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Is it time to nationalise the pharmaceutical industry?
- macinjosh 7y agoNo. Who gets to decide what drugs are worth tax payer dollars? Can we sue the government if a drug causes problems? Why would we limit who can invent drugs and bring them to market to one entity? What if a president or congress tries to stop research on an important, but controversial drug for political reasons? Just no.
- deleted 7y ago[deleted]
- basch 7y agoYou could nationalize ownership of successful necessary drugs. Not dissimilar from eminent domain. Figure out fair market value for it, and then divide the cost over decades, instead of price gouging the first 7 years of customers. You dont need to nationalize the entire industry to control the intellectual property (and lets be real, that and regulation are most of the "cost.") Turning something with only short term incentives into a long term payout is something government excels at. Government can afford to pay things back slowly without quarterly returns. Private industry can still handle invention (possibly with NSF grants involved in initial production cost and testing, maybe leading to partial government ownership or a rebate during the eminent domain part) and production and distribution.
- lcall 7y agoA better way would be to privately support and further nonprofit efforts to compete, such as Civica Rx (https://en.wikipedia.org/wiki/Civica_Rx https://en.wikipedia.org/wiki/Civica_Rx https://duckduckgo.com/?q=civica+rx&ia=web https://duckduckgo.com/?q=civica+rx&ia=web ).
- zeveb 7y ago> Figure out fair market value for it How would one do that without a fair market?
- basch 7y agolobbying :)
- RcouF1uZ4gsC 7y agoI think a lot of issues can be solved not by nationalizing the pharmaceutical industry, but by setting up a competing government funded drug company. What the drug company researches and what it charges for it's drugs can be determined by government policy. If done, it would be interesting to look at how efficient it was vis-a-vis the private sector and what drugs actually got developed at what cost.
- eganist 7y agoYou mean like a public option, but for drugmaking? or a drugmaking co-op chartered and initially funded by the feds? I'd be down for this.
- Seenso 7y agoI'd be fine with either, and I think it'd also help with price-gouging like Turing Pharmaceuticals engaged in with Daraprim. A public drugmaker could be obligated to have implemented processes to manufacture every approved drug. If a maker engaged in price-gouging, or had its facilities disrupted, the public drugmaker could supply an alternative supply at fair prices.
- tells 7y agoI would like nationalization if it were split up into a research co-op with manufacturing contracted out to US companies. I would like to maintain some level of competitiveness but also have knowledge sharing across research teams.
- jfengel 7y agoFTA: Big pharma excels at the subsequent stage: taking the best ideas generated by scientists and bringing them to market, using its huge financial firepower to navigate the complex regulatory environment. If the government were to nationalize the industry, wouldn't the regulatory environment become simpler? Regulations exist because of the fundamental antagonism between profit-making and safety & efficacy. If the sector were nationalized, that would shift (and possibly diminish) that conflict. Industry may well have expertise in the expensive process of ensuring safety and efficacy, but if that's made more expensive by having regulations thrust on it from outside, why not save the cost?
- kichik 7y agoWon't you just get similar cost in the form of bureaucracy?
- TheOtherHobbes 7y agoBureaucracy is rarely as expensive as aggressive profiteering. In fact the opposite is more likely. If pharma is nationalised - or better, internationalised - it would become economic to fund solutions for common conditions that aren't currently considered profitable.
- throwaway3157 7y ago> Bureaucracy is rarely as expensive as aggressive profiteering. Have you seen the DoD and other gov entity contracting? Perhaps we can expect the same level of contracting that the DoD has today, outsourcing those expensive mistakes to others, for them to take the blame/fall/ I can see a situation where pharma bureaucrats refuse to approve or pursue things, because government mistakes are more unforgivable than business mistakes (where failure and experiments are often encouraged). I would expect more layers of approval/red-tape to develop as no-one wants to accept the blame of approving.
