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A government which can't regulate effectively can't be trusted with a monopoly. Anyway, how does holding antibiotics in reserve help anything? Why let the bugs

A government which can't regulate effectively can't be trusted with a monopoly. Anyway, how does holding antibiotics in reserve help anything? Why let the bugs evolve resistance to one antibiotic at a time, rather than hitting them them with multiple antibiotics and thus raising the evolutionary hurdle to resistance? Was this strategy designed by the bad guys in a Jacky Chan movie?

wolverine876 3y ago
Whatever the theory, the government achieves quite a bit. Look at NASA, as one example, not to mention nuclear energy in all its applications, etc.
- travoc 3y ago
  70-80% of NASA's budget is spent on contracts with commercial companies, research institutions, and other external organizations.
  - wolverine876 3y ago
    I'm not sure how that matters. The commercial companies also subcontract.
- marcusverus 3y ago
  SpaceX created a reusable first stage in ~10 years, for less than NASA spends in a single year. In that same time period NASA spent a quarter of a TRILLION dollars… to send out a handful of probes. NASA does interesting things, sure, but nothing that the private sector couldn’t do in half the time for 1/10th the sticker price. The government may have contributed to the discovery of nuclear power, but for the last 50 years it has been the largest impediment to nuclear power.
  - wolverine876 3y ago
    > NASA does interesting things, sure, but nothing that the private sector couldn’t do in half the time for 1/10th the sticker price. The private sector has never done anything like what NASA has accomplished, and NASA is far and away the most successful explorers and engineers in human history. I have no reason to believe anyone else could do it. Has Space-X left Earth orbit? > NASA spent a quarter of a TRILLION dollars… to send out a handful of probes Look at NASA's budget (or any other source) and you'll find they do far, far more. The all caps, btw, are against HN guidelines. Why have so many started using them this week?
    - marcusverus 3y ago
      > The private sector has never done anything like what NASA has accomplished Nonsense. NASA spent 50 years using disposable lift vehicles. Only the government could bring itself to create single-use articles that cost hundreds of millions of dollars. SpaceX has fixed this by building the Falcon 9, which is not only reusable, it has the highest success rate of any orbital rocket in human history. They're not only "doing something like what NASA has accomplished", they are objectively doing it better and far, far cheaper. > and NASA is far and away the most successful explorers and engineers in human history. I have no reason to believe anyone else could do it. No belief necessary. SpaceX has already done it. > Has Space-X left Earth orbit? Yes. > Look at NASA's budget (or any other source) and you'll find they do far, far more. My point wasn't that they didn't do a bunch of stuff, but rather that they didn't do enough to justify their $0.25 Trillion per-decade budget. > The all caps, btw, are against HN guidelines. Ah, I see that in the guidelines. I'll avoid them in the future, thanks!
      - wolverine876 3y ago
        NASA has done so much more than lift vehicles. To focus only on that doesn't address the question. What exploration and engineering has SpaceX done to match NASA (except in one narrow area). NASA has a telescope at L2 looking back over 13 billion years, a helicopter flying on Mars, it has left the Solar System, it has satellites and probes all over orbit and other planets.
stupidcar 3y ago
How would you ensure things like industrial farms use a more expensive multi-antibiotic approach instead of a cheaper single-antibiotic one without effective regulation?
Broken_Hippo 3y ago
A government which can't regulate effectively can't be trusted with a monopoly. If only the world were as simple. But it isn't, and everyone knows that those with power (in general, governments) will never be regulated effectively enough for everyone - but that doesn't make them never to be trusted with monopoly, nor does it mean that the government's monopoly is bad. Sorry, I don't really want private militaries nor private tax collection. I'm happy the government runs things like IDs and drivers licenses. In fact, various department of motor vehicles (or whatever your local thing is called) is an excellent example of how a monopoly can be a good or bad experience. I'm originally from Indiana and the motor vehicle folks are great there and the service is easy to use - by design - but it isn't like that everywhere in the US. This has nothing really to do with how "effective" their regulation is. I'm not sure actual monopolies are better - are you really satisfied with your electricity provider or ISP?
- bakedoatmeal 3y ago
  Antibiotics harm the host as well. Giving grandma 4 antibiotics to treat a typical case of pneumonia goes against “do no harm”. Not to mention the added cost of prescribing more antibiotics. When we can safely give multiple therapies without harming the patient, we do it. Standard HIV treatment uses 4 different drugs to raise the evolutionary hurdle for the virus.
- marcusverus 3y ago
  > Sorry, I don't really want private militaries nor private tax collection. You can't have a government without a military or taxes, so it makes sense that government handles those things. They are requirements for the existence of government, and can't be delegated without existential risk. Medical research is not a core government function. > I'm happy the government runs things like IDs and drivers licenses. You'd probably be happier if you weren't required by law to get a license in the first place. > In fact, various department of motor vehicles (or whatever your local thing is called) is an excellent example of how a monopoly can be a good or bad experience. I'm originally from Indiana and the motor vehicle folks are great there and the service is easy to use - by design - but it isn't like that everywhere in the US. This has nothing really to do with how "effective" their regulation is. "Sometimes governments can handle basic services" doesn't strike me as a great argument for entrusting the government with complicated, vital services. > I'm not sure actual monopolies are better - are you really satisfied with your electricity provider or ISP? The alternative to government monopoly on the development of antibiotics isn't a private monopoly, it's no monopoly, and ideally without regulations which destroy the market incentives to develop antibiotics.
shzhdbi09gv8ioi 3y ago
Anyway what? You don't win an internet argument by dumping some random quote. If you have some ideas, do share them.
- sfilmeyer 3y ago
  They did share an idea. > rather than hitting them them with multiple antibiotics and thus raising the evolutionary hurdle to resistance? It was surrounded by some rudeness and is probably a poor idea (but I'm no expert), but it was an idea.
  - marcusverus 3y ago
    > some rudeness It was a joke. Please laugh.
CatWChainsaw 3y ago
I don't know if multiple antibiotics helps prevent resistance necessarily. Resistance usually comes about when the dosage given allows survivors with resistance mutations to become the main population. I mean, I can see where multiple antibiotics and sub-lethal dosages that disrupt function in multiple ways could be enough pressure to break the bacteria, but sufficient dosing is important, and making sure a patient does their regimen properly is entirely the patient's responsibility. In order to prevent the exact same situation playing out with any new antibiotics, we shouldn't allow history to repeat itself. Plus the normal gut flora would be disrupted by the multiple antibiotics as well, so there would be more work involved in the recovery of the symbiotes and commensals.
devilbunny 3y ago
> how does holding antibiotics in reserve help anything? If they have novel mechanisms of action, quite a lot. If it's just another entrant in a class of antibiotics for which we have numerous drugs (and thus resistances) already, probably not as much.
pshirshov 3y ago
> rather than hitting them them with multiple antibiotics and thus raising the evolutionary hurdle to resistance? You want to preserve your own bacterias, you won't survive without them. Combinations are effective, but they might kill too much of your friendly gut bacterias.
scotty79 3y ago
We are routinely trusting completely random commercial entities that have overtly misaligned incentives (make money). Government monopolies in modern democracies are orders of magnitude safer.

