Don't Like High Drug Costs? Blame Canada.

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It's fun to bash the high cost of health care these days. Whether you take aim at doctors or health insurers or drug companies, they're all easy targets.

But I'm not sure lower costs are what patients really want. Sure, the rising cost of health care is unsustainable, but people's first priority is to live longer. In the long run, reducing the cost of drugs may hamper that priority.

Yes, drugs have very high gross margins: As little as $0.15 of every dollar spent by retailers or drug distributors like McKesson (NYSE: MCK  ) or Cardinal Health go toward the production of the tablet or vial.


Gross Margin (Trailing 12 Months)

Pfizer (NYSE: PFE  )


Amgen (Nasdaq: AMGN  )


Eli Lilly (NYSE: LLY  )


Source: Capital IQ, a division of Standard & Poor's.

But drugs are also very expensive to develop. Clinical trials are costly to run, and consumers have to pay for the development of all the failures in addition to the ones that make it to the clinic. About 16% of every dollar that Pfizer brought in over the past 12 months went toward developing next-generation drugs.

After paying for everything else -- marketing, administrative costs, taxes, and so on -- drug companies have healthy but not overbearing net margins, especially considering that patents on many blockbusters are expiring soon, and the resulting reduced revenue will cut into margins. The companies have also offered to reduce prices of drugs for seniors in the Medicare doughnut.


Net Income Margin Over Trailing 12 Months





Eli Lilly


Source: Capital IQ, a division of Standard & Poor's.
*Adjusted for non-tax-deductible acquired in process R&D.

If customers expect drug companies to continue to innovate, they can't have their government forcing drug companies to charge less.

But Canada does it!
Through a combination of price controls instituted by the Patented Medicine Prices Review Board (PMPRB), and through government negotiations at the provincial level, Canada is able to keep its drug costs down for its citizens. But that doesn't make it right.

In fact, I'd argue that I'm supplementing Canadians' health-care costs. If drug companies were able to charge more in Canada, they could charge less in the U.S. and still make the same net profit.

As much as I'd love to blame Canada's altering of the free market as the sole cause of the difference in drug costs, there are a couple of things Canada does that probably keeps its costs lower than ours.

First, direct-to-consumer advertisements aren't allowed in Canada. It seems reasonable to assume that U.S. consumers are paying for the advertisements through higher drug costs. There's a reason Costco's (Nasdaq: COST  ) Kirkland store brand coffee is cheaper than the name brand, even though it's actually roasted by Starbucks (Nasdaq: SBUX  ) . Of course, such advertising also drives up demand, which increases total dollars spent on health care.

There's also some evidence that lower legal liability limits in Canada may contribute to the lower cost of drugs. It's reasonable that companies should want to be paid more for taking on the risk of having to pay $4.85 billion settlements, as Merck (NYSE: MRK  ) did to settle Vioxx lawsuits. I know it's controversial, but tort reform could take care of that issue.

Because Congress seems as though it might be approaching a stalemate, the simple solution could be to export drugs from Canada and elsewhere. However, while that idea sounds good in practice, the reality is that drug companies would never let it happen in large numbers. They've attempted in the past to stop shipments to Canadian pharmacies that then import to the U.S., and I'm fairly certain drug companies would do so again if they thought they were going to lose large profits.

As with everything else in this debate, setting a cheaper price for drugs is not as simple as it seems on the surface. And as investors, we require the pharma companies to continue developing and selling new drugs.

What do you think? Does controlling health-care costs mean the demise of drug development as we know it? Do you have a better proposal? Let us know in the comments section below.

Costco, McKesson, and Starbucks are Motley Fool Stock Advisor recommendations. Costco, Pfizer, and Starbucks are Inside Value picks.

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. The Fool owns shares of Costco and Starbucks and has a disclosure policy.

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Comments from our Foolish Readers

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  • Report this Comment On September 09, 2009, at 2:31 PM, djkumquat wrote:

    i don't like that nice green canadian bud costs way more than it should due to the market driven prohibition "tax" levied by the US led war-on-drugs.

  • Report this Comment On September 09, 2009, at 3:51 PM, prelad wrote:

    Your comments about Canadian prices are on the mark. What should be pointed out is that drugs are more part of the solution to health-care costs than the problem. Drug expenses are a small part of the health-care dollar and are very effective in reducing the necessity of the big-bucks treatments.

  • Report this Comment On September 09, 2009, at 4:36 PM, cleansweepgov wrote:

    The comment about tort reform is spot on. Lawyers are quick to sue the first sign of any issues with a drug and patients would rather sue than taking any responsibility for their own actions.

    You also have to look at the patent rules. Drug companies have to patent their drug early in the process to protect innovation and once the patent is approved the clock starts ticking. Sometimes the product life is shortened because of other issues. Effient, for example, sat waiting for approval for nearly 18 months. Neither company was able to recoup any of the money invested in the drug and probably spent additional funds waiting for the approval.

    Personally I would like the patent rules to be changed. Allow a company to patent their drug but the patient expiration clock does not begin until after it is approved. If the company decides to stop the compound, the patient expiration clock begins. The time period would be shorted from 20 to 10-15 years but would still provide an incentive for innovation.

  • Report this Comment On September 09, 2009, at 4:36 PM, ByrneShill wrote:

    Hmm, you guys are as much subsidizing our drugs as the guy who buys a bottle of ketchup at Whole Food is subsidizing the guy who's buying at costco.

    We can negociate a better deal on drugs because we pretty much end up buying bulk. The ban on advertisement and the lower legal liabilities laws also play in our favor, but they're no-brainers that should be implemented in US. I mean, to some extent, the amount a drug company is liable for is determined by a society, and it's a societal choice of the US citizen to have higher liability for its drug companies, and higher drug cost.

    But the advertisement ban is really a no-brainer. Advertisement is an arm race, and by banning it in a given industry, you relieve that industry of marketing spendings. Then it's either lower price or higher net margin. Of course that will never happen in US cause then the drug companies will cry censorship, against their own self-interests.

    Bah, until then I guess our drugstores near the borders will keep making a bundle every sunday when buses full of seniors will come buy their pills up here.

  • Report this Comment On September 09, 2009, at 4:38 PM, ByrneShill wrote:

    @csg: patent rules are the same in canada. It doesn't explain why our drugs are so much cheaper than yours.

  • Report this Comment On September 09, 2009, at 4:43 PM, boysmakegoodpets wrote:

    people would rather live longer than pay less for drugs? what are you...on drugs?

  • Report this Comment On September 09, 2009, at 4:49 PM, RichardKelleher wrote:

    This has got to be one of the idiotic things I have seen written anywhere, not just here. The fact it made it past the editors appalls me. I have gotten Fool emails for almost a decade, but this is the last one. I am unsubscribing today.

    Kindest Regards,

    Richard Kelleher

  • Report this Comment On September 09, 2009, at 4:50 PM, calskeptic wrote:

    It seems that quite a few of the most popular medicines in the US were developed in Europe or Japan, and in some cases, England which is Single Payer, as is well known but little understood here. Somehow, these countries have developed systems that ensure universal health care and profit incentives for drugs producers and equipment manufacturers.

    Pharmaceuticals and equipment play major roles in the efficient delivery of health care and must be protected in whatever system we finally adopt. Other than that I would like to see a system that removes profit making from the delivery of health care to all.

    I'm just sayin'.

  • Report this Comment On September 09, 2009, at 4:52 PM, ferg6 wrote:

    Surely you jest! If Canada pays more, the drug companies will charge us less?!! Oh, that's a good one. No, what will happen is that Canada will pay more and so will we.

  • Report this Comment On September 09, 2009, at 4:58 PM, yzfinance wrote:

    Your arguments make sense (advertisement and legal costs), but singling out Canada as a reason why drugs in the US are more expensive?... The Canadian population is about 10% of the American one, and I can't believe big pharma only does business in those two countries. Unless you can tell me how a total population of about 30 millions can impact the price in a country of 300 millions, when the companies involved do business all over the planet, that argument is flawed.

  • Report this Comment On September 09, 2009, at 4:58 PM, spinindog wrote:

    The only reason Canadians are able to do this is through blackmail. If US drug companies refuse to sell drugs to Canada below cost, Canada will just violate patent laws and produce generic versions of the drug themselves.

    The US government should let it be known that we will enforce our patent laws and send a signal to US drug companies that market forces are back in place.

    I love Canada and Canadians, but I have little respect for this type of behavior.

  • Report this Comment On September 09, 2009, at 5:00 PM, CommonPaine wrote:

    Ah, the simplicity of blind fealty to theories that one never examines or questions.

    Canada responsible for our high drug prices? The author needs to dispose of his hillbilly heroin or meth as issued by his drug co. benefactors. Canada has a population only about 1/10 of ours. Even if they got their meds for free, they couldn't cause our prices to be so high.

    Our prices are so high because of simple greed and graft by PHARMa. With campaign contributions they buy politicians who protect them from us.

    High costs to develop drugs? They get taxpayer funded research and medicines in most cases for free and then turn around and stick it to us. The domestic auto industry spends more annually on R&D than does the pharmaceutical industry. These guys are thieves.

  • Report this Comment On September 09, 2009, at 5:00 PM, Canadiana wrote:

    I have worked in Clinical Research for both big pharma and smaller CROs for the past 15 years.

    In all this time, the process of testing and approving drugs has not improved in any remarkable way. It is an extremely inefficient and unnecessarily long process. It is an industry that seems to have bypassed most improvements in information technology that have occurred in the past 10 years. The reason is simple; outsized profits have led to an unbelievable degree of complacency with regard to process and technology.

    Some pioneering CROs (Contract Research Organizations that are at times hired by Pharma Cos to conduct their trials) have already managed to reduce clinical trial costs by as much as 40%! Mostly through rational protocol design and the intellingent use of IT.

  • Report this Comment On September 09, 2009, at 5:01 PM, spinindog wrote:

    >>It seems that quite a few of the most popular >>medicines in the US were developed in Europe or >>Japan, and in some cases, England which is Single >>Payer, as is well known but little understood here. >>Somehow, these countries have developed systems >>that ensure universal health care and profit incentives >>for drugs producers and equipment manufacturers.

    Yes, those drugs are quite popular in the US. If it weren't for the US paying market prices for those foreign developed drugs, they wouldn't have been developed in the first place.

  • Report this Comment On September 09, 2009, at 5:02 PM, KeitaiOtaku wrote:

    Along the lines of calskeptic's comments, many molecules and drug concepts are developed in university laboratories, at very little cost to the drug companies themselves.

    I wonder, if companies like Pfizer didn't spend so much money illegally promoting their drugs, whether their costs would be so high. I think there are a lot of people on Pfizer's payroll's that the world could use in other programs, say road-side-water-runoff-control.

    Let's face it. Smart people will always want to solve tough problems, and lazy people will always want to sit on their tail-coats and enjoy the ride. Pull the money out of the system, and you won't stop innovation. You'll just reduce advertising and the promotion of yet another sleep-aid.

  • Report this Comment On September 09, 2009, at 5:03 PM, ssdh wrote:

    Oh, puleez!

    The drug industry spends much MORE on advertising than it does on research AND earns as much NET as it spends on research. Therefore, Canada is at fault. Yes, I can see where that logic runs straight north to the people who have massively BETTER health care than we do.

    Has it escaped your attention that the U.S. TAXPAYER subsidizes much of the pure research, especially the good stuff at universities?

    How is it that pharma's slimeball Billy Tauzin was willing to forego 80 BILLION in drug sales over 10 years to fill in the massive TAXPAYER donation to drug companies a.k.a. Medicare Part D? AND....Medicare is precluded from negotiating price. Ah, yes, I recall now, we socialize business support and leave the individual to fend for himself in the 'free market'.

    Have you read ANY of the controversy of drug companies paying off providers with 'seminars' to luxury resorts, and in some cases....CASH?

    In short, are you awake yet?

    The entire U.S.medical industry, including drugs is our national shame.

  • Report this Comment On September 09, 2009, at 5:04 PM, foolhardy7 wrote:

    Hmmm. sounds like more people are believing all that pharmaceutical industry-sponsored hype on fox news.

    No other industry gets such favored treatment. The software industry is incredibly competitive, and manages to sustain huge margins on new products---until a competitor comes up with something competitive, without infringing their patent, and the price goes down. Those companies do just fine, and are creating new software every day.

    Maybe, just maybe, our protection of the pharmaceutical industry in this country is what allows governments like Canada to negotiate such good deals with the companies. Do you think the companies would agree to prices as low as those given to Canada (and other countries) if their profits were not protected on the backs of Americans, who are paying double premium prices to support everyone else? The author admits the drug companies' power with the statement,

    "[T]he simple solution could be to import drugs from Canada and elsewhere. However, while that idea sounds good in practice, the reality is that drug companies would never let it happen in large numbers. They've attempted in the past to stop shipments to Canadian pharmacies that then import to the U.S., and I'm fairly certain drug companies would do so again if they thought they were going to lose large profits."

    That should tell us all something---something very disturbing---about the power wielded by corporations who control the medicine you receive. If they don't like who a pharmacy's customers (like the US), they just cut them off. Sound just a little anti-competitive to you?

    Connect the dots. We are paying double because no one is willing to say "no."

    However, lest I end on a negative note, I agree wholeheartedly with the criticism of direct-to-consumer advertising. Look through any non-business consumer magazine---images of purple, orange, and other colored pills floating everywhere. We take more steps towards a "Brave New World" drug-dependent culture every day.

    Whoops, got negative again. Sorry.

  • Report this Comment On September 09, 2009, at 5:04 PM, ngibat wrote:

    I'd agree with RichardKelleher that this was pretty much a "nothing" article. However I can't see going off the deepend and pulling my email. Some of these articles are very good and it's well worth wading through a little trash now and then to read the good ones.

  • Report this Comment On September 09, 2009, at 5:04 PM, JHShort wrote:

    Of course, you're ignoring the research that's been done that shows that more than 60% of drug company research goes into what amounts to minor formula variations so that they can extend their patents. The amount of actual next generation drug research is relatively small compared to their total research cost.

    Look at Caduet -- it's just a combination of Norvasc which treats high blood pressure and Lipitor which treats high cholesterol. Yet Pfizer claims to have spent close to $1 billion developing Caduet. It doesn't do anything the other two pills don't already do, but since it does it one pill it they can extend their patent.

    You're also ignoring the research that shows that drug companies spend far more on marketing and sales per year than they do on research.

