Yes, I think that is what I said. I don't know if he faces charges but I do know that the prices are still around $700 for two. That's still around a 700% profit (or more)
You are trying to oversimplify the metrics for appraisal, so that you are not seeing the forest, due to your efforts to sketch a neat-looking birdhouse, hanging from one of the trees. Let me be less metaphorical. Take one pill that averages 20¢ each, to manufacture. The most common dosage is 1 per day. So a 90-day supply costs $18 to produce. But the research expense, developing the drug, was rather high. If we cap their profit at 60%, that means the retailer cost is $28.80, for a 3-month supply. Unless that is for a VERY common problem, that company would not see any actual profit for a long while. Say roughly $45/yr profit per customer, if the development costs had been $1 billion-- which is actually on the cheap, if the claim of one of the members of our debate was accurate, saying that the average is $3 billion-- and they average 1 million customers a year, it would take over 22 years, just to recoup their original investment (which, would still put them behind, even if this system kept up with inflation, because the funds had been invested years before the first prescriptions for it would be written). A different drug may have 50 million prescriptions written. But if the average length of treatment for that drug is only 7 days, instead of forever, the results work out to be about the same. Though this is already, for the sake of trying to fit real life into your hypothetical % question, ignoring the fact that the number of pills one gets at a time generally make a vast difference your price per pill cost, in our current system. The pharmacy has a minimum price per prescription. Let's say that equates to roughly 20 pills, for a 30-pill prescription. But if you are just prescribed 8 or 10, you're still gonna pay for 20. So that brings us to another important consideration: does it make sense to limit the manufacturer profit, w/out not also preventing the retailer from taking extra profit for themself? As you might imagine, trying to follow the path you are trying to regiment, soon has us at a system of essentially government-franchised pharmacies. My only real point is that there are a lot of considerations that you are leaving aside like, what is the production cost? If, instead of 20¢, in my example, that drug cost $1.60 per pill, which would make the wholesale cost of 90 pills, $230; so retail what, $300? What if it was something the patient had to take 3 times per day, so 90 pills would only be a 1 month supply: that's $10 a day, for life, for this one medication-- would, then, a 60% profit margin, by which a million customers would recoup your R & D costs, if they were similar, in just under 1 year-- really be comparable to the first situation I described? More differences: what is the health concern that the problem treats? How serious is it? How many are afflicted? Might it not make sense to allow a drug company that develops a cure for Lou Gehrig's disease (just a hypothetical), to make a bigger % profit, than a for a pill to cure baldness? Otherwise, why would not drug companies focus on only the most common ailments, which might promise the most sales, & just ignore anything that afflicts too small a number of people to make it financially worth their while?
Well... it's 18 August 2021. Has anybody seen a noticeable drop in drug prices (or anything else, for that matter)? Ya know, we hear all this political blather about how some president is going to do this, or that, but what actually HAPPENS? I remember that Trump was spouting off about how he was going to take action to cut prescription drug prices, but what happened? NOTHING. Now we've got Geriatric Joe blowing around about what he's going to do to champion lowering prescription drug prices, and what's happened? NOTHING....
Can't do it because then big Pharma won't invent some new chemical magic that they can sell for a gazillion dollars and Humanity will perish.
Aw, shucks... you're right! I'd forgotten that's us in the United States who are always the ones who pay for all the R&D for all the pharmaceutical drugs in the world. My German friends howl with laughter at me when we compare prices of what prescription drugs cost here in the States versus what they cost in Europe! The logic? Well, hell, America won World War II seventy-five fugging years ago, so, America needs to pay for EVERYTHING!
This is about what the pharma companies are making and that whether they make too much and that should be controlled so the SALIENT question is what profit margin is TOO MUCH. This is not about one $.20 pill. It's not about one person. This is about the industry and the cost through all development and licensing and testing and approvals and all the failures they also have. What do you think would be too much profit for a pharmacy? Give me your numbers. And not made up numbers with your questionable math.
