6 ms·

I guess all doctors should be cosmetic surgeons then? Seriously, the argument is that drug companies should only do the most profitable thing? If that's the ca

by kurthr 3y ago

I guess all doctors should be cosmetic surgeons then? Seriously, the argument is that drug companies should only do the most profitable thing? If that's the case, they deserve to have all subsidies removed, and be regulated into oblivion, because they will serve no purpose, but profit. Just see what happened with the opioid epidemic. If you're only looking at next quarters profits and destroy public trust, while skirting the legal boundaries you'll make bank until you're not. https://www.bbc.com/news/world-us-canada-60610707 https://www.bbc.com/news/world-us-canada-60610707

s1artibartfast 3y ago
>Seriously, the argument is that drug companies should only do the most profitable thing? You're the first one to make any kind of suggestion for what they should do, so I'm not sure why you're jumping to that conclusion >If that's the case, they deserve to have all subsidies removed, and be regulated into oblivion, because they will serve no purpose, but profit. The purpose that they serve is to save your life with drugs. If that doesn't mean anything to you and isn't worth any money then I don't think we will find much common ground. In your analogy, drug companies are the doctors. They want to make money for saving your life. Why would you want to regulate them out of existence?
- kurthr 3y ago
  Your response to: >Was it 'unprofitable' as in 'losing money', or 'unprofitable' as in 'not worth the time'? was: >If you can make more money by not doing X, than doing X, it doesnt matter. It's confusing, because you certainly seem to imply only doing the most profitable things. >The purpose that they serve is to save your life with drugs. If that doesn't mean anything to you and isn't worth any money then I don't think we will find much common ground. My point was that if their purpose is only to do the things that make marginally more money (while killing significant numbers of people or allowing them to die) such as the Sacklers and Purdue with Oxy, they deserve to be regulated into oblivion. If you think the heavy marketing and distribution of known addictive drugs into disadvantaged areas of the country is in the public interest, then I don't think we will find much common ground. Frankly, most doctors, biochemists, and pharma-chemists I know have little difficulty seeing this. It is about helping people not just making money, and doing otherwise while selling it as the former, is unethical.
  - s1artibartfast 3y ago
    >It's confusing, because you certainly seem to imply only doing the most profitable things. I thought I was clear, but I will try again. The financial calculus is the same between "losing money" and "not worth it". It doesnt matter if the J&J division of communicable disease is running a positive or negative balance if J&J (or its owners) can more doing something entirely different. The question is do we want to be losing money on this. That is not to say they can't or shouldnt keep doing it as a public service or out of altruism, but the question is the same. >My point was that if their purpose is only to do the things that make marginally more money. I dont think that is a valid assumption to make about the industry. 99.9% of the time, the way to make more money is to make a product that saves or cures more people. If your product saves fewer people, People would by the old thing instead of the new thing for 2x the price. Now, everyone is free to say they dont like the price, which is fair. However, the price is high because rich American customers dont care about the price. IF they did, they could always buy the cheap old thing. It is like someone who is angry at the butcher for the price of filet minion, but keeps paying ever higher prices, and refuses to buy the tri-tip. Europeans prices are half the US simply because they stop buying filet minion and get tri-tip when the price gets too high. US prices are twice that because we pay it! It is crazy to blame the butcher for raising the price when you willingly keep throwing more money at ever higher prices! No industry anywhere in the world expects the seller to keep prices low when customers keep throwing money at them. The fundamental problem with US healthcare costs is that not one party in the system is willing to control spending. Nobody will say no to a treatment 1% better for 200% the cost. Patients will pay anything for the latest drug because they want it, and the costs get spread over everyone's premium. Insurance is happy to see medical costs balloon because their profit is capped as a % of healthcare costs. manufacturers are happy to see costs go up, because that's what they are selling.
    - shkkmo 3y ago
      > 99.9% of the time, the way to make more money is to make a product that saves or cures more people. That is laughably optimistic.
      - 3y ago
- deleted 3y ago
  [deleted]
- lenerdenator 3y ago
