Broom:
That is a FACT. Medicare does not cover drugs at all you ignoramus,
Learn to read:
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Medicaid has 1 dollar copays; and those can be waived if the patient is completely indigent. In other words you mother pays a miniscule fraction of the true cost of her medecine because she can afford it."
If your mother were poor she would be eligible for medicaid, which has more lenient standards for admittance of seniors. In such a scenario she would NOT HAVE 800 dollar copays. There is a reason that Medicaid exists and why it is easier for seniors to enroll than the general populace, as well as the chrononicly ill, but what the hell let's just pretend I said Medicare so you can rant and rave about a strawman.
In fact, anyone over 65 is more or less forced into Medicare unless they are extremely wealthy. What's Medicare? A government-run insurance. So why, if it's good enough for those over 65 and has been for 40 years it's not good for those under 65? The nasty, dirty fact is that we already have single-source insurance in this country - but just for one segment of the population.
I would like to reform medicare, as I have already stated. It is among the stupidest forms of insurance in the country. As you amply noted it doesn't cover medicine, even thought that TENDS to be the most cost effective treatment. Likewise its PM policy sucks ass. Medicare is wonderous example of the stupidity of the US government at managing care and why I sure as hell don't trust them to take over the rest of the market.
An indigent senior might qualify for both programs, but most seniors do not. Those qualifying for both are most often the disabled.
By federal mandate any senior who is below the poverty line is automaticly eligible for Medicaid. Further spenddown policies allows one to deduct medical expenses from income or wealth until they meet the eligibility requirements. Most seniors do not qualify for Medicaid because most seniors are in the wealthiest quartile of the American population. The vast majority of seniors are wealthier than half the country. The atypical senior is poor and the atypical senior has a variety of programs designed to cover them.
And in the US thousands of babies die each year who might not have to if we provided better prenatal care to women.
Let's see the stastics. Pregnant women whose family income is below 185% of the federal poverty limit are covered by Medicaid.
Just completely ignore that Britons as a whole are terrible about showing up for routine screening tests, as chronicled in the BBC over the past few years. Japan has the lowest rate of breast cancer and breast cancer deaths in the world - by your argument that makes them better than the US.
No by arguement we'd first discount the differences in genetics. As the International Journal of Epidemology did and showed that Japanese women had a higher survival rate than other women ("Caucasian", Chinese, and
Filipino) even when they were all treated under the US health system. Indeed it mattered not a whit if the woman was a first or second generation Japanese woman, she was still more likely to survive than someone from a different genetic heritage. Thank you for yet another example of why comparing unnormalized stastics is lousy science and worse public health policy.
What makes you think all the profits are going to research? American drug companies have bigger marketing budgets than research budgets, and their executives have huge salaries, perks, and bennies.
You claim that all the profits are going to these things, then PROVIDE SOME NUMBERS SHOWING IT.
In any event advertisement does have public health benifits. When a company advertises a drug, say a statin, people who otherwise wouldn't seek treatment, do. On average this results in earlier treatment (more lives saved), better preventative medicine (more lives saved), and fewer complications (more lives saved and more money saved). If you have some data showing a clear adverse affect on public health that isn't washed by an offsetting benifit, please post. Everything I've seen has shown either a slight net benifit, or is wash.
What about the insurance companies? The only insurance companies I'm aware of that put money into any form of research with an aim to benefit patients are a couple of the Blue Cross companies, and Kaiser which has a joint partnership with the national group of Blue Cross. That's it. All the other meta-analysis shops like Hayes and ECRI are outside the insurance company herd. MOST insurance companies in the US, especially among the for-profit ones, plow that money back into their companies and no patient benefits from their profits.
Except of course that those profits bring other investors to create more insurance companies, bringing more competition to the table, and resulting in more consumer choice as well as competition.
The big thing private insurers do is provide a NICHE MARKET for treatments that haven't yet become universal. They provide the reason for other investors to plow massive investment into mass production and price reduction.
The US has done well by having the government sudsidize basic research, the research for the sake of knowledge, then have private companies use the results to bring the work to market. Private industry wants to deal with things that make money - understandably so - and companies like DuPont, which do perform basic, frequently not-immeidately-profitable reserach are the exception, not the rule. But it's the basic research angle that most often gives us the blockbuster breakthroughs.
