For pharma and medical device makers, U.S. is The Big Rock Candy Mountain

The New York Times' Elisabeth Rosenthal is out with another front-page chapter in her incomparable epic detailing the dysfunction of the U.S. healthcare system. She's spotlighted (1, 2, 3) price-gouging by various physician specialties, hospitals, and now medical device makers and pharma.

Rosenthal focuses mainly on diabetes treatment. It really has improved radically over the past two decades, with ever-more sophisticated insulin pumps and accouterments, and synthetic human insulin.  But near-monopoly pricing power -- unmitigated, in the U.S. alone, by strong government pushback -- forces many patients to buy more sophisticated treatment than they need, at astronomical markups. As is de rigeur in Rosenthal's pieces, the contrast with other wealthy countries hurts most. The contrast with the U.K. highlights strengths and, to a lesser extent, weaknesses of a system that contrasts starkly with our own:

In Britain, each hospital negotiates for pumps for its patients, getting prices that are typically less than half those in the United States, Dr. Pickup said. The vial of insulin analogue that Ms. Hayley gets for $200 at an American pharmacy is typically bought by British pharmacists for under $30 and dispensed free....

A little distance on the post-truth campaign

I've been on vacation with my wife in the Finger Lakes and fell off the grid for reasons I won't bore you with -- off completely for one day, near-completely for three. When we get away, usually, I'm eager to dive back into the political/policy news when I can, but this time, my brief forays have felt like dropping into a coal mine.  A bit of distance defamiliarizes our degraded politics and brings home what a high-stakes, dangerous and disgusting contest it is.

Reconnecting for a bit last night, I caught up with this elevated argument from the Romney campaign:

Not our finest hour?

What's missing from the President's short history of the U.K.-U.S. alliance, delivered to Parliament today?

We are the allies who landed at Omaha and Gold, who sacrificed side by side to free a continent from the march of tyranny, and help prosperity flourish from the ruins of war.  And with the founding of NATO –- a British idea –- we joined a transatlantic alliance that has ensured our security for over half a century.


     Together with our allies, we forged a lasting peace from a cold war.  When the Iron Curtain lifted, we expanded our alliance to include the nations of Central and Eastern Europe, and built new bridges to Russia and the former states of the Soviet Union. And when there was strife in the Balkans, we worked together to keep the peace.

Today, after a difficult decade that began with war and ended in recession, our nations have arrived at a pivotal moment once more.  A global economy that once stood on the brink of depression is now stable and recovering.  After years of conflict, the United States has removed 100,000 troops from Iraq, the United Kingdom has removed its forces, and our combat mission there has ended.  In Afghanistan, we’ve broken the Taliban’s momentum and will soon begin a transition to Afghan lead.  And nearly 10 years after 9/11, we have disrupted terrorist networks and dealt al Qaeda a huge blow by killing its leader –- Osama bin Laden.   

Bush and Blair's adventure in Iraq is present only as an absence, a place where troops are removed. No attempt to count the eight-year war and nation-building exercise as an accomplishment of the alliance.

And half the parents are above average

The Times;' Landon Thomas has a story today about welfare benefits in the UK that are not means-tested -- for example, every household with children under 20 gets a child support allowance, regardless of income. One sentence knocked me off-topic into Deep Math:

Research shows that, although payments are promoted as a direct and simple means to allay child poverty by putting money into the hands of needy mothers, nearly half of the payments go to families with above-average incomes.

I suppose a disproportionate percentage of high income families may not have children at home, and that wealthier families may have fewer children on average, so that statement is not as tautological as it may appear.  But still.