wolverine876 3y ago

Whatever the theory, the government achieves quite a bit. Look at NASA, as one example, not to mention nuclear energy in all its applications, etc.

travoc 3y ago
70-80% of NASA's budget is spent on contracts with commercial companies, research institutions, and other external organizations.
- wolverine876 3y ago
  I'm not sure how that matters. The commercial companies also subcontract.
marcusverus 3y ago
SpaceX created a reusable first stage in ~10 years, for less than NASA spends in a single year. In that same time period NASA spent a quarter of a TRILLION dollars… to send out a handful of probes. NASA does interesting things, sure, but nothing that the private sector couldn’t do in half the time for 1/10th the sticker price. The government may have contributed to the discovery of nuclear power, but for the last 50 years it has been the largest impediment to nuclear power.
- wolverine876 3y ago
  > NASA does interesting things, sure, but nothing that the private sector couldn’t do in half the time for 1/10th the sticker price. The private sector has never done anything like what NASA has accomplished, and NASA is far and away the most successful explorers and engineers in human history. I have no reason to believe anyone else could do it. Has Space-X left Earth orbit? > NASA spent a quarter of a TRILLION dollars… to send out a handful of probes Look at NASA's budget (or any other source) and you'll find they do far, far more. The all caps, btw, are against HN guidelines. Why have so many started using them this week?
  - marcusverus 3y ago
    > The private sector has never done anything like what NASA has accomplished Nonsense. NASA spent 50 years using disposable lift vehicles. Only the government could bring itself to create single-use articles that cost hundreds of millions of dollars. SpaceX has fixed this by building the Falcon 9, which is not only reusable, it has the highest success rate of any orbital rocket in human history. They're not only "doing something like what NASA has accomplished", they are objectively doing it better and far, far cheaper. > and NASA is far and away the most successful explorers and engineers in human history. I have no reason to believe anyone else could do it. No belief necessary. SpaceX has already done it. > Has Space-X left Earth orbit? Yes. > Look at NASA's budget (or any other source) and you'll find they do far, far more. My point wasn't that they didn't do a bunch of stuff, but rather that they didn't do enough to justify their $0.25 Trillion per-decade budget. > The all caps, btw, are against HN guidelines. Ah, I see that in the guidelines. I'll avoid them in the future, thanks!
    - wolverine876 3y ago
      NASA has done so much more than lift vehicles. To focus only on that doesn't address the question. What exploration and engineering has SpaceX done to match NASA (except in one narrow area). NASA has a telescope at L2 looking back over 13 billion years, a helicopter flying on Mars, it has left the Solar System, it has satellites and probes all over orbit and other planets.