(cost of R&D spread over 5 years) + (Cost of manufacturing, distribution, etc) + 60% I think that's fair Why does this number matter to you?
Are you even being serious? You believe a President needs only snap his fingers, to fix the complicated free-market system that now governs drug prices? It is very involved, a bit arcane, and never well explained, by "experts," for the benefit of the general public, so I would rather not have to try to convey my imperfect understanding of it, to you; it is better, I think, for you to look into this yourself, if you have any doubt of what I'm saying. But how many years did you give Trump, before you decided that he was full of crap? So, how about giving Biden that same chance? The argument you seem to be presenting is: well it hasn't happened so far, despite all the talk, so therefore it's reasonable to believe that it never will. Really? Nothing big, ever takes time, building up momentum? Do you remember the public, healthcare reform, that took place, when Bill Clinton took office, spearheaded by 1st Lady, Hillary? Oh wait, that's right, it failed. And, in fact, the call for universal healthcare & similar renovations had been heard for some time, before that. So I should have known, that it would never happen, and we'd still have the exact same system today, right? In fact, we've heard politicians talking about getting out of Afghanistan since, at least, the discussion that led to, "the Surge," which was over a decade ago, so I guess we'll never leave. How many more of these, do you want me to do? Biden has clearly shown that he is willing to break new ground, to do things that some have spoken of, but have not had enough support for, before now. You seem to leave this out of your equation, as if all it takes to get things done, are a couple of politicians with an intention. But you are no doubt keenly aware of the limitations that objecting members in Congress can impose, despite the preponderance of public opinion in favor of something, whenever you hear Democrats talk about "gun-control." So your no-waiting attitude, in this case, seems utterly unwarranted. Most of the changes Biden proposes, require legislative action. It was Congress, for example, which passed a law which prohibited Medicare from negotiating drug prices, with suppliers (manufacturers). Therefore, it will take Congressional action to change this. Shall I start thinking of you as so politically wet behind the ears that you don't understand that there are numerous, generally time-consuming, steps between the mentioning of ideas, in a policy speech, and the passage of a law, and then the implementation of that law, and then one feeling & seeing the effects from its implementation? Likewise, Biden's desire to recruit our government health services (National Institutes of Health, I presume) in the search for new drug treatments, will be a matter for the next federal budget (also a Congressional matter). Is it necessary to explain to you why, on whatever day the next budget is passed, even with it including additional funds for this purpose, you should not expect it to result in a medical discovery that same week? I don't usually enjoy speaking on such a low grade-level, to someone who I presume is capable of understanding better-- so why the ridiculous comment about it being knowable that nothing will change, under Biden? Just having a particularly pessimistic day?
Point #1: if you found anything questionable about my math, it only proves your own fecklessness, in that discipline. My examples, gave all the necessary information for any math-competent 7th-grader to work out the totals, without any trouble. But I'm not going to argue the matter with someone who clearly has no footing, in this field. Just tell me you couldn't verify the math in my examples, and I will, "show all my work," every simple calculation, just for you. Beyond that unwarranted shade, coming from you, I will point out that these were merely hypothetical examples, meant to demonstrate my point; a point which your repetition of your question (which my prior post had been addressing), demonstrates, went completely over your head. The answer to your simplistic conception of drug margins is: they are not at all CONSISTENT, over ALL products. In other words, it is the profit margin on the drug maker's ENTIRE PORTFOLIO of products, which should be the focus of your attention, not the individual drug. Some, they will likely sell in great quantities; others, in relatively small amounts. If you would re-read my reply, you will (hopefully, this time) notice that my other main point was that thought need be given to the vast differences in the applications (& societal benefits, etc.) of different drugs; so there is a potential basis for saying, for instance, that drug makers who devote resources to such-n-such underserved area, should be entitled to a greater profit margin, when those drugs come to market, than more drugs developed in a class, for example, in which there are already a plethora of available products. Any of this getting through, in the second go 'roud?
