6 ms·

The article touches on one of the risks to the health care industry today, at least here in the US: In many cases, the pharmaceutical companies are making bill

The article touches on one of the risks to the health care industry today, at least here in the US: In many cases, the pharmaceutical companies are making billions by selling drugs which merely reduce undesired symptoms. But do not CURE the underlying problem. And the symptom reduction only lasts while the user continues to buy and consume the drug. Therefore, in many cases, these companies have a strong financial incentive to NOT cure a disease, instead, to prolong it and only sell palliatives. Government funding and government directed research should be one of the ways we ensure that we have people actively trying to CURE diseases. It's a classic example of an area where government can do something better than business, because there does not have to be a profit motive. Just a collective desire to reduce human suffering. This also touches on why it's important to vote carefully in US presidential and congressional elections. Because certain political groups cater to the Big Pharma companies. A vote for them is almost certainly a vote towards a world where there are more palliatives than cures. Where even new forms of ill health can just be considered new "markets" or new ways to increase profits.

dennisgorelik 16y ago
That's a classic example of an area where government can NOT do better than business, because government sucks at innovation. There are plenty of companies that are not selling insulin, so they would be interested to be able to sell diabetes cure. Assuming the chances of developing the cure are reasonably good.
- steveklabnik 16y ago
  They can fund the researchers that actually do the innovation, is what I read it as.
- mkramlich 16y ago
  Disagree. Individuals (scientists, doctors, lab technicians, inventors) can do the innovating, can do the research. They just need to be paid and given space and tools and time to do it in. Enter government. Government does not need to innovate, just write checks. The problem with the alternative, like a large private corporation, can be that it may not be in their best interests profit wise to pursue a certain line of development. Could reduce their profits. Or at least they can be afraid it might. And they have a fiduciary responsibility to their shareholders. Not necessarily a sense of ethical obligation to their fellow man.
  - bedris 16y ago
    Individuals (scientists, doctors, lab technicians, inventors) can do the innovating, can do the research. They just need to be paid and given space and tools and time to do it in. Enter government. Government does not need to innovate, just write checks. In principal, you are correct, but you are neglecting one very important point: the government is not a nebulous entity with an endless supply of money. Therefore, the individuals that comprise the government must identify (either directly, or by selecting individuals who are most qualified in a given area of expertise to serve as proxies) the scientists whose ideas, proposals, past productivity, and requests for facilities most warrant funding. Separating the wheat from the chaff is a non-trivial exercise. It may not be be direct innovation, but I would argue that it is every bit as challenging.
    - mkramlich 16y ago
      a business would have to do the same thing. so i'd argue this factor is net neutral
- idiopathic 16y ago
  You might be right that government can not do better than business, but this particular story is an example of where they can. If there really "are plenty of companies that are not selling insulin, so they would be interested to be able to sell diabetes cure", none of them has come forward. This might be because the chances of developing are not good enough, but it sounds to me like you are starting from an assumption ("private sector would jump on this is if it was a good idea") and working your way backwards ("therefore this cannot have been a good idea"). Personally, my belief is that the best funding approach is multi-polar. In other words, there should be some government funding, some private sector, and some non-profit foundation funding. Each of these funders has blind spots, and is frightened by some research while others embrace it. The combination allows the entrepreneurial scientist to push their research forward at each stage.
- crocowhile 16y ago
  Government sucks at innovation? What are you talking about? Pretty much everything that is basic science is paid by government in every nation. It is govt that gave us the internet, the bomb, and the man on the moon. Virtually every nobel prize in history has been given to people who worked for public universities.
  - grandalf 16y ago
    See my other reply: http://news.ycombinator.com/item?id=1465601 http://news.ycombinator.com/item?id=1465601
    - detst 16y ago
