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To: Pres Raygun
Of course the monopolies I cite are a result of regulation. All monopolies (or at least all monopolies that can effectively abuse their monopoly status to the harm of consumers) can only exist with the support of the state. In a free market (the existence which, incidentally, does depend upon the existence of certain sorts of regulations -- read Luigi Zingales A Capitalism for the People for a clear and expansive explanation) the only way to prevent competitors from arising is to provide good service at fair prices so that new entrants cannot get traction in the market.

However, patents are not a constitutional right, but a constitutional prerogative of the Congress. It doesn't have to grant them. It doesn't have to grant them under the current terms. For life-saving drugs and medical device, I'd advocate a regime under which the developer can chose between a short-duration monopoly with unregulated prices, and a long-duration monopoly with regulated prices. And I'd subject *all* patents to much closer scrutiny for lack of obviousness -- in the case of pharmaceuticals (albeit not life-saving drugs) the patent on esomeprazole (Nexium) was plainly an abuse of the patent system.

I also think you underestimate the degree to which the unnecessary cost of insurance bureaucracy is a creation of physicians. The whole system of CPT codes which govern insurance reimbursements by minutely classifying medical procedures is a creation not of the insurance industry, but the American Medical Association, which collects monopoly rents on the basis of its required use.

56 posted on 04/22/2014 5:29:00 PM PDT by The_Reader_David (And when they behead your own people in the wars which are to come, then you will know...)
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To: The_Reader_David
Of course the monopolies I cite are a result of regulation. All monopolies (or at least all monopolies that can effectively abuse their monopoly status to the harm of consumers) can only exist with the support of the state. In a free market (the existence which, incidentally, does depend upon the existence of certain sorts of regulations -- read Luigi Zingales A Capitalism for the People for a clear and expansive explanation) the only way to prevent competitors from arising is to provide good service at fair prices so that new entrants cannot get traction in the market.

I also think you underestimate the degree to which the unnecessary cost of insurance bureaucracy is a creation of physicians. The whole system of CPT codes which govern insurance reimbursements by minutely classifying medical procedures is a creation not of the insurance industry, but the American Medical Association, which collects monopoly rents on the basis of its required use.

While it is undoubtedly true, that the primary purpose of the AMA's existence is rent seeking, I don't believe there is any evidence they are very good at it. While doctors earn significantly more than most other professionals, their pay is not exorbitant when their intelligence, training, skill, financial risk, job stress are compared to other professionals such as engineers or university professors. The fact that doctors make what one would expect given the value of the services they provide is evidence that any monopoly they might have is slight. Primary care physicians make 50-100% more than the average electrical engineer and specialist make 200-400% of an EE. Seems reasonable to me.

And how do CPT codes create a rent seeking monopoly? Could anyone provide doctor services if they only knew the secret CPT codes? And if the bureaucracy of the CPT codes is inefficient it is not due to AMA rent seeking, it is because a third party (the insurer) is the payer who has to negotiate generic fee schedules in advance of yet unknown service to be rendered. That is not an optimal system for price discovery. If the patient paid the doctor and the hospital directly, then the patient could easily shop for the best price for the procedure in question. Insurance would still be necessary to reduce risk, but it would not play the role of a one size (one CPT code) fits all purchasing agent. Yes, insurance companies may increase the buying power of consumers, but I doubt much better than I could do for myself especially when shopping for primary care services.

However, patents are not a constitutional right, but a constitutional prerogative of the Congress. It doesn't have to grant them. It doesn't have to grant them under the current terms. For life-saving drugs and medical device, I'd advocate a regime under which the developer can chose between a short-duration monopoly with unregulated prices, and a long-duration monopoly with regulated prices. And I'd subject *all* patents to much closer scrutiny for lack of obviousness -- in the case of pharmaceuticals (albeit not life-saving drugs) the patent on esomeprazole (Nexium) was plainly an abuse of the patent system.

Yes it is true that the Constitution leaves the granting of patent rights up to Congress, but it does authorize Congress to do so and only to so for individuals. Sounds like a right to me. And yes I agree the US Patent Office is broken. Nonetheless, the whole concept of patent rights and copyrights is to grant a monopoly for a period of time to incentivize the "progress of science and useful arts". Despite its flaws it has worked amazingly well. Personally, I wouldn't disclose any invention in return for the promise of a "regulated price".

59 posted on 04/23/2014 1:05:33 AM PDT by Pres Raygun (Repent America)
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