

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