I know for a fact that Merck, Dow, 3M, GSK, ISSYS, Medtronics, and a host of others do basic research as well. In my own personal experience at the industry conferences the rule is to devote a small fraction of your R&D budget to basic research and the vast overwhelming of it to scale up, targeted research, and development.
I have no problem with a government that is a player in the research game, I have a problem when it becomes the dominant player.
By the way - when the government subsidizes medical research it's usually in the form of grants, and NOT as an "investor".
Actually normally it is in the form of salary at a state school or subsidization of facilities. Those things tend to come from budgets not earmarked for R&D, but make up a massive chunk of the cost. For many fields, like say all the computational ones, salaries are a bigger chunk of the budget than anything else.
As I said, the US has done well with a mix of basic and "practical" research, with the basic research (frequently NOT profitable at all) subsidized by the government and/or private institutions/organizations and the "bring to market" development by private industry. None of that has to change under a single-payer system.
I have NO problem with a mixed research system. My problem is that if just count on government to 'increase the research spending' it will suffer from the over centralization. A balance of centralization vs autonomy shows a better track record for more benificial research.
Corporate research which is also assisted by government funding. And part of the reason private industry is researching these things is that, while each is a long shot, the pay off for even one good "hit' is enormous.
Oh please. How many SCIDS patients are there? How in bloody hell will that give an enormous payout? The real reason pharma is working there is because it is a good "model condition" to work out techiniques to later apply to other ailments; that and of course the PR benifits. The average payout for improved chemo is pathetic, I don't think there has been a cancer blockbuster in decade, the drugs themselves pretty much have to be expensive as all to make and a large profit margin eliminates any incremental improvement in cost effectiveness.
Right. Just ignore the fact that most government-funded research isn't concerned with mass production and marketing, it's looking for discoveries which can then be made profitable by private interests.
My point is that one without the other is USELESS. Right NOW the limiting factor isn't basic research, it is scale up. There are more ideas out there that would be benificial to implement than could seriously be looked into for scale up in a dozen years. A market orientated system has a better historical record of pumping the obscene R&D investments needed into the process than public funding.
But we don't have "egalitarian access". If you're employed or rich you have access. If you're not either of those accessing the system will bankrupt you which, whether you believe it or not, IS a barrier.
Most public health policy number crunchers agree with the economists that increasing access comes at the price of decreasing efficiency, ceteris parabis. There are ways to improve access and increase efficiency, but one must be extremely careful of TAANSTAFL. The current US system is both inefficient - i.e. Medicare, oodles of incompatible paperwork forms, and has some access gaps - mostly the so called "working poor". A monoposony, or similar price leverage/standardization scheme provide better efficiency and access, but almost always there are bad reprocussions that enter the system then. When you leverage prices down, you spur monopoly formation to rebalance the lever. When you have but one centralized provider you are more likely to be less responsive as well as have negative pressures on R&D and capital outlays.
Code: Select all
Then why has the US been closing hospitals in recent years rather than opening more? Why do we have a shortage of nurses and general practitioners? Why do people in rural areas have to travel long distances for even basic care?
1. Because hospitals are writing off billions of dollars in uncollected debts every year. Most of that is due to paperwork SNAFUs which I have already addressed. Of course much of the rest of the world has been closing hospitals down. Canada closed something like 10% of hospitals several governments ago (early-mid 90's).
2. Because there are not enough slots in Nursing schools to maintain even replacement rates, let alone deal with the demographic reality that Nursing demand is spiralling upward as the baby boom greys out. Hospitals are paying massive premiums for Nurse, here in Ann Arbor - with no less than 3 nursing schools in a half hour radius - there is a page of classifieds seeking nurses, I'd give pretty good odds your local classifieds have several listing for nurses wanted. There are far more people applying to be nurses and doctors than ever get to go through schooling, that is your bottleneck. Not surprisingly I have already covered this point with your before.
3. Because people are moving further out of the urban areas and there is a very long time lag for building new medical infrastructure.
I don't know anyone who wakes up and thinks "gee, I like to spend a week in the hospital".
People wake up with joint pain and they face a choice of Cox II or aspirin. If the cost THEY pay is all the same, many will take the Cox II because they can. Likewise if it is going to cost you the same amount of money, would you rather have cheap meta amlagaml dental fillings r more expensive but cosmeticly superior ionomeric or porcelain dental fillings? Most people would take the nice white looking fillings over the grey amalgam - yet the cost effectivene choice is the latter. If you have no checks on the system people tend to game it to get the most possible care out, no matter if the behaviour in question would bankrupt the system if everyone engaged in it.
