(student) I am a full-time student and I also work in a pharmacy
and it's the beginning, relatively the beginning of the year right now
and for those who are in the middle class that be means deductibles and premiums
yes! now, the epipen for example back in 2006-2007 was around $90
now we look at the price of the same drug
same drugs now made out of gold although ironically
it is yellow and now costs $595
yes, um in light of yesterday's debate with us and Mr Sanders and mr. Cruz
how should we take care of these insanely huge deductibles
there's people that cannot afford a life-saving medications like the EpiPen which helps with allergies
if not setting a price
range if not importing drugs from Canada
(Shapiro) well we should have drug importation obviously.
i think more competition in the marketplace is better
when people have a monopoly on the EpiPen it's a problem
(student) and a big issue with this is that the open market
has cost this patent system where any pharmaceutical company
Milan Perico etc... etc...
(Shapiro) right! now this is a race issue this is very serious issue
(student) yeah! what is your suggestion to resolve
the growing costs of life-saving drugs?
(Shapiro) yeah! I mean I think that as populations grow
the period in patent exclusivity is going to have to shrink
so the, you know, patents have a certain life period thats handed
the Congress has the power to license patents for a certain amount of time
(student) for years but the companies can manipulate it to extend that
just by changing things scientifically based like chirality, vectors
(Shapiro) yeah it has to be shortened
particularly in cases where there's really only one type of drug
because some some drugs obviously can make sort of a generic competitor
it's not exactly the same but it's really close
I mean you know more about this than I do
but there are certain areas where there's an absolute monopoly on the type of drug
and there you have to talk about shortening the period
because otherwise you're going to end up with monopolies in the market
like that's a true monopoly that's a natural true monopoly
(student) they are
(Shapiro) yes and that's obviously a problem
as far as you know our health insurance system right now
there's two questions to be had
one is what does the ideal health insurance system look like?
or the health care system look like?
and one is, how do we get from here to there?
and those are not the same question
and I think people tend to conflate the two
so for example there's a lot of people right now who have pre-existing conditions
and when I say 'free market' people think, oh I'm going to immediately throw them off their insurance,
and that means they're going to die in the streets because I'm saying free market
no what I'm saying is that we've had a system where for a very long time
there hasn't been a free market
and so what you have to do is you basically have to say to young healthy people
that you need to make good decisions now
right it's on you you want to buy insurance you buy insurance
but we're not going to apply to you the same rules we're going to apply to 65 year old
who's been living under a bad to health care regime for the last 40 years
(student) aside from an EpiPen, how can you prevent having an allergy
(Shapiro) right now i'm not saying that you can prevent having an allergy
I'm talking about health insurance now I mean if you want to talk about you know
the EpiPen and how people get access to it?
first of all I think that there may be and I think there probably
let's put this way, there e are community solutions that don't necessarily come from government
meaning that in my community, right, my Jewish community
people when there's a health problem people really put a lot of money into it
to help out their friends and neighbors
which is why I talk so much about social fabric
and I say if there's no social fabric you end up with the growth of government
because somebody has to take care of the people who fall between the cracks
that used to be churches right now it's the government
so you know on a long-term level you want to sort of redirect it away from government
and back toward those churches
for now we're going to have to give subsidies
I mean that's just reality I mean, Cruz said it himself last night
virtually everyone on the right understands
but the question is is that a temporary stopgap
or is that your final solution
and I think it should be a temporary stopgap
aiming toward eventually eliminating a lot of these subsidies
and making people responsible for their own health insurance
because if you're not going to...
eventually look, if you're not going to pay for your own child's health insurance
or if you're not going to pay for your own health insurance
then the market attends.
if you don't take care of yourself and you don't pay for your health insurance
you can't penalize people who make good decisions on behalf of people who make bad decisions
it's different for children I think than it is for parents obviously
(student) all right thank you can I shake your hand
(Shapiro) sure
