8 ms·

The Hackers groups are doing what they can to expose Mylan's (EpiPen makers) Greed which is laudable. What is really needed is also an explainer on why a bit of

The Hackers groups are doing what they can to expose Mylan's (EpiPen makers) Greed which is laudable. What is really needed is also an explainer on why a bit of govt. leverage (socialism if you will) is good in Medicine Pricing as well. Mylan is a really great user of buying legislation. They leveraged their 90% market ownership of the epinephrine auto-injector market such that [1] It lobbied hard to ensure that all parents of school going kids (or tax payers) paid for EpiPens by making it into a bill that politicians could easily justify. Once the bill passed and schools all over the country purchased these by the boatloads, then they just kept raising the price over and over and milking the profits. When it got too much and they could not ignore the patient backlash they have turned again to purchasing legislation.. [2] Now they want to make it so that the patients do not see the copays - instead every one suffers by paying more for health insurance. [1] https://www.opensecrets.org/lobby/billsum.php?id=hr2094-113 https://www.opensecrets.org/lobby/billsum.php?id=hr2094-113 [2] http://www.nytimes.com/2016/09/16/business/epipen-maker-mylan-preventative-drug-campaign.html http://www.nytimes.com/2016/09/16/business/epipen-maker-myla... With scumbags like these, is it any wonder that the USA has the most expensive healthcare system in the world?

gnipgnip 10y ago
Alan Watts mentions somewhere that USSR was essentially a single corporation (can this be said of China ?) - a disgrace to human creativity. Killing of competition using Gov. regulation and red-tape is not much different in function.
- bonoboTP 10y ago
  This is why the US is where it is. Anything pointing towards any social programs - something that benefits not only you but also your neighbor - gets shot down using the Red Scare. Europe's social welfare programs, universal healthcare and free education don't make these countries "socialist" or "communist". These countries are still capitalist market economies with a few critical aspects about people's livelihood regulated for accessibility. As long as the response to these ideas is always "but that's communism", it won't ever improve.
  - hueving 10y ago
    >This is why the US is where it is. Anything pointing towards any social programs - something that benefits not only you but also your neighbor - gets shot down using the Red Scare. This is why the US has one of the smallest militaries, the smallest public road system, unsafe aviation due to no air traffic control, no public schools for children, and unsubsidized farming and food purchases. /s
- ralfd 10y ago
  Competition is normally a very good mechanism, but there are areas were it is suboptimal. https://en.wikipedia.org/wiki/Natural_monopoly https://en.wikipedia.org/wiki/Natural_monopoly
anaolykarpov 10y ago
Can this be a side effect of the "free healthcare" goal that the state is trying to achieve? When people don't have to pay for something straight from their pocket, they're not feeling the ripoff so strongly, so they don't revolt. That's why I personally think that the systems where people vote with their wallets are much more efficient.
- bigchewy 10y ago
  the challenge is that ~40% of healthcare spend is even plausibly directed by the patient. the majority is not elective, a result of an acute situation, etc. The concept of free market, unfortunately, doesn't work. It's easy to confuse this because most people on HN are (relatively) healthy. 15% of the population consumes 80% of total healthcare spend. These are the ones that we need to solve for Sources: lots of research I could link to but don't have handy and, with great dismay/frustration, I've spent a decade analyzing the root causes of US healthcare spend.
  - nickff 10y ago
    How much does the government have to intervene in this market before it is at least partially culpable for the problems? Will government be blamed for any systemic problems even when there is a single-payer system, or will the problems then be attributed to underfunding?
  - deleted 10y ago
    [deleted]
- rickycook 10y ago
  here in australia where social healthcare pays for plenty of things including medicine subsidies, i'd tend to disagree
- willvarfar 10y ago
  And yet in countries with universal health care, the cost of health care in real total terms is much lower: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... Monopolies can dictate terms, which is why monopolistic companies are regulated. But if that monopoly is the state, then it actually works in the citizens favour if the monopoly presses down costs.
deleted 10y ago
[deleted]
blake8086 10y ago
Surely this problem caused by regulation can be fixed with a little bit more regulation!
- bonoboTP 10y ago
  Regulation isn't some amorphous thing that you can only get "more" or "less" of. The US would need different regulations. But the American ideology will probably not allow that.
  - hueving 10y ago
    >But the American ideology will probably not allow that. Ah, the old strawman. Let's bring it out and beat it around a bit. That's the "American ideology" in the same way the "European ideology" is to not work and collect a check from the government.
    - bonoboTP 10y ago
      By American ideology I meant that everyone can become anything they want if only they work hard. Everyone can be a hero and defy their fate. Therefore if someone is in need, it's their fault for not working hard enough. If they don't have the money to afford medicine, then they don't deserve it, end of story. And additionally, a gut-level fear of government and way too much trust in corporations.
      - hueving 10y ago
        If what you were saying was true, America wouldn't have any of the things I identified.
natmaster 10y ago
So you're complaining about fire, and your solution is more fire? How about some water? http://thelibertarianrepublic.com/epipen-monopoly-hint-not-runaway-capitalism/ http://thelibertarianrepublic.com/epipen-monopoly-hint-not-r...
- laksjd 10y ago
  I know you're just using it as an off-hand metaphor but fire is actually one of the most useful tools in preventing and fighting large fires (e.g. forest fires).
- aikah 10y ago
  > But liberals will blame capitalism anyway, not government. The "no true capitalism" of the libertarians ? Communists also claim USSR was "no true communism". A doctrine or ideology is never "pure" or "perfect" in practice since men aren't.
  - nickff 10y ago
    The only difference being that places with more liberty are more prosperous, and places with more socialism are less prosperous. There doesn't seem to be an optimal 'middle-ground'.
    - bonoboTP 10y ago
      Universal healthcare is not socialism. Tax-paid social services aren't socialism. Socialism is the collectivized ownership of the means of production and a centralized plan-based economy with fixed production quotas and prices. Scandinavia isn't socialist. The Eastern Bloc in Cold War times was socialist. Social democracy != socialism.
briandear 10y ago
Socialism isn't the answer. In fact over government caused the epipen debacle by reducing competition. If an epipen costs $5 to produce, competition means that the price would eventually approach $5 -- it would commoditize it. Doing things like price caps only result in shortages: see Venezuela's economy for a case study. Look at the FDA process: you reform that and drug costs will decrease dramatically.
tracker1 10y ago
What would be better would be FRAND-style licensing requirements on prescription medications and the application of patents on medical devices. Beyond this would be a requirement of two sources for ALL medical prescriptions and devices in order to sell them in the U.S. (or whatever country you, the reader, are in). This would ensure at least competition, even though there's still greed there can be momentum for competition.
jasonm23 10y ago
Hope I'm not out of line helping you out with this, but laudable probably doesn't mean what you think it does, unless you wanted to praise Mylan's greed? But that didn't seem like something you wanted to do.
- patorjk 10y ago
  He's not saying the greed is laudable, he's saying the effort to expose it is laudable.
jasonm23 10y ago
Hope I'm not out of line helping you out with this, but laudable probably doesn't mean what you think it does, unless you wanted to praise Mylan's greed? But that didn't seem like something you wanted to do.

