In actual fact, pharmaceutical / medical device companies will simply charge whatever the market will bear, and it just so happens the US market will bear almost any price. If some market won't bear a profit making price, pharma companies simply won't sell into it.
It makes utterly no sense to sell at a loss and then cross subsidise using the massive rents extracted from US markets, yet that is exactly what most people here seem to think is happening. Although maybe Trump really has managed to 'make America great again'. Speaking of great...
The US spends 17.1% of of its GDP on healthcare. The 5 countries that are richer than the USA (GDP per capita) pay an average of 7.77%. Excluding Qatar, it's 9.03%. The top 10 richest countries (excluding the USA) spend an average of 8.03% of their GDP on healthcare, and I'm pretty sure at least a few of these have universal public health insurance.
You're paying more than DOUBLE compared to the 9 other richest countries in the world. You're simply getting gouged. If you can't even admit that maybe there's a problem here, and instead want to persist with all these insane American exceptionalist fantasies, it's unlikely anything is going to change in American healthcare.
Data from here: http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?end=2014&...
And here: https://en.wikipedia.org/wiki/List_of_countries_by_GDP_(nomi... (using IMF GDP figures)
EDIT: Given I am unable to address the 'econ101 argument', would you care to take a shot?
FWIW I do apologise for the sarcastic tone of my posts above. You're right; it's probably not the right way to spark a constructive discussion. To be honest, my tone was a fairly deliberate departure from how I usually post. It's just that I've been in a number of these 'US Healthcare' discussions on HN now and have seen the same points and counterpoints made many times, yet no progress seems to have been made.
I suppose that's a good indication that I should just stay out of these threads until I can maintain a civil tone.
Here I go tilting at this windmill again...
"Selling, marketing, and administrative expenses" (SMA) is not just marketing or advertising. It is all the costs of operating the company that are not either R&D or direct costs of producing products sold.
But you did 10 minutes of Googling so I defer to you I guess.
-- https://en.wikipedia.org/wiki/Johnson_%26_JohnsonThe remaining 81.5 per cent of their revenue comes from the sale of pharmaceuticals and medical devices.
The information in the pdf does not support the narrative of the original article, because of the use of consolidated figures.
It looks like a dumpster category for all kinds of expenses, not just "marketing".
That would be bad. Based on 5 minutes of googling and 10 minutes of reading, the largest US pharma company is Johnson & Johnson. Their latest earnings report has the following for the 12 months in 2016 (not all expenses are listed here):
- Sales (i.e. revenue): $71.8bn
- Marketing expense: $19.9bn
- R&D expense: $9.1bn
- After tax, after expenses profit: $16.5bn
So, on behalf of my fellow Australians, I'd just like to thank J&J for selling into my country at a substantial loss (and, in doing so, bravely running the risk of breaching their fiduciary duties to their shareholders).
I'd also like to express my gratitude to consumers in the United State, who are apparently so generous that they are willing to subsidise my country's single-purchaser medical system. It's a shame you can't have one as well, but at least you have the world's gratitude for your sacrifice. USA #1!
EDIT: Link - http://files.shareholder.com/downloads/JNJ/4178180194x0x9249...