Drug Prices

I do not see any need to "replace medical license requirements". We currently have the "reputation system" in place.

As I recall, recent reports show that around 40% of patients use alternative medicine in the past 12 months. Supplement market is huge for most common ailments or prevention. Hospitals in India, Singapore, China, South American, and Southeast Asian countries have been attracting paying foreign (including American) patients in increasing large number due to their high standards and low costs.

Thus, medical licensees in this country are judged as a group like everybody else on reputation. Take away the licensing authority of the medical societies, whom the public rely on? Consumer Reports or Ralph Nader's organization?

"This is the pilot speaking. We have a medical emergency onboard. Is there a five-star rated health practitioner aboard? no license needed of course."

I advocate a Bonding process which replaces Malpractice insurance, as I am sure Underwriters will do the best job of performance appraisal. I suggest a minimum bond of $5m. Failure of appropriate Bond gaining an individual ten years in prison without benefit of Probation or parole. Punitive damages will be limited to the size of the Bond, though the Individual's income can be garnished to pay for remedial costs.

The prior scope of your Post needs examination. The only effective manner for Drug Patent registration may be a two-tier system, where a awarded, stipulated Patent royalty is granted until registered R&D costs are recouped, then a much lower Patent royalty is granted thereafter--posssibly only minescule in amount for perpetuaty. The incentive remains, but the amounts allowed are regulated. lgl

And how, exactly, is the FDA going to assign these letter grades without clinical trials?

Frankly this is market-worship at its worst. Information is not free, and relying on a "reputation system" for medical practitioners or drugs is likely to have huge costs.

Thank you for bringing these facts to light.

Quan Nguyen raises a serious point that I overlooked in my previous comment.

A reputation system depends on consumers making informed choices. In an emergency, how is the patient going to make such a choice? Doesn't there have to be a minimum standard that practitioners must meet, and isn't that what a licensing system aims at?

Portraying Big Pharma, the poster child for state capitalism and corporate welfare if their ever was one, as a victim of "anti-market" bias takes chutzpah. Do away with their patents, the half of their R&D funding that's carried out on the taxpayer's teat, and their reliance on the FDA and the licensing boards' "standards of practice" to suppress competition, and I'll take that seriously. The drug industry has about as much to do with the "free market" as ADM's Dwayne Andreas, who said "The competitor is our friend; the customer is our enemy."

The entire thing about importing drugs from Canada is a tempest in a teapot that does not meet the basic test of common sense. Importing drugs from Canada is taking advantage of a loop hole. As long as a few people do it they can get away with exploiting the loophole. But once a significant number of people try to import drugs from canada the system will break down. Put the numbers for Canada vs the USA in perspective and you will see that the issue is not worth your time thinking about.

"And how, exactly, is the FDA going to assign these letter grades without clinical trials?

Frankly this is market-worship at its worst. Information is not free, and relying on a "reputation system" for medical practitioners or drugs is likely to have huge costs."

Having a 10-15 year ban on new drugs also has huge costs.

There are situations where people will need to take drugs even if they haven't been through the whole testing process - is it right for the FDA to deny them their shot at survival and seal their doom? I think not.

"A reputation system depends on consumers making informed choices. In an emergency, how is the patient going to make such a choice? Doesn't there have to be a minimum standard that practitioners must meet, and isn't that what a licensing system aims at? "

Well, a reputation system, just like a licensing system, only requires someone to make informed choices and prove themselves trustworthy, and not necessarily the people having the emergency. The only difference between a reputation system and a licensing board is that the private operators lack the power to make their word into law, and thus must prove their judgements trustworthy. And long before you have an emergency, you will have plenty of opportunity to decide whose judgement you will accept.

And how do you propose to measure the quality of a practitioner? I'm fairly ignorant of health economics, but if you revoke or "downgrade" a medical practitioner for each "error", it would seem like providers of health care would see incentives to perform only risk-free procedures, thus starving the market for procedures that can possibly give rise to such penalties. In addition, grading would seem to only punish those who have wronged (intentionally or not), instead of rewarding those who do well.