What cuts would you make to the US Federal budget?

Hitcounter

The US defence budget is $841.4 billion on paper, in reality the pentagon has an additional trillion slush fund, and the CIA has its own money.

In spite of these unfathomable amount of money the US military complex failed to defeat a bunch of cave dwelling AK toting medieval people.

In the hand of the DOJ the money is worthless cause DOJ staffers are brainless Ivy League carbon copy’s all with the exact same goal, how can I enrich myself and my friends when the goal should be how do we defend the indefensible.

Drop the CIA entirely, Drop the FBI, NSA and all other 3 letter groups leaving only homeland give homeland 200billion, and advise them that America will no longer play the role of world police, if the world wants multi polar Chinese and Russian influence so be it don’t come crying when you end up in a gulag cause America broke.   

just_sayin

Hitcounter said:

The US defence budget is $841.4 billion on paper, in reality the pentagon has an additional trillion slush fund, and the CIA has its own money.

In spite of these unfathomable amount of money the US military complex failed to defeat a bunch of cave dwelling AK toting medieval people.

In the hand of the DOJ the money is worthless cause DOJ staffers are brainless Ivy League carbon copy’s all with the exact same goal, how can I enrich myself and my friends when the goal should be how do we defend the indefensible.

Drop the CIA entirely, Drop the FBI, NSA and all other 3 letter groups leaving only homeland give homeland 200billion, and advise them that America will no longer play the role of world police, if the world wants multi polar Chinese and Russian influence so be it don’t come crying when you end up in a gulag cause America broke.   

I agree that the Pentagon budget is bloated and cuts can be made that do not impact national security.  I wouldn't drop the CIA, FBI, or NSA as they do essential work, but I do think that there is unnecessary spending that could be cut in those agencies.

Hitcounter

@just_sayin the 3 letters essential work has become partisan hackery, once infected with politics its practically impossible to remove the mind virus i mean lets take stock here in the DOJ's hands money has went to Trans Generals, this makes the US military the laughing stock of the world, the idea of a tough force is out the window they are now and unless Trump intervenes Biggley then the Rainbow army will continue to rainbow its way into a puddle.

The CIA, NSA and FBI's work has become so vague that its difficult to determine tangible results I mean what's the CIA been doing for the past 4 years? we know the FBI and NSA have been targeting American citizens, they need scraping, replaced with the TIA (Trump Intelligence Agency) one agency, one mission "Don't so much as look at an American as the enemy or its the death sentence" apply that across the board if you fail in government or the military the penalty should match the power to affect lives, it might be unpopular but the death penalty needs to be more prevalent in our society, we need to get past this idea that everybody deserves life, old Joe is actively trying to trigger WW3 before leaving office, that's a death penalty level crime.  

just_sayin

Hitcounter said:

@just_sayin the 3 letters essential work has become partisan hackery, once infected with politics its practically impossible to remove the mind virus i mean lets take stock here in the DOJ's hands money has went to Trans Generals, this makes the US military the laughing stock of the world, the idea of a tough force is out the window they are now and unless Trump intervenes Biggley then the Rainbow army will continue to rainbow its way into a puddle.

The CIA, NSA and FBI's work has become so vague that its difficult to determine tangible results I mean what's the CIA been doing for the past 4 years? we know the FBI and NSA have been targeting American citizens, they need scraping, replaced with the TIA (Trump Intelligence Agency) one agency, one mission "Don't so much as look at an American as the enemy or its the death sentence" apply that across the board if you fail in government or the military the penalty should match the power to affect lives, it might be unpopular but the death penalty needs to be more prevalent in our society, we need to get past this idea that everybody deserves life, old Joe is actively trying to trigger WW3 before leaving office, that's a death penalty level crime.  

Have government agencies become infected with political agendas?  Sure.  However, that doesn't mean that the agencies are not needed.  Further, as long as these agencies reside in Washington DC, which gave Trump 6.6% of their vote (that's almost a 50% increase from last time), you will have a lopsided political perspective in the federal government.  I think you can implement a lot of policies to address some of this and prevent it in the future, but I don't think you can realistically remove it all.  Calling it out and making a public issue of government political bias such as happened when FEMA wouldn't help homes in Ashville NC that had Trump signs in their yards will make people more aware. 

Hitcounter

@just_sayin: unfortunately I think America is finished, Trump is the best of a bad bunch but when you look to China and Russia you see superpowers who spent their money in the right places, China has infrastructure century's ahead of anything in the west. Russia via sanctions has become almost 100% self sufficient specifically in Agri and Manufacturing. then when we look west we see debt slaves trapped in a perpetual debt cycle as final defaults loom across the board and who's the creditor? China. as good as America has been for freedoms in the world it has also poisoned every corner of its utopia.