      That's not really fair. The government funds more than "development of military technology".
      - grandalf 16y ago
        What percentage of the technologies that people cite as being made possible by the government were developed for non-military purposes? Edit: The NSF started out as a way of enhancing military research: http://en.wikipedia.org/wiki/National_Science_Foundation http://en.wikipedia.org/wiki/National_Science_Foundation
        detst 16y ago
        What's wrong with the NSF starting that way? Are they not a significant source of funds for "basic science" research? Even if you want to be cynical about this issue, haven't we been doing this long enough to know that research for military purposes often translates to advances in non-military applications? EDIT: and don't get me wrong; I would love to see some shift in the way funds are allocated.
        grandalf 16y ago
        My point isn't that central coordination doesn't work, it was just that central coordination is extremely unsophisticated and is typically not a source of added insight, just a source of funds. In my experience in academe, researchers tailor their work to what the NSF is funding, not what they consider most interesting/important.
- donw 16y ago
  Wow, massive strawman. The government sucks at innovation? Who do you think funded and developed ARPANet? You know, the network we're using to communicate right now. Upon which countless businesses have been built. Nuclear power? Government. First electronic computer? Government. Furthermore, when it comes to drug discovery, that 'evil government' has one advantage over businesses, because they have no profit motive. Businesses exist to make money. Period. No business is going to destroy its market for the sake of the common good. If you're in the business of creating drugs, you aren't going to wipe out a disease with a one-time cure, because drugs are expensive to produce, and palliative treatments are way more profitable. This is exactly an area where governments do better than businesses, because the reward (improving quality of life) means more votes and support for those in office.
  - deleted 16y ago
    [deleted]
  - grandalf 16y ago
    To paraphrase: The government allocates dollars obtained via taxation to the development of military technology, which often finds unintended peaceful uses. The scientists who develop military technology (weaponized nuclear, a nuclear-proof decentralized communication grid, code braking machines, etc.) are simply hired to build it or to weaponize promising areas of reasearch. Anyone with lots of money and the desire to develop powerful weapons would have developed the innovations you cite. To credit "government" implies that something about the government (other than money and the desire for weapons) is responsible for the success. Any dictator could do precisely the same thing with sufficient money. Fortunately for those of us in the US, our economic system results in incredible wealth, and the taxes generated by it can buy lots of weapons tech.
  - dennisgorelik 16y ago
    Could anyone please point me to government scientific or technology accomplishments in the last 30 years? Something that noticeably improved our quality of life. Something on par with achievements by IBM (Business PC), Microsoft (OS, Office, and other software), Google (search), Apple (smartphones, music, ...), Intel (microprocessors), Pfizer (drugs). It was surprising to see down-voting just on the basis that you disagree with the idea. Welcome to groupthink.
- mkramlich 16y ago
  man on the moon: government
stretchwithme 16y ago
a lot of truth to that. I also think that if consumers were actually paying the full direct cost of treatments, they would be a lot less willing to pay for a chronic drug habit instead of a cure. Selling cures can be profitable too. Consumers are perfectly able to see and pay for the benefits of a one time solution as opposed to a cheaper chronic solution. That's why they buy cars and houses instead of renting them. The market will deliver what the consumer wants if the consumer were making the spending decisions. Government can't be somehow better than business at deciding what to fund. Its manipulated by business! The current pattern has evolved in a government funded research environment. Only ending the interference in the normal process of making decisions at the consumer level can fix this problem.
- ahoyhere 16y ago