I'm asking YOU what YOU believe not ME. Your dodges notwithstanding. And no you cannot make a simpleton statement about just one of their products. Try again. How much profit should the government "allow" a pharmacy to make if you are going to give the government the power to do so.
I certainly don't exonerate Trump for blowing off about how he was lowering drug prices in America. He created an Executive Order on Sept. 20, 2020, and announced it with full fanfare on Twitter: https://thehill.com/policy/healthca...executive-order-aimed-at-lowering-drug-prices You know what an Executive Order is... right? "Messiah" Obama used them extensively all during his second term especially, bragging infamously, "I've got a pen and a phone...." -- and that's essentially how the country was governed until Trump replaced him... and that was certainly good enough for everybody left-of-center. Anyway, as I said, along comes Trump -- very belatedly -- right before the 2020 election (what a coincidence!), and says he's done it -- he's taken ACTION to make sure that we don't pay any more for prescription drugs in the United States than my German friends do. HA! What a pantload of crap THAT turned out to be.... Still in all, it's funny how Obama's EO's worked routinely, but Trump's somehow, uh, didn't.... Now, here's Geriatric Joe, promising within the last week to "urge" Congress to lower drug prices, at the same time he's drowning in disgrace, laughter, and scorn over his totally botched handling of the Afghanistan 'withdrawal' (again, what a coincidence!). Ya, see? I'm an 'equal-opportunity' critic -- I'll call 'bullshit' on Trump, and turn right around and do the same for Biden! And meanwhile, prescription drugs in the United States remain greatly higher than they are in any other First-World nation on the planet! . "Americans are RICH! They should pay more for everything!" -- "And our lobbyists agree!"
Well I congratulate you on your open-mindedness, in being an EOC (equal opportunity critic), but encourage you to now be more DISCERNING of mind, in your criticisms. Your impression of how our country "was governed," for 8 years, under Obama notwithstanding, EXECUTIVE ORDERS are limited in the scope of what they can accomplish; for certain purposes, they can be very effective, especially as a stopgap measure, when there is a Congress that doesn't have the will to take up the issue, itself. Many other things, however, can NOT be affected by E.O.s-- though that doesn't stop a President from signing a meaningless order, which amounts to nothing more than wishful thinking, on the Chief Executive's part. The price of prescription drugs, falls under this category of situations that-- in this case, because Congress took it upon itself to pass LEGISLATION, prohibiting Medicaid from negotiating prices-- Executive Orders cannot override, or impact upon. Without that previous legislation, Trump could have done something (though I have a feeling that Obama's "pen," would have already traversed that parcel of governmental practice, had it been doable). So, chin up-- if you are genuinely hopeful of reform, in this area, it IS possible, and the will is sincerely there from Biden, from all indications, as well as from the majority of the Democratic caucus; which is an amazing thing, considering all the money, in one form or another, that the Pharmaceutical Industry throws at politicians. This is the kind of thing which has, over the last year, increasingly rehabilitated my ideas about the potentials for either of the two Major Parties, in our political duopoly. What you should watch, carefully-- if you wish to have a sophisticated, nuanced, and accurate view of the politics surrounding this issue-- is the tack taken by Republicans in Congress. I have a feeling that most, if not all, will be unwilling to work with Democrats, to remove the roadblocks which their branch of government had set up, preventing lower-negotiated prices. I have no idea what lame pretext had been used, at the time; and I cannot imagine what bogus reason they will give when this comes to the floor in the House & Senate (perhaps something having to do with trans-sexual athletes? Or the Dr. Seuss legacy?). But you can count on Democrats, with Biden's clearly indicating his desire to focus on this, to take a run at it. What increases the likelihood of their success, is that this is an agenda item that unambiguously has a budget impact, & so qualifies under the, "Reconciliation," rules, to allow Democrats to pass it, with only a majority vote. If you doubt that the attempt will be a genuine one, just consider how popular a move like this would be, if successful. It might even cause some MAGA seniors to rethink their allegiance to their Trump Savior. Certainly, you know that Biden & the Deez, want to enact as much popular legislation as possible, before the midterm elections. So the only two questions that remain are: 1) how do Manchin, Sinema, and any Democrats who get a significant part of their campaign funding from Big Pharma, feel about this; and 2) is this one more issue that Republicans, en masse, are willing to turn over, completely, to the other Party (which I think would be a catastrophic miscalculation, on their part) or, as with part of the infrastructure package, will some Repubs have the guts to stand up to Trump-- who, hypocritical as it is, you can almost be sure, will lobby against it-- and see what is, clearly, in not only America & her peoples' (their constituents') best interests, but also those of their own, political futures?
