8 ms·

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US go

by cheriot 10y ago

Eminent domain is not just for land. In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Edit: Just a reminder that eminent domain requires paying the property owner. https://en.m.wikipedia.org/wiki/Just_compensation https://en.m.wikipedia.org/wiki/Just_compensation

nickpsecurity 10y ago
We could do that. On other hand, we could just pay them the expected market value of the drug when they first invent it then give it to public for almost nothing. "You can cure cancer with those three drugs? Was going to make tens of billions? Here you go: guarantee of tens of billions of subsidies over next 20 years in exchange for the patent and license for anyone to produce it generically." Boom! Tens of thousands of lives saved a year. Way better than investing into the TSA. :)
- cheriot 10y ago
  Agreed, that's exactly what I'm trying to suggest :) Eminent domain requires paying the property owner.
- necessity 10y ago
  When you say "we pay the market value" and "give to the public for almost nothing", "we" and "the public" are the same group and therefore it makes no sense to make the distinction. Unless by "we" you mean "the wealthy" and "the public" you mean "the poor", in which case the increased tax that has to be set up for that will just be reverted into the cost of the service/good provided by the wealthy, the wages of their employers, or turn into capital flight, and so forth. In short, you're basically taking money from other areas of people's lives and making them put it into health care. Which could be achieved by themselves by saving, if that's what they wanted to do.
  - nickpsecurity 10y ago
    I live in the U.S. if I didn't mention it. Here, we differentiate between the rights of the public as a whole and private individuals. Businesses and I.P. tend to be a form of private property. So, "we" the public can't take what "we" consider private. That's a contradiction. In this specific case, it's the public paying money to private parties for their property to move into public hands. Then, that public property is manufactured to be distributed to the many, private parties in need that constitute the general public.
refurb 10y ago
Let's walk through this. Drug develop is mostly funded with private money. Yes, the NIH funds basic research that often support drug research, but private companies fund most of the bill. It's in the hundreds of billions each year. Now why would they do that? Well, they expect that they'll give a company $500M and it will turn into $2B or $3B. However, most of those companies will fail and the $500M will turn into $0. So that would mean that the returns on the drugs that are successful need to be really high. What if they weren't? Well, all that private money would dry up pretty dam quickly. Look at the money going into cancer research. It's a huge amount every year. It's not just because cancer is a terrible disease and affects everyone, it's because the returns on cancer therapy are high. You could just tell private companies, "stuff it, you don't get to make money" and try and have the gov't do it on their own. Of course you'd need to increase the NIH budget by what? 10x? Our current system isn't perfect, but it does a dam good job aligning the incentives of people with money and people who need new drugs.
- x5n1 10y ago
  Scientists are not profit motivated. Scientists don't work to produce more drugs faster just because the CEO is managing better. This is definitely something that can be funded by the public and should be funded completely by the public on a not-for-profit basis. Then we can no longer make these sort of ridiculous economic arguments.
  - gaius 10y ago
    Do they hand out sainthoods with PhDs now? A scientist working in the commercial sector has the same motivations as anyone else.
    - x5n1 10y ago
      Then why not make any scientist who discovers any very important drug or therapy into a billionaire. If they are motivated the same way corporations are, then that should super motivate them produce more drugs faster. In fact why don't universities work the same way?
Lazare 10y ago
> In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. Yeah, but, as your own link notes, courts (and the constitution) require fair market value for compensation. This doesn't save you any money at all; eminent domain can only have an impact when someone is refusing to sell at the market price. But Gilead is very very happy to sell at the market price. The issue is people upset at what that market price is. If the US government could come up with the fair market value of the exclusive rights to manufacture Harvoni and Sovaldi, the problem wouldn't exist, because the same amount of money could also just buy all the doses of Harvoni and Sovaldi on the open market. > As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Oh sure, they'd love for the US government to buy a million doses at $84k each and start handing them out. I don't think that solves any problems though. Edit: Wait, or is your comment actually just an argument for single payer healthcare, and I'm just being obtuse? If so, my apologies for missing the joke, and I think you're right: The most obvious role for the government is funding universal catastrophic care, and I think this should be a part of that.
- cheriot 10y ago
  Yes, it amounts to single payer healthcare for drugs. It's different from the government buying individual doses on the market because the current price is set to achieve the fair market value of the drug by treating a small subset of infected patients. Manufacturing costs are so small in comparison, we could treat everyone for nearly the same price.

