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> That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. What should it cost instead? > Dude was li

> That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. What should it cost instead? > Dude was living off of government research grants. Let's imagine his work comes to fruition. The drug is expensive but efficacious - is this not a good thing? Should the government have not helped fund this drug because now it's expensive? The alternative is a world without that drug and without as much incentive to produce the drug. I'm not sure that's a good trade.

chris_wot 4y ago
I’m sorry, but that’s a non sequitur. The alternative is not that the drug wasn’t produced. It is that the drug wasn’t developed by private enterprise.
- brigandish 4y ago
  Please don't give insincere apologies, they're rhetorically weak and pairing insincerity with something that should be sincere isn't a good look. Which segues nicely to this pairing of public funding and private enterprise. No, if the drug wouldn't be sold for a profit then the incentive to make it wouldn't exist and the funds would not be applied for and the ironic pairing - if it is ironic, which I don't think it is - wouldn't exist either. Unless we're going to believe that researchers go through the mill of applying for funding and doing research simply to get the funding and stay in badly paid employment?
  - chris_wot 4y ago
    Your response assumes that all medical research is done solely to make a profit.
    - brigandish 4y ago
      It's not an assumption, it was in the example I responded to: > When he was asked what the device would cost, he cheerily replied "whatever the market will bear." I also do not need to assume that companies undertaking research are doing it for profit as that is their reason for being companies, and even in the case of research being not directly undertaken for profit, that research - if useful - will go into drugs that are then sold with the intention of making a profit. Not solely, whether cynically or altruistically, the hope will be that the drug is effective.
  - pmyteh 4y ago
    I don't know about medical research, but that's exactly what the rest of us in universities do.
    - astrange 4y ago
      You get social rewards like titles, getting into vicious personal arguments over personal things, and being able to reject younger researchers’ work in peer review if it would disprove yours. Can’t displace Chomsky as a famous linguist if he writes a letter to everyone’s dissertation committee if they criticize him.
    - brigandish 4y ago
      Academic research is valuable, as is the research done by commercial entities. They're really not comparable in their intent though, and that's a good thing.
goodpoint 4y ago
> What should it cost instead? To patients? It should be free. To society? The initial research cost plus the bare manufacturing cost.
- brigandish 4y ago
  > To patients? It should be free. Someone has to pay. Who pays? > To society? The initial research cost plus the bare manufacturing cost. And we're back to a society which is poorer in terms of both health and wealth.
  - turtledove 4y ago
    Ah yes, a society with low cost medicines and a healthy research investment - definitely a recipe for low wealth and health. /s
    - brigandish 4y ago
      I also dream of utopia but when I wake up I have to supply the logic that fills in the gaps else it remains a dream. If you remove the profit motive then investment falls, new medicines become less likely and lesser in number, and medicines remain higher in cost due to lack of pressure (competition from new drugs, competition from new entrants, new techniques etc). Altruism, necessary as it is, does not fill that void alone, and it certainly won't be filled by hoping government makes everything "free".
      - goodpoint 4y ago
        > If you remove the profit motive then investment falls The last 200 years proven otherwise. All basic research around airplanes, semiconductors, satellites, GPS, GSM, fiber optics, CD/DVD and much much more was almost entirely tax funded.
klyrs 4y ago
> Should the government have not helped fund this drug because now it's expensive? No, the government should set a reasonable price for the product they funded. A high enough price to fund manufacturing, a low enough price to ensure that people who need the treatment have ready access to it. If the upper bound on price is too low for universal access, that's what subsidies are for. Instead, we have free money to bootstrap extractive capitalists, at cost and detriment to people who need care.
- brigandish 4y ago
  > No, the government should set a reasonable price for the product they funded. Do the investors at the company you work at set the prices for the products you produce? That would be strange. > Instead, we have free money to bootstrap extractive capitalists, at cost and detriment to people who need care. It's "free" money because the capital costs are high and it's risky. I don't think it's the only or the best way but it is a valid way, but it doesn't remove the right to make a profit. As to it being "detriment[al]" to the people who need care, they're getting a drug that didn't exist before, right? And this also should (generally) make existing drugs cheaper, right?
jlarocco 4y ago
> Should the government have not helped fund this drug because now it's expensive? If he wants to charge "what the market will bear," then he should fund the research through the market. If he wants government handouts to do the research then the public deserves to get the benefit that it's paying for - we're not funding it to make some guy rich. I'm not saying it should be free, but he's already opted out of the market, so he loses out on market pricing. Manufacturing cost plus some reasonable percentage for the creator.
- brigandish 4y ago
  I'm all for cutting subsidies, but the problem is that if you want risky things then investors might decide it's better not to invest and the drugs never appear. The government (which is really a government of and for the people, right?;) gets what it wants - a new drug - and jobs are created, trade happens, taxes are levied, health improves leading to (theoretical) money saved, more hours worked, more taxes… There's no need to punish the creator by not letting them make money off of their creation just because the government was involved, the government is getting plenty out of their investment.
  - jlarocco 4y ago
    > I'm all for cutting subsidies, but the problem is that if you want risky things then investors might decide it's better not to invest and the drugs never appear. So? Nobody has a right to free money. If investors don't want to fund the research, and the researcher doesn't want to share the results with the public, then no money for them. They can go off and work on something else. > There's no need to punish the creator by not letting them make money off of their creation just because the government was involved, the government is getting plenty out of their investment. You're putting words in my mouth. I said the cost of government funded drugs should be the cost of manufacturing plus a percentage for the inventor. Second, that's not how government funding works. If the public funds a thing, then the public has a right to use that thing. If the inventor doesn't like it, then they shouldn't take funding from the government. Funny to see a pro-corporate welfare argument on HN.

