4 ms·

You are correct. The exact detail of my comment is inaccurate, but the point still stands that it is up to the federal government. The buck has to stop somewher

You are correct. The exact detail of my comment is inaccurate, but the point still stands that it is up to the federal government. The buck has to stop somewhere. Continuously blaming the insurance industry for high costs is popular but there are a lot of other factors too which the media conveniently seem to neglect to mention. It helps no one if brilliant minds would rather go work on a "data analytics" healthcare startup (think fancy wearables) using "machine learning" that is purely dry lab (the bio academia preferred term for data science) without a single bit of wet lab physiology research that contributes to drug cures because commercialisation is too difficult, takes too long, too regulated.

eesmith 7y ago
"which the media conveniently seem to neglect to mention" What? No. These are well-known structural problems that are mentioned often. I mentioned one related to funding residency programs. Another which has come up is the lack of public pricing information. Eg, "how much does it cost to give birth at your hospital if there are no complications?" - https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bills https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bi... . (I believe this information is now required to be public.) A third is how Medicare is prohibited from negotiating for better drug prices. The exact details of your comments are important because if you don't know the source of the problems - which in part are due to the same federal government that you pin your hopes on - then you are at a high risk of being manipulated by the same mistaken views that have perpetuated this broken system. Take your final statement, "takes too long, too regulated". That is a common talking point pushed by those who want to sell "drugs" that haven't been proven to actually work, and by those who are philosophically opposed to government regulations. Quite simply, the US isn't the only country developing new drugs. Other countries have their own, different regulations, and if it were a simple matter of the US being "over regulated" then we see companies elsewhere doing significantly better. Or, look at all the people who, desperate for treatment, go to another country with weaker regulations to seek an experimental treatment which not only doesn't work, but drains them of money, and sometimes makes things worse.
- sansnomme 7y ago
  The US is the most powerful nation in the world. At the end of the day, broken or not, it is still the one nation that sets the rules of the game. When its protocols change, others follow on its wake. There has yet to be another that have as much risk-appetite and the population to support a large domestic market for bootstrapping. Germany, Japan, China and pretty much any other country with the same or more population that are equally developed are hardly known for being trailblazers of R and D in the medical field. Sure they may have plenty of manufacturers and produce tons of research but they still implicitly follow American regulations. Legal and political arguments aside, the number of Nobel Laureates in Medicine are still overwhelmingly American; there has only been 1 Chinese winner in the field in recent years despite their supposed superpower status. It is popular and convenient to always blame companies and revolving doors. Just as you won't build a tech headquarters in rural Midwest, you are not going to easily find "advanced treatments" in other countries that are hardly as innovative or has as much money sloshing around. I know big federal governments interfering is an unpopular opinion here on HN but something has failed when funding is incentivized to build web app gimmicks rather than into critical life science research. There is nothing wrong with the fact that the government keeps drugs that are not proven to work out of people hands, but somebody to bear the cost of doing the tests, if not them, then who? Life sciences have an incredibly high failure rate. Imagine the number of times your code fails to compile properly when you push to CI. Imagine the number of tries it takes for you to get it build successfully and deployed. A single cycle or iteration in computing is measured from anywhere nanoseconds to hours. Machine learning perhaps takes slightly longer. Take your number of tries for code compilation and assume that it takes the same number of tries to get a drug approved. In life sciences a single cycle or iteration is a matter of months and years or in the worst case, decades. Lyme disease continues to plague us thanks to the fact that a readily available vaccine was shut down for political reasons. We have more than enough life science grads to easily triple, quadruple or even increase the number of researchers in the field by an entire magnitude. There is absolutely no shortage of biology majors. You can hairsplit and yak shave the things that I attribute to being the root cause but massive "production level" double blind-type trials aren't the sort of thing that your average researcher can exactly afford. It's easy to be dismissive when your entire day job involves sitting on an Aeron chair in front of a massive monitor and value is generated when you push new code to the cloud. Your git push won't magically bring a molecule into production if the powers that be takes their own sweet time with accreditation and certification and expects you to pay for it (and no in pharmacy, there are no magical AWS grants or credit bonus to help lower the cost your double blind human trials when you send your buddy a referral link)

eesmith 7y ago

"which the media conveniently seem to neglect to mention" What? No. These are well-known structural problems that are mentioned often. I mentioned one related to funding residency programs. Another which has come up is the lack of public pricing information. Eg, "how much does it cost to give birth at your hospital if there are no complications?" - https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bills https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bi... . (I believe this information is now required to be public.) A third is how Medicare is prohibited from negotiating for better drug prices. The exact details of your comments are important because if you don't know the source of the problems - which in part are due to the same federal government that you pin your hopes on - then you are at a high risk of being manipulated by the same mistaken views that have perpetuated this broken system. Take your final statement, "takes too long, too regulated". That is a common talking point pushed by those who want to sell "drugs" that haven't been proven to actually work, and by those who are philosophically opposed to government regulations. Quite simply, the US isn't the only country developing new drugs. Other countries have their own, different regulations, and if it were a simple matter of the US being "over regulated" then we see companies elsewhere doing significantly better. Or, look at all the people who, desperate for treatment, go to another country with weaker regulations to seek an experimental treatment which not only doesn't work, but drains them of money, and sometimes makes things worse.

sansnomme 7y ago
The US is the most powerful nation in the world. At the end of the day, broken or not, it is still the one nation that sets the rules of the game. When its protocols change, others follow on its wake. There has yet to be another that have as much risk-appetite and the population to support a large domestic market for bootstrapping. Germany, Japan, China and pretty much any other country with the same or more population that are equally developed are hardly known for being trailblazers of R and D in the medical field. Sure they may have plenty of manufacturers and produce tons of research but they still implicitly follow American regulations. Legal and political arguments aside, the number of Nobel Laureates in Medicine are still overwhelmingly American; there has only been 1 Chinese winner in the field in recent years despite their supposed superpower status. It is popular and convenient to always blame companies and revolving doors. Just as you won't build a tech headquarters in rural Midwest, you are not going to easily find "advanced treatments" in other countries that are hardly as innovative or has as much money sloshing around. I know big federal governments interfering is an unpopular opinion here on HN but something has failed when funding is incentivized to build web app gimmicks rather than into critical life science research. There is nothing wrong with the fact that the government keeps drugs that are not proven to work out of people hands, but somebody to bear the cost of doing the tests, if not them, then who? Life sciences have an incredibly high failure rate. Imagine the number of times your code fails to compile properly when you push to CI. Imagine the number of tries it takes for you to get it build successfully and deployed. A single cycle or iteration in computing is measured from anywhere nanoseconds to hours. Machine learning perhaps takes slightly longer. Take your number of tries for code compilation and assume that it takes the same number of tries to get a drug approved. In life sciences a single cycle or iteration is a matter of months and years or in the worst case, decades. Lyme disease continues to plague us thanks to the fact that a readily available vaccine was shut down for political reasons. We have more than enough life science grads to easily triple, quadruple or even increase the number of researchers in the field by an entire magnitude. There is absolutely no shortage of biology majors. You can hairsplit and yak shave the things that I attribute to being the root cause but massive "production level" double blind-type trials aren't the sort of thing that your average researcher can exactly afford. It's easy to be dismissive when your entire day job involves sitting on an Aeron chair in front of a massive monitor and value is generated when you push new code to the cloud. Your git push won't magically bring a molecule into production if the powers that be takes their own sweet time with accreditation and certification and expects you to pay for it (and no in pharmacy, there are no magical AWS grants or credit bonus to help lower the cost your double blind human trials when you send your buddy a referral link)