by cheriot 10y ago

nickpsecurity 10y ago

We could do that. On other hand, we could just pay them the expected market value of the drug when they first invent it then give it to public for almost nothing. "You can cure cancer with those three drugs? Was going to make tens of billions? Here you go: guarantee of tens of billions of subsidies over next 20 years in exchange for the patent and license for anyone to produce it generically." Boom! Tens of thousands of lives saved a year. Way better than investing into the TSA. :)

cheriot 10y ago
Agreed, that's exactly what I'm trying to suggest :) Eminent domain requires paying the property owner.
necessity 10y ago
When you say "we pay the market value" and "give to the public for almost nothing", "we" and "the public" are the same group and therefore it makes no sense to make the distinction. Unless by "we" you mean "the wealthy" and "the public" you mean "the poor", in which case the increased tax that has to be set up for that will just be reverted into the cost of the service/good provided by the wealthy, the wages of their employers, or turn into capital flight, and so forth. In short, you're basically taking money from other areas of people's lives and making them put it into health care. Which could be achieved by themselves by saving, if that's what they wanted to do.
- nickpsecurity 10y ago
  I live in the U.S. if I didn't mention it. Here, we differentiate between the rights of the public as a whole and private individuals. Businesses and I.P. tend to be a form of private property. So, "we" the public can't take what "we" consider private. That's a contradiction. In this specific case, it's the public paying money to private parties for their property to move into public hands. Then, that public property is manufactured to be distributed to the many, private parties in need that constitute the general public.

refurb 10y ago

Let's walk through this. Drug develop is mostly funded with private money. Yes, the NIH funds basic research that often support drug research, but private companies fund most of the bill. It's in the hundreds of billions each year. Now why would they do that? Well, they expect that they'll give a company $500M and it will turn into $2B or $3B. However, most of those companies will fail and the $500M will turn into $0. So that would mean that the returns on the drugs that are successful need to be really high. What if they weren't? Well, all that private money would dry up pretty dam quickly. Look at the money going into cancer research. It's a huge amount every year. It's not just because cancer is a terrible disease and affects everyone, it's because the returns on cancer therapy are high. You could just tell private companies, "stuff it, you don't get to make money" and try and have the gov't do it on their own. Of course you'd need to increase the NIH budget by what? 10x? Our current system isn't perfect, but it does a dam good job aligning the incentives of people with money and people who need new drugs.

x5n1 10y ago
Scientists are not profit motivated. Scientists don't work to produce more drugs faster just because the CEO is managing better. This is definitely something that can be funded by the public and should be funded completely by the public on a not-for-profit basis. Then we can no longer make these sort of ridiculous economic arguments.
- gaius 10y ago
  Do they hand out sainthoods with PhDs now? A scientist working in the commercial sector has the same motivations as anyone else.
  - x5n1 10y ago
    Then why not make any scientist who discovers any very important drug or therapy into a billionaire. If they are motivated the same way corporations are, then that should super motivate them produce more drugs faster. In fact why don't universities work the same way?

Lazare 10y ago

> In extreme cases like this where a profit motive is the only thing keeping us from curing huge numbers of people, the US government should write a single check, take the rights, and start handing out pills. Yeah, but, as your own link notes, courts (and the constitution) require fair market value for compensation. This doesn't save you any money at all; eminent domain can only have an impact when someone is refusing to sell at the market price. But Gilead is very very happy to sell at the market price. The issue is people upset at what that market price is. If the US government could come up with the fair market value of the exclusive rights to manufacture Harvoni and Sovaldi, the problem wouldn't exist, because the same amount of money could also just buy all the doses of Harvoni and Sovaldi on the open market. > As far as the company is concerned, that could even be a preferable outcome. Cash now and the marketing benefits to promote its other drugs. Oh sure, they'd love for the US government to buy a million doses at $84k each and start handing them out. I don't think that solves any problems though. Edit: Wait, or is your comment actually just an argument for single payer healthcare, and I'm just being obtuse? If so, my apologies for missing the joke, and I think you're right: The most obvious role for the government is funding universal catastrophic care, and I think this should be a part of that.

cheriot 10y ago
Yes, it amounts to single payer healthcare for drugs. It's different from the government buying individual doses on the market because the current price is set to achieve the fair market value of the drug by treating a small subset of infected patients. Manufacturing costs are so small in comparison, we could treat everyone for nearly the same price.