Your post encompasses three categories of written information: the unintelligible, what is plainly wrong, and the vague and insufficiently defined. So why don't you try again. The unintelligible part is in your first paragraph, with some plainly wrong mixed in. For example, I never even tried to tell you what YOU believe. If that is not what you are saying, in your first sentence, refer to the "unintelligible," category. For that matter, my answer, which I took pains to carefully explain, twice, applies without regard to person, so what you mean by suggesting you want the answer for, "ME," is a nonsensical request. It's like if I asked you, how can I tell if I need an oil change, and your answer included information about assessing both the dirtiness, and the viscosity of oil, to which I responded, "I asked how to tell if MY oil needs changing, not YOURS! Your dodges notwithstanding." IOW, the answer, in both cases, applies to anyone, is not specific to any particular individual. And therefore, I have no clue to what you possibly could be referring, as a "dodge." I know you like to keep your posts short, but to do that, one must speak with considered clarity, which is NOT reflected, in the least, in your post. So I suggest you put in those words that you thought you could dispense with, and some more, besides-- not to go off on a tangent but-- to make it lucidly clear what you are trying to say. This brings us to your vague, 2nd paragraph. Again, I have no idea as to what you are talking about, when you ask, "How much profit should the government "allow" a pharmacy to make if you are going to give the government the power to do so?" Under what circumstance, do you refer to? Let me give you an example of what clear communication looks like: You say that the government should be able to set the price of all prescription drugs. What profit margin, therefore, should it permit? It's just a few extra words, but it would be perfectly comprehensible to anyone who had said that the government should set all drug prices. I, however, never maintained this. So you must be asking something else. But you can use the same model that I provided. Instead of quoting this reply, quote the claim of mine, about which you are asking. Please show it, in context and, if that means a longer paragraph with the possibility of any uncertainty over which statement you are referring to, you can simply highlight or embolden that line. Then you can say, "You said this; OK, how is this price determined?" Honestly, I don't recall advocating, myself, for any such policy. I DID say I supported Medicare's being free to negotiate drug prices. But, as a NEGOTIATION, this would not seem, to my mind, to meet the specifications of what you are asking me about. That's why I need you to better communicate your thought; not because I'm trying to dodge anything, but because I really don't understand what it is, that you are trying to ask.
@Pollycy I am just correcting a mistake, in my last post. I have recently begun associating the two Democratic Senators, Manchin & Sinema, with the Conservative/Republican views, because of their stances on some recent issues. So I, unthinkingly, tossed their names in, since many Republicans will, with little doubt, find some reason to oppose allowing Medicare the flexibility to negotiate lower prices, from drug suppliers (actually, come to think of it, since the prescriptions get paid for through pharmacies, which each have their own prices for any given drug, it would seem Medicare would have to negotiate with them; though any cost-cutting, to be really effective would need involve the wholesaler/manufacturer, as well). My mistake was that not allowing Medicare to use free market principles, to get better prices, is NOT a "Conservative," issue. Since I believe Joe Manchin (who I am a little more familiar with) generally tries to do what is best for the people of his state, and whether one is on Medicare, or just a taxpayer, this common sense step is going to be beneficial, I have, therefore, no reason to think that he, or Sinema, specifically, would be against the plan.
