5 ms·

We are entering a new dark ages ruled by the priests of austerity, unable to value anything but short-term money.

by dv_dt 7y ago

pinewurst 7y ago
It's more than austerity here - their governor also punitively cut their state Supreme Court budget for upholding abortion rights.
AnthonyMouse 7y ago
The general austerity theory is contradicted by the fact that government budgets in most of the US haven't been reduced. The problem is the largest programs that already eat most of the budgets continue to expand to consume everything that's left. We dramatically increase taxpayer-funded healthcare spending while doing nothing about underlying healthcare costs and then wonder where all the money went.
- chillacy 7y ago
  Such a big issue. We all see the high healthcare and education costs and want healthcare and higher education for all, but our healthcare (current system) is way more expensive than other developed nations' and college prices have only increased over time, turning student loans into college administrators. We'll have to address this inflation either way.
  - omegaworks 7y ago
    This is why these universal programs are coupled with monopsony leverage. Healthcare prices have exploded because the government has been intentionally hobbled at the bargaining table, legislatively blocked from using its weight to negotiate better deals for prescription drug prices. Tuition has exploded because a system of credit has been created that is untouchable by bankruptcy. These are solvable problems.
    - chillacy 7y ago
      Agreed, they look pretty solvable and semi-obvious to me, but the pace of government has been slow (assuming they're not being incentivized against fixing these problems through lobbying in the first place). It's very sad to watch.
    - AnthonyMouse 7y ago
      > This is why these universal programs are coupled with monopsony leverage. Healthcare prices have exploded because the government has been intentionally hobbled at the bargaining table, legislatively blocked from using its weight to negotiate better deals for prescription drug prices. "Monopsony leverage" and "bargaining" is just price controls. You don't even need single payer for that if you want to do it, you can just legislate prices. The problem is price controls have a long record of being problematic, because everybody wants lower prices but if you set the price too low you get shortages. This is complicated in this case by the fact that most of the cost is R&D, so the thing that isn't supplied isn't pills for already-developed drugs, it's research into new drugs. And then comparisons to other countries fall flat because it's a global market, so as long as anyone (i.e. the US) is paying a lot to create a return for R&D spending, the research gets done and the other countries get access to it. So one of the reasons we pay so much more than everybody else is that we subsidize medical R&D for the rest of the world. Solving that isn't just a matter of us paying less, it also has to somehow involve them paying more, unless we want a lot less R&D. Moreover, a lot of the costs basically amount to regulatory capture or drug companies outsmarting the government. It's them finding ways to limit competition for things that should be cheap commodities, or get patents on things that are only marginally better than the status quo, and use that to raise prices. So you have to find ways to distinguish that stuff from real medical advances that are actually worth paying higher costs to get. But if you can do that then you can restrain that type of behavior without actually regulating prices, so that genuine medical advances continue to get the funding they require to be developed. Which is really what we need to do, but easier said than done.
      - omegaworks 7y ago
        >"Monopsony leverage" and "bargaining" is just price controls. You don't even need single payer for that if you want to do it, you can just legislate prices. No, monopsony leverage is not the same as a price control. The minimum price that monoposony can give you is the cost to produce the given drug. Price controls allow you to mandate a price lower than their cost to produce, hence the negative effects you mention. >This is complicated in this case by the fact that most of the cost is R&D This is also false. Marketing outweighs the R&D budgets at most private pharmaceutical companies. >a lot of the costs basically amount to regulatory capture or drug companies outsmarting the government It sounds like you’re advocating for the dismantling of the drug patent system, which is a far more radical proposal. I agree that regulatory/market failure also contributes to high costs, it’s why I believe the free market poorly maps onto the problem of providing healthcare.
hindsightbias 7y ago
What was it Sagan said, "The 21st Century will mark the final battle between religion and science, who will win?" But their might be more priesthoods than he thought of.
LanceH 7y ago
Austerity. That's laughable. Where would this be?
kleer001 7y ago
Nope, just plain old basic million year old human nature. Always been there, always will.
maerF0x0 7y ago
I have yet to see a government that believes in Austerity for all. And almost all governments i've seen believe in Austerity for someone else, just not their voter base. I always remind myself, when I say "The government ought to X" that is someone else's money that I am using the might of the state to forcibly extract from them and spend on _my_ priorities.
turk73 7y ago
Two things: 1) Stop importing so many needy people. Do it today. Cut the welfare benefits in half or better. 2) Cut the pension obligations in half or better. The promises were overblown to begin with. Negotiating with pensioners is better than them getting nothing and us getting high taxes and nothing else.
dang 7y ago
Maybe so, but please don't post unsubstantive comments here. Lack of new information plus grandiose ideological rhetoric guarantees a generic, predictable discussion. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

We are entering a new dark ages ruled by the priests of austerity, unable to value anything but short-term money.

by dv_dt 7y ago

We are entering a new dark ages ruled by the priests of austerity, unable to value anything but short-term money.