  The best health advances of all time were developed by passionate, and sometimes uneducated, volunteers -- people who were not working for a profit motive, but for a good-of-all motive. Case in point: the discoverer of penicillin, and the inventor of the vaccine, the inventor of the public blood bank, and on, and on, and on. Inventing then was (arguably) less costly and technical than it is now, because those were low-hanging fruit. A lot of the low-hanging fruit has probably been discovered by now, though we can't be sure, meaning that future research aims at higher-hanging fruit and so, metaphorically, the would-be inventors need ladders. These people need help, not profit, because profit isn't what motivates them anyway. EDIT: Let's not forget public health reform can save more lives than just about anything else (thank you Oliver Wendel Holmes/Ignaz Semmelweis http://www.accessexcellence.org/AE/AEC/CC/hand_background.php http://www.accessexcellence.org/AE/AEC/CC/hand_background.ph..., Sara Josephine Baker, http://en.wikipedia.org/wiki/Sara_Josephine_Baker http://en.wikipedia.org/wiki/Sara_Josephine_Baker and their present day equivalent, Atul Gawande).
  - _delirium 16y ago
    Somehow it seems that the profit motive in pharmaceuticals motivates good science, but targeted at relatively strange things. "Lifestyle" drugs are huge: everyone wants the next Viagra, basically. Perhaps not surprising, because recreational drugs have always been popular, and the "fluff" end of legal pharmaceutical development is the part that sort of bleeds into recreational, since it tends to target something closer to "enhancing" the lives of already fairly healthy people with money, rather than "treating" the ill.
rsheridan6 16y ago
The big companies that already have treatments for diabetes (for example) definitely have an interest in not curing it, but a small startup would be happy to make millions destroying a multibillion dollar industry.
- mattmanser 16y ago
  People upvoting this are dreamers as that industry costs a phenomenal amount of money to put something through trials. Millions is a trivial amount on what you could throw down the drain and end up with no actual product. It's not vulnerable to a startup as a startup can't practically enter that market. You'd need to be producing something else first. And small? Not gonna cut it. Something that works on mice and even something that looks in the lab to cure the disease often doesn't work in trials and doesn't beat the placebo effect.
  - rsheridan6 16y ago
    There are lots of pharmaceutical startups. And, yeah, drug development is high risk. In other news, the sky is still blue. Type 1 diabetes is still a pretty big market even if you had a one shot cure. There are hundreds of thousands of type 1 diabetics. If they pay a thousand dollars each (a steal at that price), that's hundreds of millions of dollars. For comparison, there are a few thousand people with CML, but that didn't stop Gleevec from being developed for it (it's very expensive).
    - dpik 16y ago
      A steal at a thousand dollars ? I have Type 1 and would consider an actual cure a great deal even if it cost everything I own plus my entire earnings for 10 years.
      - yummyfajitas 16y ago
        You might feel that way, but lots of politicians and commentators would decry that as "evil, greedy drug companies making a profit off sick people".
HeyLaughingBoy 16y ago
I hear this argument all the time and it ignores one fundamental fact: there is more than one large pharmaceutical company and they don't all make $disease_x_treatment. That one company makes billions selling a treatment for a disease has no bearing on a competing company making a cure for that disease and cornering the market. If anything, it's the very definition of a market-driven solution to a problem. Now, it's true that there are diseases which are so rare that it's not commercially worth developing a cure, and perhaps government funding is useful in that case but that's a completely different topic.
- LaGrange 16y ago
  "That one company makes billions selling a treatment for a disease has no bearing on a competing company making a cure for that disease and cornering the market." But it's actually more efficient to develop a treatment for the second company. It's better to share an extremely big market with a competitor than to corner it while making it much smaller. The goal is not to destroy all competition, it's to make more money.
  - Tuna-Fish 16y ago
    Yes, but what if you have no presence at all in that extremely big market? In addition to the big ones, there are dozens of smaller companies with the cash and the experience in drug development that would jump at the opportunity to cure type 1 diabetes. Unless the risks vastly outweigh the rewards, which seems to have been the case here.
    - LaGrange 16y ago
      If you have "no presence at all" then you either have no money, in which case you can't really afford entering it (in this case, anyway), or you have the money, but then the above rules still apply. Effectively it would be better to market your mediocre product to physicians than to kill the cash-cow. Also, large risks are actually typical for this type of research. It's expensive and risky, so it has to give really large rewards. Research for completely new cures is even more risky and expensive, and the rewards are smaller.