gnipgnip 10y ago

Alan Watts mentions somewhere that USSR was essentially a single corporation (can this be said of China ?) - a disgrace to human creativity. Killing of competition using Gov. regulation and red-tape is not much different in function.

bonoboTP 10y ago
This is why the US is where it is. Anything pointing towards any social programs - something that benefits not only you but also your neighbor - gets shot down using the Red Scare. Europe's social welfare programs, universal healthcare and free education don't make these countries "socialist" or "communist". These countries are still capitalist market economies with a few critical aspects about people's livelihood regulated for accessibility. As long as the response to these ideas is always "but that's communism", it won't ever improve.
- hueving 10y ago
  >This is why the US is where it is. Anything pointing towards any social programs - something that benefits not only you but also your neighbor - gets shot down using the Red Scare. This is why the US has one of the smallest militaries, the smallest public road system, unsafe aviation due to no air traffic control, no public schools for children, and unsubsidized farming and food purchases. /s
ralfd 10y ago
Competition is normally a very good mechanism, but there are areas were it is suboptimal. https://en.wikipedia.org/wiki/Natural_monopoly https://en.wikipedia.org/wiki/Natural_monopoly

anaolykarpov 10y ago

Can this be a side effect of the "free healthcare" goal that the state is trying to achieve? When people don't have to pay for something straight from their pocket, they're not feeling the ripoff so strongly, so they don't revolt. That's why I personally think that the systems where people vote with their wallets are much more efficient.

