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Price doesn't even have to be fixed for it to be depraved! Good time to remind everyone that Shkreli is in prison for financial crimes largely unrelated to the

Price doesn't even have to be fixed for it to be depraved! Good time to remind everyone that Shkreli is in prison for financial crimes largely unrelated to the pharma side of his businesses, the rest of the pharma industry continued doing the same things as him as usual.

deleted 6y ago
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fastball 6y ago
That was kinda the point, no? Shkreli was made into a bogeyman, but he was just doing in the open what every other pharma was smart enough to keep secret (pricing things higher than necessary). He also did it an excessively bombastic way. Don't hate the player, hate the game. Fix the root causes, not the symptoms.
- freeone3000 6y ago
  The root cause, in that, medicine is a for-profit endeavor and people are not only profiting, but seeking to maximize their profits on other people's basic needs?
  - fastball 6y ago
    Pretty much. Other things that don't help (somewhat US specific): 1. Layer of indirection created by the entire insurance system, which at this point is clearly not a good model for healthcare. Everyone needs/should have some amount of healthcare, so a system built entirely around the idea that only a minority of people should need to take advantage of the system is silly. 2. The half-assed government intervention of Medicare/Medicaid/ACA/etc – worst of both worlds in that when a government just injects shittons of money into the private sector (without very strong controls on price and behavior), what you end up with is ballooning costs... and that's about it. See also the govt. guaranteeing student loans for another example of the same. Or the Military Industrial Complex. And so on.
  - chongli 6y ago
    It's a bit more complicated than that. Health care costs have skyrocketed in the US. One of the big contributors to that has been the explosion in testing, both routine and diagnostic. These large costs aren't always shared to the same degree with other countries that have socialized medicine. One example is with MRI scans. MRI machines, and the technicians and doctors who work with them, are insanely expensive. The US is, of course, not the only country with MRI machines. However, in countries with socialized medicine there may be a much longer wait for people to get an MRI scan for a non-critical issue. What about in the US? If you've got the money, you can get one right away. As a Canadian, I've seen tons of advertisements over the years targeting Canadians for MRIs as a cross-border service. So the question is: is getting an MRI now instead of waiting 6 months a basic need? Private MRI clinics are definitely profiting from it. It definitely seems frustrating for people on the waiting list who can't afford to cross the border and pay out of pocket. However, it doesn't seem nearly as bad as a company price-gouging people on life-saving insulin, for example.
    - Animats 6y ago
      Too much of that is markup. The cost of MRI machines is down, and the cost of CT scanners is way down. But charges for those services have not dropped to match.
  - sbarzowski 6y ago
    You could say the same about bakeries ("seeking to maximize their profits on other people's basic needs"). IMO the problem is more about (very) imperfect competition. Also medicine is very special in many ways (desperate buyers, doctors making decisions for them, moral and emotional weight, etc.), so it's hard to have incentives aligned.
    - freeone3000 6y ago
      The entire food pipeline is heavily subsidized by the government, from advantageous loans to crop price insurance to direct cash subsidies to a sales tax exemption, to SNAP to people who can't afford food. I agree wholeheartedly with the bakery comment, that they try to maximize profits, but, bread is less than a dollar a loaf and significant expense and effort is taken to ensure everyone is fed. There seems to be no will to do the same for healthcare.
- cforrester 6y ago
  "Don't hate the player" is the kind of thing you say about people scraping by at a day job, who hold no real power over the business practices. He wouldn't have gone hungry if he'd behaved acceptably, so he had a choice free of influence by the immediate need to survive. I wouldn't characterize Shkreli's moral failure as a symptom of "the game," but rather one of several root causes of its perpetuation to begin with. In my view, fixing the problem includes denouncing powerful people who fail to abide by the ethical standards that we want them to hold.
  - fastball 6y ago
    Morality is not objective. If you want people to stop doing something, make it illegal. If you can't muster the political will to do so, clearly not enough people agree with your view of morality (assuming a functional democracy).
    - scarby2 6y ago
      This is something people often forget, nothing is objectively good or bad as they are social/individual constructs. Even things like killing or theft could be seen as good looking through the right lens.
    - cforrester 6y ago
      I made no statement about "objective" morality. I explained my own morals, and why I'm comfortable encouraging people to blame the wealthy for the harms they perpetuate. Could you please elaborate on how you think this reply is relevant to that? As slow as it seems to be, my perception is that societal attitudes towards wealth have been shifting over the past few decades. I'm hopeful that one day, the tolerance for their misdeeds continue to dropbenough to inspire progressively more social and legal change, as you suggested.
      - fastball 6y ago
        Innocent until proven guilty, etc. etc. Public witch hunts are called "witch hunts" for a reason, and it's not a pretty one. It's also known as "mob justice", which despite the name is generally considered to be not justice at all.
- jonny_eh 6y ago
  There are many root causes, one of them being execs with decision making abilities, like Shkreli, making greedy decisions at the cost of people's health. It's ok to hold them accountable.
- deleted 6y ago
  [deleted]

deleted 6y ago

[deleted]

fastball 6y ago

That was kinda the point, no? Shkreli was made into a bogeyman, but he was just doing in the open what every other pharma was smart enough to keep secret (pricing things higher than necessary). He also did it an excessively bombastic way. Don't hate the player, hate the game. Fix the root causes, not the symptoms.