dennisgorelik 16y ago

That's a classic example of an area where government can NOT do better than business, because government sucks at innovation. There are plenty of companies that are not selling insulin, so they would be interested to be able to sell diabetes cure. Assuming the chances of developing the cure are reasonably good.

steveklabnik 16y ago
They can fund the researchers that actually do the innovation, is what I read it as.
mkramlich 16y ago
Disagree. Individuals (scientists, doctors, lab technicians, inventors) can do the innovating, can do the research. They just need to be paid and given space and tools and time to do it in. Enter government. Government does not need to innovate, just write checks. The problem with the alternative, like a large private corporation, can be that it may not be in their best interests profit wise to pursue a certain line of development. Could reduce their profits. Or at least they can be afraid it might. And they have a fiduciary responsibility to their shareholders. Not necessarily a sense of ethical obligation to their fellow man.
- bedris 16y ago
  Individuals (scientists, doctors, lab technicians, inventors) can do the innovating, can do the research. They just need to be paid and given space and tools and time to do it in. Enter government. Government does not need to innovate, just write checks. In principal, you are correct, but you are neglecting one very important point: the government is not a nebulous entity with an endless supply of money. Therefore, the individuals that comprise the government must identify (either directly, or by selecting individuals who are most qualified in a given area of expertise to serve as proxies) the scientists whose ideas, proposals, past productivity, and requests for facilities most warrant funding. Separating the wheat from the chaff is a non-trivial exercise. It may not be be direct innovation, but I would argue that it is every bit as challenging.
  - mkramlich 16y ago
    a business would have to do the same thing. so i'd argue this factor is net neutral
idiopathic 16y ago
You might be right that government can not do better than business, but this particular story is an example of where they can. If there really "are plenty of companies that are not selling insulin, so they would be interested to be able to sell diabetes cure", none of them has come forward. This might be because the chances of developing are not good enough, but it sounds to me like you are starting from an assumption ("private sector would jump on this is if it was a good idea") and working your way backwards ("therefore this cannot have been a good idea"). Personally, my belief is that the best funding approach is multi-polar. In other words, there should be some government funding, some private sector, and some non-profit foundation funding. Each of these funders has blind spots, and is frightened by some research while others embrace it. The combination allows the entrepreneurial scientist to push their research forward at each stage.
crocowhile 16y ago
Government sucks at innovation? What are you talking about? Pretty much everything that is basic science is paid by government in every nation. It is govt that gave us the internet, the bomb, and the man on the moon. Virtually every nobel prize in history has been given to people who worked for public universities.
- grandalf 16y ago
  See my other reply: http://news.ycombinator.com/item?id=1465601 http://news.ycombinator.com/item?id=1465601
  - detst 16y ago
    That's not really fair. The government funds more than "development of military technology".
    - grandalf 16y ago
      What percentage of the technologies that people cite as being made possible by the government were developed for non-military purposes? Edit: The NSF started out as a way of enhancing military research: http://en.wikipedia.org/wiki/National_Science_Foundation http://en.wikipedia.org/wiki/National_Science_Foundation
      - detst 16y ago
        What's wrong with the NSF starting that way? Are they not a significant source of funds for "basic science" research? Even if you want to be cynical about this issue, haven't we been doing this long enough to know that research for military purposes often translates to advances in non-military applications? EDIT: and don't get me wrong; I would love to see some shift in the way funds are allocated.
        grandalf 16y ago
        My point isn't that central coordination doesn't work, it was just that central coordination is extremely unsophisticated and is typically not a source of added insight, just a source of funds. In my experience in academe, researchers tailor their work to what the NSF is funding, not what they consider most interesting/important.
donw 16y ago
Wow, massive strawman. The government sucks at innovation? Who do you think funded and developed ARPANet? You know, the network we're using to communicate right now. Upon which countless businesses have been built. Nuclear power? Government. First electronic computer? Government. Furthermore, when it comes to drug discovery, that 'evil government' has one advantage over businesses, because they have no profit motive. Businesses exist to make money. Period. No business is going to destroy its market for the sake of the common good. If you're in the business of creating drugs, you aren't going to wipe out a disease with a one-time cure, because drugs are expensive to produce, and palliative treatments are way more profitable. This is exactly an area where governments do better than businesses, because the reward (improving quality of life) means more votes and support for those in office.
- deleted 16y ago
  [deleted]
- grandalf 16y ago
  To paraphrase: The government allocates dollars obtained via taxation to the development of military technology, which often finds unintended peaceful uses. The scientists who develop military technology (weaponized nuclear, a nuclear-proof decentralized communication grid, code braking machines, etc.) are simply hired to build it or to weaponize promising areas of reasearch. Anyone with lots of money and the desire to develop powerful weapons would have developed the innovations you cite. To credit "government" implies that something about the government (other than money and the desire for weapons) is responsible for the success. Any dictator could do precisely the same thing with sufficient money. Fortunately for those of us in the US, our economic system results in incredible wealth, and the taxes generated by it can buy lots of weapons tech.
- dennisgorelik 16y ago
  Could anyone please point me to government scientific or technology accomplishments in the last 30 years? Something that noticeably improved our quality of life. Something on par with achievements by IBM (Business PC), Microsoft (OS, Office, and other software), Google (search), Apple (smartphones, music, ...), Intel (microprocessors), Pfizer (drugs). It was surprising to see down-voting just on the basis that you disagree with the idea. Welcome to groupthink.
mkramlich 16y ago
man on the moon: government

stretchwithme 16y ago

a lot of truth to that. I also think that if consumers were actually paying the full direct cost of treatments, they would be a lot less willing to pay for a chronic drug habit instead of a cure. Selling cures can be profitable too. Consumers are perfectly able to see and pay for the benefits of a one time solution as opposed to a cheaper chronic solution. That's why they buy cars and houses instead of renting them. The market will deliver what the consumer wants if the consumer were making the spending decisions. Government can't be somehow better than business at deciding what to fund. Its manipulated by business! The current pattern has evolved in a government funded research environment. Only ending the interference in the normal process of making decisions at the consumer level can fix this problem.