- Seenso 7y ago
- zebrafish 7y agoMy opinion is no. Share buybacks should be taxed as dividends. Tax credits implemented for capital expenditures. Pharma patents should be subject to export control. Nationalizing anything exposes it to the risk of flippant regulation and pressure from the executive branch. Imagine if Trump had the power to dictate which drugs were produced and researched.
- pkaye 7y ago> During last year’s election campaign the Labour leader, Jeremy Corbyn, highlighted patients being “held to ransom” by one manufacturer, Vertex, which was locked in a battle with the National Institute for Health and Care Excellence (NICE) over Vertex’s £100 000-plus price tag for the cystic fibrosis drug Orkambi.15 It wasn’t pretty, but it was resolved by negotiation, and the drug is now available on the NHS. The interesting thing about this is the Cystic Fibrosis Foundation had to fund the research themselves in the small hopes they found anything. And then the drug was sold to a company for a good amount which will be used for ongoing research on Cystic Fibrosis. Now the CFF has a pile of money to persue better treatment. Perhaps what Corbyn should have said is these treatments are important so lets fund even more into CF research.
- Der_Einzige 7y agoEven that's far better than status quo USA policy which is to simply not negotiate on drug prices and pay 80% of whatever the bill is. There's a reason why medicare is so bloody expensive...
- Der_Einzige 7y agoNow this would be actual capital S Socialism. I'm surprised to see this advocated here Tangentially related: Bernie Sanders should stop calling himself a socialist, partly because he's never actually advocated for nationalizing industries (redistributing the means of production to the "peoples state"), and partly because it's so damn unpopular with the electorate to call yourself one.
- KevinEldon 7y agoMedicare for All nationalizes the health insurance industry. The Green New Deal would nationalize parts of the energy industry.
- krapp 7y ago> Now this would be actual capital S Socialism. I'm surprised to see this advocated here I'm just surprised to see it related to anything other than social media. It seems like every week we get a new article calling for the government to take over Google, Facebook and Twitter and force them to be "public carriers." AFAIK, Bernie advocates for Nordic style "social democracy," which isn't "capital S Socialism" per se, but I agree that Americans who tend to see anything to the left of laissez-faire free markets as just different shades of communism might not grasp the nuance. Still, for someone who should be so damn unpopular, Bernie and his socialism seems to be pretty popular. Just not with his own party, unfortunately.
- apocalypstyx 7y agoWe need more Dr Salks. Could you patent the sun? https://www.youtube.com/watch?v=erHXKP386Nk https://www.youtube.com/watch?v=erHXKP386Nk
- glennvtx 7y agoNo. First, it is unethical, and the antithesis of this countries founding principal concerning freedom and free market forces. Remove the barriers to entry and competition that government created, they have enabled the monopolies that drive up drug cost. Holding the politicians and special interest that lobbied for them responsible would be great as well.
- toohotatopic 7y agoThere is no need to nationalise at all. The solution is not reduced competition but increased competition. The power of the pharmaceutical industry comes from artificial monopolies in the form of patents, approvals and import restrictions. Since the public funds the initial research anyway, those limitations can be reduced until competition exists and medicine is once again affordable.
- Zelphyr 7y agoThe pharmaceutical industry is getting really good at gaming the patent system. My sons inhaler was pretty cheap for a long time until all of a sudden it jumped in price. Like, from $30 to $300. Turns out, all they did was change the delivery mechanism--slightly--and the next thing you know it's somehow covered under a different patent. The medication stayed exactly the same.
- burntoutfire 7y agoAssuming the previous patent expired, can't someone else just make the medicine according to the original formula, and sell it for $30?
- freehunter 7y agoIf there’s a profit, yes. But try explaining “sorry we have the ability to treat you but you’re going to die because the medicine isn’t profitable enough for a company to produce”.
