Comment by klyrs
3 years ago
I met a researcher once who was doing what appeared to be groundbreaking research on cancer care. He had this beautiful, tear-jerker story about losing his wife that cast a rosy, altruistic hue on his research. When he was asked what the device would cost, he cheerily replied "whatever the market will bear." That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. Dude was living off of government research grants.
That's not the problem, that's the reason almost all medical development happens in America.
Rich people from all around the world travel to American hospitals if they have serious health problems, not to public hospitals even in rich countries like Norway. Public healthcare works (poorly) as a way to distribute existing treatment, but is worthless at incentivizing development. Really, the entire world is unfairly parasitizing on Americans to fund medical research.
That is not true, look up medical outcome data. Most of europe is far ahead or even with the USA.
Unless you are looking at outcomes of only the top institutions it's not really what he was saying. The US has a bad system for the average person for sure, but that does not mean that the US doesn't have one of the best systems if you can afford the best care. If you have medical outcome data that disputes that specifically I'd be interested.
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Or rather America is siphoning market by having monopoly. My father works in pharma factory and wages have not risen almost at all since 20 years ago when it was bought by americans (by bribe to gov). Some drugs got 10x more expensive while workers and patients got it worse. This was ultra scam but even after change of owners it’s basically the same.
Capitalism works only with competition. But competition is against capital owners short-term extractionism (or rather against ceos who feels need to justify their pay). IMO solution is to let workers vote on CEO pay changes and punish white collar crime better and many problems of capitalism might get solved.
EDIT: IMO it won’t work as long as globalization can be exploited to suppress working class and avoid regulation
> That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. Dude was living off of government research grants.
Do the drug companies in Europe do any different though?
I mean, sort of? Except, not really, because, "what the market will bear" is determined by what governments can negotiate - there's no Medicare Part D tying their hands.
But the companies are still greedy in Europe. Zolensma one of the most expensive drugs is from Europe. Those companies sell it for what its worth. When Joe Biden proposed covid vaccine patent waivers, European leaders were quick to suck with with the corporations in opposition.
> 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.
> 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.
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.
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> 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.
> 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?
> What should it cost instead?
To patients? It should be free.
To society? The initial research cost plus the bare manufacturing cost.
> 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.
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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.
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?
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