4 ms·

This is one of the downsides of mobbing, shaming and regulating away outrageous prices. If pharma companies can't charge you in the ballpark of a lifetime's ear

This is one of the downsides of mobbing, shaming and regulating away outrageous prices. If pharma companies can't charge you in the ballpark of a lifetime's earnings for a one-shot, one-shots will be less compelling to them compared with treatments you have to take twice a day for the rest of your life.

watwut 9y ago
That assumes monopoly. Competition should solve that.
- andybak 9y ago
  Remembering basic human moral values might help as well.
  - oceanman888 9y ago
    Which is usually destroyed by competition.
  - watwut 9y ago
    The trouble is that those who remember those basic values in more complex competitive environments tend to loose competition against those who dont. Not always, but often enough.
  - emiliobumachar 9y ago
    I don't develop cures for diseases at all. Is this moral? If I may go out on a limb and speculate, you don't develop cures for diseases at all either. Is this moral? If someone is going to dedicate their careers to searching for cures to diseases, but only if they can earn a competitive salary doing so, are they more or less moral than us? For the equivalent case for investment, start with "I don't pay people to search for cures to diseases at all. Is that moral?"
    - PeterStuer 9y ago
      Small but important side-note: it is not the researchers that dedicate their lives developing the treatments and earning the 'salary' that decide on priorities or businessmodels. It's interesting that you bring up morality. Our socio-economic 'market' system is 'a-moral' (I'm specifically not saying 'immoral'), so any aspects in which there is a strong 'moral' component should not be left to the market.
    - andybak 9y ago
      Grandfather comment was: > This is one of the downsides of mobbing, shaming and regulating away outrageous prices. If pharma companies can't charge you in the ballpark of a lifetime's earnings for a one-shot, one-shots will be less compelling to them compared with treatments you have to take twice a day for the rest of your life. Companies are run by human beings. Ignoring the stuff about "fidiciary duty" (mainly because I think it's highly contentious to infer that it overrides moral choices and partly because that is a highly complex topic in it's own right) - people can make choices that involve making less profit and saving lives. If you're not high enough up the food chain to make these decisions then you can choose to leave your job in protest. Therefore companies can choose to take the "less compelling" but more moral option. And I can judge them on their choices and so can you. And they can choose to disagree with our judgement. That's how morality works. Shades of grey and difficult choices... I think in addressing the GP comment I have hopefully addressed yours too. We all make our own moral decisions and we all make our own moral judgements. Just because these processes are complex and reasonable people can disagree doesn't mean that morality is meaningless. It's just means that it's hard.
- beefield 9y ago
  Well, somehow getting rid of the monopolies (patents) faces significant resistance.
  - emiliobumachar 9y ago
    Getting rid of patents would need to be done in the context of a much larger change, which needs to address where will the money for research comes from. Today it comes from expectations of huge returns if the drug turns viable. It's solvable, but it needs to be addressed. Naively abolishing all patents will halt a lot of research overnight.
- dagw 9y ago
  The problem is that most normal market forces don't apply. Often neither the patient nor the doctor know the price of the 'product' on offer. And to the extent the doctors do know the price they have an incentive to offer the more expensive drug since they make more money that way. And since the patient is rarely paying the full cost they have no reason to price compare and will simply 'buy' what they're told is the best. In most cases Patients aren't even paying for their insurance (to a first approximation) so they don't even have a secondary intensive to keep their premiums low. Finally people are really bad and uncomfortable with putting a price on human life. I feel perfectly comfortable weighing the pros and cons of different cars or laptops at different prices, and perfectly happy to walk away if I can't find anything I like at a price I want to pay. I have no idea how I would react to having to put a price on how much I'd be willing to pay for a 70% chance to keep my daughter alive for another 2-4 years. But I suspect if forced to decide I would give the highly irrational answer "everything I own plus everything I can borrow", and all the companies in the field are completely aware of this fact
  - watwut 9y ago
    Even where patient don't negotiate, insurance company could. I have seen itemized lists of hospital stay where band-aid or temperature measuring costed ridiculous money. Not everything costly is death vs life choice. I think a lot would be much cheaper, if there would be better price transparency. The bad transparency is not so much about bad feeling of putting price on it, but also that it is profitable. The same entity that hides prices will turn you back if you are not insured without visible bad feeling. Also, plenty of people are uninsured or under-insured and money they have to pay out of pocked hurt them. They postpone doctor visit till the last possible moment, they take half dosage etc.
- deleted 9y ago
  [deleted]
qwbsdfg 9y ago
Or society could work differently, so that we try and cure people's diseases if we are able to.
worldsayshi 9y ago
Perhaps it could be regulated so that for these kind of things the price have to be proportional to the income level of the patient?
- emiliobumachar 9y ago
  I think the market will try on its own to price discriminate if it's allowed. My wild guess is that it's illegal today. https://en.wikipedia.org/wiki/Price_discrimination https://en.wikipedia.org/wiki/Price_discrimination
titzer 9y ago
>> mobbing, shaming and regulating away outrageous prices. Mobbing and shaming are absolutely part of a free market economy, as they manage information flow and create downward pressure on demand, and they punish bad actors. Regulation is essential because lo and behold, empirical evidence shows there are a number of situations where the magic free market completely fails at providing good outcomes. Good outcomes in the sense of, you know, achieving human-level fairness and progress, not shuffling money efficiently. There's a lot about power imbalance and access that would be a whole other topic that make these stupid dollar computations meaningless in any effective sense. > If pharma companies can't charge you in the ballpark of a lifetime's earnings You're being downvoted because this just shows how completely fucked this worldview is when reducing everything to dollars and cents. Not only is it a completely anti-human worldview, it's only consistently applied by corporations when they want to get their profits out of the poor souls they help with their magnanimous, oh-so-arduous drug development processes. Because you can bet when the shoe is on the other foot, and corporations fuck the environment and poor people en masse, nobody wants to do those calculations, because it would bankrupt whole industries (like coal and plastic manufacturers).

