7 ms·

I don't think the outrage was ever about Shkreli not saving someone's life. It was about Shkreli making lots of money from people's suffering, after artificiall

I don't think the outrage was ever about Shkreli not saving someone's life. It was about Shkreli making lots of money from people's suffering, after artificially inflating the price of a drug that he controlled. In other words, getting rich from increasing the amount of misery in this world.

brucephillips 9y ago
AFAIK, only the insurance companies paid his exorbitant prices.
- s73v3r_ 9y ago
  Schools and some other public places were also required to keep Epi-pens on hand, by law. Some of them did pay the exorbitant prices.
  - brucephillips 9y ago
    Shkreli did not increase epipen prices.
    - Florin_Andrei 9y ago
      It's amazing to watch the amount of mental contortions you're going through. I guess it's very important for you to maintain the consistency of your current worldview, and seeing the likes of Shkreli in a favorable light is an integral part of that. Ayn Rand would be proud.
      - rayiner 9y ago
        Shkreli literally did not increase EpiPen prices. That was Mylan.
        deleted 9y ago
        [deleted]
        tomjakubowski 9y ago
        The commenter who brought up EpiPens was drawing a comparison between two recent, famous instances of "exorbitant prices" in medicine, pointing out that in the EpiPen there were non-insurers paying the crazy prices, i.e. that non-insurer payers for medicine exist. Shkreli not being behind the EpiPen prices is irrelevant to their point.
- nate_meurer 9y ago
  And to whom do you think the insurance companies pass those costs?
- Broken_Hippo 9y ago
  That's not entirely true. If it was billed to insurance, they would pass those costs over to the people paying the premiums. Some insurance policies are self-funded: Meaning they have plans, but the insurance company is really just the administrator. The actual costs are paid by the company employing the people buying the insurance. They can both pass the costs onto the employees paying health insurance premiums plus add in that cost to the goods they sell. A great deal of insurance plans have a co-payment for drugs. If you had to pay 20% of the cost of this drug, that is still quite an increase for the patient. Not everyone needing these drugs has insurance. Luckily, some charities exist to try to pay the bills for these folks and sometimes there are other discounts available for the uninsured. Some people are on government insurance plans, both in the US and in places with state health care. In these cases, the costs are passed onto tax payers. Sorry, but pretty much everyone pays for this sort of thing.
- dragonwriter 9y ago
  Increases to insurance company costs are passed on, with markup, to the insured.
  - Turing_Machine 9y ago
    No, in the United States they're generally passed on to the insured's employer. There are several negative aspects of that, but the big one is that the patient is less likely to complain about being overcharged if someone else is paying for it. The whole idea of employer-paid insurance in the U.S. is an artifact of some tax law jiggery pokery back in (if I'm remembering right) the Depression/WWII era. Before that people paid for their own health insurance.
    - dragonwriter 9y ago
      > No, in the United States they're generally passed on to the insured's employer. Who takes them out of the total amount they are willing to pay for labor, so it still comes from the insured.
      - Turing_Machine 9y ago
        Perhaps that's how the mythical homo economicus would see it, but that's not how real people see it. See also: the way that most people view a tax refund as "free money" that the government is "giving" them, rather than them having given the government an interest-free loan of that money (which is the actual case). When they get a (partial) refund of the taxes withheld, they're happy, rather than being disappointed that they've had too much withheld (as homo economicus would). If, instead, no taxes were withheld and they were forced to come up with the (non-refunded) portion in a lump sum payment once a year they'd be outraged. Human psychology and math don't really overlap that much. In one sense, yes, the money the employer pays would be available for wages, but the problem is that any savings would come out of a pool of potential wages for all employees. There is no direct incentive for an individual employee to save money on health care, because those savings will make zero impact on his paycheck. One way of trying to get around this is, of course, the "copay". If the employee saves money, he does, in most cases, have a somewhat smaller copay. But the incentive isn't nearly as high as it would be if all the savings accrued directly to the employee.
- tjohns 9y ago
  Some insurance companies put the expensive drugs into a "specialty" tier, which can be significantly more expensive for the patient. It's the difference between a $10 co-pay for a generic drug, a $25 or $50 co-pay for a non-generic drug, and a 30-percent co-pay for a specialty drug.
rayiner 9y ago
> In other words, getting rich from increasing the amount of misery in this world. This is the fallacy. He didn't get rich from increasing the amount of misery in the world. He didn't give people toxoplasmosis. He got rich from not doing something he could do (i.e. sell drugs more cheaply) to decrease the amount of misery. Which is the exact same thing you do when you buy a Macbook Pro instead of donating the money to save a life from malaria: you forgo the opportunity to decrease the amount of misery in the world in return for your own personal benefit.
- Florin_Andrei 9y ago
  Making it harder for patients to get treatment definitely increases the amount of misery in the world. You don't have to be the toxoplasma gondii parasite to make life miserable for a lot of people. It's enough if you're the other kind of parasite who makes the treatment orders of magnitude more expensive, just for personal gain. > fallacy ROTFL - this is like talking about cherries with someone who can's see the color red.
  - stevenh 9y ago
    It's amazing to watch the amount of mental contortions you're going through. I guess it's very important for you to maintain the consistency of your current worldview, and seeing the likes of Shkreli in a negative light is an integral part of that. Ayn Rand would be proud.
    - sctb 9y ago
      You've been breaking the guidelines a whole lot by posting uncivil and or substantive comments. This just isn't the kind of conversation we're after here, so please fix this. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: we've banned this account. We're happy to unban accounts if you email us at hn@ycombinator.com and we believe you'll start following the guidelines.
  - ryanlol 9y ago
    He did not make it harder for patients to get treatment, he simply made treatment available at a higher price point. At least he made treatment available when others weren't willing to do so.