- HarryHirsch 7y agoThat's the other argument for nationalizing the pharmaceutical industry: broadening the supply chain. When Hurricane Maria destroyed Puerto Rico there was a shortage of saline in the US, because margin is so low that the market can only support very few manufacturers, many of which were on Puerto Rico. Right now we are looking at another rash of shortages. The Indian government has banned export of certain medications and pharmaceutical intermediates because India is worried about the coronavirus outbreak and domestic shortages.
- mc32 7y agoNo. Nationalizing it will politicize pharmaceuticals. (and parties change control every few years of so). Private industry may chase the longevity dollars (expensive drugs for rich people who want to make their later years easier), but they also do lots of research in lots of other mundane areas. The problem is more in the healthcare _system_ whose incentives are not aligned with the patients foremost, but rather is more geared towards extracting as much as possible from insurance companies who in turn are disincentivized to give their patients decent care, in many ways.
- halibutt 7y agoWe should nationalize twitter first. And also make it known that HN is censoring posts related to twitter/dorsey right now. Post attempts resolve with a https://news.ycombinator.com/deadlink https://news.ycombinator.com/deadlink Dorsey is being put on the chopping block by Elliott. Go check Reuters. Yes I know this is unrelated. But HN actively censoring. Holy crap. Sorry for taking over your thread. But seriously. Go try to post the Reuters link
- s1artibartfast 7y agoAgreed. Outcome based pricing is a pretty easy step in the right direction and helps to aligns the stakeholders.The drug company only gets paid if the patients get the desired outcome. The current system is completely bonkers. Insurance company profits are capped at a fixed percent, so they want to drive costs as high as possible. Pharma Benefit managers get paid by insurance based on list prices, so they also want to maximize price. Lastly, the manufacturer gets paid by PBMs based on list price minus kickbacks, and obviously wants to turn a profit
- guerrilla 7y agoAs if medicine hasn't always been political and can somehow avoid that in private hands.
- snarf21 7y agoAgreed. I also think that there are certain endeavors (medicine, space travel, etc.) where we need global cost sharing. Why are drugs cheaper in Canada? A lot of the drugs that go around the world are paid for by the US middle class. This cost sharing also removes the need for patent protections as everyone is opted in and buys from the global source. Obviously there are more details to solve but I'd like to see this approach tried.
- swayvil 7y agoObviously we should nationalize all necessities. Dead obvious.
- AnimalMuppet 7y agoI can't tell if this is parody, sarcasm, or serious. But in case you're serious: Sure, because that worked so well for the USSR's food supply. (That was sarcasm.)
- swayvil 7y agoYa I'm serious. The logic seems plain. Grow your own food or hire a guy to do it for you, but the guy wants to skin you.
- lcall 7y agoPlease, please, just: no. I have some background studying Russian (including Soviet) history (a semester class on Stalin, other reading, etc); we can observe what is happening to Venezuela, and many other cases where it sounded good, to someone, to make things better by more government control. I have experience dealing with Medicare (USA) (details at http://lukecall.net/e-9223372036854586100.html http://lukecall.net/e-9223372036854586100.html ). And (I hope) some grasp of the underlying principles involved of freedom vs. control, allowing mistakes vs. severely stifling everyone. All of which most strongly persuade me that nationalizing more health-related things is a really bad idea. It prevents us from doing more good otherwise, in the private sector. Edit: One interesting positive is civica rx, a nonprofit that is a great start, for example. (https://duckduckgo.com/?q=civica+rx&ia=web https://duckduckgo.com/?q=civica+rx&ia=web https://en.wikipedia.org/wiki/Civica_Rx https://en.wikipedia.org/wiki/Civica_Rx ). Other laws could be appropriate, but only very thoughtfully, with foundational principles of liberty in mind.
- deleted 7y ago[deleted]
- gojomo 7y agoBecause we want all drug discovery, manufacturing, & distribution to be done with the same efficiencies as the FDA, ICE, TSA, & CDC? No, thank you.
