How do YOU propose to really overhaul America's current welfare

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   gmwilliamsposted 10 years ago

   
   system as it is currently?  There are people using EBT cards, living and eating better than honest, working people who are constantly struggling, putting food on the table and roofs over their heads.  Number one, there should be a more stringent reinforcement of workfare programs for able bodied welfare recipients.  Welfare recipients can be used to build and contruct roads, clean up parks and recreation centers and do other useful jobs.  A penality of imprisonment should be applied to those welfare recipients who REFUSE to work.   Do YOU agree?  Why?  Why not?

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   Motown2Chitownposted 10 years ago

   I'm actually going to take a chance on this thread.
   
   First, government assistance should be available for minor children, the disabled, and, IMO, senior citizens who need help.  Able bodied adults who CAN work, should work.  In that case, what they receive from the government would be considered "in-kind" wages.  Services and goods provided in lieu of cash wages.
   
   There should be NO reason for a child to starve because their parents are/have been gaming the system.  Nor should they EVER have to go without basic, preventive health care measures.  Same for senior citizens who have paid into a system for the entirety of their adult lives, and simply need some help to be sure that they can both eat AND have access to their maintenance medications.
   
   That said, in order to overhaul the welfare system, other beasts need to be taken down first.  For example-more people need government assistance to provide for health care than anything else.  Overhaul the health care system and make actual health CARE available to all on an ability to pay basis.  And if they can't pay, they should still be able to get routine healthcare and medications.
   
   Second, overhaul the prescription drug industry.  Stop the advertising!  The drug industry is full of crap when it says meds are expensive because of research.  No.  Meds are astronomically expensive because they spend millions of dollars on advertising and promotion and lunches and free samples to doctors.
   
   People need to eat.  Period.  So, give them food stamps, right?  Yes.  For the things that are absolutely necessary for the growth and proper development of their children.  Then (wow, work for welfare!) teach them how to produce and sustain their own food sources.  As their children get older and stronger, help teach them how to contribute to providing food for their families.
   
   Do not, and I mean absolutely do NOT provide cash allowances to parents who are known drug users and lawbreakers.  But, wait, cash buys clothes and shoes for my children (if there's any left after I buy a dime bag or a couple hits of meth).  Well, clothing vouchers or accounts at clothing retailers can do the same thing, and NOT be misappropriated for other things.
   
   I've seen many welfare recipients knocked off the rolls because they are asked to participate in job training and can't do so because of lack of transportation.  Provide that transportation to them and have it repaid in small increments when gainful employment has been secured.
   
   I'm sure I could go on, but that's a start.

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      Quilligrapherposted 10 years agoin reply to this

      Good Evening Mo.
      
      You may have a bunch of good suggestions here but it is hard to tell since none of your claims are supported by any data. One of your claims, however, does appear to be exaggerated. At least, it is contradicted by a number of recent studies. In particular, I am talking about the statement, “the drug industry is full of crap.” I would love to see the numbers that support this claim.
      
      Nearly all of the really big pharmaceutical companies are public companies that must disclose their R&D cost. Furthermore, approval by the FDA clearly marks the end of R&D costs for the US market and the beginning of the marketing and promotional phase. It is not too hard to separate them. 
      
      It is your opinion “meds are astronomically expensive because they [pharmaceutical companies] spend millions of dollars on advertising and promotion and lunches and free samples to doctors.”
      
      Many may spend millions of dollars on promotion, Mo, but many of the larger firms spend billions on research! Rice University noted, “the current drug development process is costly (greater than 1 billion dollars) and requires considerable effort (around 12 to 15 years). Currently, only one in ten drugs entering human clinical trials becomes an approved product.” {1} That is a nine to one losing streak.
      