There is this concept called "triage". It's when you look a person in the eye and say "You aren't sick enough to be here. Go home." Best done by a trained professional, naturally.
I understand triage, thank you. However as noted before if you have the choice of telling the rich guy to go home, or of having him paying a hefty enough premium to allow for increased capacity, which would you choose? Allowing the rich access to superior care, care that you simply cannot afford to give to everyone in society, allows good things to happen. Capacity can be increased through premium charges, revenue streams thicken - leading to increasing commoditization and decreasing per unit costs, and of course the rich person is healthier.
As an addendum, the "abortion pill", RU-486, was developed in France - the US long ago ceased to be on the cutting edge in birth control technology, if it ever was there in the first place.
Never was. Birth control was initially researched and developed by Roche, trade secrecy has allowed a collection of French interests to maintain a lead on new R&D - though some have been bought out by global companies. US pharma tends to derivatize developments from abroad and tries to undercut on cost predominantly. Any type of abortificiant, or whatever the damn class has been called by the FDA, is a massive PR liability in the US and virtually all the work done on medicine or devices targeting those is done by some no name corporate shell with many layers of plausible deniability. Not the least of which is moving it offshore to reduce reporting requirements.
Because the US system overuses antibiotics, which does keep infection down short-term but creates drug-resistant strains down the road.
Everyone overuses antibiotics. Some socialized countries, particularly outside the G-7 have horrid records in this regard.
American cancer rates are dropping because rates of things like smoking are dropping, we no longer utilize asbestos and other toxis substances quite so freely in industry, and we've managed to clean up our water and air significantly since the 1950's and 1960's.
Everyone is smoking less. Asbestos has a miniscule cancer risk and every single bloody case I've seen happened to workers in the industry with piss all for protection.
You are right that improvements in safety procedures and waste disposal have had dramatic impacts. Of course I've never heard anyone claim that Canada has or has had inferior safety regulations nor that Canada has had worse waste disposal procedures; quite the opposite in fact.
I dunno about that "organ failure" thing - I'd think the high incidence of diabetes among Native American/First Nation populations would skew that statistic at least for pancreas failure.
How much?
Even if that means YOU are left to die from a treatable condition because you can't cough up the money, but someone else lives because they're wealthy? Do you really mean that? Are you willing to die without a peep for your stance?
At this point in time I'd like to say yes. I hope I'm altruistic enough to do so. Having not faced a life or death choice like that I can't say for certain.
You know, you can get insurance to cover natural disasters.
You can get insurance to cover health problems too
In some cases - such as flood insurance - the government actually provides the insurance because private industry refuses to enter the market. Gee, I guess the "free market" doesn't solve all problems.
Private insurance refuses to enter the market because people refuse to premiums remotely close to real cost.
The government steps in because most flood damage ends up disaster relief. After spending years forking out wads of cash on disaster relief the government started charging a fraction of the true cost for insurance premiums in order to lesson costs. The reason American taxpayers subsidize the insurance of wealthy beach dwelling morons is because people refuse to let "disaster victims" go bankrupt, even when their house is hit by its 5th hurricane and destroyed for the third time.
By the way - how do you feel about the new US bankruptcy bill (as of today on the verge of becoming law) that, among other things, prevents discharge of medical debts in all but a very few cases?
Mixed. I like moving towards more partial relief and reserving full debt forgiveness to those cases that truly need it - forgiving debt drives up prices, forgive only as much as needed. I hate the fact that it did piss all to stop people from keeping trusts and various assests off the ledgers. It might end up being benificial, but it is far from what I'd have liked.
Funny - the Wall Street Journal isn't
What is their DATA?
So we should be like the US and neglect things like pre-natal care in favour of the particular kind of patient care which just happens to coincidentally be most beneficial for rich white men?
It is most benificial for old poor black men, going by the numbers, but what the hell that would ruin the racists connotations wouldn't it?
Canada is easily doing as well as the US. Could Canada spend more money on cardiac care? Sure, but that would mean taking it from somewhere else, wouldn't it?
Yes maybe from francophone publicity. Maybe Canada just isn't as commited to public health as the US, seeing as Canada is willing to spend as much on it.