Well, when we mash all the air bubbles, farts, and fumes out of the whole issue regarding the regulation of prescription drug prices in any country BY that country, I suggest that we take a good, long, investigative look at HOW European countries achieved much lower prices for their citizens than we pay here in the United States! Surely we can agree on at least THAT much.... Hint: How does Germany get lower prices for pharmaceuticals? The German Federal Joint Committee (G-BA, Gemeinsamer Bundesausschuss) is a public legal entity comprising the four leading umbrella organizations of the self-governing German healthcare system: the National Associations of Statutory Health Insurance Physicians and Dentists, the German Hospital Federation, and the Central Federal Association of Health. Prices for new drugs are established in Germany through collective negotiations between a single buyer (the umbrella organization representing the insurers, also known as the Sickness Funds) and a single seller, the drug maker. Germany’s system, which uses centralized drug assessment and price negotiation for new drugs coupled with reference pricing for noninnovative drugs, has resulted in substantially lower drug prices compared with the United States.
OK your rant notwithstanding you refuse to answer the simple question, what profit level for pharma's is too much and at what point under these proposals would government limit it. And yes that thing called brevity.
A very wise man once said, "You don't get what you deserve -- you get what you negotiate!" Indeed, that's ambrosia-class 'food for thought'....
My initial reaction, was thinking that it would be difficult to get that to happen, here; that is, having all private insurance companies join a pool, in which one representative negotiates a single price for all of them. Our respective systems-- both healthcare & political-- vary significantly enough, as well as do our cultures, for this very sensible modification to not get a warm reception, in the U.S. Then, however, I remembered what Biden had said, in his speech (video in the OP), about negotiating a Medicare price, that should then apply to ALL INSURERS. This was something that I spoke of, in an earlier post, as seeing as potentially the most problematic of Biden's proposals, since it was very akin to price-fixing, or price controls, which are considered anti-free market (which, ironically, is the magic carpet that is touted as bringing us the best services, at the lowest prices; and, in this case, as your German example shows, it is producing just the opposite effect). It will be interesting to see if President Biden has any luck, cracking this corporate business nut. But the real hold-up, I'm sure, is going to be legal challenges from the Pharmaceutical Industry (with perhaps a few aspiring Republican presidential candidates, contributing amicus briefs).
Apparently, English is not your first language (or, for your sake, I hope that is the explanation). I stated that your question made no sense; I gave examples of why it made no sense. I explained how you could fix that problem. This meets NO definition of a, "rant." It was an attempt to correct your incomprehensible post, so that it could achieve its presumable goal, of conveying to me an understandable request, so that I could then give you an answer. (English lesson: the foregoing recap, necessitated by your deficiency in understanding our conversation, was, also, not a rant). Your response was to REPEAT the same, unclear question, in the same way. You have, then, essentially ignored my response, completely, making all my effort to understand you, a total waste of time. I can only take this to mean-- besides that you are rudely inconsiderate-- that you really don't want an answer, to your question. I had even, specifically told you to NOT quote my explanation of why your post was confusing, and my idiot-proof (I thought) directions on how to remedy that, but to instead reply with MY post that would clarify which of my statements you were referring to, which you also disregarded, as if you'd not even bothered to read my reply. I will not be likewise troubling myself, again. (And yes, that thing called intelligibility).