Now as America lurches forward in to the abyss as expected the most optimistic presidential candidate has emerged victorious, unfortunately I believe it is too little to late, had he have won the 'rigged one' in 2020 the world might not be standing on the precipice of world war 3 right now unfortunately that didn't happen so here we are. is the world going to make it to January 20th? its 50/50 at the min, the disgusting democrats seem hell bent on leaving WW3 for Trump to deal with.

I don't think we are making it the ruskys are provoked, the chi-knee are provoked, The Arab League are provoked even Kim is provoked and he's the gentlest of all the leaders, Kim wouldn't hurt a fly yet they've got him threating all sorts.

just_sayin

@Hitcounter
@just_sayin: unfortunately I think America is finished, Trump is the best of a bad bunch but when you look to China and Russia you see superpowers who spent their money in the right places, China has infrastructure century's ahead of anything in the west. 

What have you been smoking and is it legal where you live?  China has a horrible infrastructure problem even though it spends a ridiculous amount on it.  See https://www.aii.org/chinas-infrastructure-and-construction-problem/

At first glance, it seems ridiculous that China has an infrastructure and construction problem. China spent 4.8 percent of GDP on inland transport infrastructure in 2021, an astounding amount. The U.S. spent just 3.5 percent of GDP on the military. So how could China have an infrastructure problem? It all comes down to the quality of infrastructure being built and its larger effect on China’s economy. 
China has relied considerably upon infrastructure projects to generate growth while also helping modernize its economy. By continually building roads and railways, China was investing into itself while also creating jobs and markets. This strategy was so successful that the Chinese Government massively increased infrastructure spending for many years, approving almost any project and lending billions of dollars to construction companies. Railroads, highways, skyscrapers, and airports were all built at an astounding pace. For a while, this system worked perfectly. As a share of GDP, total Chinese infrastructure investment increased to an astronomic 24% in 2016. 
The problem is that it was always unsustainable. The government approved projects that were unneeded and poor quality for the sake of growth. China is now famous for its “ghost cities”, where infrastructure and urban development has drastically outpaced demand. Millions of apartments and offices sit empty, but the Chinese government continued to approve projects because it produced economic growth. Empty apartments are especially useless for a nation that will soon have a declining population. 
Beyond just too much, the infrastructure and construction projects in China are very often of extremely poor quality. China has spent billions helping build massive infrastructure projects in other countries to improve relations and increase trade, but even some of these projects have been criticized for poor quality. China is spending big on infrastructure in Africa, but its international ‘Belt and Road’ initiative is beginning to decrease lending. 
In China itself, the remaining big infrastructure projects have less return on investment than they did before. Hundreds of half-finished projects are littered across China, where funding simply ran out. Chinese mega projects, once a great harbinger of economic growth, are now contributing massively to the local government debt crisis. China’s government is quick to brag about its high-speed rail network, by far the largest in the world, but most lines generate a loss and operate a fraction of the capacity. Only the lines between large cities generate profits, and the rural train stations are underused and contribute to local government debt. 

Jules1

@just_sayin
Military budget (~50 Billion) to NASA (~15 Billion), DOE (~15 Billion), and HHS (~20 Billion)
To clarify military budget would be cut to go to the following departments

Dreamer

Tax the wealthy for starters. The problem with budget cuts, is then people find cheaper alternatives like the private prison system that is for profit. Which turns around and causes more damage. End tax exemptions for non-profits, this is effectively giving away money for people to build mosques, Mormon temples, Scientology, and more.

https://time.com/3939143/nows-the-time-to-end-tax-exemptions-for-religious-institutions/

Overall, our economy could be more efficient if we simply got rid of all the monopolies and Oligopoly. Here's just one example, Americans pay more for high speed Internet and receive lower speed due to oligopoly of cable companies.

https://www.vox.com/the-goods/2020/2/18/21126347/antitrust-monopolies-internet-telecommunications-cheerleading

Medicare is so high because of fake prices invented by hospitals to appease insurance companies. Also, because drug companies have oligopoly often or even monopoly raising drug prices that tax payers pay for. The repeated failure of self regulation shows that pure laissez-faire is untenable.

just_sayin

Dreamer said:

Tax the wealthy for starters. The problem with budget cuts, is then people find cheaper alternatives like the private prison system that is for profit. Which turns around and causes more damage. End tax exemptions for non-profits, this is effectively giving away money for people to build mosques, Mormon temples, Scientology, and more.

https://time.com/3939143/nows-the-time-to-end-tax-exemptions-for-religious-institutions/

Overall, our economy could be more efficient if we simply got rid of all the monopolies and Oligopoly. Here's just one example, Americans pay more for high speed Internet and receive lower speed due to oligopoly of cable companies.

https://www.vox.com/the-goods/2020/2/18/21126347/antitrust-monopolies-internet-telecommunications-cheerleading

Medicare is so high because of fake prices invented by hospitals to appease insurance companies. Also, because drug companies have oligopoly often or even monopoly raising drug prices that tax payers pay for. The repeated failure of self regulation shows that pure laissez-faire is untenable.