    Please -- this particular article was worthy of a Mitch McConnell or other Republican liars desperately trying to protect a broken medical system.

  • Report this Comment On September 09, 2009, at 5:05 PM, NEPA18704 wrote:

    I think it was a bit over the top to blame Canada for our high drug costs. First of all Canada doesn't have the population nor the prescription use of the US. Secondly you don't address the lower costs in all of the civilized countries that that provide a one payer system.

  • Report this Comment On September 09, 2009, at 5:05 PM, batteredup wrote:

    Blaming Canada for the high cost of pharmaceuticals is pure idiot logic. It's like slamming your car into a tree and blaming the tree for the damage. Do you expect the Canadian gov't to bid higher to appease our best interests? The real problem is our out-of-control for profit health care system and the lobbyist-bought-and-paid for Congress that represents THEM instead of the people they're supposed to represent. If our plutocratic gov't did the bidding for us, bought in mass quantities to drive the prices down, as do ALL countries with universal health care, which by the way is EVERY damn country of the industrialized world except the US, prices would go down for every American and universal health care would be affordable. And I want this person's judgement to base my stock selection on? Like Jon Stewart said of Gym Crammer, he could make me a millionaire - but only if I started out with $10 million.

  • Report this Comment On September 09, 2009, at 5:07 PM, 508250 wrote:

    I agree with the tort reform proposal, but the courts and legislatures are controlled by lawyers and bar associations. Wishful thinking. One thing I have never understood, however, is why the drug companies are allowed to sell drugs to other countries at lower prices than they charge us USA citizens in the home market? Basically, I think they should charge with a reasonable profit, but they should charge Americans no more than the least they charge foreigners. If they're willing to sell to Canada or Europe or Asia cheaply, they should be required to sell to Americans at the same price, or a lower one. And, if the give drugs away to foreigners, they should give drugs away to us. Who do you think is paying for gifts of drugs around the world? There's no free lunch, despite what some say.

  • Report this Comment On September 09, 2009, at 5:08 PM, MisterRogers wrote:

    In the US, part of the prescription drug cost for the consumer is the cost of the doctor visit to get the prescription. With insurance, that could mean a $20 copay. Without insurance, that means $70 out of pocket. If you are uninsured and need an antibiotic for a common sinus infection, you pay more for the doctor visit than for the medicine. In many countries, certain prescription drugs are available over the counter (or after free consultation with a pharmacist). That saves the consumer considerable money. I've gone without necessary medication in the past because I was uninsured and could not afford the combined cost of the medication AND the doctor visit. The US should consider changing the laws regarding prescriptions instead of simply looking for ways to make the drugs cheaper.

  • Report this Comment On September 09, 2009, at 5:09 PM, gamala wrote:

    Wouldn't the cost of drugs also come down if the research and development aspect were taken over by large universities where there should far less of conflict of interest and profit motive determining their research decisions? Then the pharmaceutical companies could stick to production and marketing. I also think marketing guidelines need to scrutinized greatly so as not to confuse or pull the eyes over the public.

  • Report this Comment On September 09, 2009, at 5:11 PM, sgmorr wrote:

    I am getting a bit tired of hearing "tort reform" as the solution for all our health care expenses. Why is it that business and industry always wants to relieve themselves of the risk of getting sued for defective products or services by the consumer? And on the other hand, where is the first place any business goes when it thinks that it has been the least bit adversely affected by another entity?--that's right, the courthouse.

    Why should we consumers be willing in any way to give up our ability to seek justice via a lawsuit when the really big boys do it on a daily basis and would never give it up in a million years?

  • Report this Comment On September 09, 2009, at 5:11 PM, JennieCessia wrote:

    The tenets upon which this article is based are patently absurd. How can we possibly deduce that we'll live longer if we pay more for drugs? One thing I'm thankful for regarding drug advertisments is how blatently it illustrates the preponderence of detrimental side effects, like gastrointestinal bleeding, produced by drugs that treat very minor conditions, such as heart burn.

    Lowering the cost of healthcare will only be accomplished by reducing our dependence on drugs to solve all of our health problems, as well as eliminating the direct-to-consumer advertisements and enacting tort reform. Frivolous law suits contribute to onerous restrictions and heavy costs in all aspects of American life.

  • Report this Comment On September 09, 2009, at 5:12 PM, davisamr wrote:

    Brian Orelli - do you work for a drug company by any chance? I have to agree with Richard Kelleher that this is be one of the most idiotic things I have seen written anywhere.

  • Report this Comment On September 09, 2009, at 5:15 PM, phenukus wrote:

    As a retired MD who has practiced in the private sector, the military, and at the VA I want to comment on two issues raised:

    Since I finished Medical School the amount of advertising to physicians has increased markedly, but the biggest change is in direct to the patient ads. Here the patient is called the consumer, but he/she is the target while the MD is the Rx writing consumer. These ads create demand for medicines that may be contra-indicated, or can be subbed for at less cost. Drug company advertising is a major and not yet counted factor in costs.

    I also can vouch for the mass buying on bids as is used by the VA. It works.

  • Report this Comment On September 09, 2009, at 5:15 PM, sunvalleyfool wrote:

    I agree, it is all about the advertising. I quit the practice of law 25 years ago when lawyers became allowed to advertise. Once an honorable and respected profession, it became the king of sleaze. I was ashamed to admit my occupation.

    Look at their ads now— they foment and encourage controversy. In a winning class action, each member of the class gets a coupon for 10 bucks off on another purchase of the defective product. The defendant corporation has to increase prices to pay the enormous judgment and the hundreds of millions in fees that the law firm pockets. Great program!

    And drug and doctor advertising—another travesty. We don't need a weatherman to tell which way the wind is blowing. We are not idiots. We know when we need to call a doctor. And the doc knows when we need drugs. It's bad enough that the drug companies wine and dine the docs, but we have overlook that and trust the doc's integrity regardless. If we can't trust our doctor, we're in bigger trouble than just the price of pills.

  • Report this Comment On September 09, 2009, at 5:16 PM, HeyPacketMan wrote:

    Markets work, government doesn't. That is a lesson we are doomed to repeat since our kids are never taught basic economic laws and principles.

    Government is a monopoly and like any private monopoly, it's bloated, inefficient, wasteful and self-preserving. I worked for the old Ma Bell and you'd be furious if you knew how much money we wasted because the FCC and PUCs allowed us to add it to your phone bill. I also worked several years for state government and it's even worse.

  • Report this Comment On September 09, 2009, at 5:17 PM, FreeTruth wrote:

    It's all a wash because Canadians have to 30-40% more for magazines and books. A Harry Potter hardback is like 35-40 dollars in Canada. What's fair about? They deserve cheap drugs. Obviously I'm being funny. Have a good day folks, eh!

  • Report this Comment On September 09, 2009, at 5:19 PM, cummingsr wrote:

    I wouldn't really blame Canada for this controversy. What I question is the willingness of drug companies to sell identical pills north of the border at substantially lower pricing. Is it not their choice whether or not to accept lower "negotiated" prices from Canadian buyers?? Given that it is quite difficult to isolate the one marketplace from the other, the "leakage" back across the border and the accompanying controversy are predictable and embarassing for the Pfizers of the world! Set the Canadian price to be comparable to ours and let Canada decide if the pills are worth the full price. Lower pricing in Canada obviously undermines their whole pricing structure in the much larger US market........dummies!!

  • Report this Comment On September 09, 2009, at 5:19 PM, hankbalto wrote:

    Actually the price that Canadian provinces pay for drugs is similar to the price that HMO's pay for drugs. People without insurance pay significantly higher drug prices than people with insurance. And it's not just Canada (or US HMO's) that get low prices. The rest of the earth pays prices that are much lower than US uninsured people pay. The truth is that in the US drug companies can charge what they can get away with -- just as every other business does. There's nothing wrong with that per se -- that's how the system has been designed to work. it's just incorrct to fall for the industry argument that nothing should be permitted to change since whatever is is right..

  • Report this Comment On September 09, 2009, at 5:21 PM, jls01mail wrote:

    The US consumer subsidizing the rest of the world makes no sense, but neither does trying to take out any profit from providing healthcare. How many of you would be willing to work for free or invest in a company with no investment return?

    Why not just require drug companies to sell their products in the US at the lowest price they sell them to other countries, excluding what they donate to underdeveloped counties?

  • Report this Comment On September 09, 2009, at 5:27 PM, casahanson1 wrote:

    As an ex-pat Canadian w/o medical coverage in US due to a pre-existing condition (American Invention) I have this to say to all of you out there still happy with your medical coverage, don't wait until you are diagnosed with something terrible before you read the fine print on your plan coverage. "Generic drugs only" (American Invention) are what a lot of Americans will have in their medical plan coverage. Guess what? They don't work. The huge cost of the drugs that actually do work are either not available in the US due to let say issues with the FDA (collusion) and the big drug companies or they are just too expensive to purchase outside your plan. Maybe you’ll be faced with bankrupting your family or suffer the consequences of the only western nation on the planet still operating without universal medical.

  • Report this Comment On September 09, 2009, at 5:28 PM, settler100 wrote:

    You're forgetting one key fact: some 50 percent of the research that produces new pharmaceutical products is the result of government-funding, not private investment.

    In the early 1980s I worked with a pharma industry analyst at SRI. This guy was very conservative, a true free-marketer who was to the right of Ronald Reagan. And he would tell me that--even then!--the big pharma companies were making out like bandits--by which he meant a fairly literal comparison.

  • Report this Comment On September 09, 2009, at 5:31 PM, LTT17 wrote:

    Brian you wrote

    "In fact, I'd argue that I'm supplementing Canadians' health-care costs"

    After reading this, I think you should. This article isn't even recyclable !!!!!!!!!!!!!!

  • Report this Comment On September 09, 2009, at 5:32 PM, richint wrote:

    Dear Brian,

    I would be grateful if U would be more neutral and

    objective when writing OP-ED pieces. "Blame Canada" Is inflammatory.

    France and the UK ( like most Western Industrialized

    countries except notably the USA ) have health plans

    that benefit ALL citizens. Analyse who benefits from

    health care profits in the USA before blaming another

    country. Canada is NOT half as litigious as the USA-

    probably it's your lawyers, your insurers, your

    pharma companies that drive up health costs ? I came to Canada in 1970 after gaining the MSW degree from U of California in San Diego. I had worked with clients who had to seek welfare aid after medical costs had bankrupted them. When 42 million people don't have medical insurance and many have to choose between buying food and medical aid something's deeply wrong.

    Watch "Sicko" even if U hate Michael Moore. My son, a plastic surgeon was the

    Canadian doctor who was featured in the film. He re-

    attached the fingers of the patient in London, Ontario.

    Mark his words : " I am glad I don't have to make the choice whether to turn away a patient or not, because

    he doesn't have the $$."

    The same surgical operation cost $62000 to attach

    a finger in the USA. The US man had 1 choice only- no $$$, no finger."

    I think it's sad when Insurance companies hire lawyers to parse a claim in order to deny or decrease

    benefits to a patient.

    Canada, with all its shortcomings, is a kind and

    equitable place to live- where people matter more than

    $$$. Our Canada Health Act came into being because of the passion of 1 man- Tommy Douglas. As a child he lay seriously ill and his parents were

    poor. He lived to bring health care to all persons in

    Canada. Go to "Bing " and read about his heroic

    life. I hope Obama follows in his footsteps- despite

    all the misinformation and vitriolic hate that's erupting

    in your town hall meetings. America find your soul !!

  • Report this Comment On September 09, 2009, at 5:33 PM, sgmorr wrote:

    Imagine how much lower drug sales would be if not for all those crazy, ridiculous TV and magazine ads that market drugs for conditions that weren't even medical problems a few years ago. There are so many billions of dollars of sales that occur of drugs that are simply not needed for any condition at all. The side effects of many of these things vastly outweigh the possible benefits.

    That above post about Caduet is pretty enlightening too. I'm a physician and for a while combination drugs were frowned upon. Putting two or three different compounds together in on capsule resulted in the practice of bad medicine. It was taught that we should use only those specific drugs that were called for. Now there's a big PHARM push to market combo pills again for pure profit's sake. All of a sudden, everyone's got high blood pressure and high cholesterol and now they're trying to push the cholesterol lowering drugs for their "anti-inflammatory" properties so people with normal cholesterols can "benefit" from buying these things also. The drug companies need to be hauled out to the woodshed and beaten with a big stick.

  • Report this Comment On September 09, 2009, at 5:39 PM, casahanson1 wrote:

    The US consumer is not subsidizing the rest of the world. R&D in other countries are providing the bleeding edge of many forms of treatment because they are heatlth based systems. For example, Biological therapies use the body's immune system, either directly or indirectly, to fight cancer or to lessen the side effects that may be caused by some cancer treatments. Are these treatments mainstream in the US? No, and they're not being approved in the US because they're not huge profit centers, they just make people well.

  • Report this Comment On September 09, 2009, at 5:40 PM, cfreeman62 wrote:

    While "Blaim Canada!" is an amusing motto, I think the reasoning in this article is faulty and weak.

    The value of this fool service is diminishing.

  • Report this Comment On September 09, 2009, at 5:41 PM, Perspicacity2 wrote:

    There is something definitely wrong when Canada and several other countries can purchase prescription medication a much lower costs then what is available in the United States. We should establish laws making it illegal for Drug companies to advertise to individuals promoting their products; severely limit their ability to 'buy off'' politicians; enforce the Robinson-Patman act to eliminate discriminatory pricing anywhere or a policy or stopping the sale of drugs to other countries that send cheaper drugs to the U.S which eliminates competition. Reduction of Advertising, Marketing to individuals, Excessive Lobbying costs aimed at politicians and excessive remuneration to Corporate executives would reduce the cost of medications in this country while still giving them the funds and ability to continue needed research and developement.

  • Report this Comment On September 09, 2009, at 5:44 PM, Laaf wrote:

    The problem of the healthcare system currently is that it is a SICK-Care system. It's built on the profits of the drug companies, and not upon educating people on the benefits of prevention and the use of natural methods like for example Vitamin D is a very good antiviral. (hint - swine flu)

    If people start taking responsibility, and NOT looking for a 10second problem suppression pill, but a SOLUTION to their illnesses and ailments, and be acceptable of solutions outside the western medicine only, the cost of health-care would plummet. We as health-care consumers all have this responsibility.

    Important would be to remove the perks for the physicians offered by the drug companies when they prescribe more of their pills.