Did Hiden explain why other countries sometimes pay less for certain drugs? Because neither you nor he seem to understand how that works. Not only that, your position is hypocritical. The Liberal meme is that the wealthy should pay their fair share, right? Well, you are paying your fair share and you don't like it. You're the richest/wealthiest country on Earth, so you should pay more and you are paying more, so what's the problem? Shall we talk about Price Elasticity? Cost-of-Living is a function of that. How much will you pay to send your child to the very best private school in India where they will become tri-lingual and math wizards and science warlocks and coding gurus? $698/year. No, I didn't stutter. Can you send your child to a private school in the US for $698/year so's they can steal everybody's job? Do you think every Indian can afford $698/year for the bestest private school? No, they cannot. Then how in the hell are they gonna afford $215 for Nexium (that's 2013 data by the way)? For many Indians, $215 is like 20 years of wages. That raises some moral and ethical issues, but I get that Liberals have no moral compass and ethics change every 6 nanoseconds, but it would be manifestly unfair to deny people treatment on the basis that they cannot pay for it, if it is life-saving treatment. If you contact the pharmaceutical company, like my sister did, they'll send a representative to your home to verify your financial need and then discount your drugs if you qualify. So, my sister was paying $800/month for a drug she has to take every day lest she go into a coma and die within 3 days if you ain't got it, and Astra-Zeneca reduced it to $0, and then reduced another drug to $60/month. The Dutch and miserable fat Belgian bastards only paid $23/month for Nexium (again, 2013 data). Why? Because that's the price their governments negotiated. Why? Because they have universal healthcare. I'll let the former German Minister of Health explain it to you so that you can easily understand: "In the past 20 years, our overriding philosophy has been that the health system cannot spend more than its income. Virtual budgets are also set up at the regional levels; these ensure that all participants in the system—including the health insurance funds and providers— know from the beginning of the year onward how much money can be spent." [emphasis mine] Source: How Germany is reining in health care costs: An interview with Franz Knieps pp 29-30 The German government sets the budget. That money is allocated to each German State based on population and then allocated to the insurance funds and providers on a pro rata basis each fiscal quarter. Once they run out of money in a fiscal quarter, that's it: Game Over. There ain't mo' money until the next fiscal quarter. Of course, they could always hold private fund-raising events, like the Brits did when the NHS went bankrupt due to STUPID-19. Can you imagine holding a walk-a-thon to fund your local hospitals? Because a 98 year old WW II British veteran did exactly that when his local NHS facility ran out of money. What I'm hearing is Joe Hiden doesn't give a damn about Americans' health and is ready to ram through drugs with little or no testing at breakneck speeds. Yes, Americans are and have been subsidizing these wonderful universal healthcare systems in other States by paying higher prescription drug prices to off-set losses incurred. Whose fault is that? The pharmaceutical companies to be sure, but some old saws come to mind, like "A bird in the hand....," and "Something is better than nothing." So, it could get real interesting since if major US players start negotiating prices that means pharmaceutical companies will have to raise prices on those countries with universal healthcare, and Britain is the only State in a position to fund its pensions and healthcare system through 2045. Note I said they're in a position to do so, not that they could actually do it, although they can if they make serious cuts to their pension plans and healthcare budgets. So you admit you want to politicize healthcare. Got it. Instead of Göbbelizing with Liberal Taking Memes, it would behoove you to do some actual research. According to the National Institute of Heath (an oxymoron), between 2008 and 2019, your government spent more on breast cancer research than it did on prostate cancer research, in spite of the fact that prostate cancer kills more men than breast cancer kills women. In fact, if you analyze government spending, it's whatever gets the most Media attention, so guess what government has been wasting your tax dollars on of late? Alzheimer's and other forms of dementia. "The squeaky wheel gets the oil" is not a good way to run a business and certainly not a good way to run a government. That's even more true given the clout the government allows WHO to have with respect to research money. R & D is subject to the Laws of Economics just like everything else in this Universe. R & D monies are scarce and to allow the government to meddle with the Media and WHO meddling more is just plain wrong. Drug companies spend $10s of $Millions on R & D for only a fraction of drugs to make it to clinical trials where 90% of them get 86'd. If you want to levy a valid criticism against drug companies, then criticize them for developing non-essential drugs, like Nexium. Those people can change their ****** diet instead of soaking us for their prescription drugs. But, then, there's moral hazard with the system you allowed your federal and State governments and the American Hospital Association to put into place. We're so sure you got evidence to back that up.