bigchewy 10y ago
the challenge is that ~40% of healthcare spend is even plausibly directed by the patient. the majority is not elective, a result of an acute situation, etc. The concept of free market, unfortunately, doesn't work. It's easy to confuse this because most people on HN are (relatively) healthy. 15% of the population consumes 80% of total healthcare spend. These are the ones that we need to solve for Sources: lots of research I could link to but don't have handy and, with great dismay/frustration, I've spent a decade analyzing the root causes of US healthcare spend.
- nickff 10y ago
  How much does the government have to intervene in this market before it is at least partially culpable for the problems? Will government be blamed for any systemic problems even when there is a single-payer system, or will the problems then be attributed to underfunding?
- deleted 10y ago
  [deleted]
rickycook 10y ago
here in australia where social healthcare pays for plenty of things including medicine subsidies, i'd tend to disagree
willvarfar 10y ago
And yet in countries with universal health care, the cost of health care in real total terms is much lower: https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... Monopolies can dictate terms, which is why monopolistic companies are regulated. But if that monopoly is the state, then it actually works in the citizens favour if the monopoly presses down costs.

deleted 10y ago

[deleted]

blake8086 10y ago

Surely this problem caused by regulation can be fixed with a little bit more regulation!

bonoboTP 10y ago
Regulation isn't some amorphous thing that you can only get "more" or "less" of. The US would need different regulations. But the American ideology will probably not allow that.
- hueving 10y ago
  >But the American ideology will probably not allow that. Ah, the old strawman. Let's bring it out and beat it around a bit. That's the "American ideology" in the same way the "European ideology" is to not work and collect a check from the government.
  - bonoboTP 10y ago
    By American ideology I meant that everyone can become anything they want if only they work hard. Everyone can be a hero and defy their fate. Therefore if someone is in need, it's their fault for not working hard enough. If they don't have the money to afford medicine, then they don't deserve it, end of story. And additionally, a gut-level fear of government and way too much trust in corporations.
    - hueving 10y ago
      If what you were saying was true, America wouldn't have any of the things I identified.

natmaster 10y ago

So you're complaining about fire, and your solution is more fire? How about some water? http://thelibertarianrepublic.com/epipen-monopoly-hint-not-runaway-capitalism/ http://thelibertarianrepublic.com/epipen-monopoly-hint-not-r...

laksjd 10y ago
I know you're just using it as an off-hand metaphor but fire is actually one of the most useful tools in preventing and fighting large fires (e.g. forest fires).
aikah 10y ago
> But liberals will blame capitalism anyway, not government. The "no true capitalism" of the libertarians ? Communists also claim USSR was "no true communism". A doctrine or ideology is never "pure" or "perfect" in practice since men aren't.
- nickff 10y ago
  The only difference being that places with more liberty are more prosperous, and places with more socialism are less prosperous. There doesn't seem to be an optimal 'middle-ground'.
  - bonoboTP 10y ago
    Universal healthcare is not socialism. Tax-paid social services aren't socialism. Socialism is the collectivized ownership of the means of production and a centralized plan-based economy with fixed production quotas and prices. Scandinavia isn't socialist. The Eastern Bloc in Cold War times was socialist. Social democracy != socialism.

briandear 10y ago

Socialism isn't the answer. In fact over government caused the epipen debacle by reducing competition. If an epipen costs $5 to produce, competition means that the price would eventually approach $5 -- it would commoditize it. Doing things like price caps only result in shortages: see Venezuela's economy for a case study. Look at the FDA process: you reform that and drug costs will decrease dramatically.

tracker1 10y ago

What would be better would be FRAND-style licensing requirements on prescription medications and the application of patents on medical devices. Beyond this would be a requirement of two sources for ALL medical prescriptions and devices in order to sell them in the U.S. (or whatever country you, the reader, are in). This would ensure at least competition, even though there's still greed there can be momentum for competition.

jasonm23 10y ago

Hope I'm not out of line helping you out with this, but laudable probably doesn't mean what you think it does, unless you wanted to praise Mylan's greed? But that didn't seem like something you wanted to do.

patorjk 10y ago
He's not saying the greed is laudable, he's saying the effort to expose it is laudable.

jasonm23 10y ago