It's more than austerity here - their governor also punitively cut their state Supreme Court budget for upholding abortion rights.

AnthonyMouse 7y ago

The general austerity theory is contradicted by the fact that government budgets in most of the US haven't been reduced. The problem is the largest programs that already eat most of the budgets continue to expand to consume everything that's left. We dramatically increase taxpayer-funded healthcare spending while doing nothing about underlying healthcare costs and then wonder where all the money went.

chillacy 7y ago
Such a big issue. We all see the high healthcare and education costs and want healthcare and higher education for all, but our healthcare (current system) is way more expensive than other developed nations' and college prices have only increased over time, turning student loans into college administrators. We'll have to address this inflation either way.
- omegaworks 7y ago
  This is why these universal programs are coupled with monopsony leverage. Healthcare prices have exploded because the government has been intentionally hobbled at the bargaining table, legislatively blocked from using its weight to negotiate better deals for prescription drug prices. Tuition has exploded because a system of credit has been created that is untouchable by bankruptcy. These are solvable problems.
  - chillacy 7y ago
    Agreed, they look pretty solvable and semi-obvious to me, but the pace of government has been slow (assuming they're not being incentivized against fixing these problems through lobbying in the first place). It's very sad to watch.
  - AnthonyMouse 7y ago
    > This is why these universal programs are coupled with monopsony leverage. Healthcare prices have exploded because the government has been intentionally hobbled at the bargaining table, legislatively blocked from using its weight to negotiate better deals for prescription drug prices. "Monopsony leverage" and "bargaining" is just price controls. You don't even need single payer for that if you want to do it, you can just legislate prices. The problem is price controls have a long record of being problematic, because everybody wants lower prices but if you set the price too low you get shortages. This is complicated in this case by the fact that most of the cost is R&D, so the thing that isn't supplied isn't pills for already-developed drugs, it's research into new drugs. And then comparisons to other countries fall flat because it's a global market, so as long as anyone (i.e. the US) is paying a lot to create a return for R&D spending, the research gets done and the other countries get access to it. So one of the reasons we pay so much more than everybody else is that we subsidize medical R&D for the rest of the world. Solving that isn't just a matter of us paying less, it also has to somehow involve them paying more, unless we want a lot less R&D. Moreover, a lot of the costs basically amount to regulatory capture or drug companies outsmarting the government. It's them finding ways to limit competition for things that should be cheap commodities, or get patents on things that are only marginally better than the status quo, and use that to raise prices. So you have to find ways to distinguish that stuff from real medical advances that are actually worth paying higher costs to get. But if you can do that then you can restrain that type of behavior without actually regulating prices, so that genuine medical advances continue to get the funding they require to be developed. Which is really what we need to do, but easier said than done.
    - omegaworks 7y ago
      >"Monopsony leverage" and "bargaining" is just price controls. You don't even need single payer for that if you want to do it, you can just legislate prices. No, monopsony leverage is not the same as a price control. The minimum price that monoposony can give you is the cost to produce the given drug. Price controls allow you to mandate a price lower than their cost to produce, hence the negative effects you mention. >This is complicated in this case by the fact that most of the cost is R&D This is also false. Marketing outweighs the R&D budgets at most private pharmaceutical companies. >a lot of the costs basically amount to regulatory capture or drug companies outsmarting the government It sounds like you’re advocating for the dismantling of the drug patent system, which is a far more radical proposal. I agree that regulatory/market failure also contributes to high costs, it’s why I believe the free market poorly maps onto the problem of providing healthcare.

hindsightbias 7y ago

What was it Sagan said, "The 21st Century will mark the final battle between religion and science, who will win?" But their might be more priesthoods than he thought of.

LanceH 7y ago

Austerity. That's laughable. Where would this be?

kleer001 7y ago

Nope, just plain old basic million year old human nature. Always been there, always will.

maerF0x0 7y ago

I have yet to see a government that believes in Austerity for all. And almost all governments i've seen believe in Austerity for someone else, just not their voter base. I always remind myself, when I say "The government ought to X" that is someone else's money that I am using the might of the state to forcibly extract from them and spend on _my_ priorities.

turk73 7y ago

Two things: 1) Stop importing so many needy people. Do it today. Cut the welfare benefits in half or better. 2) Cut the pension obligations in half or better. The promises were overblown to begin with. Negotiating with pensioners is better than them getting nothing and us getting high taxes and nothing else.

dang 7y ago

Maybe so, but please don't post unsubstantive comments here. Lack of new information plus grandiose ideological rhetoric guarantees a generic, predictable discussion. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html