brucephillips 9y ago

AFAIK, only the insurance companies paid his exorbitant prices.

s73v3r_ 9y ago
Schools and some other public places were also required to keep Epi-pens on hand, by law. Some of them did pay the exorbitant prices.
- brucephillips 9y ago
  Shkreli did not increase epipen prices.
  - Florin_Andrei 9y ago
    It's amazing to watch the amount of mental contortions you're going through. I guess it's very important for you to maintain the consistency of your current worldview, and seeing the likes of Shkreli in a favorable light is an integral part of that. Ayn Rand would be proud.
    - rayiner 9y ago
      Shkreli literally did not increase EpiPen prices. That was Mylan.
      - deleted 9y ago
        [deleted]
      - tomjakubowski 9y ago
        The commenter who brought up EpiPens was drawing a comparison between two recent, famous instances of "exorbitant prices" in medicine, pointing out that in the EpiPen there were non-insurers paying the crazy prices, i.e. that non-insurer payers for medicine exist. Shkreli not being behind the EpiPen prices is irrelevant to their point.
nate_meurer 9y ago
And to whom do you think the insurance companies pass those costs?
Broken_Hippo 9y ago
That's not entirely true. If it was billed to insurance, they would pass those costs over to the people paying the premiums. Some insurance policies are self-funded: Meaning they have plans, but the insurance company is really just the administrator. The actual costs are paid by the company employing the people buying the insurance. They can both pass the costs onto the employees paying health insurance premiums plus add in that cost to the goods they sell. A great deal of insurance plans have a co-payment for drugs. If you had to pay 20% of the cost of this drug, that is still quite an increase for the patient. Not everyone needing these drugs has insurance. Luckily, some charities exist to try to pay the bills for these folks and sometimes there are other discounts available for the uninsured. Some people are on government insurance plans, both in the US and in places with state health care. In these cases, the costs are passed onto tax payers. Sorry, but pretty much everyone pays for this sort of thing.
dragonwriter 9y ago
Increases to insurance company costs are passed on, with markup, to the insured.
- Turing_Machine 9y ago
  No, in the United States they're generally passed on to the insured's employer. There are several negative aspects of that, but the big one is that the patient is less likely to complain about being overcharged if someone else is paying for it. The whole idea of employer-paid insurance in the U.S. is an artifact of some tax law jiggery pokery back in (if I'm remembering right) the Depression/WWII era. Before that people paid for their own health insurance.
  - dragonwriter 9y ago
    > No, in the United States they're generally passed on to the insured's employer. Who takes them out of the total amount they are willing to pay for labor, so it still comes from the insured.
    - Turing_Machine 9y ago
      Perhaps that's how the mythical homo economicus would see it, but that's not how real people see it. See also: the way that most people view a tax refund as "free money" that the government is "giving" them, rather than them having given the government an interest-free loan of that money (which is the actual case). When they get a (partial) refund of the taxes withheld, they're happy, rather than being disappointed that they've had too much withheld (as homo economicus would). If, instead, no taxes were withheld and they were forced to come up with the (non-refunded) portion in a lump sum payment once a year they'd be outraged. Human psychology and math don't really overlap that much. In one sense, yes, the money the employer pays would be available for wages, but the problem is that any savings would come out of a pool of potential wages for all employees. There is no direct incentive for an individual employee to save money on health care, because those savings will make zero impact on his paycheck. One way of trying to get around this is, of course, the "copay". If the employee saves money, he does, in most cases, have a somewhat smaller copay. But the incentive isn't nearly as high as it would be if all the savings accrued directly to the employee.
tjohns 9y ago
Some insurance companies put the expensive drugs into a "specialty" tier, which can be significantly more expensive for the patient. It's the difference between a $10 co-pay for a generic drug, a $25 or $50 co-pay for a non-generic drug, and a 30-percent co-pay for a specialty drug.

rayiner 9y ago

> In other words, getting rich from increasing the amount of misery in this world. This is the fallacy. He didn't get rich from increasing the amount of misery in the world. He didn't give people toxoplasmosis. He got rich from not doing something he could do (i.e. sell drugs more cheaply) to decrease the amount of misery. Which is the exact same thing you do when you buy a Macbook Pro instead of donating the money to save a life from malaria: you forgo the opportunity to decrease the amount of misery in the world in return for your own personal benefit.

Florin_Andrei 9y ago
Making it harder for patients to get treatment definitely increases the amount of misery in the world. You don't have to be the toxoplasma gondii parasite to make life miserable for a lot of people. It's enough if you're the other kind of parasite who makes the treatment orders of magnitude more expensive, just for personal gain. > fallacy ROTFL - this is like talking about cherries with someone who can's see the color red.
- stevenh 9y ago
  It's amazing to watch the amount of mental contortions you're going through. I guess it's very important for you to maintain the consistency of your current worldview, and seeing the likes of Shkreli in a negative light is an integral part of that. Ayn Rand would be proud.
  - sctb 9y ago
    You've been breaking the guidelines a whole lot by posting uncivil and or substantive comments. This just isn't the kind of conversation we're after here, so please fix this. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Edit: we've banned this account. We're happy to unban accounts if you email us at hn@ycombinator.com and we believe you'll start following the guidelines.
- ryanlol 9y ago
  He did not make it harder for patients to get treatment, he simply made treatment available at a higher price point. At least he made treatment available when others weren't willing to do so.