    That very certainly would reduce the income from the manufacturers, but what's more important? Real health for the people or profits? Real Caring needs to come back into the society, and not more magic pills.

  • Report this Comment On September 09, 2009, at 5:47 PM, miteycasey wrote:

    "In fact, I'd argue that I'm supplementing Canadians' health-care costs. If drug companies were able to charge more in Canada, they could charge less in the U.S. and still make the same net profit."

    Or they'd charge more in Canada and the same in the USA and make more profits.

    Isn't that how companies work?

  • Report this Comment On September 09, 2009, at 5:55 PM, RaulChapin wrote:

    Can you blame a guy for buying a Playstation 2 at a cheaper price today than it costed before Playstation 3 came up? Can you blame Sony for raking in extra profit from a design that is no longer favoured but still usable?

    Being on the leading edge has a cost, that cost is to pay more for the product than the late adapters will pay later..

    Now, when you have Cancer and you think you might have a better chance to survive if you get the newest pill, you might not care if this pill costs more than what the Canadians are paying as long as you get it now.

    If the goverment is allowed to decide what pill you take and they have to keep the same budget for everyone... you might not be able to take these pills, because the cheaper ones might just work... now people might say it is not fair for the poor that the rich can take this new pill, but the sad fact is... if there were no rich guys buying playstations 3, there would be no playstations 2 for the rest of the not so wealthy.

    In short, Americans should be happy that their health care costs are higher, it might mean that they are getting the leading edge in life preservation and life enhancement, of course they might also be spoiled brats who have to have the Playstation 3... even if they will only use it to play Playstation 2 games on it!!!

  • Report this Comment On September 09, 2009, at 5:56 PM, greyhound44 wrote:

    Crazy anecdote:

    I live in Mexico, and buy my Lipitor from Canada.

    Way less expensive than in Mexico!

    I currently pay US$134.10 for a 180 day supply of Pfizer's - but when, in Dec, I'm on US Medicare, and pay for a Part D policy - they want to pay god knows what and they want me to pay US$67 a month.

    US Insurance companies are dumber that dirt!

    ret expat MD: NBME; ABIM; ABNM; ABR w/spec comp NR

  • Report this Comment On September 09, 2009, at 5:58 PM, visualize wrote:

    I'm thinking that the Fool is so desperate for articles to spam us with, that they'll print anything, including something they know is obviously wrong. Anything to get eyeballs on the site.

  • Report this Comment On September 09, 2009, at 5:59 PM, land4apostles wrote:

    The article hit on two important points:

    1) Eliminate consumer advertising. My doctor can tell me what I need to take.

    2) Tort reform, but not to the point where malfeasance goes unpunished.

    A third potential for cost reduction, both for drugs and all forms of health care: hire sufficient personnel to investigate unnecessary dispensation of prescriptions and outright cheating at all levels of the distribution chain. Recovered costs would more than cover salary expense and, at the same time, provide jobs for the unemployed.

  • Report this Comment On September 09, 2009, at 6:01 PM, gba273 wrote:

    The simple solution?





  • Report this Comment On September 09, 2009, at 6:01 PM, ControlledBurn wrote:

    Do you know anyone who has chronic heartburn, erectile dysfunction or Jimmy legs? I don't, but watching TV you would think these are epidemics sweeping the nation.

    Need to lower your cholesterol? Stop the fatty food and exercise.

    Why are billions spent developing markets for useless drugs? We're Americans, we'll buy anything.

    This comment is not to be taken if you are pregnant, nursing or may become pregnant.

  • Report this Comment On September 09, 2009, at 6:05 PM, whatsafool wrote:

    This is the silliest thing I've read about drug prices. Since drugs have been allowed to be marketed directly to consumers, drug firms spend over SIXTY percent on commercials. Their excuse for high prices used to be R&D, but that's not where they spend their money now.

    We pay more than anyone in the *world*, never mind Canada. That's because our gov't supports the drug executives' profit. It's obscene profit that Canada curbs. And if they didn't, you can bet that here in the USA, you would pay the highest prices, just because no one is working to curb the prices.

    For pete's sake - anyone who manufacturers anything will sell it cheaper in bulk. But here, Congress has forbidden Medicare from negotiating a bulk price.

    The price has nothing to do with Canada.

  • Report this Comment On September 09, 2009, at 6:06 PM, RaulChapin wrote:

    The author is not saying blame Canada... that is a tongue in cheek comment for those of you who obiously did not get it... it is like saying "Blame the rain"

    He does say that Canada strong arms the companies into charging less.... but the companies are free not to sell to Canada... plain and simple.

    But by selling to Canada the company can better use their production capacity, that actually makes it possible to operate with lower margins at their main market (arguably the USA)

  • Report this Comment On September 09, 2009, at 6:06 PM, gjoyan wrote:

    I think the usa should put price controls in like canada has. many have no insurance or cheaper insurance and therefore pay extremely high costs for their meds. You ask if controlling health-care costs means the demise of drug development as we know it...drug development as we know it is a very dangerous situation and we need to see the demise of drug development as we know it. we are often the guinea pigs for big pharma...the numbers of deaths from either poorly tested drugs or drugs that tested poorly and the results were covered up is on the rise every day. if the drug companies would make fewer drugs that were safer and that hit the intended mark for the patient, that alone would lower the drug costs. a better proposal? you bet! let's put a bunch of the money thrown into r&d and health costs into preventative care. let's help people learn how to take care of their own health and the health of their families. that would slice health care costs and drug costs to the bone. then we wouldn't need all that money to go into r&d. we wouldn't have near as much heart disease, cancer, strokes or diabetes...the top killers in the u.s. but of course, if we did that, then all of these industry's, i.e., the cancer industry, heart attack industry, pharmaceutical industry...what would happen to them? they wouldn't be able to sustain themselves!

  • Report this Comment On September 09, 2009, at 6:08 PM, TxTom wrote:

    Blame Canada!

    Sounds like something out of a Southpark movie.

    All I have to say about healthcare and possible legislation is that I hope costs are contained, the healthcare giants are NOT allowed to continue soaking everyone, and that people will have access to doctors regardless of their income.

    I hear TV people screaming about "socialized healthcare" and they are the very folks that can afford any private plan they choose. Are Americans not at all empathetic? I'm not a bleeding heart liberal, but c'mon!

    We can't go on letting people die on hospital steps because an emergency room is the only place they can get treatment. There MUST BE a better way.

  • Report this Comment On September 09, 2009, at 6:08 PM, sensibleshake wrote:

    Please. Drug companies spend more on marketing than research. Pfizer just got hammered for $2+ billion pushing drugs whose only benefit is they are more profitable - happens all the time. Gimme a break.

  • Report this Comment On September 09, 2009, at 6:16 PM, Ladydidi wrote:

    As Richint says, here, France, same as in Canada : Everybody gets the treatment needed, no $$$ problem ever, drugs prices are discussed with the administration and we have no direct-to-consumer advertising.

    New drugs prices are defined a on cost/efficiency basis. If a new drug is just a me-too product, since we dont have direct-to-consumer advertising there is no demand for it from the patient and the doctors can easily stick to a former, cheaper one which gets better health care refund.

    If it is really new drug, it is paid more, taking in account R.D. cost, and the labs don't seem to complain.

    Our reason for France forbidding direct-to-consumer advertising is that it is not only costly, it is just making the doctor's work more complicated since most consumers don't have enough medical knowledge to know if the new drug they demand is better for them or not.

  • Report this Comment On September 09, 2009, at 6:19 PM, RaulChapin wrote:

    Hmm i did not know that the goverment had forbiden Medicare from negociating better prices. So basically they are strong arming arguably the largest domestic consumer to pay whatever the companies want to charge... that is a sweet deal if you ever had one :-)

    It works the same way in other industries though... it is cheaper to import Guatemalean beer from Mexico than to buy it at the store.... and it is of course illegal... (some might argue that medicine is more important than beer...but the jury is still out on that one!)

  • Report this Comment On September 09, 2009, at 6:23 PM, GSmith42 wrote:

    Just to be clear, we do have 20 years of protection for patents in Canada.

    Why do we and every other country pay less for health care per capita than people in the U.S.?

    A few good reasons have been suggested in the article and in the comments. Another reason could be that we don't allow corporations to finance our political parties anymore. That way our politicians are not in the pockets of the corporations. Each citizen here can contribute $1100 and get most of it back as a tax credit and each vote a party gets in a federal election gives it about $2 of funding out of tax revenues.

    If you continue to believe that corporations unfettered and unregulated will look after your nations best interests then look at our banks and look at your banks.

    I do appreciate and enjoy visiting the United States and know that our economy is heavily linked to yours, but you have to get over this ideology that prevents you from making sense of health care issues. Corporations are great at producing cars efficiently but, when it comes to health care, corporations can't produce health and aren't motivated to produce health like a government of the people. It's not a product corporations have an interest in creating. It's in their interests to keep you sick and paying more - that's in the interests of the shareholders.

    Look at the reality, we pay less for health care in Canada and live longer and healthier lives. The same holds true for citizens of European nations.

    What else matters?

    I'll raise a nice rich glass of California Zinfandel this weekend to your health and mine.

  • Report this Comment On September 09, 2009, at 6:29 PM, HeyJuan wrote:

    What a lousy article!

    First he writes that poor Merck paid out $4.85 billion in a settlement, than goes on about the poor drug companies can't make enough money to afford to cut their prices.

    Obviously they are making billions.

    Limit the amount paid out on lawsuits, advertise to doctors only,(instead of flogging their pills like the greatest new cereal), and charge the same price for the product to every country instead of gouging US.

    When a pill used for healthy cows (and sold to farmers for approx. a penny each) turned out to have some benefits for humans the price jumped to $1.00 per pill.

    Was it higher costs all of a sudden, or was it greed?

    No, it must be Canada's fault.

  • Report this Comment On September 09, 2009, at 6:50 PM, depthcharge45 wrote:


    I do not agree with your analysis. Many countries negotiate better drug prices to keep costs lower. Many drugs were developed in other countries where the prices are lower, and that includes Canada (one of the first drugs used to treat AIDS was invented in Canada). I am a physician and I see the amount of money the drug companies put on marketing. Why, it was so much that the medical bodies and governments had to step in (they were paying trips for physicians and their families, "conferences" about their products, etc.) The companies still make a huge profit in Canada. The argument you use of financing innovation is typical of an over inflated health care system. The same way that a surgeon makes $800 for a procedure that is paid $5,000 in the USA. When you leave a health care system and the pharmaceutical companies without any public overseeing you let the costs explode and the health of the population deteriorate. The drug companies all the time stop making a drug that is useful just because the profits are no so high anymore, even though this will impair patient care (brietal, amytal are among those. A few years ago they wanted to stop manufacturing some medications used to treat malaria and they just backed off because of the tremendous outcry. Look also at the drug trials that took place in Africa that would be illegal in North America. All the expenses related to health care are much higher in the US and Canada has nothing to do with it. Fix your system instead of trying to blame other countries. Childhood mortality in the US is worth than that in Cuba and several public health indicators in the US are among the worst of industrialized nations. Your system is good for those who can afford its high prices. For the others, well, they try to get care and drugs across the border when they can.

  • Report this Comment On September 09, 2009, at 6:59 PM, NEPA18704 wrote:

    Since the comments have wandered into the health care debate in general I would like to add another comment regarding health insurance. How much fire insurance would an insurance company sell or rather would they sell it if they knew that every building they insured would catch fire? I think everyone knows the answer to that and it is no they wouldn't sell it. The same scenario holds true for health care. Everyone will at some point in their lives have claims, and some more than others. It comes about by just getting old , some have inherited bad genes and some by accident as well. Now how is it that knowing this reality the health insurance companies can rack up record profits? Basic health care should be a right for all as it is in most other developed countries. The only insurance that should be allowed in health care is for needs or wants that go beyond the basics and that is as it should be.

  • Report this Comment On September 09, 2009, at 7:01 PM, jcarter2 wrote:

    I have a twoj-page rant, but it's all pretty much said. Still, I would like to repeat one thing. It’s discouraging for an organization like TMF to argue that,

    “Canada's altering of the free market…”

    Does Canada alter the free market? The Canadian health care ministry simply negotiates with the drug companies over the price of the drugs. The drug companies are free to decline to sell the drugs to Canada.

    When congress passed the Medicare drug bill, Medicare was forbidden to negotiate with the drug manufactures over price. The military and VA negotiate with the drug companies over price. My private health insurance drug plan negotiates over price. Why not Medicare?

    All those lobbying dollars at work.

    That’s altering the free market.

  • Report this Comment On September 09, 2009, at 7:19 PM, irvwol wrote:

    Foolish or disingenuous? Which is it, Brian Orelli?

    Read the comments.... they're overwhelming! The Pharmaceutical industry and its fellow travelers have duped the American public for too long. It's an old-boy network which can't go on because at the end of the day it is actually counterproductive to the market economy.

    It is small business and the competitive spirit which builds this country. Let's remember that!

  • Report this Comment On September 09, 2009, at 7:21 PM, Stagewalker wrote:

    There is a feature of drug prices and medical costs that I do not believe is being addressed. The administrative load the doctors and pharmacies must carry to get paid for the products and services they provide is enormous. If the forms the doctors and pharmacies submitted to the insurance companies were standardized, that small step would save tremendous amounts of money across the system. My guess is that the reduced cost as a result of solving the morass of administrative log jams would pay for its development and implementation in a single quarter.

    This is not politics. It is not about marketing. It is about efficiency. This is engineering. Perhaps now we have a government willing to carry the ball. Only time will tell.

  • Report this Comment On September 09, 2009, at 7:22 PM, 2kicksofamule wrote:

    Everytime I go to a doctor I see drug reps coming in or leaving. They are all youngish and attractive. I've been in exam rooms waiting interminably while hearing the doctor talk with drug reps. So I asked a relative in a medical office and she says that various drug reps provide office lunches almost on a daily basis. She says she has and could dine out with them at the most expensive restaurants in town on the pharma dime. They pay for docs, p.a.'s, and nurses to fly to wonderful vacation locations to hear a couple of lectures on a drug and give them a stipend of $1500 or more for coming. If the medico will give a talk among peers concerning the drug they can receive thousands of dollars more.

    Yet we all believe them when they say that this doesn't influence their choice of drug, right?

  • Report this Comment On September 09, 2009, at 7:32 PM, LookThinkJump wrote:

    Yeah, I agree. Canada is responsible for global warming, the disappearance of the the dodo bird and hurricanes in Florida.