stupidcar 3y ago

How would you ensure things like industrial farms use a more expensive multi-antibiotic approach instead of a cheaper single-antibiotic one without effective regulation?

Broken_Hippo 3y ago

A government which can't regulate effectively can't be trusted with a monopoly. If only the world were as simple. But it isn't, and everyone knows that those with power (in general, governments) will never be regulated effectively enough for everyone - but that doesn't make them never to be trusted with monopoly, nor does it mean that the government's monopoly is bad. Sorry, I don't really want private militaries nor private tax collection. I'm happy the government runs things like IDs and drivers licenses. In fact, various department of motor vehicles (or whatever your local thing is called) is an excellent example of how a monopoly can be a good or bad experience. I'm originally from Indiana and the motor vehicle folks are great there and the service is easy to use - by design - but it isn't like that everywhere in the US. This has nothing really to do with how "effective" their regulation is. I'm not sure actual monopolies are better - are you really satisfied with your electricity provider or ISP?

bakedoatmeal 3y ago
Antibiotics harm the host as well. Giving grandma 4 antibiotics to treat a typical case of pneumonia goes against “do no harm”. Not to mention the added cost of prescribing more antibiotics. When we can safely give multiple therapies without harming the patient, we do it. Standard HIV treatment uses 4 different drugs to raise the evolutionary hurdle for the virus.
marcusverus 3y ago
> Sorry, I don't really want private militaries nor private tax collection. You can't have a government without a military or taxes, so it makes sense that government handles those things. They are requirements for the existence of government, and can't be delegated without existential risk. Medical research is not a core government function. > I'm happy the government runs things like IDs and drivers licenses. You'd probably be happier if you weren't required by law to get a license in the first place. > In fact, various department of motor vehicles (or whatever your local thing is called) is an excellent example of how a monopoly can be a good or bad experience. I'm originally from Indiana and the motor vehicle folks are great there and the service is easy to use - by design - but it isn't like that everywhere in the US. This has nothing really to do with how "effective" their regulation is. "Sometimes governments can handle basic services" doesn't strike me as a great argument for entrusting the government with complicated, vital services. > I'm not sure actual monopolies are better - are you really satisfied with your electricity provider or ISP? The alternative to government monopoly on the development of antibiotics isn't a private monopoly, it's no monopoly, and ideally without regulations which destroy the market incentives to develop antibiotics.

shzhdbi09gv8ioi 3y ago

Anyway what? You don't win an internet argument by dumping some random quote. If you have some ideas, do share them.

sfilmeyer 3y ago
They did share an idea. > rather than hitting them them with multiple antibiotics and thus raising the evolutionary hurdle to resistance? It was surrounded by some rudeness and is probably a poor idea (but I'm no expert), but it was an idea.
- marcusverus 3y ago
  > some rudeness It was a joke. Please laugh.

CatWChainsaw 3y ago

I don't know if multiple antibiotics helps prevent resistance necessarily. Resistance usually comes about when the dosage given allows survivors with resistance mutations to become the main population. I mean, I can see where multiple antibiotics and sub-lethal dosages that disrupt function in multiple ways could be enough pressure to break the bacteria, but sufficient dosing is important, and making sure a patient does their regimen properly is entirely the patient's responsibility. In order to prevent the exact same situation playing out with any new antibiotics, we shouldn't allow history to repeat itself. Plus the normal gut flora would be disrupted by the multiple antibiotics as well, so there would be more work involved in the recovery of the symbiotes and commensals.

devilbunny 3y ago

> how does holding antibiotics in reserve help anything? If they have novel mechanisms of action, quite a lot. If it's just another entrant in a class of antibiotics for which we have numerous drugs (and thus resistances) already, probably not as much.

pshirshov 3y ago

> rather than hitting them them with multiple antibiotics and thus raising the evolutionary hurdle to resistance? You want to preserve your own bacterias, you won't survive without them. Combinations are effective, but they might kill too much of your friendly gut bacterias.

scotty79 3y ago

We are routinely trusting completely random commercial entities that have overtly misaligned incentives (make money). Government monopolies in modern democracies are orders of magnitude safer.