watwut 9y ago

That assumes monopoly. Competition should solve that.

andybak 9y ago
Remembering basic human moral values might help as well.
- oceanman888 9y ago
  Which is usually destroyed by competition.
- watwut 9y ago
  The trouble is that those who remember those basic values in more complex competitive environments tend to loose competition against those who dont. Not always, but often enough.
- emiliobumachar 9y ago
  I don't develop cures for diseases at all. Is this moral? If I may go out on a limb and speculate, you don't develop cures for diseases at all either. Is this moral? If someone is going to dedicate their careers to searching for cures to diseases, but only if they can earn a competitive salary doing so, are they more or less moral than us? For the equivalent case for investment, start with "I don't pay people to search for cures to diseases at all. Is that moral?"
  - PeterStuer 9y ago
    Small but important side-note: it is not the researchers that dedicate their lives developing the treatments and earning the 'salary' that decide on priorities or businessmodels. It's interesting that you bring up morality. Our socio-economic 'market' system is 'a-moral' (I'm specifically not saying 'immoral'), so any aspects in which there is a strong 'moral' component should not be left to the market.
  - andybak 9y ago
    Grandfather comment was: > This is one of the downsides of mobbing, shaming and regulating away outrageous prices. If pharma companies can't charge you in the ballpark of a lifetime's earnings for a one-shot, one-shots will be less compelling to them compared with treatments you have to take twice a day for the rest of your life. Companies are run by human beings. Ignoring the stuff about "fidiciary duty" (mainly because I think it's highly contentious to infer that it overrides moral choices and partly because that is a highly complex topic in it's own right) - people can make choices that involve making less profit and saving lives. If you're not high enough up the food chain to make these decisions then you can choose to leave your job in protest. Therefore companies can choose to take the "less compelling" but more moral option. And I can judge them on their choices and so can you. And they can choose to disagree with our judgement. That's how morality works. Shades of grey and difficult choices... I think in addressing the GP comment I have hopefully addressed yours too. We all make our own moral decisions and we all make our own moral judgements. Just because these processes are complex and reasonable people can disagree doesn't mean that morality is meaningless. It's just means that it's hard.
beefield 9y ago
Well, somehow getting rid of the monopolies (patents) faces significant resistance.
- emiliobumachar 9y ago
  Getting rid of patents would need to be done in the context of a much larger change, which needs to address where will the money for research comes from. Today it comes from expectations of huge returns if the drug turns viable. It's solvable, but it needs to be addressed. Naively abolishing all patents will halt a lot of research overnight.
dagw 9y ago
The problem is that most normal market forces don't apply. Often neither the patient nor the doctor know the price of the 'product' on offer. And to the extent the doctors do know the price they have an incentive to offer the more expensive drug since they make more money that way. And since the patient is rarely paying the full cost they have no reason to price compare and will simply 'buy' what they're told is the best. In most cases Patients aren't even paying for their insurance (to a first approximation) so they don't even have a secondary intensive to keep their premiums low. Finally people are really bad and uncomfortable with putting a price on human life. I feel perfectly comfortable weighing the pros and cons of different cars or laptops at different prices, and perfectly happy to walk away if I can't find anything I like at a price I want to pay. I have no idea how I would react to having to put a price on how much I'd be willing to pay for a 70% chance to keep my daughter alive for another 2-4 years. But I suspect if forced to decide I would give the highly irrational answer "everything I own plus everything I can borrow", and all the companies in the field are completely aware of this fact
- watwut 9y ago
  Even where patient don't negotiate, insurance company could. I have seen itemized lists of hospital stay where band-aid or temperature measuring costed ridiculous money. Not everything costly is death vs life choice. I think a lot would be much cheaper, if there would be better price transparency. The bad transparency is not so much about bad feeling of putting price on it, but also that it is profitable. The same entity that hides prices will turn you back if you are not insured without visible bad feeling. Also, plenty of people are uninsured or under-insured and money they have to pay out of pocked hurt them. They postpone doctor visit till the last possible moment, they take half dosage etc.
deleted 9y ago
[deleted]

qwbsdfg 9y ago

Or society could work differently, so that we try and cure people's diseases if we are able to.

worldsayshi 9y ago

Perhaps it could be regulated so that for these kind of things the price have to be proportional to the income level of the patient?

emiliobumachar 9y ago
I think the market will try on its own to price discriminate if it's allowed. My wild guess is that it's illegal today. https://en.wikipedia.org/wiki/Price_discrimination https://en.wikipedia.org/wiki/Price_discrimination

titzer 9y ago

>> mobbing, shaming and regulating away outrageous prices. Mobbing and shaming are absolutely part of a free market economy, as they manage information flow and create downward pressure on demand, and they punish bad actors. Regulation is essential because lo and behold, empirical evidence shows there are a number of situations where the magic free market completely fails at providing good outcomes. Good outcomes in the sense of, you know, achieving human-level fairness and progress, not shuffling money efficiently. There's a lot about power imbalance and access that would be a whole other topic that make these stupid dollar computations meaningless in any effective sense. > If pharma companies can't charge you in the ballpark of a lifetime's earnings You're being downvoted because this just shows how completely fucked this worldview is when reducing everything to dollars and cents. Not only is it a completely anti-human worldview, it's only consistently applied by corporations when they want to get their profits out of the poor souls they help with their magnanimous, oh-so-arduous drug development processes. Because you can bet when the shoe is on the other foot, and corporations fuck the environment and poor people en masse, nobody wants to do those calculations, because it would bankrupt whole industries (like coal and plastic manufacturers).