The problem with budget cuts, is then people find cheaper alternatives like the private prison system that is for profit.

Doesn't the government write the contract for the private prison to run by?  Why yes it does.  The reality is that private prisons who don't comply lose their contract, government prisons who don't follow the rules, stay open and get more tax money.  See the difference.  If you don't like something in a private prison, renegotiate the contract. 

End tax exemptions for non-profits, this is effectively giving away money for people to build mosques, Mormon temples, Scientology, and more.

https://time.com/3939143/nows-the-time-to-end-tax-exemptions-for-religious-institutions/

Cringy.  A lot of religious bigotry there, my friend.  The U.S. ​is dependent upon religious institutions helping the poor and people in need,  70-80% of the aid directed to the poor from charitable organizations derives from religious organizations.  Tax that, and it goes away.  Unlike the government agency FEMA, Samaritan's purse was onsite within hours of the Florida and North Carolina hurricanes.   

Tax churches and religious institutions and this will trigger a dramatic drop in discretionary spending - ie - charitable programs.  You didn't think this through did you?

Overall, our economy could be more efficient if we simply got rid of all the monopolies and  

Whose a monopoly other than the government?

Medicare is so high because of fake prices invented by hospitals to appease insurance companies. Also, because drug companies have oligopoly often or even monopoly raising drug prices that tax payers pay for. The repeated failure of self regulation shows that pure laissez-faire is untenable.

You aren't doing a paper in school on this are you?  That answer is overly simplistic and will get you a failing grade.  From my AI:

Understanding why Medicare is expensive and why drug prices are high in the United States involves examining a range of interrelated factors including demographic shifts, healthcare utilization, systemic inefficiencies, and market dynamics.

    Medicare Expenses

    1. **Aging Population**: 

   The primary driver of Medicare’s rising costs is the aging of the baby boomer generation. As this demographic ages, the number of Medicare beneficiaries increases significantly, leading to higher enrollment and, consequently, higher spending. This trend is projected to continue over the next several decades, further straining Medicare's resources.

    2. **Increased Healthcare Needs**: 

   Older adults generally have more complex healthcare needs, which drives up the demand for medical services. Chronic conditions such as diabetes, heart disease, and arthritis—common among older populations—account for a significant portion of Medicare spending. As people live longer, they are likely to require more healthcare services.

    3. **Technological Advancements**: 

   The introduction of new medical technologies and treatments often leads to higher costs. Many new technologies, while beneficial, can be expensive and may not always provide a commensurate benefit compared to less costly options. The rapid adoption of advanced medical technologies contributes to spiraling healthcare costs.

    4. **Administrative Costs**: 

   The U.S. healthcare system has relatively high administrative expenses, which consume a significant portion of total healthcare spending. For instance, studies indicate that administrative costs in the healthcare system can account for about 14% of all health expenditures. This inefficiency is partially due to the complex structure of healthcare providers, payers, and regulations.

    5. **End-of-Life Care**: 

   Medicare often incurs substantial costs associated with end-of-life care. Approximately 27% to 30% of Medicare spending covers the care for individuals in their last year of life due to increased utilization of healthcare services during this period. Managing chronic diseases and acute conditions requires extensive medical intervention, contributing to higher overall expenditures.

    High Drug Prices

    1. **Lack of Price Negotiation**: 

   Unlike many other developed countries where a central negotiating body controls drug prices, the U.S. has a fragmented system with multiple payers, including private insurance companies and government programs like Medicare. This diversity results in significantly less bargaining power for buyers, allowing drug manufacturers to set higher prices.

    2. **Research and Development Costs**: 

   Pharmaceutical companies often cite high research and development (R&D) costs for new drugs as a justification for elevated prices. While R&D spending is considerable, evidence shows that there isn't always a direct correlation between R&D costs and the prices set for medications. Many companies also factor in marketing and operational costs, which can inflate drug prices further.

    3. **Market Dynamics and Consolidation**: 

   The consolidation of pharmacy benefit managers (PBMs) and health insurance companies has led to a situation where a few entities hold substantial control over drug pricing negotiations. This consolidation can reduce competition and transparency, enabling higher prices. Small and medium-sized pharmacies may struggle to compete with larger chains, impacting pricing strategies.

    4. **Direct-to-Consumer Advertising**: 

   Aggressive marketing strategies, including direct-to-consumer advertising, significantly contribute to rising drug prices. Pharmaceutical companies spend billions on advertising, which affects how drugs are perceived by consumers and can drive demand for pricier newer drugs instead of more cost-effective alternatives.

    5. **Regulatory Environment**: 

   The regulatory landscape also plays a role in drug pricing. The lengthy and expensive process for drug approval through agencies like the FDA can lead to higher initial prices to recoup costs. Additionally, the lack of international price controls means that U.S. consumers often bear the financial burdens of R&D investments that benefit other markets.