Irrelevant; are you saying they could not develop these production methods if necessary?
Absolutely. Your generic drug manfacturers don't employ the right people, don't have the right facilities, and don't have the experience to do it. You could give them a billion bucks and then let them do so, but then what distinguishes them from pharma clones?
The fact remains that the original innovation is by far the most important stumbling block; everything else is just a matter of putting in the effort.
In terms of cost and expenditures, the original innovation is the cheapest part of the process.
So? If the huge US market became partially socialized like the Canadian market, how would that eliminate this money?
Well let's use drug price controls for an example. Lipitor in Canada was less than 50% of the US price, sounds like a good deal, right? Well except for the fact that Pfizer was returning 15% or something in TOTAL profit. Even worse Lipitor sales were carrying a good portion of Pfizer's pharamcopedia - numerous drugs weren't showing total net profits - they would never recoup their R&D costs. So if the US opted to socialize and leverage price controls Pfizer would have gone from an extremely healthy profit margin to an extremely bad loss. Pfizer then can cull its expenses - and R&D in marginal drugs would likely have been the first option, or simply go bust. Even if the discount was just eliminating all the profit, Pfizer would still be a world of hurt because they capitalization numbers would tank, their credit rating would plummet and their ability to raise investment via stock offers would evaporate overnight.
Similar kinds of things happen with surgery, medical devices, etc. dramatic Canadian style price cuts exceed the profit margins and there isn't enough fat to cut outside of the marginal R&D.
Well what happens if the US doesn't opt to take Canadian price control measures? Well the US of course has higher costs, but without the price controls people in the US would be paying to close to what the rich do now for medical care and face fewer incentives to practice cost effective medicine. Higher demand would either raise costs or result in lowering of care and more people would die.
Ah yes, the "because I say so" argument.
You ask me, "are you so sure?" and I give an answer based off my personal experience.
So you prove I'm wrong about the benefits of the Canadian system where we use generic drug makers and price limits to drive down costs by ... using an example where people bought generic drugs?
Generic drug makers don't save you money. The average cost of a generic drug in Canada is higher than in the US - you have fewer players in the market. Your price controls are completely and utterly unfeasable for the US to implement. In 2003 the average price differential between US drugs and Canadian drugs was 38%. The profit differential is not reported, but is going to be even more dramatic. There isn't a drug company in existance that has a 38% total profit margin. If you drop prices globally that much, many many drugs in the pipeline don't ever have a hope of being profitable. Say goodbye. Not suprisingly as Americans are reimporting ever increasing volumes of Canadian drugs, the price differential is dropping, last year being 29%. That still is unsustainable even with zero pharma profits. If the US government were to throw the floodgates wide your price controls would evaporate overnight.
They're symbolic, meant to discourage stupid things like running into a hospital for a Band-Aid rather than freezing out entire socio-economic classes from using the system unless they're on death's door.
American copays are largely symbolic as well. Typicly you have one two thousands dollars in deductible and then maybe a 80/20 or 90/10 spilt for the next thousand or two, and then the insured pays nothing.
To quote you, I'm only concerned about the dead bodies.
Yep. When dealing with relative mortality it is standard best medical practice to renormalize data; you know that's why the best peer reviewed journals do it.
Rather than try to duck your burden of proof, why don't you just do the legwork and find renormalized mortality numbers?
Do you understand how "as little as one thousand out of pocket" could actually be a big deal for, say, a single mother working a part-time job?
Do you understand that copays scale down for the poor? That most single mothers working parttime are either making oodles of dollars per hour are eligible for Medicaid by federal mandate?
Given the number of people who do not have such coverage, I assume that such regulation is either not in place or is not federal.
The latter.
I'm talking about the aforementioned bankruptcy figures; don't play dumb.
Alright, disaggregate them then.
You tell me
Not my burden of proof. You made the claim, you provide the numbers.
Competition for a completely unnecessary middleman spot makes the middleman worthwhile?
GM and Delphi. Rather than a have the majority of Americans paying into competitive insurance providers, and then having the single largest block of money being paid by the federal government, just subsidize entry of the lower incomes into the pre-existing market. Really even if the middleman had no a priori economic benifit, the past record of the government at running Medicare is reason enough for not trusting the government to make health policy decisions.
That's nothing more than a restatement of the current system, which has produced the current morass and the "gap" which you admit to be a serious problem.
