<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>robbiep</author><text>I believe this to be a fallacy: see my post further down &lt;a href=&quot;https://news.ycombinator.com/item?id=5447890&quot; rel=&quot;nofollow&quot;&gt;https://news.ycombinator.com/item?id=5447890&lt;/a&gt;&lt;p&gt;Too much effort: didn&apos;t read?&lt;p&gt;The summly version:&lt;p&gt;Most of the excess expenditure in the US is &lt;i&gt;not&lt;/i&gt; going to pharma and other device companies for research; it is instead being divided up by billing companies working for hospitals, doctors and other businesses in the supply chain.&lt;p&gt;This should be obvious to anyone who looks at the charts and sees the mean cost vs the high and low end: companies are charging what they can when they can to the end user because there is no good advocate for the end user and they are up against a wall.&lt;p&gt;I also expand on who does in effect pay for medics research and the answer is not the American consumer but mostly the taxpayers (and philanthropists to university endowments etc) of the world given that most of the research that advances medical knowledge, that is &lt;i&gt;innovative&lt;/i&gt; rather than &lt;i&gt;iterative&lt;/i&gt; research, is performed in universities.</text><parent_chain><item><author>michael_miller</author><text>Another way to look at this is that the US is subsidizing the world&apos;s healthcare. Take the example of drugs in the linked article [1]. Given their pricing power in the environment, the article asserts that we pay 2x what other countries do for identical drugs, for no other reason than we aren&apos;t negotiating as a large group. As an anecdotal example, when visiting Beijing, I had some trouble breathing, so I went to a pharmacy to buy an inhaler. I didn&apos;t have insurance that worked in China, so I had to pay out of pocket. Not only did I not need a prescription, but I also only paid $4 for the inhaler, complete with medicine. The same inhaler + medicine costs $10 with insurance in the US (god knows how much without it).&lt;p&gt;Tom Sackville, a UK politician quoted in [1] summed it up nicely: &quot;We end up with the benefits of your investment. You’re subsidizing the rest of the world by doing the front-end research.&quot;&lt;p&gt;[1] &lt;a href=&quot;http://www.washingtonpost.com/blogs/wonkblog/post/why-an-mri-costs-1080-in-america-and-280-in-france/2011/08/25/gIQAVHztoR_blog.html&quot; rel=&quot;nofollow&quot;&gt;http://www.washingtonpost.com/blogs/wonkblog/post/why-an-mri...&lt;/a&gt;</text></item></parent_chain></comment><story><title>Graphs that show America’s health-care prices are ludicrous</title><url>http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>NoPiece</author><text>That&apos;s true of drugs costs, but it doesn&apos;t explain the expense of things like an office visit.</text><parent_chain><item><author>michael_miller</author><text>Another way to look at this is that the US is subsidizing the world&apos;s healthcare. Take the example of drugs in the linked article [1]. Given their pricing power in the environment, the article asserts that we pay 2x what other countries do for identical drugs, for no other reason than we aren&apos;t negotiating as a large group. As an anecdotal example, when visiting Beijing, I had some trouble breathing, so I went to a pharmacy to buy an inhaler. I didn&apos;t have insurance that worked in China, so I had to pay out of pocket. Not only did I not need a prescription, but I also only paid $4 for the inhaler, complete with medicine. The same inhaler + medicine costs $10 with insurance in the US (god knows how much without it).&lt;p&gt;Tom Sackville, a UK politician quoted in [1] summed it up nicely: &quot;We end up with the benefits of your investment. You’re subsidizing the rest of the world by doing the front-end research.&quot;&lt;p&gt;[1] &lt;a href=&quot;http://www.washingtonpost.com/blogs/wonkblog/post/why-an-mri-costs-1080-in-america-and-280-in-france/2011/08/25/gIQAVHztoR_blog.html&quot; rel=&quot;nofollow&quot;&gt;http://www.washingtonpost.com/blogs/wonkblog/post/why-an-mri...&lt;/a&gt;</text></item></parent_chain></comment><story><title>Graphs that show America’s health-care prices are ludicrous</title><url>http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/</url></story>