4 ms·

When this gets brought up as a positive to our high healthcare spending (which you're not exactly doing, more just making note of the existence of the argument)

When this gets brought up as a positive to our high healthcare spending (which you're not exactly doing, more just making note of the existence of the argument) it's such a head-scratcher for me. 1) OK... maybe we should stop, then? Like, that seems like a terrible deal? How is that a justification at all? It seems like just a description of something very stupid we're doing. 2) This would be a good deal if we were getting other countries to also pay high prices and bringing that money "home", but basically the exact opposite is happening. WTF. 3) More often than not, the side of the issue that raises this as a good thing is also the side full of folks who think we should e.g. reduce spending on foreign aid, so it's especially weird that they're bringing it up. Plus, I'm very skeptical that the idea that drug development would dramatically slow down if the US stopped over-spending to the tune of 2x-100x on lots of drugs is even true. But setting that aside, it's still just a bizarre line of argument, to me.

AStonesThrow 2y ago
You see, development of new drugs, devices, and treatments is definitely something that we must continue at breakneck pace, by any means necessary, because people keep discovering how awful and harmful the existing ones are, so we need to make consistent progress beyond the status quo. If you move faster than the science and the lawsuits, then you can keep selling deadly crap to a naïve and trusting populace. https://en.wikipedia.org/wiki/Reye_syndrome https://en.wikipedia.org/wiki/Reye_syndrome https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Tardive_dyskinesia https://en.wikipedia.org/wiki/Tardive_dyskinesia https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine
AnthonyMouse 2y ago
> OK... maybe we should stop, then? Like, that seems like a terrible deal? How is that a justification at all? It seems like just a description of something very stupid we're doing. The US pays for drug development and then the rest of the world caps prices and gets the drugs cheaper. If the US stops then the money for drug development goes down, which is not great. What you really want is to get the other countries to pay their share, but how do you propose to do that?
- kelseyfrog 2y ago
  The reality is we have no evidence that other countries other countries wouldn't start developing drugs. Our fear that no one else would do is not grounded in the rational and we shouldn't let irrational fears decide what we do. This isn't something we can logic out ahead of time, we simply need to commit to not doing it.
  - airstrike 2y ago
    Other countries already develop drugs. They just charge more in the US market.
    - XorNot 2y ago
      People always forget it's "what the market will bear". Price caps set a very explicit bar and then ask a company to think very carefully if they truly think the drug can't be sold at that price (and surprise: turns out when motivated a ton of them discover that yes, it can be).
      - zaphar 2y ago
        What the market will bear affects an already existing product. R&D is driven by one of two things: 1. An expectation of profit at the end. 2. A highly desired outcome from a motivated pool of Investors. Price caps can dampen #1. Which can put more of the burden on #2 as a source of funding. Whether you think that is an improvement or not probably depends on your particular ideological position around markets and healthcare. But there is definitely an objective argument to be made that this might decrease the speed of improvements in healthcare technology.
        XorNot 2y ago
        > But there is definitely an objective argument to be made that this might decrease the speed of improvements in healthcare technology. Every American posts about "healthcare improvements" like they're a millionaire and that cancer wouldn't bankrupt them (and then also get them fired from their job when their insurer casually mentions the "bad risk" they've got which is driving up the cost right now).
kiba 2y ago
Not all subsidy is a bad thing. The money is used to fund real expertise and industrial capacity.

AStonesThrow 2y ago

You see, development of new drugs, devices, and treatments is definitely something that we must continue at breakneck pace, by any means necessary, because people keep discovering how awful and harmful the existing ones are, so we need to make consistent progress beyond the status quo. If you move faster than the science and the lawsuits, then you can keep selling deadly crap to a naïve and trusting populace. https://en.wikipedia.org/wiki/Reye_syndrome https://en.wikipedia.org/wiki/Reye_syndrome https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Tardive_dyskinesia https://en.wikipedia.org/wiki/Tardive_dyskinesia https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine https://en.m.wikipedia.org/wiki/Fenfluramine/phentermine

AnthonyMouse 2y ago

> OK... maybe we should stop, then? Like, that seems like a terrible deal? How is that a justification at all? It seems like just a description of something very stupid we're doing. The US pays for drug development and then the rest of the world caps prices and gets the drugs cheaper. If the US stops then the money for drug development goes down, which is not great. What you really want is to get the other countries to pay their share, but how do you propose to do that?

kelseyfrog 2y ago
The reality is we have no evidence that other countries other countries wouldn't start developing drugs. Our fear that no one else would do is not grounded in the rational and we shouldn't let irrational fears decide what we do. This isn't something we can logic out ahead of time, we simply need to commit to not doing it.
- airstrike 2y ago
  Other countries already develop drugs. They just charge more in the US market.
  - XorNot 2y ago
    People always forget it's "what the market will bear". Price caps set a very explicit bar and then ask a company to think very carefully if they truly think the drug can't be sold at that price (and surprise: turns out when motivated a ton of them discover that yes, it can be).
    - zaphar 2y ago
      What the market will bear affects an already existing product. R&D is driven by one of two things: 1. An expectation of profit at the end. 2. A highly desired outcome from a motivated pool of Investors. Price caps can dampen #1. Which can put more of the burden on #2 as a source of funding. Whether you think that is an improvement or not probably depends on your particular ideological position around markets and healthcare. But there is definitely an objective argument to be made that this might decrease the speed of improvements in healthcare technology.
      - XorNot 2y ago
        > But there is definitely an objective argument to be made that this might decrease the speed of improvements in healthcare technology. Every American posts about "healthcare improvements" like they're a millionaire and that cancer wouldn't bankrupt them (and then also get them fired from their job when their insurer casually mentions the "bad risk" they've got which is driving up the cost right now).

kiba 2y ago

Not all subsidy is a bad thing. The money is used to fund real expertise and industrial capacity.