    Conclusion

The complexity of both Medicare expenses and high drug prices stems from a combination of demographic factors, systemic inefficiencies, market dynamics, and innovation costs. Addressing these issues requires comprehensive reforms to improve efficiency, enhance negotiation powers, and adapt to the needs of an aging population while ensuring sustainable healthcare financing.

Sources: 

[1] Drivers of Health Care Costs: A Physicians Foundation white Paper, https://pmc.ncbi.nlm.nih.gov/articles/PMC6179664/

[2] Health Care Costs and Affordability | KFF, https://www.kff.org/health-policy-101-health-care-costs-and-affordability/?entry=table-of-contents-what-factors-contribute-to-u-s-health-care-spending

[3] Why Are Americans Paying More for Healthcare?, https://www.pgpf.org/blog/2024/01/why-are-americans-paying-more-for-healthcare

[4] What to Know about Medicare Spending and Financing | KFF, https://www.kff.org/medicare/issue-brief/what-to-know-about-medicare-spending-and-financing/

[5] 9 Reasons for Rising Healthcare Costs - PeopleKeep, https://www.peoplekeep.com/blog/nine-reasons-for-rising-health-care-costs

[6] NHE Fact Sheet - CMS, https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet

[7] Medicare Households Spend More on Health Care Than Other ..., https://www.kff.org/medicare/issue-brief/medicare-households-spend-more-on-health-care-than-other-households/

[8] The Expansion of Medicare Advantage and Solvency of Traditional ..., https://ldi.upenn.edu/our-work/research-updates/the-expansion-of-medicare-advantage-and-solvency-of-traditional-medicare/

[9] Trends in health care spending | Healthcare costs in the US | AMA, https://www.ama-assn.org/about/research/trends-health-care-spending

[10] The high cost of prescription drugs: causes and solutions - PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC7311400/

[11] Six Reasons Drug Prices Are So High in the U.S., https://www.nytimes.com/2024/01/17/health/us-drug-prices.html

[12] Why do your prescription drugs cost so much? - Harvard Health, https://www.health.harvard.edu/blog/why-do-your-prescription-drugs-cost-so-much-202401183007

[13] Prescription Drug Spending in the U.S. Health Care System, https://www.actuary.org/content/prescription-drug-spending-us-health-care-system

[14] High Drug Prices: So Who Is to Blame? - PMC, https://pmc.ncbi.nlm.nih.gov/articles/PMC5278914/

[15] Costs of Drug Development and Research and ... - JAMA Network, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820562

[16] Costs of Drug Development and Research and Development ..., https://pmc.ncbi.nlm.nih.gov/articles/PMC11214120/

[17] Research and Development in the Pharmaceutical Industry, https://www.cbo.gov/publication/57126

[18] Costs of Drug Development and Research and ... - ASPE, https://aspe.hhs.gov/reports/drug-development-rd-intensity

[19] Quantifying Research and Development Expenditures in the Drug ..., https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820566

[20] Negotiating for Lower Drug Prices Works, Saves Billions - CMS, https://www.cms.gov/newsroom/press-releases/negotiating-lower-drug-prices-works-saves-billions

[21] FAQs about the Inflation Reduction Act's Medicare Drug Price ... - KFF, https://www.kff.org/medicare/issue-brief/faqs-about-the-inflation-reduction-acts-medicare-drug-price-negotiation-program/

[22] Impact of federal negotiation of prescription drug prices, https://www.brookings.edu/articles/impact-of-federal-negotiation-of-prescription-drug-prices/

[23] Medicare Drug Price Negotiation - CMS, https://www.cms.gov/inflation-reduction-act-and-medicare/medicare-drug-price-negotiation

[24] Prices of Drugs Medicare Is Negotiating | Commonwealth Fund, https://www.commonwealthfund.org/publications/2024/jan/how-prices-first-10-drugs-medicare-negotiations-compare-internationally

[25] Middlemen have outsized influence on US drug prices, FTC says, https://www.reuters.com/business/healthcare-pharmaceuticals/middlemen-have-outsized-influence-us-drug-prices-due-market-consolidation-ftc-2024-07-09/

[26] Middlemen have outsized influence on U.S. drug prices due ... - CNBC, https://www.cnbc.com/2024/07/09/middlemen-have-outsized-influence-on-us-drug-prices-due-to-market-consolidation-ftc-says.html

[27] Competition, Consolidation, and Evolution in the Pharmacy Market, https://www.commonwealthfund.org/publications/issue-briefs/2021/aug/competition-consolidation-evolution-pharmacy-market

[28] Generic Competition and Drug Prices | FDA, https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/generic-competition-and-drug-prices

[29] Alternative Approaches to Reducing Prescription Drug Prices, https://www.cbo.gov/publication/58793

polytheistwitch

IRS. They do not function within the confines of the Constitution.  There should be a sales tax. Criminals and people working under the table don't pay taxes. The rich don't pay taxes. I don't think you should text necessities like food but you should certainly be able to text anything else.  Homeland Security should not exist. It's an agency used for politics that formed out of 9/11. It operates outside the confines of the Constitution.  We have investigative agencies. I believe the CIA is completely corrupt. Do they do good work possibly do they do necessary work possibly but in general they're usually used to screw other countries over. There are some agencies I don't think need to be ended but they need complete overhauls and that would be FEMA and the VA. 

just_sayin

@polytheistwitch
There should be a sales tax.