    You're not discussing policy here, you're grinding an axe.

  • Report this Comment On September 09, 2009, at 7:36 PM, friscolorado wrote:

    The American people have been lied to about health care cost so long they believe most of what they are told.

    It is a big conspiracy, allowed by the 535 members of congress. Because big business pays them off, [Thats

    why we need lobbyist].

    I lived in USA more than 50 years, I have lived In Canada more than 20 years, I know what health care cost in both countries.

    Wake up Americans. My wife and I pay less than $2000.00 [Cdn] PER YEAR FOR HEALTH INS.

    We must pay for eye care and dental care like Americans. However doctor visits are FREE, hospital beds are FREE,[private rooms cost less

    than a hotel room, drugs are free in the hospital.

    My wife and I have a combined cap of $1700.00

    per year for priscriptions.


    Jim Corbin

    Castlegar BC Canada


  • Report this Comment On September 09, 2009, at 8:01 PM, Howard1ii wrote:

    Seems to me, the obvious answer is to extend the term of the patents, and help protect the drug companies investment, in return, drug companies stop advertising directly to the consumers. Most people do not recognize it but many generics are produced offshore, so allowing the U.S. drug companies to maintain their patents, would also create/protect U.S. jobs

  • Report this Comment On September 09, 2009, at 8:01 PM, naicman wrote:

    If the U.S. should proceed to this "Obama-Nation", why is it , i see the pharma giants going to produce Generic drugs, rather than research and development ?

    Lets face it: the ONLY reason that these outfits develope new drugs is because the U.S. customers are willing to pay for them- What killer drug has been developed, in , Canada, Great Britain, or even France?

    This is a great way to send medical advances back to the stone age. Oh, well, welcome to "Obamacare"

  • Report this Comment On September 09, 2009, at 8:13 PM, alchik wrote:

    I own a small pharmaceutical factory in Russia. For years we have struggled because the large Western Phama companies bribe the Russian Ministry of Health. Now because of the economic crisis the Russian Government is starting to buy from its own producers. In order to counter this the Western Pharma companies are running large advertising campaigns to make the public frightened of using generic drugs. Corruption in high places, probably also in the USA is the reason for large health care costs.

  • Report this Comment On September 09, 2009, at 8:17 PM, ariel1939 wrote:

    Canada requires competion by purchaser's of drugs. We should also. We could allow the drug companies to make as much profit as they spend on legitimate reasearch. Perhaps minus spending for (warmed over drugs like Caudet) and minus direct advertising to consumers. Direct advertising to consumers should be eliminated for drug companies, fast food joints and lawyers.

    By the way I thought it was ingenious to use the "Canadian" ploy to get everyone's attention; well done.

  • Report this Comment On September 09, 2009, at 8:21 PM, ChicagoGrad wrote:

    Ultimately, our healthcare costs are the highest in the world because our healthcare industry is profit-based. The primary concern for every company in the healthcare industry is profit. Imagine if we took the same approach with education or fire and police protection.

    If the police were primarily concerned with making a profit, only rich people could afford good protection. Oddly, about the same number of people die each year from lack of health insurance as from murders. If we consider protection from being murdered as essential enough to be paid from taxes, what about people dying because they can't afford profit-based healthcare. Everyday, insurance companies deny treatment to someone that eventually dies so that they can increase their profits. Basically, our healthcare system puts profits above the lives of the sick, and those that oppose universal healthcare simply want poor people to die if they get sick.

  • Report this Comment On September 09, 2009, at 8:25 PM, HeyJuan wrote:

    It's not a matter of not developing new drugs. That will always be done around the world, even if it's done by scientists and universities. Even Cuba has developed new drugs. And of course it will also be done privately if there is any profit to be made.

    So quit panicking about health care for all. The downside is that doctors, hospitals and drug companies are not going to make the huge bucks they make now.

    Also not many people will be filing for bankruptcy because they can't handle a medical bill.

    I'm guessing the ones in favor of the status quo all have cheap or employee-paid health care, and don't give a rat's ass about anyone else.

  • Report this Comment On September 09, 2009, at 8:41 PM, cleansweepgov wrote:

    And who is funding the universities? The student's activity fund? No it's goverment funding the majority of that research. So maybe Pharma should have the government pay for all the research if they agree to lower costs.

    It already takes over 800 million to get a drug to the approval stage so let the government pay half or more of that cost and then the drug companies can charge less. If the drug doesn't get approved, the government can refund the money to pharma and they can charge less for the drugs that do. We can also send more of the jobs overseas to help Pharma reduce cost.

    While we're at it, why should we pay more for gas than they do in other countries?

    Why should I pay property taxes when churches, non-profits, and most businesses do not? I'm sure they are less in other countries too.

    Yes let's all stop profits and share ... share ... share. We should also stop paying Americans so much, people in India earn far less and live longer so it must be our high wages and lifestyles.

    Maybe there's a czar or two or three that will help...

  • Report this Comment On September 09, 2009, at 8:41 PM, sully100 wrote:

    Health care is not the real issue here.

    I am a retired exec. who has live in, worked in , payed taxes in, and payed for health care in both Canada and the US for twenty years.

    To be sure the US system is brigther shinier and easier to access if you have the money. It is also wastefull and profit centric as opposed to being Patient centric.

    The diference in the US system and those of other industrialized countries is a core belief in the US that all things government are bad and all things operating under free enterprise are good. If this were true we wouldn't need this debate.

    Just look at the VA,a government run system, which is held up as an example of efficiency world wide.

    In my view the US system is no longer free enterprise but is seriously tilted to favour the rich at the expense of the lower middle class.The playing field is no longer in balance. As long as the rich can pay there is no incentive to be efficient and muti-nationals don't care. This has to continue until government steps in and re-levels the field or untill it is unsustainable.

    One thing for sure it has diddly squat to do with the price of tomatoes in Toronto.

  • Report this Comment On September 09, 2009, at 8:48 PM, kiwikeef wrote:

    I love the absurd yankee jingoism of this rant and all the supporters. Laughter is the best medicine after all. Blame Canada eh!

    Naicman asks "What killer drug has been developed, in , Canada, Great Britain, or even France? " Go Team USA! Clearly medical advances made by europeans such as Pasteur, Curie, Fleming (penicillin) don't count under american rules.

    And please don't feel bad about all those poor drug companies with their drugs that no longer work or have fatal sideeffects because you can continue to dump them in the third world as is standard practice for american companies.

    As for health care I have been treated in public health systems in Australia, New Zealand, Fiji and CHina and never hadto worry about being too poor, the wrong colour or not having enough insurance. They treat you anyway - a bit like those evil Canadians or the English healthcare deathpanels that wanted to kill Stephen Hawking according to US reports..

  • Report this Comment On September 09, 2009, at 9:00 PM, xetn wrote:

    In their book "Against Intellectual Monopoly" professors

    Boldrin and Levine argued that there is little or no benefit to IP and in fact, that it does not support the claim that it is necessary for innovation.

    It seems to me that the whole "high cost" problem with the U. S. health system is an absence of a real free market. At almost every level, you have government involvement such as protective tariffs granted to drug companies in the form of IP, the FDA that extends the time to approval of new drugs, the AMA that limits the number of new doctors to prop up prices, licensing that does nothing to prove the value of service, but limits services, etc.

    The following article will provide greater clarity:

    What we do not need is more government.

  • Report this Comment On September 09, 2009, at 9:19 PM, grip66 wrote:

    Blame Canada, You are so wrong- the US is the only country without drug price controls - This article was a big waste of time and effort and has no biz in Motley but then again the Fool is becoming weak and appears to need filler, Get back to your roots FOOLS, Thanks for the sound off.

  • Report this Comment On September 09, 2009, at 9:25 PM, Appear wrote:

    Reducing the price of drugs by negotiating in the free market is what drives business. If it is tough to make a buck, so be it. Join the real world. The lower the cost the more benefit it is to the American and global societies. The more lives saved. They need motivation and extending patents to longer terms only stifles innovation and creation to develop a new drug. Instead , Big Pharmas just continue to modify current older drugs in some immeasurable way, only to extend a longer patent. They are lazy and greedy.

  • Report this Comment On September 09, 2009, at 9:57 PM, Sleddawg63 wrote:

    For once, as a Canadian, I am enjoying the Canuck bashing. (okay except for the article, everyone seems rather reasonable about this topic.)

    I won't debate the two health care systems, there is good and bad in both...but it's overlooked that the Canadian-style system is more preventative while the US system is more reactive.

    Although I pay health care through taxes, money and health are not linked that closely. An entire level of judgement is taken out of the health care experience here. If I want something checked out, I go do it without anyone's blessing. I think Canadians thus catch issues quicker.

    That is reflected in the huge difference in per captita expenditures and % of GDP according to WHO. The result is better stats in many important areas.

    The wealth of advertising in the USA is a sign of a reactionary line of thinking. No need to pay attention to the latest pill on tv if you don't even think you have the disease. Diagnosed diseases are big money makers...preventative medicine isn't where the profits are.

    The biggest issue facing the Canadian system is the lack of money put into it. Our governments could do more to keep doctors here and fund more MRI's and other preventative and diagnostic options. Otherwise I'll keep this way of doing health.

  • Report this Comment On September 09, 2009, at 10:02 PM, stevedj98 wrote:

    I've been buying all my family's drugs in Canada for the last five years. I can't buy health insurance, due to my combination of previous conditions, so no discounting for drugs either. On average I pay my Canadian pharmacy 25-30% of what the big chain drug store down the street charges. That's a huge difference. Plus generics are available in Canada that are not available in the US.

  • Report this Comment On September 09, 2009, at 10:04 PM, madinga wrote:

    In my opinion consuming too much beneficial "corporate drugs" may negate the goal of the people's first priority to live longer.

    More attention should be focus on why people get sick/ill and look for preventive imply that Canada may hamper that goal is ridiculous...

  • Report this Comment On September 09, 2009, at 10:05 PM, 181steward wrote:

    Buying a drug should be like buying a quart of milk. The drug company should price the dose based on cost, add a morally justifiable margin and post the price on the shelf. It should be the same price for everyone, American, Canadian, European, Asian, whoever.

    I don't get crazy often. But, standing in line at the pharmacy with a state uninsured drug card, a store pharmacy club membership and an ID so I can prove my age - - all so I can try to negotiate the lowest possible price on required medications - - only to be told that one drug isn't covered by the club card, a second isn't eligible for the competitive price matching program and the third one is one price if covered by insurance and another price if not covered, drives me BATTY!

    And how exactly does this assure a better return for us stockholders? If I ran my business like that, I would quickly have no customers at all? But, then, I don't have profit protected patents on my products and don't have a virtual monopoly on product distribution as a supplier. And, I care about providing value for my customers. (It's an uncorporated approach).

    The costs of the current drug situation is not just in the dollars. It is also in the tremendous lack of consumer access and care.

    Access to health care should be a right. One possible solution is to cut out the obfuscation and provide a good product at a reasonable price and treat everyone the same.

    Shareholder gains will assuredly follow.

  • Report this Comment On September 09, 2009, at 10:08 PM, jbrt wrote:

    whos in the pocket of the peoples responsible for that HOGWASH ? ..... I've had the " benefit " of living with a lifelong illness ( not of my choice nor desire ) brought upon by Encephalitis , where one nearly dies from temperature levels in excess of 106 degrees , good for some brain damage , just ask me . I've been taking drugs as a result for over 32 years and will till the day I drop DEAD . Even then , they will be using drugs !.....most mnftrs. will sit and watch peoples suffer and not enable them to access to a better one they are either just omitting something , combining something or changing the " time release " to extend the " half life " AND WA-LA ! ..... THEY HAVE A NEW .." BRAND NAME ONE ! " . Your suckers ! to even consider these local drug mnftrs. as " heroes " or " saints " . Just ask me , I've taken over 200,000 pills and just popped a Simvastatin ( heart disease ) JACKPOT FOR THEM ! . Pay more attention to McDonalds , Pizza Hut and all the other CRAP out there . THATS THE WAY TOO PAY LESS and thats through AVOIDANCE and ones better personal health care . ake another one for Condoms so we can watch the commercials non-stop or cigarette quitting . There will come a day , mark my words , YOU WILL ALL BE ON DRUGS , have another piece of cake and wash it down with a nice ICE OLD SODA !

  • Report this Comment On September 09, 2009, at 10:17 PM, wintrwman wrote:

    Smoke & mirrors...if we focus on high drug prices we can continue to ignore the Health Care Crisis in this country. Again...Some more. Do you feel better now?

  • Report this Comment On September 09, 2009, at 10:23 PM, ItsAGoodLife wrote:

    I agree with 181steward - as a Canadian living in the US for over 10 years - working in the pharmaceutical industry and health care industries in both countries (and in Japan) the present health care system is just like the housing system. If the government tries to do something for the people someone else will just try to make a profit from it (i.e., lenders that pushed the housing crash).

    So drugs are cheaper in Canada, well alcohol, cigarettes, and junk food are cheaper in the US. Hmmm... let's see... more people unhealthy - more people on Prozac - more money for the health care companies that lobby the government and give $$$ contributions ...

    The US Health Care system has been set for a long time to keep Americans sick and dependent on drugs. And the health care system is also keeping the doctors in check as to prescribed certain drugs more than others (but that’s another story for another day)... Not quite a free country is it.

  • Report this Comment On September 09, 2009, at 10:32 PM, drchemy wrote:

    Health care in countries such Germany, Sweden, France and Switzerland is of comparable quality to that in the USA and costs 2/3 as much. They also cover ALL of their citizens not 85% of them. How do they do it. There are 5 ways they do it

    1. Drug costs are less - for many of the reasons outlined in this article

    2. Administrative costs are less because with single payer everyone knows what is covered and a for profit company is not trying to make 10% off the top of your premiums

    3. Medical education is much cheaper so people who graduate from medical school as well as nursing and other medical professions are not saddled with debt and are willing to work for less money.

    4. Malpractice is handled in a much less expensive way.

    5. There are fewer emergency room visits because people can afford to see a doctor before problems become too severe.

    It would be nice if Motley fool with their infinite financial wisdom would do a comprehensive article on the the effect of these factors on the cost of health care and propose some real solutions to the problem instead of just being hecklers. As Sam Rayburn used to say "Any Jackass can kick down a barn, it takes a craftsman to build one"

  • Report this Comment On September 09, 2009, at 11:46 PM, holisticfool wrote:

    In all of these responses I've seen no mention of CAM, Complimentary and Alternative Medicine. Around the world, less than 30% of medicine used is what is called "patented"

    Medicine's that have been in use in Asia for several thousand years, and those that have been used in Europe for almost as long are referred to as quackery by those protecting the profits of big Pharma.

