Hacker News Reader

Comment by lotsofpulp | Hacker News Reader

No one is stopping government leaders from spending money to develop, trial, manufacture, and sell medicine.

Yet not a single candidate campaigns on this initiative.

Also, patents are not a “natural” monopoly.

The article makes it clear the crazy-high rates for these drugs aren't because of the price hospitals pay for the drugs, but hospital mark-up.

Does the medicine expire quickly? Or does the cost of storing it/administer it differ from other medicine?

Hospital profit margins don’t seem particularly high (~10%).

https://www.macrotrends.net/stocks/charts/HCA/hca-healthcare...

The other publicly listed company I could find is Tenet, which doesn’t do so well:

https://www.macrotrends.net/stocks/charts/THC/tenet-healthca...

> Why the high price? One explanation is that hospitals can — and do — mark up products to balance overhead costs and generate revenue.

This is something all businesses do. Some products/services are sold at higher margin than other products/services, for a variety of reasons.

Edit: CHS is the other large publicly listed hospital company, also has very low profit margins.

https://www.macrotrends.net/stocks/charts/CHSCP/chs-inc/prof...

More and more hospitals are owned by for-profit corporations that own many rather than administered by municipalities and non-profits. They're all about profits, rarely outcomes, as the evidence shows.

This doesn’t seem to be true, at least as of 2013:

https://www.statista.com/statistics/824788/total-number-of-f...

The numbers seem like they trend downwards, with 1,219 in 2024.

https://www.aha.org/system/files/media/file/2024/01/fast-fac...

The two hospitals in the linked article are government owned.

https://en.wikipedia.org/wiki/Palomar_Health

https://en.wikipedia.org/wiki/Rady_Children%27s_Hospital

Then you haven't been paying attention or your sources are inadequate.

> From 2013 to 2017, nearly 1 in 5 of the nation's 5,500-plus hospitals were acquired or merged with another hospital

https://www.usnews.com/news/healthiest-communities/articles/...

https://www.pbs.org/wgbh/frontline/documentary/the-healthcar...

https://hms.harvard.edu/news/what-happens-when-private-equit...

My experience (SE Michigan) is that a large "non-profit" hospital can be every bit as horrible as a for-profit one. There ain't no "be nice" requirement in the legal definition of nonprofit. And once you're talking billions of dollars, with big-ego executives and income streams that are independent of the org's actual do-good cred...yeah. Things get very feudal.

What do you mean "no one is stopping"? The "ones stopping" are lobbiests and their associated bribes.

They can try to influence, but they are not successful all the time. I would bet the American public does not have the stomach for government spending on risky trials that more often than not fail to result in a medicine.

I don’t think any government in the world does.

The US government does most of the hard work on medicine. Pharma takes over from there. It's quite literally privatizing the successes and tax payer funded failures.

If that was true, then it should be a slam dunk for a party to win elections on reducing the cost of medicine by obviating pharmaceutical companies, the businesses with the highest or second highest profit margin in the healthcare delivery chain. I assume healthcare software (like Epic) perhaps has higher profit margins.

However, I suspect the reality is that the clinical trials cost a ton of money and politicians don’t want to be associated with the failures.

You don't think that Pharma and Insurance aren't paying off both sides? That's rule number 1 in lobbying - you work both sides.

Reply on news.ycombinator.com