What kind of sales tax do you propose?

Criminals and people working under the table don't pay taxes.

I agree.  If you can eliminate the benefit to chicken plucking companies that pay workers under the table (shout out to you @Barnadot), then illegal labor will dry up and low skilled legal workers will be better able to get ahead and have more negotiating power.  

The rich don't pay taxes.

Rich people are about the only ones paying taxes in the US.  Taxing them more, just means they will go elsewhere and take their wealth with them.  From my AI:

The distribution of tax payments among different income quintiles in the United States reveals a significant concentration of tax burden among wealthier individuals. Below is a detailed breakdown of who pays taxes by quintiles.

    Overview of Tax Payments by Income Quintiles

    1. **Top 1% of Income Earners**:

   - The top 1% of taxpayers, who earn an adjusted gross income (AGI) of approximately $682,577 or more, paid **45.8%** of all federal individual income taxes in 2021. This group's income share has risen significantly over the years, contributing to a large portion of federal revenue.

    2. **Top 10% of Income Earners**:

   - Those in the top 10% of income earners (AGI over about $169,800) paid around **75.8%** of federal individual income taxes. This affirms the progressive nature of the U.S. tax system, where higher-income earners contribute disproportionately to total tax revenue.

    3. **Top 50% of Income Earners**:

   - The top 50% (individuals with an AGI of roughly $46,637 or more) accounted for **97.7%** of all federal individual income taxes paid. This indicates that the vast majority of federal income tax revenue is derived from a relatively small percentage of the population.

    4. **Bottom 50% of Income Earners**:

   - Conversely, those in the bottom 50% of earners (with an AGI below $46,637) contributed only **2.3%** of total federal individual income taxes. The average tax rate for this group is around 3.3%, reflecting the lower income levels and various tax credits that reduce their overall tax burden.

    Summary of Tax Payments by Quintiles

    Top 1%**: Paid **45.8%** of federal individual income taxes.

Top 5%**: Paid **65.6%** of federal individual income taxes.

Top 10%**: Paid **75.8%** of federal individual income taxes.

Top 25%**: Paid **89.2%** of federal individual income taxes.

Top 50%**: Paid **97.7%** of federal individual income taxes.

Bottom 50%**: Paid only **2.3%** of all federal individual income taxes.

    Conclusion

The tax burden in the U.S. is heavily skewed towards higher-income earners, demonstrating the progressive nature of the federal income tax system. Wealthier individuals contribute a significant majority of the total tax revenue compared to lower-income earners. This structure is designed to ensure that those who have a greater ability to pay contribute more to federal revenues.

Sources: 

[1] Income in the United States: 2023 - U.S. Census Bureau, https://www.census.gov/library/publications/2024/demo/p60-282.html

[2] [PDF] Income in the United States: 2023 - Census.gov, https://www2.census.gov/library/publications/2024/demo/p60-282.pdf

[3] Distribution of Personal Income - Bureau of Economic Analysis, https://www.bea.gov/data/special-topics/distribution-of-personal-income

[4] New Income Distribution Data from the U.S. BEA - Bloustein School, https://bloustein.rutgers.edu/examining-new-income-distribution-data-from-the-u-s-bea/

[5] Household Income Quintiles | Tax Policy Center, https://taxpolicycenter.org/statistics/household-income-quintiles

[6] income quintile - Census Bureau Tables, https://data.census.gov/table?q=income quintile

[7] Table 5. Quartiles and selected deciles of usual weekly earnings of ..., https://www.bls.gov/news.release/wkyeng.t05.htm

[8] Summary of the Latest Federal Income Tax Data, 2024 Update, https://taxfoundation.org/data/all/federal/latest-federal-income-tax-data-2024/

[9] Federal Income Taxes by Quintiles of Income Before Taxes: Lowest ..., https://fred.stlouisfed.org/series/CXUFEDTAXESLB0102M

[10] [PDF] Graphs of Distribution of Current Law Tax Burden and Income by ..., https://home.treasury.gov/system/files/131/Graph-Distributional-Analysis-2024-11162023.pdf

[11] Summary of the Latest Federal Income Tax Data, 2025 Update, https://taxfoundation.org/data/all/federal/latest-federal-income-tax-data-2025/

