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This is the classical "tricke down economy" type of solution. Give companies, who are additionally acting unethically, a guaranteed and direct profit increase a

by jahaja 7y ago

This is the classical "tricke down economy" type of solution. Give companies, who are additionally acting unethically, a guaranteed and direct profit increase and _hope_ that it solves itself in the long-term. Surely it depends on the barriers and how much of a cut those actually are in practice. Furthermore, private corps aren't the only way drugs can be invented.

nate_meurer 7y ago
No, trickle-down refers very specifically to tax breaks tailored narrowly to the wealthy, in hopes that they will in turn distribute their wealth via increased employment of capital and, ultimately, labor. Since its origins in Gilded Age populist political writing and depression era popular media, it has never meant anything else, and it has nothing to do with the subject at hand. > Give companies, who are additionally acting unethically, a guaranteed and direct profit increase... No, lowering barriers to competition doesn't give anyone guaranteed profit. It reliably does the opposite, depriving incumbent companies of their monopolies. > Furthermore, private corps aren't the only way drugs can be invented. Nobody -- literally nobody -- would dispute that. The question is whether the government is able to do the various parts of drug development as efficiently as the private sector. This is not a simple analysis, but I think the answer is more often than not, No.
- jahaja 7y ago
  Sigh, this is such a typical HN response, "I read everything literally and need to explain what it _actually_ means". I wrote _type_, as in similar. I know the origin. > This is not a simple analysis, but I think the answer is more often than not, No. Why not? Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public interests.
  - tptacek 7y ago
    Because in most markets, one of the more straightforward ways to make money is to deliver products more efficiently, split the reduced cost basis with the customer, and outcompete incumbents. You're not doing your argument any favors with this "typical HN response" stuff. Have a discussion with people on the thread or don't; it is fine for you to simply disagree and walk away.
    - jahaja 7y ago
      And in many markets it's not. Well-run state companies, that exists, and have existed for a long long time, efficiency is not a problem and they can focus their efforts and money on what's important, not profits and marketing. Don't tone police me please. I find it rude to assume ignorance and go on explaining. Did you miss the whole mansplaining wave?
      - dang 7y ago
        Would you please stop posting in the flamewar style to HN? It's not what this site is for, and we ban accounts that keep doing it. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
        jahaja 7y ago
        Sure. However, given the rudeness in the replies I feel that I restrained myself decently with a few slips. "You can't coherently and simultaneously believe" "You might as well call it "fascist" or "colonialist". It's jibberish." "it is fine for you to simply disagree and walk away" "Right, so it was a bullshit distraction that can safely be ignored." "You're still not understanding." "Now read this slowly and carefully" "You are completely misunderstanding the argument." "I think you're trying to construct a straw man" "which discussion you opened with a snarky, dismissive one-liner." "[if] you're able to use google for five minutes. At this point, though, I'm confident that you're interested only in polemics, rather than actually learning anything about the issue."
  - nate_meurer 7y ago
    Ah I see. So as long as we append the word "type", we're free to throw phrases into completely non-sensical contexts? How convenient. Kidding aside, your use of the phrase here indicates a fundamental misunderstanding. This isn't "similar" to trickle-down. This has nothing to do with it whatsoever. You might as well call it "fascist" or "colonialist". It's jibberish. Try this: You can find the Hopkins paper that Rayiner cited at https://sci-hub.tw/10.1056/nejmms1411398 https://sci-hub.tw/10.1056/nejmms1411398. It's a consice description of the causes of the ongoing dearth of generic biologic (non-small-molecule) medicines. Read that. It's only five pages. Then tell me how the various possible ways to limit the monopoly position of incumbent insulin makers -- patent reform, lowered regulatory barriers for new competitors, whatever -- would constitute a "trickle down type" giveaway to said incumbents. Tell me how that makes any sense at all. > Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public interests. Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. In this case, a strong regulatory framework around biosimilars may be unavoidable due to their extreme complexity (again, read the paper). But if there are regulatory hurdles that can safely be removed, and thus allow generic drug makers to enter the market with cheaper alternatives, how exactly would that be unfair or unjust for anybody?
    - jahaja 7y ago
      The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it. > Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more. My main point was that the profit motive causes this kind of skew: "Scientific publications brought the evidence that there was a lack of news drugs for diseases that cause high mortality and morbidity among people living in poor areas. One showed that only 1.1% of new drugs were approved specifically for neglected diseases over a period of 25 years (1975 to 1999) despite the fact that these diseases represented 11.4% of the global burden" > It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. I would argue that "free-markets" is the exact reason for anti-competitive regulations, among others, in the form of regulatory capture, which is inherent with capitalism.
shpongled 7y ago
You are completely misunderstanding the argument. Lets say the current price for insulin is $200. I see this margin, and say "I can produce insulin for cheaper, and I'm happy with selling it for $50". The government is placing restrictions on new competitors, so I can't just come in and sell insulin for $50. There is a restriction on competition, which causes artificial prices
- jahaja 7y ago
  The presumption is that it's actually the regulations that prevents the competition, which haven't at all been made clear. How about patents for example? How about the cheap prices of Europe?
  - tptacek 7y ago
    The presumption is that the regulations add a major cost hurdle to delivering unencumbered insulin products at lower prices, because that is in fact what they do.
    - jahaja 7y ago
      Are drug companies operating at a loss in Europe?
      - tptacek 7y ago
        I think you're trying to construct a straw man. Nobody on this thread is suggesting that pharma be deregulated. Rather, Rayiner pointed to a specific regulatory problem that may be contributing to the price of insulin. Whether or not drug companies operate at a loss in Europe is immaterial to that point.
        jahaja 7y ago
        I'm not sure what straw man that would be? I haven't suggested that either. What I'm implying is that Europe have regulations too, and that the price difference is not in proportion to the difference in regulatory strictness.