ahoyhere 16y ago
The best health advances of all time were developed by passionate, and sometimes uneducated, volunteers -- people who were not working for a profit motive, but for a good-of-all motive. Case in point: the discoverer of penicillin, and the inventor of the vaccine, the inventor of the public blood bank, and on, and on, and on. Inventing then was (arguably) less costly and technical than it is now, because those were low-hanging fruit. A lot of the low-hanging fruit has probably been discovered by now, though we can't be sure, meaning that future research aims at higher-hanging fruit and so, metaphorically, the would-be inventors need ladders. These people need help, not profit, because profit isn't what motivates them anyway. EDIT: Let's not forget public health reform can save more lives than just about anything else (thank you Oliver Wendel Holmes/Ignaz Semmelweis http://www.accessexcellence.org/AE/AEC/CC/hand_background.php http://www.accessexcellence.org/AE/AEC/CC/hand_background.ph..., Sara Josephine Baker, http://en.wikipedia.org/wiki/Sara_Josephine_Baker http://en.wikipedia.org/wiki/Sara_Josephine_Baker and their present day equivalent, Atul Gawande).
- _delirium 16y ago
  Somehow it seems that the profit motive in pharmaceuticals motivates good science, but targeted at relatively strange things. "Lifestyle" drugs are huge: everyone wants the next Viagra, basically. Perhaps not surprising, because recreational drugs have always been popular, and the "fluff" end of legal pharmaceutical development is the part that sort of bleeds into recreational, since it tends to target something closer to "enhancing" the lives of already fairly healthy people with money, rather than "treating" the ill.

rsheridan6 16y ago

The big companies that already have treatments for diabetes (for example) definitely have an interest in not curing it, but a small startup would be happy to make millions destroying a multibillion dollar industry.

mattmanser 16y ago
People upvoting this are dreamers as that industry costs a phenomenal amount of money to put something through trials. Millions is a trivial amount on what you could throw down the drain and end up with no actual product. It's not vulnerable to a startup as a startup can't practically enter that market. You'd need to be producing something else first. And small? Not gonna cut it. Something that works on mice and even something that looks in the lab to cure the disease often doesn't work in trials and doesn't beat the placebo effect.
- rsheridan6 16y ago
  There are lots of pharmaceutical startups. And, yeah, drug development is high risk. In other news, the sky is still blue. Type 1 diabetes is still a pretty big market even if you had a one shot cure. There are hundreds of thousands of type 1 diabetics. If they pay a thousand dollars each (a steal at that price), that's hundreds of millions of dollars. For comparison, there are a few thousand people with CML, but that didn't stop Gleevec from being developed for it (it's very expensive).
  - dpik 16y ago
    A steal at a thousand dollars ? I have Type 1 and would consider an actual cure a great deal even if it cost everything I own plus my entire earnings for 10 years.
    - yummyfajitas 16y ago
      You might feel that way, but lots of politicians and commentators would decry that as "evil, greedy drug companies making a profit off sick people".

HeyLaughingBoy 16y ago

I hear this argument all the time and it ignores one fundamental fact: there is more than one large pharmaceutical company and they don't all make $disease_x_treatment. That one company makes billions selling a treatment for a disease has no bearing on a competing company making a cure for that disease and cornering the market. If anything, it's the very definition of a market-driven solution to a problem. Now, it's true that there are diseases which are so rare that it's not commercially worth developing a cure, and perhaps government funding is useful in that case but that's a completely different topic.

LaGrange 16y ago
"That one company makes billions selling a treatment for a disease has no bearing on a competing company making a cure for that disease and cornering the market." But it's actually more efficient to develop a treatment for the second company. It's better to share an extremely big market with a competitor than to corner it while making it much smaller. The goal is not to destroy all competition, it's to make more money.
- Tuna-Fish 16y ago
  Yes, but what if you have no presence at all in that extremely big market? In addition to the big ones, there are dozens of smaller companies with the cash and the experience in drug development that would jump at the opportunity to cure type 1 diabetes. Unless the risks vastly outweigh the rewards, which seems to have been the case here.
  - LaGrange 16y ago
    If you have "no presence at all" then you either have no money, in which case you can't really afford entering it (in this case, anyway), or you have the money, but then the above rules still apply. Effectively it would be better to market your mediocre product to physicians than to kill the cash-cow. Also, large risks are actually typical for this type of research. It's expensive and risky, so it has to give really large rewards. Research for completely new cures is even more risky and expensive, and the rewards are smaller.