No it isn't . Currently the bottom rungs get a government benifit that is similar to Canada's government benifit. The gap get jack didly squat. And then everyone else pays their own. There is a cutoff point for Medicaid and one has to rise up the income ladder to get to a point where they can afford insurance premiums, copays, etc. Have a subsidy which inversely scales with income is friggen new. Right now government aid is pretty much all or nothing.
Unless your system can always perfectly match the dividing line to shifting socio-economic conditions, there will always be a gap under this system.
Unless you overegineer it with a margin of error sufficient to weather socio-economic shifts
Market-driven industries have their strengths, but that doesn't validate the asinine assumption that more privatization is always better, or that more socialization is always worse. Particularly since one of the intrinsic features of a market-driven system is exclusion and inequality.
Inequality isn't a bad thing. Canada is one of the few systems in the world that doesn't have some, minus the few Canadians that can border hop.
So? The fact that reality is not black/white does not validate your asinine claim that increased socialization is always bad.
Quote:
I said it TENDS to be bad.
given US political conditions, the notion that the US would tend toward the most radicalized possible form of socialized medicine is sheer idiocy.
Given US political considerations ANY socialized medicine is sheer idiocy. Are we going to ignore political realities or are we going include them in analysis, you can't have it both ways.
By the way, did anyone else notice that Tharkun is so completely obsessed with drugs that he assumes drug mass-manufacturing methods are an intrinsic feature of medical R&D?
I'm more familiar with drugs, seeing as my lab partners with pharma and gives us money. Not to mention that those are the majority of the industry conferences I attend. I know how to find drug data more easily than I can other forms of data; hence I tend to use those for examples.
I guess medical procedural research is irrelevant in Tharkun-world,
Procedural research tends to be limited to the availible tools, which I call "devices". I have less knowledge of that side of the business, but even there many of the same basic trends hold.
just like any kind of medical treatment that is geared toward single mothers rather than rich white men
Remind me again who a HPV vaccine is going to treat?
Oh yes
It's interestingly convenient too, because there's this place called the Sick Kid's Hospital here in Toronto which is a world-class treatment and research facility for childrens' ailments. Among other things, they discovered the cystic fibrosis gene and they made the astounding discovery that it is possible to transplant a heart of the wrong blood type into a child patient. But I forgot; in Tharkun-world, nobody but the US ever discovers anything worthwhile, and discovery is useless without some kind of connection to mass-manufactured high profit-margin drugs anyway, right Tharkun?
you do love your strawmen don't you. It really is a shame you can't debate without them.
I said that most useful discoveries are the fruit of US effort. I have said that the major cost of bring a new device or drug to market is scale up. Never have I made an exclusive claim. I've been over this multiple times with you, I'm not speaking of "any", "all", or "none"; just relative rates.
There have been a lot of plant extracts which have resulted in patented drugs. But don't you think it's a bit perverse that there's a patent on a drug which is nothing more than a synthesized version of a plant ingredient, at the same time that the medical industry tells you that it's alternative medicine quackery to simply eat the original plant?
Marinol and marijauna. Unlike marijuana, Marinol doesn't have hundreds of other psychoactive compounds in it. This tends to be the rule, herbal remedies tend to have piss all for consistency, purity, or concentration. For many drugs eating the original plant in quantities equivalent to the synthetic pill mean you ingest enough other crap to kill you, would have to eat a kilo or two of some horrid tasting plant, or get to play Russian roulette where you might not get enough of the active ingredient for effective treatment - or poison yourself due to the natural variability.
Broom Again:
Are we sure we aren't doing too many procedures?
Are normalized mortality rates rising?
Drug secreting stents, which are considerably more expensive than non-drug secreting, may be used in situations where they aren't really needed, increasing costs.
So what is the difference in QALYs and how much are you paying per?
If giving these medications as a skin cream poses some immunological risk, how much more could there be when implanted in the body in a time-release mechanism such as a stent?
As little 0. This would be a job for - quantitative analysis.
Because the WWII built up the medical-industrial base to the point where the idea of mass production entered the mainstream.
Oh BS. They threw cantelope mold in vats of corn steep liquor. The medical-industrial base for making penicillin has been around since mass production of corn whiskey was possible in the 1800's. The real effort was chugging through all the mold varients, growing conditions, and optimizing phenylacetic acid concentrations. The only reason penicillin wasn't mass produced a decade earlier was nobody dumped the money into it needed to hire the brains, brute trial and error, and of course the multi-million dollar tanks to get it to work.