    The NIH and others in government apparently will not support cancer research that goes beyond "cut, burn and poison". A recent article in The New York Times alluded to this. For example, they said that cancer research dollars were supporting research that will determine whether or not there is a relationship between the sense of taste and a tendency toward obesity.

    I was buying agricultural minerals a few years ago and found that the price of selenium had increased six-fold in a little over a year. The Chinese had been buying shiploads of it, and using a variety of procedures to get it into their selenium deficient citizens. The end result was a substantial decrease in the incidence of cancer, heart disease and hepatitis B and C. There has been research in this country showing that consumption of as little as 200 mcg per day could result in a reduction of some cancers by almost 50%. Research at Oxford in England found that the same dose of selenium will reduce the incidence of knee arthritis by 40%. A southwestern university in the US found that if persons who had cancerous polyps removed during a colonoscopy consumed 200 mcg of selenium, they were 40% less likely to have cancerous polyps the next time around. Never heard of this? There's a reason.

    Have you heard of the ancient Greek use of Hawthorn for heart failure? How about the adaptogens like Reishi and Cordyceps? I know a fellow with Lupus SLE who used Reishi to clear-up a disfiguring facial rash. Another person cured his IBS with probiotics and a couple of quackery supplements. A lady with Terminal cancer went with the Budwig Diet, featuring cottage cheese and flaxseed oil. Several years later, she is still cancer free.

    I could go on about Astragalus, Curcumin, Manuka Honey...............

    Inexpensive medical care? No problem. Just open the gates to CAM.

  • Report this Comment On September 10, 2009, at 12:30 AM, jmtrph wrote:

    Your piece regarding Canadian drug prices sounds like it was written by PHARMA. Manufacturers in Canada must submit their lowest bids, then Pharmacies add on a fee depending on their services, (delivery, charge accounts, etc.) and the patient takes their choice. Most of the research claimed by the US drug companies is actually done, and paid for, by the government, and/or the universities with federal money. Patents running out?

    What's new? They had 17 years, plus extensions, to make money which would make Bernie Madoff blush.

    The 'Senior Help' program lets them charge off drugs at full price, while only costing them ingredient cost, since any development costs have been written off years ago. Don't be alarmed by Obama's proposals- the pharmaceutical companies and the insurance companies will squash these like they did Hillary's back in the early 90s. As a Pharmacist, I've seen this going on for fifty years, but I honestly don't see any chance of it ending without something like the Canadian system. If you don't tell your represenatives about this, its your choice. Good Luck.

  • Report this Comment On September 10, 2009, at 12:32 AM, beawinner2 wrote:

    2kicksofamule the doctors offices have cut that down a lot from what I heard. I'm not sure if they started doing it again though.

    I heard that now the drug companies pay on performance. The drug company get's a list of meds sold and doctors that wrote those meds to their patients. The Pharma company then sends a check to the doctor for a % of those meds.

    I don't have a clue if this is true.

  • Report this Comment On September 10, 2009, at 12:32 AM, ahausheer wrote:


    What a retard.

    So the author is saying companies would charge us less? Why would they do that? They would just charge us and Canadians more. Are these companies like nice people, ''oh sure we will charge you less even though you are willing to pay more, we like you and we will just charge the other country more because we don't like them as much, good thing we like you''. HUH? We get charged what we do for the sole reason that we are willing to pay more, and Canadians are not willing to pay more. They just voiced their willingness to pay as a whole, ie their government.

  • Report this Comment On September 10, 2009, at 1:15 AM, Brian0712 wrote:

    Canada is 'altering the free market' by negotiating price? Isn't that the definition of 'free market'?

  • Report this Comment On September 10, 2009, at 5:59 AM, stlhobbit wrote:

    I'd like to see full disclosure by all critics of the current administration's efforts at healh care reform regarding their own health insurance coverages and costs. Much of the so-callled discussions and defense of the drug companies, health insurance companies, and their paid champions who've been duly elected to represent the people - are from people who are not struggling to pay their continuously rising premiums and to maintain coverage and some degree of health. I am a healthy 55 year old male who never gets sick - work for myself & must pay $3k in premiums & another $3k in calendar year deductibles before the health insurance industry will pay one red cent! Am I angry? Yes - especially at the arm chair defenders of those whose billions in profits are at the cost of the blood, sweat, and life of those of us who are at their mercy.

  • Report this Comment On September 10, 2009, at 7:25 AM, driller101 wrote:

    You left out some costs that drug companies face here like lobbying expense and campaign donations. If it weren't for these activities we would have had universal health care years ago.

    Don't blame Canada for making the best deal they can, blame our political system for allowing this farce to go on. I can't really blame the current US healthcare establishment for trying to maintain their profits, but why are the rest of us so gullible?

  • Report this Comment On September 10, 2009, at 7:42 AM, peterbailey wrote:

    You're full of it. I'm unsubscribing from this newsletter, too.

  • Report this Comment On September 10, 2009, at 8:48 AM, drdonrs wrote:

    This article may be the ultimate in stupidity and misinformation. The poor, poor pharmaceutical companies don't give a damn about the ultimate customer. As a senior citizen living on social security and a retirement fund that was battered beyond belief, drug costs are an integral part of my living expenses, just as it is for millions of others. To suggest that drug costs are a direct result of Canada's successful program to contain prices, that are obscene here in the US, is total nonsense.

    I am going to have to reevaluate if I want to continue reading this newsletter after seeing garbage such as this article.

  • Report this Comment On September 10, 2009, at 10:42 AM, hadika wrote:

    Spoken as someone with money, a good job, and good health insurance, who is out of touch with anyone who doesn't have these.

  • Report this Comment On September 10, 2009, at 11:06 AM, stonebusted wrote:

    Greed and lawyers without regard to the common man.

    Is there something new here?

  • Report this Comment On September 10, 2009, at 11:22 AM, denisepw wrote:

    Look a little outside out north-american continent:

    -in most industrialized countries there are no ad campaigns for drugs directed at consumers,

    -pharmaceutical companies are doing great in spite of state-negotiated drug prices and single-payer healthcare systems

    -they are coming up with new and effective drugs as good and cheaper than ours

    -and lastly, all our vaccines are made outside the US

    So ?

    Don't blame it on the Canadians, blame it on our greedy system !!

  • Report this Comment On September 10, 2009, at 11:39 AM, TMFKris wrote:

    "Of course, such advertising also drives up demand, which increases total dollars spent on health care."

    People may want the medicines they see advertised, thus demand (as applied to the Rx-writers) goes up. But should the amount of drugs being prescribed (the demand for pills to be produced) go up just because people are becoming aware of them? Are patients getting medicine they wouldn't have gotten if they hadn't seen the ad and asked their doctors for it? That would indicate a flaw. Are doctors the targets of the ads?

    Kris (Motley Fool copyeditor)

  • Report this Comment On September 10, 2009, at 1:06 PM, clydejazz wrote:

    Richard is right: very dumb article.

    We're already living shorter lives because of our for-profit medical system. Hospitals have a dire need for new antibiotics since existing ones are losing effectiveness. But profit margins on antibiotics are not high enough to attract big pharma, so lots of people die of infections that we can't treat with existing antibiotics.

    A huge percentage of medical research is already paid for by us taxpayers, and the average person in Europe and Canada lives a longer, healthier life than the average person here in the U.S., so why the constant barrage of scare stories about reforming parts of our medical system?

  • Report this Comment On September 10, 2009, at 1:34 PM, theHedgehog wrote:

    The thing that the author left out is that the drug companies charge consumers in each country based on the general level of wealth in that country. In poverty ridden areas, the price is practically give-away. In the US, the costs are very high. The fact that the per-capita income in Canada is lower than that in the US makes their drug costs lower; it also makes Canada a cheap target for articles such as this.

    OTOH, the author does have the right idea.


  • Report this Comment On September 10, 2009, at 1:41 PM, theHedgehog wrote:

    "it will be a cold day in hell the patient tells the RX writer what to prescribe"

    One common complaint among doctors is about the pressure they feel to write "up prescriptions" or even prescriptions that aren't really needed. How many times do YOU, as a doctor, tell your patient "no, this older cheaper drug works better than the new expensive one" before you just give in a write the prescription?

    I know that I have had the other problem - asking my doc for the older, more reliable one instead of the fad drugs with the large "black box" warnings. Why do I have to do this? Because the pharma companies lobby directly at the doctors' offices for their newer products, just like they lobby to the patients on TV.

    So, yes, there is a problem with prescription medicine in the US. We have been thoroughly consumerised into believing that more expensive means more better. Taking medical ads off the TV would probably go a long way toward halting the dis-information campain the pharmas have mounted in the effort for higher profits.

  • Report this Comment On September 10, 2009, at 1:45 PM, capsd wrote:

    Of course, the underlying assumption is that the drug companies will be perfectly happy once they make 1 honest buck and will not charge a single penny more than they need to make that honest buck. Quite amusing assumption, it is along the same lines that the financial companies only want to make an honest buck and will absolutely not take any undue risks to just to maximize profits.

    This is a capitalist system, and as many have pointed out, being allowed to charge more in Canada will do nothing to the prices in the US. Price pressure from the consumers does not exist in the drug market (given, as you mention, that all of the new drugs are protected by patents and thus are exclusive), so the there is no market based counter-pressure on the drug prices. You can either find another counter-pressure as Canada does, or give them free reign as the US does (of course, you indirectly counter-pressure by making health care cost prohibitive to the point where only the people that can afford the high cost will be ensured and only the ensured will be given access to the drugs).

    If drug companies could get away with it, they would charge infinite amounts of dollars for their products (just as any other industry in a capitalism system would). In the US is where they get the closest to being allowed to do so in the world.

    As for the myth that pouring infinite amounts of money into drug companies will result in great new drugs being developed: big pharma has developed very few new drugs - they just get their deep pockets and go buy the little drug companies that are responsible for all of the innovation these days. Their money is all spent in advertising and lobbying.

  • Report this Comment On September 10, 2009, at 2:55 PM, partsfeeder wrote:

    Regulation of medical industry is the key. For example, utilities are regulated as to how much they can charge Remeber Enron. After deregulation, it didn't take long for the electric complanies to screw Californians out of billions.

    It has been proven that life necessary resourses will be manipulated if the government lets the crooks run the companies freely.

    Decrease drug prices. Maybe they can cut pay to their overpaid employees. No pay to doctors when they run an unsuccessful prognosis. No pay to hospital when they send a patient home to have said patient die at home the next day due to unsolved medical problems.....on and on.

  • Report this Comment On September 10, 2009, at 7:01 PM, markosaur wrote:

    I think its a good article, with much good followup comments. And yes, Canada is only 10% size of US, but Euro countries also have similar deal, so factor that in, as well.

  • Report this Comment On September 11, 2009, at 12:23 AM, bfoley4444 wrote:

    Interesting article, unfortunatly the United States is the only country in the world that allows the prices we pay for drugs, it is not just Canada. So what the article is implying is that the citizens of the US have to support the development of new drugs for the entire world. Gee great.

  • Report this Comment On September 11, 2009, at 9:09 AM, actuary99 wrote:

    A lot of these comments voice their disagreement very disrespectfully. I wish some of these posters would show more maturity and tact in their posts, instead of over-assured posts with a condescending tone. Quit talking about the evils of big-Pharma greed and start thinking in terms of financial incenctives. We all make decisions based on incentives - neither you nor I hold any moral high ground over the "evil" Pharma execs - we all just do what's best for us (and that includes doing what is best for our familty and friends). If a company have a financial incentive to do something, why should they care if it increases, on average, everyone's health costs?

    One example: Say a drug is available as a brand or generic - the brand version costing $100 and the generic costing $40. Say a senior has a Rx plan that has a $10 generic copay and a $25 copay for brand drugs. The senior would likely choose the generic, EXCEPT that now, in many of these situations, Pharma companies have offered to supply the entire copay to seniors if they choose their brand drug over the generic.

    This helps the Pharma company and the senior, but it hurts the rest of us because we subsidize the seniors insurance company. Why is the senior not as much to blame as the Pharma company?

  • Report this Comment On September 11, 2009, at 12:51 PM, theHedgehog wrote:

    actuary99 acturiates: "Why is the senior not as much to blame as the Pharma company?"

    Because the senior was not a principal in the Pharma decision to lower the price. This was a Pharma response to keep customers.

    One thing you're probably forgetting (or just waving a hand at) is that it doesn't cost "Big Pharma" any more to make their brand drug than it does for the generic to make theirs. Ten million pills of either one probably costs the same within a few dollars. The reason Big Pharma charges so much is to recoup R&D costs; not to pay for the price of production.


  • Report this Comment On September 11, 2009, at 12:54 PM, Turfscape wrote:

    It's better for stock price and company valuation to develop a drug that can be sold at huge margin for an easily preventable condition than it is to modify the health system to provide preventive care for all Americans.

    How much is spent to develop pharmaceuticals that exist simply to extend the lives of those that choose to not care for themselves physically? How many hypertension, cholesterol, blood pressure, type II diabetes, etc. medications are being developed and marketed? Now, compare that to how much we spend on preventive medicine to keep people from gorging on saturated fats and refined sugar while avoiding any and all physical activity. Just how much do we need to spend on necessary medication in order to prop up unnecessary medication?

  • Report this Comment On September 11, 2009, at 1:23 PM, theHedgehog wrote:

    Turfscape scoped: "How much is spent to develop pharmaceuticals that exist simply to extend the lives of those that choose to not care for themselves physically?"

    I think you oversimplify the problem to the point that the flavor is completely gone. The obese are, by and large, the poor. One fundamental reason for this is that cheaper foods contain large amounts of fat and carbohydrates. It's simply more expensive to buy a meal based on green veggies than it is to buy one based on fat and carbs. And, once you go down the high fat road, it's hard to turn back.

    It's been said that "you are what you eat", but today it would probably be more appropriate to say "you are what you can afford to eat".

    Can we do anything about this? It's hard to say. High fructose corn syrup is cheap to make. It's only natural that it goes into the food supply. It's a cinch that the political "right" won't have the desire to interfere with "legal business practices" merely for the sake of American health. After all, it's their fault they buy this stuff that makes them fat, right?