      Another study printed in Forbes reported how big pharmaceutical firms work on more than one drug at the time. Typically, R&D can cost $5 billion or more per new medicine because so many drug development projects fail. {2}
      
      Analyzing R&D costs over a ten year period, Sanofi developed six new drugs at an average cost of about $10.1B each and Pfizer produced ten new drugs at about $7.8B each. Of the 100 companies compared, 44 had an average cost exceeding $1B. {3}
      
      Bristol-Myers stands out for having focused on understanding human genetics and then using the immune system against cancer. They have had nine drug approvals, including Yervoy for melanoma and Orencia for rheumatoid arthritis, at a per drug cost of just $3.4 billion each.{4}
      
      There are examples of some of the smaller companies having had successes for $300-500 million. At the same time, however, not all companies spend millions of dollars on TV ads and lunches. The reality is that you can not make blanket statements about this or any industry without doing some homework.
      
      It seems to me that “millions of dollars on advertising and promotion and lunches and free samples to doctors” become insignificant when compared to the multi-billions in real total cost to bring a new drug to market.
      
      Of course, I did not create this data. I only repeat them. I would be happy to see anything you can provide to prove them wrong. 
      
      {1} http://events.rice.edu/index.cfm?EventRecord=21057
      {2} http://www.forbes.com/sites/matthewherp … edicine/2/
      {3} http://www.forbes.com/sites/matthewherp … es-ranked/
      {4} http://www.forbes.com/sites/matthewherp … edicine/2/

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         John Holdenposted 10 years agoin reply to this

         Good morning Quilligrapher,
         I do think that the LSE carries a little more weight than Forbes
         
         http://www.pharmamyths.net/files/Biosoc … _Costs.pdf

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            Quilligrapherposted 10 years agoin reply to this

            Hello John. So nice to hear from you.
            
            First, I presented a series of conclusions based upon a fixed set of data. To challenge those conclusions, address their flaws or point out the errors in the basic data. My conclusions are not drawn from the work of Joseph DiMasi, et. al., so a link to a paper that attacks his work is just a strawman designed to deflect attention onto an irreverent distraction.
            
            Secondly, pedigree is probably the least effective of all arguments. There is never a need to attack a source when you can attack the arguments. Verifiable facts found in Forbes can be just as valid, just as truthful, and just as relevant as any published by The London School of Economics and Political Science. I would not hesitate to quote verifiable facts found in Time, The Guardian, or Better Homes and Gardens if they are relevant to the discussion. I also cited Rice University, John. Did you follow that link to the source? {1}
            
            More to the point, however, your source does not address the data and the conclusions presented in my post. The strawman, an LSE paper published in 2011, attacks the methods of an eleven-year-old study about R&D costs published by Joseph DiMasi, Ronald Hansen, and Henry Grabowski of the Tufts Center for the Study of Drug Development in Boston, Massachusetts (DiMasi et al, 2003a). The first point to note is that Prof. Light and Assoc. Prof. Warburton do not set out to provide their own basic data set nor do they claim to know anything about the typical costs to develop a new drug. They are satisfied with generating a lot of unanswered questions which neither assert nor disprove anything.
            
            “The purpose of this report is to sharpen readers’ critical skills in asking pointed questions about the seemingly insurmountable barriers of R&D.” {2}
            
            Therefore, they aim to question the research of others and not to produce authentic data of their own. They question earlier methodology by substituting their own original, questionable methods and assumptions. In the end, their conclusion addresses the direction of R&D and NOT any theoretical irregularities in R&D estimates.
            
            “The report will conclude that the bigger problems lie elsewhere, with most R&D not being directed at discovering clinically superior medicines, even for affluent customers, because companies are so generously rewarded for developing hundreds of new products little better than the ones they replace.”
            {3}
            
            Now, I would love to discuss any data, yours or mine, regarding the real cost of bringing a new drug to market in the USA.
            
            I really hope, John, you have been doing well in recent months. I extend my virtual arm across an ocean to shake your hand.
            
            {1} http://events.rice.edu/index.cfm?EventRecord=21057
            {2} http://www.pharmamyths.net/files/Biosoc … _Costs.pdf p.3
            {3} Ibid. p. 3.

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         Motown2Chitownposted 10 years agoin reply to this

         Quill, first, I've no desire to "prove you wrong" as it were.  I rarely address these types of threads for just this reason.  I've no hard data, and if I did, people would dispute it.  My evidence, in general, is anecdotal.  I would never claim otherwise.
         
