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> Don’t have to look hard to find people giving reasons why pharma companies are evil. Case in point: Imagine you find someone grasping a cliff edge by their

> Don’t have to look hard to find people giving reasons why pharma companies are evil. Case in point: Imagine you find someone grasping a cliff edge by their fingertips. Pulling them back to safety is good! Pulling them back to safety only after they promise you all their worldly wealth forevermore is less good. Being in the business of offering people this deal is not better. Funding the effort to prevent people from restraining your exploitation of cliff danglers is still worse. This isn't an insoluble moral puzzle. I don't think pharma is an ideal example for your larger point. Most businesses don't thrive on the desperation of their customers. But I also don't think your point is correct. There are better and worse companies. I understand one needs to make one's peace with one's choices. I've worked for companies that were doing evil (not exclusively, but at all). I've worked for companies that were mediocre at best. I'm currently working for a company that I would say is positively good. I got paid more by the evil companies. I have been happier working for the good companies though it's harder to support my family. But I understand people who choose to keep working for their evil company, particularly when others depend on their income. In one of the more egregious outbursts of evil at one of the companies I worked for I had friends who quit. They didn't want to be complicit. I stayed. I had kids and didn't want to throw my family into turmoil. But I saw the choice I was making.

edanm 4y ago
> This isn't an insoluble moral puzzle. I don't think pharma is an ideal example for your larger point. Most businesses don't thrive on the desperation of their customers. I mean, pharma as an industry also creates the ability to pull people back from the edge. Medicine isn't created out of thin air, the universe doesn't just owe us a steady supply of new innovations that have kept so many people alive and in better comfort. Money needs to be invested, that money has to be paid by someone. (I'm not talking about specifics of the US healthcare system or anything, where there are problems, just pharma in general.) Like seriously, what is your alternative?
- DFHippie 4y ago
  My point is that when a highwayman says "your money or your life" we call it a crime. He gets lots of money because those are the choices. But those are the choices which, in the USA, pharma and other medical professionals offer. They can charge enormous amounts because these are the conditions. Does it cost a lot to develop drugs? Sure. But the profits more than cover the costs. Obviously. This market sector is hugely profitable. Other people who solve difficult problems where their potential customer isn't desperate cannot achieve equivalent profits. If you work in medicine you have lots of ways to wash your conscience. Medical school is hard and expensive! You are saving lives! But in the end you can charge the rates you charge because your customer is desperate (to say nothing of the information asymmetry, the cost and difficulty of seeking a second opinion, etc.). There is a huge market failure here and that is the source of your enormous profit. There are many alternative ways to achieve the same end without the market failure fleecing the unfortunate in the middle. Offer bounties for medical breakthroughs. Finance healthcare as a public good. This will reduce the rate of improvement in medical science because the payoff for breakthroughs will be less. Maybe this is the wrong way to go about it. But I'd rather take my chances with a less broken medical system. I've been fleeced many times in my life by the US healthcare system. If I have to sacrifice my well being for some cause, there are others I'd prefer. Will innovations slow if the US stops being a patsy? Yes. But I'd just like access to the medicine we already have.
sebzim4500 4y ago
I don't think that's a great analogy, since giving someone a hand when they are dangling off a cliff is easy and anyone (who happened to be around) could do it at low cost. Developing new medical treatments is incredibly expensive and difficult, and only part of that is because of regulatory burdens. You aren't just playing to develop the treatment you are receiving, but also the dozens of potential treatments that the pharma companies invested huge amounts of money into that didn't end up working out.
- DFHippie 4y ago
  This is all beside the point. It is incredibly difficult to carve a palace into a grain of rice inside a bottle. There is no great profit in it, though. Pharma is profitable not because it is difficult but because its customers are desperate, have limited choices, and are dependent on experts to make those choices; experts who also profit from the market failure inherent in medicine.

edanm 4y ago

> This isn't an insoluble moral puzzle. I don't think pharma is an ideal example for your larger point. Most businesses don't thrive on the desperation of their customers. I mean, pharma as an industry also creates the ability to pull people back from the edge. Medicine isn't created out of thin air, the universe doesn't just owe us a steady supply of new innovations that have kept so many people alive and in better comfort. Money needs to be invested, that money has to be paid by someone. (I'm not talking about specifics of the US healthcare system or anything, where there are problems, just pharma in general.) Like seriously, what is your alternative?

DFHippie 4y ago
My point is that when a highwayman says "your money or your life" we call it a crime. He gets lots of money because those are the choices. But those are the choices which, in the USA, pharma and other medical professionals offer. They can charge enormous amounts because these are the conditions. Does it cost a lot to develop drugs? Sure. But the profits more than cover the costs. Obviously. This market sector is hugely profitable. Other people who solve difficult problems where their potential customer isn't desperate cannot achieve equivalent profits. If you work in medicine you have lots of ways to wash your conscience. Medical school is hard and expensive! You are saving lives! But in the end you can charge the rates you charge because your customer is desperate (to say nothing of the information asymmetry, the cost and difficulty of seeking a second opinion, etc.). There is a huge market failure here and that is the source of your enormous profit. There are many alternative ways to achieve the same end without the market failure fleecing the unfortunate in the middle. Offer bounties for medical breakthroughs. Finance healthcare as a public good. This will reduce the rate of improvement in medical science because the payoff for breakthroughs will be less. Maybe this is the wrong way to go about it. But I'd rather take my chances with a less broken medical system. I've been fleeced many times in my life by the US healthcare system. If I have to sacrifice my well being for some cause, there are others I'd prefer. Will innovations slow if the US stops being a patsy? Yes. But I'd just like access to the medicine we already have.

sebzim4500 4y ago

I don't think that's a great analogy, since giving someone a hand when they are dangling off a cliff is easy and anyone (who happened to be around) could do it at low cost. Developing new medical treatments is incredibly expensive and difficult, and only part of that is because of regulatory burdens. You aren't just playing to develop the treatment you are receiving, but also the dozens of potential treatments that the pharma companies invested huge amounts of money into that didn't end up working out.

DFHippie 4y ago
This is all beside the point. It is incredibly difficult to carve a palace into a grain of rice inside a bottle. There is no great profit in it, though. Pharma is profitable not because it is difficult but because its customers are desperate, have limited choices, and are dependent on experts to make those choices; experts who also profit from the market failure inherent in medicine.