  > They want to make money for saving your life. Not to speak for the other poster, but because it's too damn expensive for the average person now. And when the average person can't do things like "eat", "pay rent", or "get live-saving or misery-ending medical treatment", that person bands together with their ilk and tears society apart. Doctors, I'll let slide, because they do actual labor and spent decades in school (often going nearly-broke doing so) to get where they are. Most doctors are well-paid but they're not financier or c-suite level rich, and that's who today's drug prices serve. That and a bunch of ambiguous "shareholders" who more often than not had more ambition for their retirements than the economy they spent the last 50 years operating can support, despite decades of warnings.
  - s1artibartfast 3y ago
    Why is it so expensive? because the vast majority of Americans can and will pay it instead of opting for slightly cheaper options. It is a tragedy of the commons with consumers driving up price
    - lenerdenator 3y ago
      m8 when we've got people rationing their insulin because they can't afford it, it's time to stop blaming "the commons". The truth is, you absolutely can provide a life-sustaining level of care to most people without bankrupting them. In fact, we used to, and many countries do. We just don't want to do what's necessary (punish excessive executive compensation, reduce the importance of equities as a store of value, make unhealthy foods more expensive than healthy, etc.) in order to make that happen, because somehow, the laws of human behavior in western nations just don't apply in the United States.
      - s1artibartfast 3y ago
        When exactly in us history did people get free insulin and robot hearts? But this is really all besides the point. The point is that prices are high because the system is fucked up. Prices aren't twice as high as Europe because the companies more greedy here. It is the same companies! The difference is the system. Different laws and institutions
BurningFrog 3y ago
The observation is that companies don't do things that lose money. Or if they do, they run out of money and have to stop. There is no "should" here. Just a description of how the world works.
- fireflash38 3y ago
  I believe the argument is not that it's negative profit... It's just less profit than other pharmaceuticals. And without knowing the specifics, there can be a lot of value from continuing to produce those sorts of things, if it's within reason. I mean shit they probably spend more on ads saying how great they are than it would cost to actually be great (by saving lives with cheaper meds)
  - xyzzy123 3y ago
    Right, from a private capital perspective, it's a misallocation of resources. If a company can make X% return on capital (researchers, equipment, marketing, regulatory engagement, office space etc) working on communicable diseases, but Y% >> X% doing something else, a responsible steward of somebody else's pile of money is supposed to direct the capital towards Y.
  - llamaimperative 3y ago
    It’s called opportunity cost, which when inflicted regularly enough and to a great enough degree starts to just look like general incompetence.
  - s1artibartfast 3y ago
    Less profit than anything theoretically, and in practice, less than the US treasury bond rate. If the company is spending $1B/yr for a 1% return in that division, but the return on bonds is 5%, the financial answer is to liquidate, and put the cash in bonds.
    - BurningFrog 3y ago
      OK, I agree with this. My claim was a bit too strong. But I think my general point stands.
SkyPuncher 3y ago
This happens to some degree. Residency spots are limited by specialty. Over time, different specialties have come and gone as being extremely competitive.
- nradov 3y ago
  Plastic surgery is among the medical specialties with the highest job satisfaction and lowest burnout rate. It pays well, and for cosmetic procedures they don't have to deal with insurance billing hassles. Most procedures can be scheduled in advance which allows for a decent lifestyle without frequent on-call interruptions. https://www.ama-assn.org/medical-students/specialty-profiles/physician-burnout-it-s-not-you-it-s-your-medical-specialty https://www.ama-assn.org/medical-students/specialty-profiles...
  - haldujai 3y ago
    I think you’re conflating plastics with aesthetics/cosmo. Only a small minority of plastic surgeons practice primarily aesthetics. Majority will have a micro, breast or hand practice and have a side hustle in aesthetics so the overall satisfaction stat you’re citing is not reflective. There are different hassles in cosmetics like increased overhead, patient expectations (which are much higher in cosmetics) and advertising/patient recruitment. Call can be worse as the patient paying $50k for a rhinoplasty expects the surgeon to answer the phone for every whim.
mapt 3y ago
Money is how we denominate human effort, and corporations are psychopathic zombies following their fiduciary duty. Profit is everything. This is the system we built, neoliberal capitalism, and this is the system we would have to modify to do the things you think we should be doing. It's about time, frankly.