[12] Who Pays Income Taxes? - Foundation - National Taxpayers Union, https://www.ntu.org/foundation/tax-page/who-pays-income-taxes

[13] Summary of the Latest Federal Income Tax Data, 2023 Update, https://taxfoundation.org/data/all/federal/summary-latest-federal-income-tax-data-2023-update/

[14] Distribution of Federal Taxes | Congressional Budget Office, https://www.cbo.gov/topics/taxes/distribution-federal-taxes

[15] U.S. households that earn less spend a higher share of income on ..., https://www.ers.usda.gov/data-products/chart-gallery/gallery/chart-detail/?chartId=110391

polytheistwitch

@just_sayin I don't believe there should be a sales tax on food. At least food you bought at grocery store restaurants a different story. There should be some kind of reasonable sales tax I mean most people say pay 6% or 7% when they buy from a local business. That's what we're required to charge 7%. Some people propose only a tax on new items and not used ones. I'm sure there's something that can be figured out that would be doable for everyone and not put anybody in any type of hardship. I really think if people had more of their paycheck more people would even save.

Dreamer

@just_sayin

Holy chatbot that is too much for me to respond to.

"Whose a monopoly other than the government?"

Certain companies in big pharm.

"The price of the drug, used to treat infant seizure disorder, has increased from $40 a vial in 2000 to nearly $39,000 today. The price increase has pushed the drug's annual sales over $1 billion—many of those are driven by Medicare reimbursements."

Only a monopoly would be able to hike the prices this high otherwise people would buy from a competitor.

https://www.thedailybeast.com/questcor-pharma-firm-linked-to-97000-price-hike-bribed-docs-to-boost-sales-say-whistleblowers/

"“The tale of how a 65-year-old brand medication could rise in price from $40 per vial in 2001 to over $35,000 per vial by 2015 is a story of, perhaps, the most egregious monopolistic conduct and unfair trade practice in US history,” the city of Rockford alleged."

https://www.cnn.com/2018/06/29/health/acthar-mallinckrodt-questcor-price-hike-trevor-foltz/index.html

Dreamer

@just_sayin

Now your just tourturing numbers to get the results you want. There's a reason I stopped arguing with you when you kept quoting Fox News over and over. Or when you thought the immuno compriomised would be hurt by vaccine mandates, when they would benefit the most. Even if your numbers are correct, which I haven't taken the time to throughly investigate, rich people earn more money.

Bill Gates having to pay $100 hurts him less than a middle class person having to pay $50 or a very poor individual with only $2 having to pay $1.

https://en.wikipedia.org/wiki/Income_tax_in_the_United_States

According to this wikipedia the top 1% only pay 29.4% of thier income to taxes. Furthermore, rich people have lots and lots of assets but not much money making it very difficult to tax them. Instead, they buy goods and services with loans and credit cards. Which they can get at very low interest since they have so much assets that can be seized if they default.

https://www.npr.org/2021/11/13/1054711913/progressives-wealth-tax-super-rich-elon-musk-jeff-bezos

Having some techincial difficulities might have to repost t

 

Factfinder

I think the problem with wanting to steal more of the rich people's money is it makes them want to take THEIR money and go somewhere else. That very thing is happening in California right now as we speak.

California’s job creation record has been even more dismal over the last 18 months. Since January 2023, private-sector employment in the state declined by over 46,000 workers. California’s private-sector job collapse is unprecedented, and with the state representing nearly 12 percent of the country’s population, it is a drag on the nation’s economy.

Part of California’s job weakness reflects the number of people and businesses leaving the state. California’s population declined by about 75,000 between 2022 and 2023 (the latest data available), and a number of business headquarters have departed.  

https://www.hoover.org/research/californias-businesses-stop-hiring

just_sayin

Dreamer said:

@just_sayin

Holy chatbot that is too much for me to respond to.

"Whose a monopoly other than the government?"

Certain companies in big pharm.

"The price of the drug, used to treat infant seizure disorder, has increased from $40 a vial in 2000 to nearly $39,000 today. The price increase has pushed the drug's annual sales over $1 billion—many of those are driven by Medicare reimbursements."

Only a monopoly would be able to hike the prices this high otherwise people would buy from a competitor.

https://www.thedailybeast.com/questcor-pharma-firm-linked-to-97000-price-hike-bribed-docs-to-boost-sales-say-whistleblowers/

"“The tale of how a 65-year-old brand medication could rise in price from $40 per vial in 2001 to over $35,000 per vial by 2015 is a story of, perhaps, the most egregious monopolistic conduct and unfair trade practice in US history,” the city of Rockford alleged."

https://www.cnn.com/2018/06/29/health/acthar-mallinckrodt-questcor-price-hike-trevor-foltz/index.html

Don't complain about Fox/News as a biased site when you cite thedailybeast (I won't pay to read that crap) and cnn, and expect ANYONE TO TAKE THEM AS CREDIBLE SOURCES.  Did you notice that a MSNBC/NBC news interviewer was paid half a million dollars by the Harris campaign to be given a friendly interview?  Probably not.  Shame on you!!!!!