- Gatsky 7y agoThis proposal seems ill-founded. The idea that the public sector takes on the risk of early development is a misuse of the word ‘risk’. No funding agency ever thinks of investment in terms of financial risk. The money allocated to an individual project is extremely small in the scheme of things, and research budgets remain a small proportion of government spending overall. Pharma in contrast spends 8-20% of total expend on research. The long term trends don’t support this narrative either, with government spending becoming less important and privately funded research increasing [1]. [1] https://www.sciencemag.org/news/2017/03/data-check-us-government-share-basic-research-funding-falls-below-50 https://www.sciencemag.org/news/2017/03/data-check-us-govern...
- jononomo 7y agoUnfortunately the pharmaceutical industry has become corrupt. I don't know about nationalizing it, but something has to be done to bring the industry to heel. Please read Bottle of Lies, Katherine Eban's incredible new book about deadly corruption that has ravaged the generic drug industry. https://www.amazon.com/dp/B07JG49BQW/ref=cm_sw_em_r_mt_dp_U_BwwyEbX0ZH2G5 https://www.amazon.com/dp/B07JG49BQW/ref=cm_sw_em_r_mt_dp_U_...
- AnimalMuppet 7y agoHow do you feel about the federal response to the corona virus? Do you feel like they've done a good job, or does it more seem like incompetent fumbling? And if it's the latter, why do you think they'd do better at running the pharmaceutical industry?
- ryandvm 7y agoI have never met a government employee or contractor that believes that nationalizing ANY industry will result in increased efficiency. Anyone that has ever spent any time in the industry usually spends the first few months of their career trying to figure out of the organization can really be as inefficient as it seems. Letting government run something _may_ result in a more egalitarian distribution of fairly shitty service (see USPS, VA Health Care, etc.) but it absolutely will not result in a more efficient system.
- kasperni 7y ago> Letting government run something _may_ result in a more egalitarian distribution of fairly shitty service (see USPS, VA Health Care, etc.) but it absolutely will not result in a more efficient system. The US pays at least 2x more per capita for health care than pretty much any other country on the planet. And I have never seen it even close to top-ranked in any health care quality statistics.
- D-Coder 7y agoNationalizing Social Security has led to very low administrative costs, around 2%.
- gammadens 7y agoMy personal feeling about this, like a lot of things in the US at the moment is that the required approach requires cutting across current paradigms. More competition is required, which to my mind suggests introducing public pharmaceuticals, but also deregulating drugs in general.
- WheelsAtLarge 7y agoNationalization will only destroy the system that produces life-saving medicines. We have seen it over and over again with other industries in other countries. Priorities change for capitalized companies and eventually, the golden eggs that are the medicines will stop. The problem is that these companies have the wrong incentives and are producing products where they think they can get the best profits. This is where government policies will help. Governments need to give tax credits for drugs that are needed and support the development of low-cost alternatives to expensive life-saving drugs. The Orphan Drug Act of 1983 has been responsible for the development of many drugs that would never have been developed without a few government incentives. We should learn from that and apply it to other drugs. We bitch about farmers getting lots of help from the government but the result is that we get basic foods at a very affordable price. We can learn from those policies and apply them to pharma. The capitalist system works. But governments need to change policies to tweak the system so that companies develop what we need at an affordable price.
- tacone 7y agoWhy not just creating a a national pharmaceutic company? Private companies would continue to exist and probably protest about unfair competition, but still it would be a good method to prevent them forming a cartel and at the same time invest in much needed but not lucrative meds.
- boublepop 7y agoThe pharmaceutical Industry is not the problem. Nationalize the middlemen who are taking 2/3 of the profits and you’ll normalize the American market overnight.
- lsh264962 7y agoToll-free link for the full debate (which is actually more nuanced than the title suggests): http://bmj.com/cgi/content/full/bmj.m769?ijkey=wQFPxA0MpG4taog&keytype=ref http://bmj.com/cgi/content/full/bmj.m769?ijkey=wQFPxA0MpG4ta...