by kurthr 3y ago

s1artibartfast 3y ago

>Seriously, the argument is that drug companies should only do the most profitable thing? You're the first one to make any kind of suggestion for what they should do, so I'm not sure why you're jumping to that conclusion >If that's the case, they deserve to have all subsidies removed, and be regulated into oblivion, because they will serve no purpose, but profit. The purpose that they serve is to save your life with drugs. If that doesn't mean anything to you and isn't worth any money then I don't think we will find much common ground. In your analogy, drug companies are the doctors. They want to make money for saving your life. Why would you want to regulate them out of existence?

kurthr 3y ago
Your response to: >Was it 'unprofitable' as in 'losing money', or 'unprofitable' as in 'not worth the time'? was: >If you can make more money by not doing X, than doing X, it doesnt matter. It's confusing, because you certainly seem to imply only doing the most profitable things. >The purpose that they serve is to save your life with drugs. If that doesn't mean anything to you and isn't worth any money then I don't think we will find much common ground. My point was that if their purpose is only to do the things that make marginally more money (while killing significant numbers of people or allowing them to die) such as the Sacklers and Purdue with Oxy, they deserve to be regulated into oblivion. If you think the heavy marketing and distribution of known addictive drugs into disadvantaged areas of the country is in the public interest, then I don't think we will find much common ground. Frankly, most doctors, biochemists, and pharma-chemists I know have little difficulty seeing this. It is about helping people not just making money, and doing otherwise while selling it as the former, is unethical.
- s1artibartfast 3y ago
  >It's confusing, because you certainly seem to imply only doing the most profitable things. I thought I was clear, but I will try again. The financial calculus is the same between "losing money" and "not worth it". It doesnt matter if the J&J division of communicable disease is running a positive or negative balance if J&J (or its owners) can more doing something entirely different. The question is do we want to be losing money on this. That is not to say they can't or shouldnt keep doing it as a public service or out of altruism, but the question is the same. >My point was that if their purpose is only to do the things that make marginally more money. I dont think that is a valid assumption to make about the industry. 99.9% of the time, the way to make more money is to make a product that saves or cures more people. If your product saves fewer people, People would by the old thing instead of the new thing for 2x the price. Now, everyone is free to say they dont like the price, which is fair. However, the price is high because rich American customers dont care about the price. IF they did, they could always buy the cheap old thing. It is like someone who is angry at the butcher for the price of filet minion, but keeps paying ever higher prices, and refuses to buy the tri-tip. Europeans prices are half the US simply because they stop buying filet minion and get tri-tip when the price gets too high. US prices are twice that because we pay it! It is crazy to blame the butcher for raising the price when you willingly keep throwing more money at ever higher prices! No industry anywhere in the world expects the seller to keep prices low when customers keep throwing money at them. The fundamental problem with US healthcare costs is that not one party in the system is willing to control spending. Nobody will say no to a treatment 1% better for 200% the cost. Patients will pay anything for the latest drug because they want it, and the costs get spread over everyone's premium. Insurance is happy to see medical costs balloon because their profit is capped as a % of healthcare costs. manufacturers are happy to see costs go up, because that's what they are selling.
  - shkkmo 3y ago
    > 99.9% of the time, the way to make more money is to make a product that saves or cures more people. That is laughably optimistic.
    - 3y ago
deleted 3y ago
[deleted]
lenerdenator 3y ago
> They want to make money for saving your life. Not to speak for the other poster, but because it's too damn expensive for the average person now. And when the average person can't do things like "eat", "pay rent", or "get live-saving or misery-ending medical treatment", that person bands together with their ilk and tears society apart. Doctors, I'll let slide, because they do actual labor and spent decades in school (often going nearly-broke doing so) to get where they are. Most doctors are well-paid but they're not financier or c-suite level rich, and that's who today's drug prices serve. That and a bunch of ambiguous "shareholders" who more often than not had more ambition for their retirements than the economy they spent the last 50 years operating can support, despite decades of warnings.
- s1artibartfast 3y ago
  Why is it so expensive? because the vast majority of Americans can and will pay it instead of opting for slightly cheaper options. It is a tragedy of the commons with consumers driving up price
  - lenerdenator 3y ago
    m8 when we've got people rationing their insulin because they can't afford it, it's time to stop blaming "the commons". The truth is, you absolutely can provide a life-sustaining level of care to most people without bankrupting them. In fact, we used to, and many countries do. We just don't want to do what's necessary (punish excessive executive compensation, reduce the importance of equities as a store of value, make unhealthy foods more expensive than healthy, etc.) in order to make that happen, because somehow, the laws of human behavior in western nations just don't apply in the United States.
    - s1artibartfast 3y ago
      When exactly in us history did people get free insulin and robot hearts? But this is really all besides the point. The point is that prices are high because the system is fucked up. Prices aren't twice as high as Europe because the companies more greedy here. It is the same companies! The difference is the system. Different laws and institutions