chris_wot 4y ago

I’m sorry, but that’s a non sequitur. The alternative is not that the drug wasn’t produced. It is that the drug wasn’t developed by private enterprise.

brigandish 4y ago
Please don't give insincere apologies, they're rhetorically weak and pairing insincerity with something that should be sincere isn't a good look. Which segues nicely to this pairing of public funding and private enterprise. No, if the drug wouldn't be sold for a profit then the incentive to make it wouldn't exist and the funds would not be applied for and the ironic pairing - if it is ironic, which I don't think it is - wouldn't exist either. Unless we're going to believe that researchers go through the mill of applying for funding and doing research simply to get the funding and stay in badly paid employment?
- chris_wot 4y ago
  Your response assumes that all medical research is done solely to make a profit.
  - brigandish 4y ago
    It's not an assumption, it was in the example I responded to: > When he was asked what the device would cost, he cheerily replied "whatever the market will bear." I also do not need to assume that companies undertaking research are doing it for profit as that is their reason for being companies, and even in the case of research being not directly undertaken for profit, that research - if useful - will go into drugs that are then sold with the intention of making a profit. Not solely, whether cynically or altruistically, the hope will be that the drug is effective.
- pmyteh 4y ago
  I don't know about medical research, but that's exactly what the rest of us in universities do.
  - astrange 4y ago
    You get social rewards like titles, getting into vicious personal arguments over personal things, and being able to reject younger researchers’ work in peer review if it would disprove yours. Can’t displace Chomsky as a famous linguist if he writes a letter to everyone’s dissertation committee if they criticize him.
  - brigandish 4y ago
    Academic research is valuable, as is the research done by commercial entities. They're really not comparable in their intent though, and that's a good thing.

goodpoint 4y ago

> What should it cost instead? To patients? It should be free. To society? The initial research cost plus the bare manufacturing cost.

brigandish 4y ago
> To patients? It should be free. Someone has to pay. Who pays? > To society? The initial research cost plus the bare manufacturing cost. And we're back to a society which is poorer in terms of both health and wealth.
- turtledove 4y ago
  Ah yes, a society with low cost medicines and a healthy research investment - definitely a recipe for low wealth and health. /s
  - brigandish 4y ago
    I also dream of utopia but when I wake up I have to supply the logic that fills in the gaps else it remains a dream. If you remove the profit motive then investment falls, new medicines become less likely and lesser in number, and medicines remain higher in cost due to lack of pressure (competition from new drugs, competition from new entrants, new techniques etc). Altruism, necessary as it is, does not fill that void alone, and it certainly won't be filled by hoping government makes everything "free".
    - goodpoint 4y ago
      > If you remove the profit motive then investment falls The last 200 years proven otherwise. All basic research around airplanes, semiconductors, satellites, GPS, GSM, fiber optics, CD/DVD and much much more was almost entirely tax funded.

klyrs 4y ago

> Should the government have not helped fund this drug because now it's expensive? No, the government should set a reasonable price for the product they funded. A high enough price to fund manufacturing, a low enough price to ensure that people who need the treatment have ready access to it. If the upper bound on price is too low for universal access, that's what subsidies are for. Instead, we have free money to bootstrap extractive capitalists, at cost and detriment to people who need care.

brigandish 4y ago
> No, the government should set a reasonable price for the product they funded. Do the investors at the company you work at set the prices for the products you produce? That would be strange. > Instead, we have free money to bootstrap extractive capitalists, at cost and detriment to people who need care. It's "free" money because the capital costs are high and it's risky. I don't think it's the only or the best way but it is a valid way, but it doesn't remove the right to make a profit. As to it being "detriment[al]" to the people who need care, they're getting a drug that didn't exist before, right? And this also should (generally) make existing drugs cheaper, right?

jlarocco 4y ago

> Should the government have not helped fund this drug because now it's expensive? If he wants to charge "what the market will bear," then he should fund the research through the market. If he wants government handouts to do the research then the public deserves to get the benefit that it's paying for - we're not funding it to make some guy rich. I'm not saying it should be free, but he's already opted out of the market, so he loses out on market pricing. Manufacturing cost plus some reasonable percentage for the creator.

brigandish 4y ago
I'm all for cutting subsidies, but the problem is that if you want risky things then investors might decide it's better not to invest and the drugs never appear. The government (which is really a government of and for the people, right?;) gets what it wants - a new drug - and jobs are created, trade happens, taxes are levied, health improves leading to (theoretical) money saved, more hours worked, more taxes… There's no need to punish the creator by not letting them make money off of their creation just because the government was involved, the government is getting plenty out of their investment.
- jlarocco 4y ago
  > I'm all for cutting subsidies, but the problem is that if you want risky things then investors might decide it's better not to invest and the drugs never appear. So? Nobody has a right to free money. If investors don't want to fund the research, and the researcher doesn't want to share the results with the public, then no money for them. They can go off and work on something else. > There's no need to punish the creator by not letting them make money off of their creation just because the government was involved, the government is getting plenty out of their investment. You're putting words in my mouth. I said the cost of government funded drugs should be the cost of manufacturing plus a percentage for the inventor. Second, that's not how government funding works. If the public funds a thing, then the public has a right to use that thing. If the inventor doesn't like it, then they shouldn't take funding from the government. Funny to see a pro-corporate welfare argument on HN.