freeone3000 6y ago
The root cause, in that, medicine is a for-profit endeavor and people are not only profiting, but seeking to maximize their profits on other people's basic needs?
- fastball 6y ago
  Pretty much. Other things that don't help (somewhat US specific): 1. Layer of indirection created by the entire insurance system, which at this point is clearly not a good model for healthcare. Everyone needs/should have some amount of healthcare, so a system built entirely around the idea that only a minority of people should need to take advantage of the system is silly. 2. The half-assed government intervention of Medicare/Medicaid/ACA/etc – worst of both worlds in that when a government just injects shittons of money into the private sector (without very strong controls on price and behavior), what you end up with is ballooning costs... and that's about it. See also the govt. guaranteeing student loans for another example of the same. Or the Military Industrial Complex. And so on.
- chongli 6y ago
  It's a bit more complicated than that. Health care costs have skyrocketed in the US. One of the big contributors to that has been the explosion in testing, both routine and diagnostic. These large costs aren't always shared to the same degree with other countries that have socialized medicine. One example is with MRI scans. MRI machines, and the technicians and doctors who work with them, are insanely expensive. The US is, of course, not the only country with MRI machines. However, in countries with socialized medicine there may be a much longer wait for people to get an MRI scan for a non-critical issue. What about in the US? If you've got the money, you can get one right away. As a Canadian, I've seen tons of advertisements over the years targeting Canadians for MRIs as a cross-border service. So the question is: is getting an MRI now instead of waiting 6 months a basic need? Private MRI clinics are definitely profiting from it. It definitely seems frustrating for people on the waiting list who can't afford to cross the border and pay out of pocket. However, it doesn't seem nearly as bad as a company price-gouging people on life-saving insulin, for example.
  - Animats 6y ago
    Too much of that is markup. The cost of MRI machines is down, and the cost of CT scanners is way down. But charges for those services have not dropped to match.
- sbarzowski 6y ago
  You could say the same about bakeries ("seeking to maximize their profits on other people's basic needs"). IMO the problem is more about (very) imperfect competition. Also medicine is very special in many ways (desperate buyers, doctors making decisions for them, moral and emotional weight, etc.), so it's hard to have incentives aligned.
  - freeone3000 6y ago
    The entire food pipeline is heavily subsidized by the government, from advantageous loans to crop price insurance to direct cash subsidies to a sales tax exemption, to SNAP to people who can't afford food. I agree wholeheartedly with the bakery comment, that they try to maximize profits, but, bread is less than a dollar a loaf and significant expense and effort is taken to ensure everyone is fed. There seems to be no will to do the same for healthcare.
cforrester 6y ago
"Don't hate the player" is the kind of thing you say about people scraping by at a day job, who hold no real power over the business practices. He wouldn't have gone hungry if he'd behaved acceptably, so he had a choice free of influence by the immediate need to survive. I wouldn't characterize Shkreli's moral failure as a symptom of "the game," but rather one of several root causes of its perpetuation to begin with. In my view, fixing the problem includes denouncing powerful people who fail to abide by the ethical standards that we want them to hold.
- fastball 6y ago
  Morality is not objective. If you want people to stop doing something, make it illegal. If you can't muster the political will to do so, clearly not enough people agree with your view of morality (assuming a functional democracy).
  - scarby2 6y ago
    This is something people often forget, nothing is objectively good or bad as they are social/individual constructs. Even things like killing or theft could be seen as good looking through the right lens.
  - cforrester 6y ago
    I made no statement about "objective" morality. I explained my own morals, and why I'm comfortable encouraging people to blame the wealthy for the harms they perpetuate. Could you please elaborate on how you think this reply is relevant to that? As slow as it seems to be, my perception is that societal attitudes towards wealth have been shifting over the past few decades. I'm hopeful that one day, the tolerance for their misdeeds continue to dropbenough to inspire progressively more social and legal change, as you suggested.
    - fastball 6y ago
      Innocent until proven guilty, etc. etc. Public witch hunts are called "witch hunts" for a reason, and it's not a pretty one. It's also known as "mob justice", which despite the name is generally considered to be not justice at all.
jonny_eh 6y ago
There are many root causes, one of them being execs with decision making abilities, like Shkreli, making greedy decisions at the cost of people's health. It's ok to hold them accountable.
deleted 6y ago
[deleted]