Prior to WWII, the local pharmacists frequently, if not nearly all the time, compounded the drugs prescribed by the doctors. Meaning your prescription was hand made to order.
Funny they had ready made dosages of morphine in WWI. The technology to mass produce penicillin in ready to use quantities was old, it just required millions of dollars to build that size tank. Yes advances in citrus processing helped, but those were not completely necessary. Besides we are looking at injection which require nothing in the way of compounding.
Because there's not enough profit in them.
So why isn't socialized Europe mass producing them?
Correction - that saves the most number of lives in the wealthy nations. A drug that would save millions of lives in, say, Africa or Indonesia would be a good, cheap, easily distributed cure for malaria.
You mean like quinine and related compounds? In any event if you are going global the means Asia, and given the rising incidence of circulatory deaths there the point still stands.
As for Lipitor and cousins - yes, they can be of benefit, especially to people like my mother who possess defective liver enzymes that don't allow them to properly break down cholesterol and remove it from their bodies. However, for the vast majority of people with high cholesterol problems would also benefit from a change in diet and activity level, which would have additional benefits for them as well.
Zilch for disagreement there.
Why aren't we doing more research into appetite control? Given the success of bogus diet pills on the market I'd expect a real weight loss/control pill would be enormously profitable).
I know of one company with 400 million sunk into one appetite target at the moment; that will have to double to get to market.
There is also the unpleasent fact that Liptor has potentially severe side effects.
First generation drug, that is what why all those "me too" drugs you dislike are being reseached and released by everyone else. First you treat the ailment, then you bring down price, then you go after sideeffects when you can.
Fortunately, those suffering from these side effects are a minority but it's yet another illustration that these "miracles" are not unalloyed blessings.
Penicillin kills too. So do vaccines, particularly first generations.
You can, however, be fired from your job because you are unable to perform the work, at which point you will almost certainly loose your insurance within six months (if not sooner)
By law COBRA is for 18 months.
being unemployed you will have no means to pay the vastly increased premiums you will experience because you now have a pre-existing condition.
You wonder why I have individual policy even though I could get insurance from work?
That's on top of the 40+ million people in this country who have NO healthcare coverage - not private, and not governmental, either.
A good part of those, I beleive still the majority, are transitory and opted not to use COBRA. Of the remainder we must discount those who simply don't want it and then we find what I tend to refer to as "the gap"; which I have no problem saying is abhorrent.
Uh... right, because, like, eating food is such a drag and pills are so much more convenient than sitting down and eating good, healthy food?
Because eating rare herbs from half a planet away is friggen expensive. Likewise having a consistent, reliable dosage and purity isn't a good thing whatsoever
Dean Ornish came up with a program emphasizing diet, exercise, and stress reduction that was proven to halt or, in some cases, reverse coronary artery disease... but folks would rather pay for pills than learn to eat properly, walk a bit, and learn to meditate, I guess.
Fat kills. It is getting so bad that some people think American life expectancy might FALL because of obesity. The cheapest medicine, and most effective, is to be have healthy body fat percentage, that little gem would save inordinate numbers of lives, but people don't give a damn. It particularly pisses me off when children are taught eating habits that take decades off their lives. Unfortunately fat prohibition would be even less popular than booze prohibition.
If I recall correclty, it was Highmark Blue Cross in Pennsylvania actually provided coverage for the cost of people opting for the Ornish program, for awhile. Ran into all sorts of headaches though, because the government regs lean so heavily favor of drugs and surgery.
Several plans I know pay for weight watchers, nobody takes them up. Just as they tend to cover smoking cessation. Not getting fat is among the better efforts one can make to live longer, unfortunately most people can't be bothered.
To be fair, plants frequently have variable amounts of the sought-after active ingredients, which can make dosage control quite difficult. For some medications where dosage isn't critical this isn't much of an issue, but when dealing with warfin and cuarare dosing is very critical and it doesn't take much of an error to result in severe problems or death.
remember you also need to look at what else is in the plant. Many species have multiple chemical defenses and one of them might provide health benifit to humans, but the other can prove fatal.
I prefer my food to be varied, mixed, and dynamic. I prefer my medicine to pure and static.
Very funny, Scotty. Now beam down my clothes.