by jahaja 7y ago

nate_meurer 7y ago

No, trickle-down refers very specifically to tax breaks tailored narrowly to the wealthy, in hopes that they will in turn distribute their wealth via increased employment of capital and, ultimately, labor. Since its origins in Gilded Age populist political writing and depression era popular media, it has never meant anything else, and it has nothing to do with the subject at hand. > Give companies, who are additionally acting unethically, a guaranteed and direct profit increase... No, lowering barriers to competition doesn't give anyone guaranteed profit. It reliably does the opposite, depriving incumbent companies of their monopolies. > Furthermore, private corps aren't the only way drugs can be invented. Nobody -- literally nobody -- would dispute that. The question is whether the government is able to do the various parts of drug development as efficiently as the private sector. This is not a simple analysis, but I think the answer is more often than not, No.

jahaja 7y ago
Sigh, this is such a typical HN response, "I read everything literally and need to explain what it _actually_ means". I wrote _type_, as in similar. I know the origin. > This is not a simple analysis, but I think the answer is more often than not, No. Why not? Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public interests.
- tptacek 7y ago
  Because in most markets, one of the more straightforward ways to make money is to deliver products more efficiently, split the reduced cost basis with the customer, and outcompete incumbents. You're not doing your argument any favors with this "typical HN response" stuff. Have a discussion with people on the thread or don't; it is fine for you to simply disagree and walk away.
  - jahaja 7y ago
    And in many markets it's not. Well-run state companies, that exists, and have existed for a long long time, efficiency is not a problem and they can focus their efforts and money on what's important, not profits and marketing. Don't tone police me please. I find it rude to assume ignorance and go on explaining. Did you miss the whole mansplaining wave?
    - dang 7y ago
      Would you please stop posting in the flamewar style to HN? It's not what this site is for, and we ban accounts that keep doing it. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
      - jahaja 7y ago
        Sure. However, given the rudeness in the replies I feel that I restrained myself decently with a few slips. "You can't coherently and simultaneously believe" "You might as well call it "fascist" or "colonialist". It's jibberish." "it is fine for you to simply disagree and walk away" "Right, so it was a bullshit distraction that can safely be ignored." "You're still not understanding." "Now read this slowly and carefully" "You are completely misunderstanding the argument." "I think you're trying to construct a straw man" "which discussion you opened with a snarky, dismissive one-liner." "[if] you're able to use google for five minutes. At this point, though, I'm confident that you're interested only in polemics, rather than actually learning anything about the issue."
- nate_meurer 7y ago
  Ah I see. So as long as we append the word "type", we're free to throw phrases into completely non-sensical contexts? How convenient. Kidding aside, your use of the phrase here indicates a fundamental misunderstanding. This isn't "similar" to trickle-down. This has nothing to do with it whatsoever. You might as well call it "fascist" or "colonialist". It's jibberish. Try this: You can find the Hopkins paper that Rayiner cited at https://sci-hub.tw/10.1056/nejmms1411398 https://sci-hub.tw/10.1056/nejmms1411398. It's a consice description of the causes of the ongoing dearth of generic biologic (non-small-molecule) medicines. Read that. It's only five pages. Then tell me how the various possible ways to limit the monopoly position of incumbent insulin makers -- patent reform, lowered regulatory barriers for new competitors, whatever -- would constitute a "trickle down type" giveaway to said incumbents. Tell me how that makes any sense at all. > Profit-driven drug companies will obviously focus on things that make money, e.g. superficial/vanity related things, not what's necessarily aligned with public interests. Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. In this case, a strong regulatory framework around biosimilars may be unavoidable due to their extreme complexity (again, read the paper). But if there are regulatory hurdles that can safely be removed, and thus allow generic drug makers to enter the market with cheaper alternatives, how exactly would that be unfair or unjust for anybody?
  - jahaja 7y ago
    The template of trickle down economics I'm referring to is the method where the already wealthy/profiting and so on, is given immediate benefits under the premise of vague and long-term benefits for the many. This method of upwards redistribution has been applied repeatedly time and time again, and tax cuts in the style of trickle down economics are just one instance of it. > Just for fun, give me some examples of drugs that are merely "superficial/vanity related". I think you're trying to construct a straw man. Once again, it was one example, I was mainly thinking about hair loss or other male things caused by men, historically and still, earning more. My main point was that the profit motive causes this kind of skew: "Scientific publications brought the evidence that there was a lack of news drugs for diseases that cause high mortality and morbidity among people living in poor areas. One showed that only 1.1% of new drugs were approved specifically for neglected diseases over a period of 25 years (1975 to 1999) despite the fact that these diseases represented 11.4% of the global burden" > It's certainly true that the free-market does not guarantee alignment with the public interest. It's also true that over-regulation is one of things that causes such misalignments. I would argue that "free-markets" is the exact reason for anti-competitive regulations, among others, in the form of regulatory capture, which is inherent with capitalism.

shpongled 7y ago

You are completely misunderstanding the argument. Lets say the current price for insulin is $200. I see this margin, and say "I can produce insulin for cheaper, and I'm happy with selling it for $50". The government is placing restrictions on new competitors, so I can't just come in and sell insulin for $50. There is a restriction on competition, which causes artificial prices

jahaja 7y ago
The presumption is that it's actually the regulations that prevents the competition, which haven't at all been made clear. How about patents for example? How about the cheap prices of Europe?
- tptacek 7y ago
  The presumption is that the regulations add a major cost hurdle to delivering unencumbered insulin products at lower prices, because that is in fact what they do.
  - jahaja 7y ago
    Are drug companies operating at a loss in Europe?
    - tptacek 7y ago
      I think you're trying to construct a straw man. Nobody on this thread is suggesting that pharma be deregulated. Rather, Rayiner pointed to a specific regulatory problem that may be contributing to the price of insulin. Whether or not drug companies operate at a loss in Europe is immaterial to that point.
      - jahaja 7y ago
        I'm not sure what straw man that would be? I haven't suggested that either. What I'm implying is that Europe have regulations too, and that the price difference is not in proportion to the difference in regulatory strictness.