         One of my own issues with prescription drugs is the length of time that a drug MUST remain under patent and cannot be produced as a generic that costs far less.
         
         I might-MIGHT-think that it's to make back the money it took for R&D, but I can't say for sure, because how did they support their R&D to begin with.
         
         I am not being in any way flip, and my questions are not rhetorical.  I often learn a LOT from your posts. 
         
         My only disagreement is that I believe it's naive to think that because pharma companies are public and have to account for their R&D expenditures that they do it honestly.  They are as much about profit as the rest if the corporations in this country.
         
         In the meantime, I will read your links.  And appreciate your time and willingness to discuss these things.

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            Quilligrapherposted 10 years agoin reply to this

            Greetings again, Mo.  How nice of you to address my comments. I appreciate your time and consideration.
            
            First, you are, in my experience, hands down the most amicable of all posters. You should never feel you have to defend your views to anyone. My sole aim was to address statements that did not appear to jibe with industry-wide facts. It really does not matter if this leads to your altering your opinions or not. Anecdotes are fine, too, but they do not always represent the much larger segment of reality.
            
            You are quite right to observe, “One of my own issues with prescription drugs is the length of time that a drug MUST remain under patent and cannot be produced as a generic that costs far less.”
            
            Under existing US Patent laws, new drugs are granted 20 years of patent protection, although in many cases more than half of that time elapses before the drug companies can get their product to market. {1}
            
            Stepping away from hard facts, the exact length of ALL patent protection (scientific, industrial, horticultural etc.) and the underlying justifications are subjective determinations which naturally vary depending on whose money was placed at risk and how much profit that money is entitled to earn.
            
            You also mused, “I might-MIGHT-think that it's to make back the money it took for R&D, but I can't say for sure, because how did they support their R&D to begin with. ”
            
            Well, most large pharmaceutical firms are commercial ventures started small with private investment. I submit that these companies must meet investors’ expectations that include 1) taking steps to protect the stockholders’ equity and 2) delivering a return commensurate with the scale of the risks taken. This suggests that the one new drug out of ten to be approved must return a profit ten fold the profit missed by each of the nine others that failed. 
            
            Your feelings about corporate profits are noted. “My only disagreement is that I believe it's naive to think that because pharma companies are public and have to account for their R&D expenditures that they do it honestly. They are as much about profit as the rest if the corporations in this country. ”
            
            While I am not so inclined, I agree that you are welcome to adopt opinions based upon what you do NOT know. On the other hand, corporate profits should not be a cause for suspicion. Each of us is free to speculate about the honestly of any industry. I have my own doubts about some. However, suspicion is not proof and proof against one is not necessarily evidence against an entire industry. IMHO, sound judgement calls for separating theories from facts before reaching conclusions or making claims. In addition, sound judgement reminds me that my opinions can be wrong.
            
            Thank you again, Mo, for sharing your thoughts with the rest of us. Your points of view are always honest and refreshing.
            
            {1} http://www.uspharmacist.com/content/s/2 … visHJ.dpuf

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               Motown2Chitownposted 10 years agoin reply to this

               Quill, you are an entirely wonderful gentleman.  And a wealth of really, really good information!   I want to come back to this more in depth later, so forgive this really short reply. 
               
               In terms of anecdotal evidence, I often think it's overlooked for its perceived "smallness." So, so many people that I talk to have such similar experiences that I just feel (very subjectively maybe) that actual experiences are being ignored for corporate bottom lines, scientific recognition, political advantage, yada, yada.    I want to think some more on this, though, before I go sounding all silly and emotional about a topic that really does deserve rational and sound discussion and judgment. 
               
               And one question I'm really interested in finding an answer to...how long does it ACTUALLY take for a company to determine, in R&D, that a specific drgu is a failure?  Get those out of the way and STOP spending on them ASAP in order to proceed with truly viable options.  This is something that I think has a highly, highly political component at work.  I pray that I'm wrong, but that's the vibe I get.

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