Despite the implication that you were going to EXPLAIN what neither our President, nor I, understand (supposedly), you segue, at that point into a discussion of private schools, in India, then a personal story about your sister, and a slur on Belgians, before finally mentioning UNIVERSAL HEALTHCARE, which is not in the least, something I don't understand, as making the setting of drug prices more easily accomplished. I assume Biden understands this as well. The things you apparently are clueless about are that: 1) a solution that is not politically feasible, for the present time, is no solution at all; and 2) just because a single-payer system is the most logical for keeping drug prices in check, is not the same, by any means, as saying that there are no other measures that can have an impact on lowering prices. So, at this point in your treatise, the twin points that seem to be peeking out from the screed-line, are that A) you do not believe in any remedial action at all, unless it is the theoretically most ideal (even if currently unworkable) solution, and B) you are purportedly in favor of the U.S. moving to a Universal Healthcare system. So, why not save yourself all the typing, & just send me the link to your post(s) advocating for this, since you seem to be so well-versed, on the subject? If you're just in the mood to write-- you know who really appreciates a long, rambling & circuitous post? @Bluesguy. BTW, @Pollycy , posted, on this page, info from a link on the German system which, even if they have Universal Healthcare, still have private insurance companies-- suggesting that hybrid systems, and hybrid solutions, are at least possible. http://www.politicalforum.com/index...-on-drug-prices.590955/page-6#post-1072872533
If your single goal is we paying fewer of our medical dollars for drugs perhaps but can we afford tobhabe that as our single even most important goal at the cost to other concerns?
A drug company's profit margin is "too much" when other companies see them making piles of cash and hop in to capitalize, which creates competition and lower prices. That's the answer.
If one, like yourself, just doesn't have what it takes, to carry on a big-boy debate, the answer is not to start misrepresenting the other person's case: just move down to someone closer to your own level. I NEVER SAID THAT PAYING LESS FOR DRUGS WAS MY, "SINGLE GOAL," which appears to be the entire basis of your post; if you are going to just start making things up, & pulling 'em out of your arse, I'm not going to even bother to reply. A secondary thing, but one I would still like to stress, is that there is a very good reason that PUNCTUATION came into being: it is essential, for clarity of the intended meaning of written material. Therefore, please use it, in your very short messages to me-- how much trouble could that possibly be, for you? For, without it, I don't automatically "hear," your words, in my head, the way they are, in your head, when you omit periods & commas. There is no reason that I should have to try & figure out what you are trying to say, because you find it too much of an imposition, to throw in some mark of punctuation. It took me some time to understand your current word-jumble. Not a lot of time; but a lot more than it would have, or than it should have. This is especially true, because your syntax is not always correct, which makes things more confusing. Your current post, for example, seems a merging of (at least) two different ways of saying something (see below): If your single goal is we paying fewer of our medical dollars for drugs(,) perhaps but can we afford tobhabe that as our single even most important goal at the cost to other concerns? That is not correct English, & not readily understandable. The words, "perhaps but," are just red-herrings, obstructing the flow of your thought. What you apparently mean, is: If your single goal is that we pay fewer of our medical dollars for drugs, can we afford to have that as our single, even most important, goal at the cost to other concerns? It's still awkwardly put, but the correction in red, plus two commas, makes it much more readable, without adding to the length. In fact, if you strive for brevity, there is excess baggage in your sentence, beyond the words, perhaps but. For example, you could merely have asked: Can we afford to ignore, or minimize, other concerns, in order to make saving on drug costs* our single goal? (*I would have further shortened "saving on drug costs," to just, "drug savings," but wanted to include as much of your own phrasing as justifiable). So, you see, I do give thought to my words, including not wasting them, by using more than are necessary-- just to give you an idea of how much of my meaning you are discarding, when you look at a large part of my post as just, "more of the same." If you do this, it is fair to ask, are we truly even communicating? You may not like, or agree with, what I'm saying, but you can be sure that I am saying something.