The company that makes Acthar has indeed raised the price significantly.  I think you have a legit instance of price gouging (Mallinckrodt just got sentenced to 7 years in prison).  Further, the rarity of the drug has contributed to this.  Typically a patent runs out in 20 years after being filed, but because of the rarity of the condition, the companies patent runs through 2041.  From my AI;

The astronomical increase in the cost of Acthar, a medication used primarily for infant seizure disorders and other conditions, can be attributed to several interrelated factors.

    Price Increase Factors

The price of Acthar has skyrocketed from around $40 per vial in 2000 to nearly $39,000 today, largely due to corporate strategies following its acquisition. Mallinckrodt, which acquired Acthar from Questcor, significantly increased the price by more than $8,200 per vial after the acquisition, emphasizing their business model focused on boosting profitability rather than enhancing accessibility. Furthermore, the lack of competitive pressure, as no generic alternatives are available, has permitted this exorbitant pricing to persist.

    Another contributing factor is the company’s previous avoidance of paying rebates to Medicaid due to these high prices, which has raised ethical concerns and led to allegations against Mallinckrodt regarding price manipulation and market control. The unique position of Acthar, coupled with the company's substantial pricing strategy, has effectively allowed the price to rise without significant pushback from market forces.

    Availability of Generic Versions

Currently, there is no generic version of Acthar available in the United States. The lack of therapeutically equivalent options means that patients and healthcare providers have no choice but to accept the high list price of the brand-name drug. This absence in the marketplace is particularly concerning given the essential role Acthar plays in treating certain medical conditions.

    Regulatory Process for Generics

The introduction of a generic version of a drug is contingent on the expiration of its patent and relevant exclusivity protections. Typically, a generic drug cannot be marketed until after the brand-name drug's patent expires, which usually lasts about 20 years from the date of filing. However, the time frame can vary significantly depending on the specifics of the drug’s patent status and any exclusivity granted by the FDA. For Acthar, its patents are not set to expire until February 25, 2041, which suggests that there will not be a generic alternative available until at least that date.

    Conclusion

The rise in the cost of Acthar reflects intricate dynamics of corporate strategy, lack of competition, and regulatory frameworks. With no generic alternative available, the financial burden on patients needing this medication remains substantial, highlighting ongoing challenges within pharmaceutical pricing and availability.

Sources: 

[1] [PDF] Mallinckrodt—HP Acthar Gel | Drug Pricing Investigation, https://oversightdemocrats.house.gov/sites/evo-subsites/democrats-oversight.house.gov/files/Mallinckrodt Staff Report 10-01-20 PDF.pdf

[2] Industry Payments to Physician Specialists Who Prescribe ..., https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2686039

[3] Healthcare Costs and Resource Utilization in Patients with Multiple ..., https://pmc.ncbi.nlm.nih.gov/articles/PMC4969319/

[4] Medicare spent $2 billion for one drug as the manufacturer paid ..., https://www.cnn.com/2018/06/29/health/acthar-mallinckrodt-medicare-claims-doctor-payments/index.html

[5] Questcor Finds Profit for Acthar Drug, at $28000 a Vial, https://www.nytimes.com/2012/12/30/business/questcor-finds-profit-for-acthar-drug-at-28000-a-vial.html

[6] Our Product Pricing - Mallinckrodt Pharmaceuticals, https://www.mallinckrodt.com/products-landing/Our-Product-Pricing/

[7] Mallinckrodt Agrees to Pay Nearly $234 Million to Resolve ..., https://www.justice.gov/usao-ma/pr/mallinckrodt-agrees-pay-nearly-234-million-resolve-allegations-related-price-increases

[8] [PDF] Unsupported Price Increase Report | ICER, https://icer.org/wp-content/uploads/2023/04/UPI_2023_Report_121123.pdf

[9] Court Denies Class Certification in Antitrust Case Based on Expert's ..., https://www.insideclassactions.com/2024/04/16/court-denies-class-certification-in-antitrust-case-based-on-experts-reliance-on-unsupported-assumptions-in-damages-model/

[10] Generic Acthar Availability - Drugs.com, https://www.drugs.com/availability/generic-acthar.html

[11] Mallinckrodt Announces Availability of Acthar® Gel (repository ..., https://www.prnewswire.com/news-releases/mallinckrodt-announces-availability-of-acthar-gel-repository-corticotropin-injection-single-dose-pre-filled-selfject-injector-in-the-us-302214582.html

[12] Acthar Gel (Corticotropin): Uses, Side Effects, Alternatives & More, https://www.goodrx.com/acthar-gel/what-is