BurningFrog 3y ago

The observation is that companies don't do things that lose money. Or if they do, they run out of money and have to stop. There is no "should" here. Just a description of how the world works.

fireflash38 3y ago
I believe the argument is not that it's negative profit... It's just less profit than other pharmaceuticals. And without knowing the specifics, there can be a lot of value from continuing to produce those sorts of things, if it's within reason. I mean shit they probably spend more on ads saying how great they are than it would cost to actually be great (by saving lives with cheaper meds)
- xyzzy123 3y ago
  Right, from a private capital perspective, it's a misallocation of resources. If a company can make X% return on capital (researchers, equipment, marketing, regulatory engagement, office space etc) working on communicable diseases, but Y% >> X% doing something else, a responsible steward of somebody else's pile of money is supposed to direct the capital towards Y.
- llamaimperative 3y ago
  It’s called opportunity cost, which when inflicted regularly enough and to a great enough degree starts to just look like general incompetence.
- s1artibartfast 3y ago
  Less profit than anything theoretically, and in practice, less than the US treasury bond rate. If the company is spending $1B/yr for a 1% return in that division, but the return on bonds is 5%, the financial answer is to liquidate, and put the cash in bonds.
  - BurningFrog 3y ago
    OK, I agree with this. My claim was a bit too strong. But I think my general point stands.

SkyPuncher 3y ago

This happens to some degree. Residency spots are limited by specialty. Over time, different specialties have come and gone as being extremely competitive.

nradov 3y ago
Plastic surgery is among the medical specialties with the highest job satisfaction and lowest burnout rate. It pays well, and for cosmetic procedures they don't have to deal with insurance billing hassles. Most procedures can be scheduled in advance which allows for a decent lifestyle without frequent on-call interruptions. https://www.ama-assn.org/medical-students/specialty-profiles/physician-burnout-it-s-not-you-it-s-your-medical-specialty https://www.ama-assn.org/medical-students/specialty-profiles...
- haldujai 3y ago
  I think you’re conflating plastics with aesthetics/cosmo. Only a small minority of plastic surgeons practice primarily aesthetics. Majority will have a micro, breast or hand practice and have a side hustle in aesthetics so the overall satisfaction stat you’re citing is not reflective. There are different hassles in cosmetics like increased overhead, patient expectations (which are much higher in cosmetics) and advertising/patient recruitment. Call can be worse as the patient paying $50k for a rhinoplasty expects the surgeon to answer the phone for every whim.

mapt 3y ago

Money is how we denominate human effort, and corporations are psychopathic zombies following their fiduciary duty. Profit is everything. This is the system we built, neoliberal capitalism, and this is the system we would have to modify to do the things you think we should be doing. It's about time, frankly.