    And, who is one of the largest purveyors of cheap fatty/sugary foods? Your friend and mine, Warren Buffett. WEB has even publicly stated that high fructose corn syrup is one of the best businesses to be in, because it's a stealth nutrient; i.e the body doesn't really recognise the calories coming in from corn syrup and so doesn't turn off the hunger signal.


  • Report this Comment On September 11, 2009, at 1:44 PM, mike19000 wrote:

    Note to self: Brian Orelli - Remember this name and don't waste anymore time on an article by him. Totally useless info.


  • Report this Comment On September 11, 2009, at 1:53 PM, Colorator wrote:

    Kudos to djkumquat...

    "i don't like that nice green canadian bud costs way more than it should..."

    The first response on the list, and probably the only response in this post that makes light of:

    A) What can you do? and

    B) How does this really affect me on a Friday afternoon?

    Well said, happy Friday All.

  • Report this Comment On September 11, 2009, at 2:14 PM, chinbaung wrote:

    From a very personal standpoint, my opinion is that the American Medical Association is a business. Like any other business, it has a vested interest in ensuing that its members make as much income as possible - and in a capitalistic society, it means limitless funds. However, a country is not defined by capitalism alone ( or otherwise we could possibly have a large majority of starving and sick etc. people). It behooves the AMA to market the idea that "people want to live for a long time) [which barely brushes aside the notion of eternal youth]. This, in my opinion, is "marketing hype'. The Canadian system appears to me, to be more compassionate (and in a sense, i think that is what makes a nation united) - and curbs the greed that a monopolistic organization like the AMA is destined to exert on its members. So, on one hand we can call the practice of medicine an economic venture and blame Canada. On the other hand, if Medicine is a service to mankind - then Canada is certianly doing it right. No one lives forever.

  • Report this Comment On September 11, 2009, at 2:52 PM, DavidC44 wrote:

    There's no doubt that the US drug consumer is subsidising consumers in the rest of the world, not just Canada.

    However the world most powerful and innovative drug companies are American so you get the profit back as dividends or taxes.

    The rest of the world would not like American drug companies to hold them to ransom so of course they control prices.

    Consider also that drug costs are less than 15% of medical costs and effective medicines keep people out of expensive hospitals; then they start to look like a bargain, even for Americans.

  • Report this Comment On September 11, 2009, at 3:04 PM, ctpaddy wrote:

    What a bunch of fools. Reform the heath care system instead of trashing Canada. Your following the status quo like a bunch Lemmings. Who wrote this article? Sounds like more lobbyist scare tactics to me...

    Frivolous lawsuits filed in the U.S. by "Parachute Lawyers" and "Ambulance Chasers" are driving up drug costs for the rest of the world.

  • Report this Comment On September 11, 2009, at 3:40 PM, theHedgehog wrote:

    DavidC44 opined: "Consider also that drug costs are less than 15% of medical costs and effective medicines keep people out of expensive hospitals; then they start to look like a bargain, even for Americans."

    I think it's a stretch too far to say that the average case benefits the individual when the average person won't have to make the purchase. Sure, the generic "America" may have no net loss, but I can assure you that the person paying the bill has a problem with an inflated cost. Or are you saying that it's OK for wealthier Americans to live off the backs of the poor?


  • Report this Comment On September 11, 2009, at 4:24 PM, COV99 wrote:

    What about the misplaced emphasis on profits in the health industry? Drug company profits are not positively correlated with good health. Simply put, they don't make more money if you are healthy. In fact, they are tied to the consumption of drugs. Thus, profits go up when we are unhealthy. This insidious relationship also influences the products that the drug companies select to develop. For the most part, they do not have your health in mind, only profits. Sometimes they agree (health and profits), but I would argue that typically they do not. It's the American way, and it's wrong. Let the free market rule so the drug companies can make a buck off of our health? Any fool can see that this is a bad idea, but it's also the status quo. It must change.

  • Report this Comment On September 11, 2009, at 4:38 PM, COV99 wrote:

    What about the misplaced emphasis on profits in the health industry? Drug company profits are not positively correlated with good health. Simply put, they don't make more money if you are healthy. In fact, they are tied to the consumption of drugs. Thus, profits go up when we are unhealthy. This insidious relationship also influences the products that the drug companies select to develop. For the most part, they do not have your health in mind, only profits. Sometimes they agree (health and profits), but I would argue that typically they do not. It's the American way, and it's wrong. Let the free market rule so the drug companies can make a buck off of our health? Any fool can see that this is a bad idea, but it's also the status quo. It must change.

  • Report this Comment On September 11, 2009, at 4:40 PM, menefer wrote:

    Way too much waste and profit in the drug industry. If Canadian prices were also used in the U.S., the drug companies would have to get lean or perish. They'd get lean and more efficient which would improve the drug pipeline. I don't think fat cats produce better than lean and efficient companies nor are they more profitable.

  • Report this Comment On September 11, 2009, at 4:45 PM, 102971 wrote:

    This is the most ridiculous article I have ever read from TMF. Firstly, you presume that all new drugs are created in this country. This is totally untrue. Many are created in Europe, particularly Great Britain and Germeny. Secondly, you totally ignore the fact that the major drug companies usually "buy" their drugs from the smaller biotech companies like AOB and Exelisis after those companies have already passed stage three approval. The only comment you make that I agre with relates to direct to consumer advertising. We are the ONLY country in the civilized world that allows this and the pharm companies spend more on TV advertising and sales marketing than they do on research. This is DISGUSTING. Drugs should only be "sold" to doctors and hospitals AND they should be accompanied by the research and teaching as to what that drug will do and what it will not do. Pfizer has just learned a very costly lesson (in my view NOT costly enough) for persuading doctors that a drug was a suitable treatment for a situation that it had not received approval for.

    Again, I repeat that this is the most ridiculous article I have ever read from TMF and it makes me wonder about their overall approach to research.

  • Report this Comment On September 11, 2009, at 4:47 PM, FoolishRat09 wrote:

    When a drug company spends more on Marketing than R&D, with half the commercial dedicated to disclaimers about all the things that can happen to you if you use the product, then we need to take a hard look at how our drug dollars are being used. Tort reform may help with the latter, but the former needs to be addressed by the companies, the shareholders and yes, the embarrassment by government. Not allowing the Federal Government to negotiate lower costs for Medicare recipients is ludicrous. WE are the largest customer of any of these companies, and as such, should expect the lowest costs available to anyone. Political payback and lobbying have screwed us on a massive scale in just about every government spending category.

  • Report this Comment On September 11, 2009, at 4:52 PM, paul58bee wrote:

    To live longer you might want to try and get off the booze, ciggaretts, pork rinds and junk food, before you start using drugs. I know of many people who are 30% overweight and the doctors have them on high blood pressure medication.

    This is good for the drug business but not good for the human beings health.

    Canada has only 10% of the population of the US. Even if you double the cost of drugs here, it will only have a minimal effect on the US drug costs.

    What needs fixing is the sick US health system, which is based primarily on Healthy Cash Flow. The Health of the patient is all secondary.

  • Report this Comment On September 11, 2009, at 4:57 PM, gberliner wrote:

    What kind of topsy-turvy logic is this??

    I thought we all learned in highschool that when producers compete, the costs of their products get driven down: cheaper prices in one place exert downward pressure on prices everywhere else. But somehow we're supposed to believe that when it comes to drugs, all economic common sense no longer applies, and that somehow higher prices in Canada would drive prices DOWN in the US???


    Are you quite sure you don't have ANY financial interest at all in this industry?.....

  • Report this Comment On September 11, 2009, at 5:06 PM, theinkpen wrote:

    While the cost of resaerch is expensive most of the basic research is done with taxpayers money. Then Big Pharmas take it over and produces a drug which must clear the FDA protocols which are over done, slow and expensive. Make the approval process more efficient and at at a lower cost. Also if a drug has passed the approval process in other Countries, why must we redo the same trials here in the US?

    Cut out the public advertising of prescription drugs, the public can not determine if that drug is appropriate for them, they see the expensive adds and then demand the pill! Appropriate or not!

    Cut out the expensive "buying" of physicians to prescribe by the pharma representatives.

    And let the public buy from anywhere they can. brand name drugs are the same drug here as in Canada or elsewhere.

    This argument that we pay for research and other countries do not is baloney! The Pharma makes a profit in Canada , Europe and elswhere, just less than the good ole "suckers" in the USA.

  • Report this Comment On September 11, 2009, at 6:44 PM, Kevin062 wrote:

    There has been a lot of name calling and misinformation in this discussion.

    As a practicing doctor it has been my experience that it is indeed a rare and extremely enjoyable encounter to actually have a patient that is willing to DO ANYTHING to help their own situation other than be passively fixed by the doctor or take a pill (preferably a controlled substance). God help you you if you even suggest that most of their pain would be less if their weight was something close to normal and they actually did something with their free time other than watch TV, play video games, text message into the wee hours of the morning, and eat less than 3000 calorie supersized meals with fries. It is NOT someone else's fault that they give whales a bad name.

    I also am against excessive profits and could name you countless instances of medicine practiced for profit but also the mudslinging above needs to be tempered with the sober realization that if there is no profit then NOONE will go into the practice of medicine because they have to still make a living also. Yes there are medical malpractice cases and the victims should be awarded but there are many times more frivolous cases and totally unmerited cases brought continually in order to play a "Legal Lottery Ticket"- if you play enough you might get lucky and win something. Also the courts have consistently ruled that any attempts to countersue or sanction the lawyers who repeatedly engage in this practice would be "detrimental to the access to the courts". In other words there is no penalty for just throwning as many "tickets" into the legal system and hoing you get lucky despite what it costs the inocent to defend in time, money, anguish, and the stress of being attacked and maligned in court. I have personally been named in cases in which I was never even involved but the courts refused to release me despite the evidence provided. Give me a break, if the plaintiff and their lawyer can not produce a vaild and reasonable scenario for the alleged injury then it should be thrown out. If it is obvously frivolous then there should be a penalty for the lawyer in particular and for his client if he knowingly participated in what amounts to an attempt use the court to legally defraud and steal from anyone else. But of course the judges and politicians are not going to risk any ruling that might be to the detriment of their own kind.

  • Report this Comment On September 11, 2009, at 7:12 PM, LeifErickson wrote:

    An oversimplification at best and drug company propaganda at worst. The same drugs are available "cheaply" from a number of other countries like Britain and a number of the largest drug manufacturers are British, Swiss or Swedish so why are we to protect the US manufacturers on the US market when the same companies sell the same products for 1/2 or less on most other markets?

  • Report this Comment On September 11, 2009, at 8:35 PM, KJCC wrote:

    Canada is a fly on the but of an elephant when it comes to worldwide drug sales. Fact of the matter is that the Canadian system works to everyone's contridiction to those in Washington who want to spread missinformation for their own gain and that of the companies lining their pockets. It would seem to me that doing business in the USA is very expensive for the drug companies for a lot of reasons that have little to do with the drugs and a lot to do with the political/medical research culture. Time for a change.

  • Report this Comment On September 11, 2009, at 9:17 PM, ecoloney wrote:

    People need to change their thinking about healthcare and insurance. Why do they think a visit to the doc should be FREE? Look at what would happen if you filed a claim on your house insurance each time you called a plumber/electrician/handyman for the least little thing. Health INSURANCE should be for catastrophic events to keep you from going bust. We should all pay for sniffles, shots, etc. out of pocket. For one thing, that would keep costs down when paying at the counter upon leaving. When I've griped to the doc about his prices being too steep, he replied, "What are you complaining for, you've got insurance." But I won't for long if I keep getting gouged by the doctor.

  • Report this Comment On September 11, 2009, at 9:50 PM, EBerg13 wrote:

    Every time I get sinusitis, my doctor used to give me Bactrim, and I had a $2 co-pay. Last time I saw him, he gave me a designer antibiotic and a $20 coupon to offset the co-pay. After insurance and the $20, I had a $56 bill. Why did I need this? An honest physician will tell you they get some pretty good perks if they write scripts for the new and expensive stuff. The sad thing is, this new stuff will make bacteria more virulent. As for me, I get my generic celebrix from Canada Drugs, cheaper without insurance than it is in the states with it.

    No, I am not shedding tears for the big drug companies. Nor am I inclined to, since I do not own their stock.

  • Report this Comment On September 12, 2009, at 2:41 AM, BlakeFooling wrote:

    Wow, long thread...a lot of good are a few of mine regarding medical tort reform:

    1) Limit lawyers take on lawsuit settlements. Force lawyers to document hours spent on lawsuits and limit their compensation to no more than $1000 per hour (plus expenses). Yes I know they lose some cases and may not be compensated at all, but maybe this implies the suit should not have been filed in the first place or they are simply bad lawyers. The settlement money should go to the plaintiff.

    2) Instead of huge punitive awards aimed at punishing pharma companies, how about appropriate prison sentences for those pharma employees that were involved in the gross negligence in these lawsuits. Maybe a few more dotted i's and crossed t's will result before questionable drugs are release to the public.

    3) How about exposing those physicians that take 'bribes' for treating patients with questionable drugs. In the recent record Pfizer settlement 'Federal authorities said Pfizer paid doctors' expenses to attend meetings at resort locations, where some were treated to massages, golf and other activities'. Doctors should not profit from prescribing drugs to patients.

    I probably have upset lawyers, executives, and doctors with these comments. However, these actions will definitely limit medical lawsuits filed in our court systems.

  • Report this Comment On September 12, 2009, at 7:26 AM, alpoz wrote:

    when it comes to research and developement most people dont realize the tax breaks involved for the companies. An example is in Australia where for every dollar spent on R+D a tax rebate of $1.50 is granted. so the companies profit is 50% before the product is even manufactured and sold. check it out for other countries and companies such as the vehicle manufacturering industry. Your next car could be cheaper too.

  • Report this Comment On September 12, 2009, at 9:30 AM, pdono5 wrote:

    The drugs produced by the pharmaceutical companies are as much the cause of poor health in America as any other factor, including malnutrition, which is one of the major causes of poor health in the US. The over reliance on drugs as the answer to everything is foolhardy at best. There are way too many drugs on the market and research for new ones should be pared back in many areas and research effort should be focused on areas of greatest need. As things exist now r&d serves to secure companies place in the market more than contribute to the Nation's health.

    Many patients in hospitals improve by simply canceling their entire drug profile. I've seen it happen numerous times

  • Report this Comment On September 12, 2009, at 9:44 AM, greyhound44 wrote:

    I live in Mexico, but have been buying Lipitor in Canada for 6+ years (

    I last paid US$134.10 incl S&H for a 180 day supply (I buy 20mg #90 and cut them in half).