[13] Mallinckrodt Announces U.S. FDA Approval of Supplemental New ..., https://mallinckrodt.gcs-web.com/news-releases/news-release-details/mallinckrodt-announces-us-fda-approval-supplemental-new-drug

[14] Acthar Alternatives Compared - Drugs.com, https://www.drugs.com/compare/acthar

[15] Acthar Prices, Coupons, Copay Cards & Patient Assistance, https://www.drugs.com/price-guide/acthar

[16] Acthar Gel Prices, Coupons & Savings Tips - GoodRx, https://www.goodrx.com/acthar-gel

[17] Corticotropin Prices, Coupons, Copay Cards & Patient Assistance, https://www.drugs.com/price-guide/corticotropin

[18] Acthar Prices - U.S. & International | PharmacyChecker.com, https://www.pharmacychecker.com/acthar/

[19] What Is the Approval Process for Generic Drugs? | FDA, https://www.fda.gov/drugs/generic-drugs/what-approval-process-generic-drugs

[20] The Generic Drug Approval Process | FDA, https://www.fda.gov/drugs/cder-conversations/generic-drug-approval-process

[21] [PDF] s Generic-Drug Approval Process: Similarities to and Differences ..., https://acgcdn.gi.org/wp-content/uploads/2012/04/AJG_June11_FDAGeneric-DrugApprovalProcess.pdf

[22] A Review of First-Time Generic Drug Approvals - U.S. Pharmacist, https://www.uspharmacist.com/article/a-review-of-firsttime-generic-drug-approvals

[23] How the FDA Ensures High-Quality Generic Drugs - AAFP, https://www.aafp.org/pubs/afp/issues/2018/0601/p696.html

[24] Frequently Asked Questions on Patents and Exclusivity | FDA, https://www.fda.gov/drugs/development-approval-process-drugs/frequently-asked-questions-patents-and-exclusivity

[25] Drug Patent Expirations and the “Patent Cliff” - U.S. Pharmacist, https://www.uspharmacist.com/article/drug-patent-expirations-and-the-patent-cliff

[26] What Are Generic Drugs and When Does a Drug Become Generic?, https://hmsa.com/help-center/what-are-generic-drugs/

[27] [PDF] Patents and Exclusivity - U.S. Food and Drug Administration, https://www.fda.gov/media/92548/download

[28] The 180-Day Rule Supports Generic Competition. Here's How., https://accessiblemeds.org/resources/blog/180-day-rule-supports-generic-competition-heres-how

jack

just_sayin said:

This one's for you (Jack).  It was reported that in just the last four months, the US added another trillion dollars in debt.

So, how would you help bring the US debt down?

Hello just_:

If you're seeking to balance the budget, we can either CUT spending, or INCREASE income.  When I was a kid, our family, not only survived, but we THRIVED on one persons income.  Back then the top tax rate was around 95%..  I'm thinking, why not go back to the good ole days?

Just SINCE the election, Elon Musk INCREASED his wealth by $70 BILLION, and it makes me wanna puke.  Look..  As a capitalist, I'm all for people making money, but there's something really f*cked up about that.

https://www.cnbc.com/2024/11/11/elon-musk-is-70-billion-richer-since-trump-victory-due-to-tesla-surge.html

excon

just_sayin

jack said:

just_sayin said:

It was reported that in just the last four months, the US added another trillion dollars in debt.

Hello just:

If you're seeking to balance the budget, we can either CUT spending, or INCREASE income.  When I was a kid, our family not only survived, but THRIVED on one persons income.  Back then the tax rate for the rich was around 95%..  I'm thinking, why not go back to the good ole days?

Didn't Elon Musk INCREASE his wealth by $70 BILLION since the election???  He DID, and it makes me wanna puke.  Look..  As a capitalist, I'm all for people making money but there's something really f*cked up about that.

https://www.cnbc.com/2024/11/11/elon-musk-is-70-billion-richer-since-trump-victory-due-to-tesla-surge.html

excon

I don't begrudge anyone who makes money, as long as they did it legally, which Musk did.

When it comes to the budget, I think you have to ask a fundamental question 'Are we in debt, because we tax to little, or because we spend to much?"  I would argue that if we do not take care of our spending problem, then if you raises taxes, you will have to keep raising taxes for infinity to catch up to spending.  

jack

just_sayin said:

I don't begrudge anyone who makes money, as long as they did it legally, which Musk did.
Are we in debt, because we tax to little, or because we spend to much?  I would argue that if we do not take care of our spending problem, then if you raises taxes, you will have to keep raising taxes for infinity to catch up to spending.  

Hello again, just_:

Nahhh.  I'm not arguing that Musk made money illegally...  I'm arguing that making $70 billion in a few weeks is OBSCENE..

Besides, where did you learn your math?  Trump U??  Look.  Where I come from, if we take in as much as we spend, the budget is balanced.  You're not saying, are you, that we can't do that??

excon