    One can buy generic Atorvastatin from for a bit less.

    Interestingly, I'll be on MC 1 Dec and my Part D (drug coverage) will not reimburse a penny spent in Canada, but will pay a bit for the same US product.

    My share will be US$67. a month!!

    Looks like I'll continue to use the Canadian pharmacy!

    ret expat MD

  • Report this Comment On September 12, 2009, at 10:18 AM, perseus12 wrote:

    Hi everyone!! hello, from Sydney Australia here, I know a possible way how we can improve the health care system efficiently and saving costs at the same time, I am currently having a plan to go to US and study data mining analytics, I read in a book "making sense of data" by Glenn J Myatt, it is mentioned that someone has built a predictive system through a statistical/data mining algorithms by utilizing clinical patient data on Female Pima Indian population in Arizona, they were able to build a model that can predict who will get diabetes diseases in the next 5 years within 85% accuracy by utilizing data such as age, weight, DPF(Diabetes Pedigree Factor), insulin level, blood sugar level, how many times she is pregnant, I was wondering if you guys in America or the whole world are collecting those kind of data and asking your statistician/analytics expert, doctor, medical practitioner and scientist, we might have been able to build a predictive model for other kind of diseases like heart failures, hypertension/strokes, cancer, all sort of degenerative diseases as those kind of diseases above is caused by cell aging so the risk increased along with age, there are also techniques called deviation analysis, so if the model are encountering an out of world cases like a 16 or 20 year old teens who got a cancer of some sort because of certain genetics defects, we can investigate this unique/outlier/extreme cases and add more information or dimension or input variables into our predictive model to make it more accurate next time it encounters similar situations, researchers in data mining areas has found ways/algorithms that use the working of human brains like neural networks, or sensitive algorithms like adaptive fuzzy feature maps developed by American heuristics that can recognize rare patterns in the data to predict those rare cases like teens who got cancer etc, the real challenge is collecting sufficient quality data, mapping the problem into a statistical/mathematical model suitable for algorithm to work on, these techniques can even found correlation/relationship in the data like an association rules analysis: if a person smoke and his/her bodyweight are over certain kgs then what is his/her probability of getting heart diseases by certain percent, provided we have those predictive system for those diseases we can discover that there is a pattern for diseases to creep in into our body, the more data we have and the more model we have in our disposals, the more we would understand and predict the likely occurrences of diseases. Of course I didn't say this system is 100% fool proof or it can predict all diseases, but if you look all those diseases statistics, the biggest killers are those degenerative diseases, so if we know the factors that leads to those diseases, we can apply a preventive therapy that can save your lives in the future for those who are most endangered or a clear pattern existed on him/her that has been known to led to this diseases, a preventive therapy like regular exercises several hours for a week can then be incorporated in the model that can compute the reduction of probability of this person to get a diseases, it is a far more effective approach than treat the diseases I am hopeful when I've finished my study in America, I can participate in those kinds of projects, we should let everyone know about this because hopefully we can improve your living quality or life expectancy by preventing you or your family from getting or having a lifestyles that can let to these diseases at the first time, some expert has even try to use these techniques to analyzes DNA to isolate genetic defects or broken DNA that can lead to degenerative diseases like hemophilia, it is unclear how they are going to treat it, either through genetic therapy, developing new wonder drugs that can read DNA and target malignant cancer cells only(has different genetic structures than healthy cell) I am suggesting since we know in motley fool that someone has successfully made micro robots, we might want to inject these robots into our bodies to collect real time data about our body or health like blood pressures, nerve impulses, perspiration, hormone secretions/productions, all those vital statistics needed by those data mining model to monitor and update those information into a computer system through a wireless connections, maybe in the future we all can monitor and understand whats going on within our own body or develop system like early warning preventions for diseases or unhealthy living, there is a pearl of wisdom saying "1kg of prevention worths 1 ton of treatment" of course there is an ethical issues about this, first of all of course we know that your health information is a confidential matter between you and your doctors, there might be danger of possible hacker attacks to alter or damage the system or stealing your personal info, or unauthorized use of your information for bad purposes like charging you more for health insurance, hey but I think health insurers would love u to have it since that means less risk or less likely occurrence to get those diseases if we get an accurate warning system like that, if anyone had a political connection to the congress or pres. Barack Obama please tell them about it, we need the congress to discuss about this and making laws about the ethical issues of data collection and system implementation, but imagine if we can do that, we can save countless millions of lives or improve living quality, and if it works in America we can export it all over the world, American ingenuity lead the way again!, Gee all this pessimism about Iraq, Afghanistan, war on terror, GFC had made America down as a nation but I think America still and will find a way to adapt and changes to the challenges that lies ahead like it has been proven in her history, this I think is one of them!, thanks everyone, and I hope you all have faith in God/Jesus because if all else fails, you wouldn't want to be under insured for the Life after would you? Thanks for reading and God Bless all!

  • Report this Comment On September 12, 2009, at 1:57 PM, Phipsd53 wrote:

    The US is the only country that doesn't try to negotiate a better price for it's drugs. Negotiation is part of business and the heart of the free enterprise system. Other countries use their pricing power to get a better deal. Americans don't so they pay much more for their drugs.

    That's Canada's fault? Moronic.

  • Report this Comment On September 12, 2009, at 2:13 PM, data4us wrote:

    Anyone who thinks any drug company is going to reduce charges here in exchange for higher rates in Canada does not understand capitalism or profit motive. They rob the poor to give to the rich everyday.

  • Report this Comment On September 12, 2009, at 3:27 PM, Rolin4ward wrote:

    If drug companies find a way to charge more in Canada they will and still keep the prices high in the United States. There's no reason for them to lower profits from a gravy train no matter where it's coming from. There's already a deal between the U.S. government and Big Pharma in regards to drug pricing.( to a couple newspapers who wrote a story on this just recently). Stop blaming Canada for us stabbing ourselves in the foot.

    A lot of the research is subsidized is it not? A lot is done at Universities that are given huge donations by the drug industry. Not an unbiased scenario.

    Over 10,000 dollars, PER PHYSICIAN, PER YEAR,is spent towards drug reps lobbying doctors. Let's make that illegal for a start as well as kicking the drug company lobbying out of medical schools.

    And now, the pharmaceutical companies aren't liable for any side effects of the drugs and vaccines they make. That happened not long after the Vioxx legal disaster. As a result here's no liability for the new, UNTESTED, Swine Flue Vaccine so that ought to increase profits for Big Pharma also.

    I read that one country got so fed up with Big Pharma's greed that it shunned the international patents and started producing it's own HIV drugs because the prices were so high no one in that third world country could afford to pay and people were dying. Did anyone else see this?

    I almost have to wonder if this article was written to incite response to see where the opposition to Big Pharma is. It really smells.

  • Report this Comment On September 12, 2009, at 5:15 PM, Gardnermiles wrote:

    U,S. Pharma is so big they and the ACLU pretty much run our country. Donations to politicians, bribery like the Russian Pharmaceutical Co. Folk's it's all to do with the money. money, money. American's are alway's saying the Canucks are poor tippers at restaurants. In Canada the tip is included in the bill. It's Americans who are so greedy. I am talking about the CEO's and top management who are never satisfied not the average American, I think the time is now to bring these guys down a peg or two. They can start sailing smaller craft and save gasoline and lower our gas comsumption and our pollution. They should be ashamed of themselves living on such a grand scale when they pass the homes of the poor on their way to work and seeing how they have to skimp. They are Americans and part of your country. We may not be rich like you but we can hold our heads high and be proud of our actions. We don't fleece the public.

  • Report this Comment On September 12, 2009, at 6:55 PM, Rmorejr wrote:

    Obviously, this article isn't just about Canada, but about the total sum of the economies of the world which control prices for pharmaceuticals(or any other commodity, far that matter). By limiting the profits that a company can make in a certain market, those companies will obviously adjust their business model to make up the profits "elsewhere". At the moment, "elsewhere" is primarily the US market. This business model must apply to all the worlds Pharmaceutical companies, not just the ones headquartered in the US. Those who read this article and hyper-focused on the example of Canada entirely missed the point of the article, letting their emotions do the thinking for them (after-all, 'reactions' speak louder than words).

    What happens when the US finally buckles under and starts placing domestic price controls, in one manner or the other, on drugs? I don't know. Maybe the drug company's will make up the profits by increasing efficiency. Or maybe they will put pressure on the worlds other economies to raise prices "or else". My guess, is that both measures will be implemented. In the meantime, the current business model will be the most successful, and, as has been the case since the beginning of the modern world economy, the US will subsidize the rest of the world, and apparently be happy to do so, as is obvious by the current lack of evidence to the contrary.

  • Report this Comment On September 12, 2009, at 7:27 PM, Annie1139 wrote:

    In the past few years two of my relatives have suffered severe side effects from prescription medications. In one case, the problems stemming from Fosomax, a drug used by millions of women, caused months of increasing misery, culminating in a 10-day hospital stay that included an endoscopy and a colonscopy. Luckily, once the drug was stopped, my relative returned to her normal good health. In the other case, the use of Lipitor for an elderly woman recovering from a stroke resulted in a reversal of the progress she had been making and a severe deterioriation in both her physical and mental health. When the use of the statin was stopped--at our insistence, not through any independent action on the part of her physician--her condition improved, but only partially and even now, a year later, she is not doing nearly so well as she had been.

    These disturbing events led me to do a great deal of research about what is going on with the use of drugs in this country and my findings are disturbing in the extreme. I suggest that anyone who thinks that the pharmaceutical industry has our best interests at heart might try reading books and/or articles by people such as Dr. Marcia Angell, Dr. Jay Cohen, Melody Petersen, Justin Smith, or Dr. John Abramson. These people are not cranks or fringe lunatics; even if you don't in the end agree with everything they have to say, you will be enlightened. Even Business Week in January 2008 carried an article entitled "Do Cholesterol Drugs Do Any Good?" ( It's a good place to begin to get a picture of just what is going on.

  • Report this Comment On September 12, 2009, at 7:30 PM, Rmorejr wrote:

    It amazes me that so many readers of a forum on capitalism don't appear to understand 'sound' capitalism at all. The only reason a company charges a certain price for something is because they can't charge more. The reason they can't charge more is primarily due to competition and supply and demand. If they attempt to over-charge for something, they risk the very real possibility of harming their future profits, since the vast majority of their customers have options. If the cost of drugs were allowed to rise in Canada (and the rest of the world), then any company with an ounce of business sense would lower the price domestically in an attempt to expand their customer base by a) taking customers from the competition, and b) using lower costs to attract new customers into the the market. They would do this because the increased costs overseas would allow them to maintain their current profit margin, while expanding their customer base.

    This is "Capitalism 101"

    People, stop being so cynical and start thinking like the worlds premier capitalists that we are. Any good capitalist knows that outright greed is ultimately self-defeating. Regardless of the industry, sustained profits come from a smart business model and nothing else. If you find someone who appears to be excessively greedy, then they are not a very good capitalist, since their greed will ultimately lead to countering "sustained profits" and they should be immediately called to the carpet for their actions. ESPECIALLY IF THEY ARE AN OFFICER IN A PUBLIC COMPANY ( as far as I'm concerned, private companies should be allowed to crash and burn as they seem fit). Their (the greedy ones) lack of responsibility should be vigorously guarded against, They should not, however, be seen as 'typical'. For every one of them, there are countless others who 'get it'.

  • Report this Comment On September 12, 2009, at 8:33 PM, wchopkins wrote:

    While I mean no personal disrespect to Mr. Orelli, let me come down squarely on the side of those who condemn him for either gross ignorance or for being a closet shill of Big Phrma. The excellent comments suggesting he and others read the excellent books by Dr. Angell and others is a good starting point.

    It is all summarized by this: these drugs for the most part are dirt cheap (and "dirt cheap" is not an exaggeration. often fractions of a cent per dose to make, including distribution, etc. no research to speak of. patents long expired on the drug itself. billions reaped on the packaging and the exclusion of competition.) I won't even bother with examples, as they abound. A cursory review of the cost of medications around the world demonstrates that Americans pay approximately 10x the rest of the world, simply because the American (and global) pharmaceutical industry owns Congress and the FDA, lock stock and barrel.

    OK, I lied. One example: Thalidomide- $6 per pill in 1998. $148 per pill in 2007. 50+ year old drug. Zero research. Cheap to manufacture. Brazil - $.07 per pill. More examples abound. Check out Oxycontin. Read the details of the 2004 Medicare part D bill passage. If you can stand the stench.

    It is long time past the day when the average American stands up for a level playing field in the world of commerce and representative who are not bought and paid for. Where is Teddy Roosevelt when we need him? Eisenhower warned us. The country's founders warned us. Why is it so hard to remember these warnings and act responsibly?

    Make the playing field level. Get representatives to represent their constituents. Get the FDA back to its stated role. Prices of drugs will drop like a rock and still be safe. And the competent manufacturers will still make a good profit.

    WCH, MD

    38 years of disgustedly watching from the front row as Big Phrma successfully shafts the far too complacent American consumer. No, I don't get many Big Phrma invitations these days.

  • Report this Comment On September 12, 2009, at 11:22 PM, tocker100 wrote:

    Regarding drugs..not only do I blame Canada, but the EU and the other free loading countries having govt run health care systems and 2nd/3rd World countries. Not really, I blame our Congress, but it is true that US consumers suck up the costs of the majority of major drug and medical innovations in the world.

    I don't think that any American should have health care that they don't personally pay for from their own pay check. A number of other policy issues are at the root of our problems. Our lack of immigration controls and barriers to free and open absurd litigation awards, an unending pot of Medicare waste and Drs and hospitals spreading the cost of non-payers to the rest who do. So, we need rules to encourage competition... besides we can't pay for the programs that are in place defies every logical economic theory that we can cover more people and bring the overall cost of health care down. Democrats can spin this any way they want, but the facts are not on their side.

    When we get back to the purest form of competition and stop the handouts, all will get better...I'll bet it will happen right after the peak of the 'whiniest generation' of boomers (of which I am one) is gone.

  • Report this Comment On September 13, 2009, at 12:06 AM, Veloci wrote:

    "The diference in the US system and those of other industrialized countries is a core belief in the US that all things government are bad and all things operating under free enterprise are good. If this were true we wouldn't need this debate.

    Just look at the VA,a government run system, which is held up as an example of efficiency world wide."

    OMG! I'm a vet and the VA is HORRIBLE to get anything done.

    And on another topic, I see thateveryone has had drug insurance for so long that they have no idea how normal pricing (at your local pharmacist, not the hospital) works.

    If you paid the same markup for 30 seconal (a sleep medication) as you do for a shirt (that $50 shirt wholesales for about $25) you'd pay about $1.15. Instead you'll pay probably $15-20. That's because you pay for having the perscription filled, not for the drug. In more expensive drugs (wholesale over about $20) it changes to normal retail markups.

    The problem is much more complex than anyone on this site realizes.

  • Report this Comment On September 13, 2009, at 12:14 AM, Veloci wrote:

    Here's another way to reduce total drug expenditures in the US. Type 2 diabetes in kids is disasterous. THe followin is a bit off (year and number wise) but close enough that you'll get the idea.

    In 1970, 37% of schoolage children rode their bicycles to school. They school-age obesity rate was 3%. In 2006, 3% sof schoolage children rode their bicycles to school and the obesity rate was 37%.

    A healthier lifestyle will go a long way to reduce drug costs.

  • Report this Comment On September 13, 2009, at 2:10 AM, theHedgehog wrote:

    "Just look at the VA,a government run system, which is held up as an example of efficiency world wide."

    OMG! I'm a vet and the VA is HORRIBLE to get anything done."

    I'm a vet, too, and they treat me pretty good.

  • Report this Comment On September 13, 2009, at 11:47 AM, SKERICHERI wrote:

    The pharmaceutical industry is to blame for the high cost of medications.

    According to a 2008 Fortune 500 pharmaceutical companies occupy the 3rd slot on their list of the 53 most profitable industries.

    They have been gouging us for years. According to a Fair Trade Commission study released in June:

    Consumers, insurance companies and the federal government spend an extra $3.5 billion for prescription drugs every year because brand-name companies pay generic producers to stay out of the market.

  • Report this Comment On September 13, 2009, at 1:34 PM, Chuci wrote:

    Funny there are so many posts that people still believe that other countries are responsible for America's prescription issues? Wake up folks. Remember Lincoln's speech about government of the people, by the people, for the people? Maybe start looking from within before you point fingers elsewhere. I don't believe for a second that drug companies provide medicines to other countries at a loss and Americans get to pick up the difference. Must be big can of glue that someone's inhaling. Or is it that a lie told long enough becomes believable.

    As a Canadian my understanding of American Society is that when you don't agree with something you go out and protest? Why aren't there massive million person marches on Capitol Hill a la Vietnam? Why are you so complacent on such a huge issue - when typically Canada is the complacent country. Your government is party to killing your citizens - OK - sorry, allowing citizens to die. Isn't this a crime?

    Our system has flaws - no doubt - no system is perfect. From my perspective, based on your news, Americans seem more fearful of "Socialized Medicine" than the health of your people. Yes, I pay slightly higher taxes, but I also know that at any time in my life, pre-existing condition or not, when I need treatment - I'll get it and be covered. Thank you Tommy Douglas. Oh - I can pick my doctor too.

    I pay about $110 a month for our provincial healthcare insurance premiums. I had a 2-month stay in the hospital last year. My only additional expense was the $75 ambulance fee to get me there. I never received a bill detailing the .50 piece of gauze they charged me $5.00 for

    I was treated immediately (unlike many of the scare tactics I've heard from some of your politicians). Having other visits to the emergency room, you will wait if your situation isn't dire. If you go into emergency with chest pains - guess what, you're treated right away with no waits. Cut your finger and need stitches, you might be there for a couple hours.

    I think that's better than letting citizens die because they can't afford to go to a Dr. in time before an issues gets to the point of needing emergency care. It wouldn't surprise me if you lose more citizens per capita to the unavailability of healthcare due to poverty or pre-existing conditions, than we lose to alleged 'horrific' wait times in our horribly socialzed medical system.

  • Report this Comment On September 13, 2009, at 7:27 PM, danasbenson wrote:

    I have two comments as i take a drug and have been taking it for years and it is very expensive. it should have been off patent years ago but everytine it gets close they change the things that it is indicated for ( asthma, then allergies, then kid allergies etc. so it stays expensive. and unfortunately i and many others need it and continue to pay the price. another drug that i take is for hypertension. this drug is a combination of two drugs. doesn't change the efficacy but is more for convenience. well when it went generic the price didn't change because the drug company still continues to make it in generic form and still charges and exhorbitant amout. the only way i was able to lower the amount is by taking the two drugs separately, no biggie, because my insurance plan puts those separate drugs in level one and the combo in level three. so i know i really feel sorry for the companies. and the advertising is sometimes practically criminal. i am certain by the adds that every person in the us is depressed and need one or two antidepressants. don't know how the majority of us lived without them. you know sometimes life is depressing. and i am in no way denigrating the patients who actually have chronic depression. i just don't think everyone is depressed. it is the arrival of "brave new world" take a pill for everything.

  • Report this Comment On September 14, 2009, at 11:28 AM, usul2525 wrote:

    Shame on everyone here. This is capitalism. They charge what the market will bear. Just like everyone here please. I bet know one here looks for the job that pay's the least. Stop complaing and go to work,

  • Report this Comment On September 14, 2009, at 3:21 PM, spundun wrote:

    Can someone tell us what are the blockbuster patents mentioned? And when are they expiring?

  • Report this Comment On September 14, 2009, at 3:29 PM, catoismymotor wrote:

    This is comment #154. It matter not at all what I type because my thoughts would only get lost in the crowd.

  • Report this Comment On September 14, 2009, at 3:36 PM, harviau wrote:

    The Canadian government (and many other developed nations around the world) draw up a list of drugs that work (as opposed to having a menu of drugs as most US doctors do) and negotiate a price for a specific drug to be supplied to their market. The drugs are then paid for by Canadian consumers from their OWN pockets. So in effect the Canadian government looks at what is available, determines which ones are worth purchasing and negotiates and price on behalf of its citizens, who then go out an purchase the drugs at that price. They have a simple buying group - one with actual power. You cannot get every drug under the sun in Canada and you pay for it out of your own pocket. This is same system in Australia and England for the most part.

    There are a number of native drug companies in England/Canada/Australia that use university based research and produce drugs for their local markets (and they have to go through the government as well). They do not advertised (actually illegal for them to do so) and legal payouts are where near the levels in the US, the courts cut down payments to something reasonable. These companies also spend MORE on R&D than US drug companies do when you look at their relative capitalisations. The biggest problem I have with this subject is the notion that if US consumers did not pay the extortion rates required by the US drug companies that somehow we wont get the drugs we need ... the amount R&D spent by the big pharmaceutical companies are much less then many of our industries, including computing etc ... those industries are doing just fine even with prices coming down.

    You are blaming the Candians for your own stupidity.

  • Report this Comment On September 15, 2009, at 2:26 PM, anotherjames wrote:

    Dear Editors,

    Thuroughly unimpressed.



  • Report this Comment On September 16, 2009, at 2:07 AM, Rich4im wrote:

    The reason drugs are cheaper in Canada is because Canadians have lower disposable income. The average disposable income for a Canadian is $24,400 while the average disposable income for an American is $39,260 (Statistics Canada, in Canadian dollars, 2005).

    The lower prices are not because of the Canadian health care system. At the end of the day it's about maximum profits for the drug companies. They charge what the market will bear. And Americans can afford to pay a lot more for drugs than Canadians do. It's entirely fair for Americans to carry the larger load here -- they want the newest research and have the most $ to pay for it.

  • Report this Comment On September 16, 2009, at 1:08 PM, sueshe39 wrote:

    your right developing prozac - weight loss drugs and viagra is very very expensive - doesn t this tell us what american drug companies are all about - what nonsense - All drugs that save lives should be declared public property and their patents should fall into the public domain immediately - because people who do not have access to the medicine they need because of cost and die as result of not having access is called a murder and is not acceptable. In Europe those classes of drugs are free....

  • Report this Comment On September 16, 2009, at 1:46 PM, SmartSaver22 wrote:

    Some US firms have now launched a service which allows customers to verify the credentials of Canadian pharmacies before purchasing drugs from them. These firms provide information about the legal status of a pharmacy online. Pharmacies interested in going through this verification process are to first approach these sites and fill in a form that certifies that they are operating within the framework of laws of applicable jurisdictional laws. These pharmacies should comply with laws in both the city from where they are operating and the area where they are selling their products. The verification agency will then independently investigate the pharmacy and find out if the details furnished in the form submitted are true or not. One being cleared, the pharmacy website will be allowed to display a seal which indicates certification by the verifying agency.


    Look after your pennies, and your pounds will look after themselves.

  • Report this Comment On September 16, 2009, at 6:51 PM, SpaceVegetable wrote:

    One thing that's been overlooked here is that there is a need for more than one drug to treat the same condition because everyone reacts differently to medication. It's great to say that people should live a healthier lifestyle and thus prevent the need for a lot of drugs, but what about those of us who have chronic conditions through no fault of our own? I have had rheumatoid arthritis since I was 16 and have 9 prescriptions to treat it. Some drugs I tried didn't work for me or had side effects that contraindicated their use. One drug I take would cost me nearly $1500/month without insurance. I unfortunately need more expensive/newer drugs sometimes when the older, cheaper one don't work or stop working.

    I'm all for catastrophic care for everyone, but some of us are more high-maintenance than others and would need additional coverage. I pay high premiums for my small group plan through my own company and it ends up being cheaper than paying deductibles and co-insurance for someone who is a frequent user of doctors and medications.

    I'm fortunate to be able to afford my insurance, but if I couldn't get the medications I would need, I wouldn't be able to work and pay taxes, etc... It would probably be cheaper for the government to subsidize at least part of my health care than to support me completely if I couldn't work.

    One of my biggest concerns about single-payer is getting access to what I need. I've already had some joints replaced and will be needing others at a relatively young age. I don't want to end up being told to live with the pain until I'm X years old, just because of statistics saying it's the most cost-effective treatment. There's a quality of life issue here, as well. Even with good insurance it can be tough to get coverage for something if they consider them experimental. Ankle replacements, for example, have been available for years, yet some insurance companies consider them experimental and won't pay. They will cover ankle fusion, though, which would lead to more wear and tear on other joints like knees and hips and speed their deterioration since the load has to be handled somewhere if the ankle can't do it. I worry that policies like these will proliferate in a single-payer system and lead to less coverage and more expense for people like me. I don't begrudge giving coverage to those who have none, but I don't want people like me to be lost in the shuffle. Am I selfish? Maybe, but I don't think wanting less pain and more mobility makes me evil :-)

  • Report this Comment On September 21, 2009, at 11:08 AM, teamdixon1 wrote:

    We need to tell the drug companies to get their ads OFF of the TV. I am sick of seeing commercials about prescription drugs. Doctors and nurses need to inform patients of the choices and then patients can do their own research if they so desire. TV advertising is expensive and intrusive. Americans as a whole do not need to pay for this via passing higher costs on to the consumer. Part of the any health care reform should include BANNING drug ads from TV like we banned cigarette ads from TV back in the 1960's.

  • Report this Comment On September 22, 2009, at 11:27 AM, keleevin wrote:

    Article by Brian Orelli sucks. Lacks depth. Always easier to point fingers at others than themselves.

    The article already highlighted potential ways to cut cost: [1] ban advertisements; [2] legal liabilities; etc. But having a heading like '...Blame XXX' is used.

    Is this country trying to divert attention to the real problem?

    Do we have a bigger sick population in Canada or USA? Come'on USA population is heading for big health disaster in coming years. More diabetes?

    It's one country (developed) where it has amongst the lowest average life expectancy. So what's the big deal if you can find the best medicine on earth.

    What can pharma companies do to you (or make money from you) if you are healthy?

  • Report this Comment On October 05, 2009, at 7:14 PM, NOTBORNSTUPID wrote:

    Brian Orelli, Who do you work for. This whole article is so biased I would believe that the Neocons and Faux news pays your salary. Though I would believe this article is not worth the paper it is printed on.

    The HEALTH INDUSTRY as a whole is the new MAFIA of this era... They are the puppet masters of the entire Congress and governing bodies.

    I also have waited in Dr offices while the cute well dressed drug reps get preferential time with the Dr's. while sick people are waiting to be treated.

    They only invest in manipulating the government and medical industry. How much is the government paying for their research too?

    Enough...with the BS Canada has nothing to do with the conspiracy of the health care industry to bleed us all dry and let Americans die from non treatment due to exorbitant health care and drug costs.

  • Report this Comment On December 22, 2009, at 6:33 PM, Fool wrote:

    This guy is just retarted y woould u blame canada, try blaming the american government, not our fault canada has better health then america

  • Report this Comment On June 08, 2010, at 5:01 PM, mDuo13 wrote:

    @RaulChapin: Your argument that US consumers pay more because they get the more cutting-edge treatment is flawed for two reasons:

    (1) Canadians and members of other countries are not getting the last generation of these drugs, they are getting THE SAME DRUGS at lower prices.

    (2) Evidence shows overwhelmingly that citizens of the United States live SHORTER lives, on average, than citizens of most other developed countries. Sure, there are probably other factors (obesity, working too much, car culture) but then the point stands that American health industry is not addressing these factors as well as public health-care systems in other countries.

    The author of the article rather humorously makes a serious point that public health-care systems in other countries may be interfering with the free market... but as many commentors before me point out, there are probably many other more-significant factors impacting drug & health care costs.

  • Report this Comment On December 29, 2010, at 2:33 AM, jgreen48 wrote:

    yeah its true that the manufacturers spend a lot in manufacturing of the medicines.That's why the common people have to suffer.I think the government must do something against this inorder to lessen the cost of production of these medicines so that the consumer will get benefit.Thanks

  • Report this Comment On December 29, 2010, at 3:42 AM, jgreen48 wrote:

    The nature and extent of prescription drug benefits for the elderly are a continuing concern for health-care managers and policy makers. This study examined the impact of increased prescription drug cost-sharing on the drug and medical care utilization and expenses of the elderly. Methods. Two groups of well-insured Medicare risk-based members of a large health maintenance organization (HMO) had their copayments increased in different years during a 3-year period. Four 2-year analysis periods were established for comparing these elderly groups

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  • Report this Comment On February 08, 2011, at 8:40 AM, ozonemattew wrote:

    This is highly informatics, crisp and clear. I think that Everything has been described in systematic manner so that reader could get maximum information and learn many things

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