An anarchist takes on Big Pharma by teaching patients to make their own meds • Hacker News Board

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#241

Post by IanCal » Sat, Oct 14, 2017, 7:49 AM UTC

rightos wrote: post #105

amyjess wrote: post #99

Earlier quoted context omitted.

Ideally, the government should just straight-up pay companies to do drug discovery using something similar to cost-plus defense contracts (and establish DCAA-style auditing practices to keep them honest). Establish strict price controls, ban drug patents, and make production volume guarantees a hard condition of receiving federal drug discovery money. And the money should be large enough to be worth it. Ideally, 90%+…

That's a very left-wing view of things - I don't necessarily disagree with it, but I think there are far less drastic changes that can be made to achieve a comparable result. You'll have a hard time selling a plan like that to anyone even slightly right leaning - think about it politically for a second. The government decides what drug development gets priority? Remember the death panels talk from a few years ago? It…

It depends if you think it would stop other funding of drug development.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#242

Post by Trundle » Sat, Oct 14, 2017, 8:33 AM UTC

dv_dt wrote: post #230

AnthonyMouse wrote: post #225

Earlier quoted context omitted.

> Isn't that exactly what's happening in slower motion with the incredible price hikes in many drugs such as insulin? Again, the market for medicine suffers from regulatory capture. The regulations make it prohibitively expensive (literally millions of dollars) for new competitors to enter the market, which allows the incumbents to conspire to fix prices. If we had the same standards for manufacturing medicine as we…

Did you read the linked article? A generic maker of generic drugs in dramatically increasing prices with no sign of the entrance of competitors. Competition can enter but the barriers are too high - even without any government protection remaining on the generics in question. The competition doesn't pay the cost of duplicating production - not after the competition has lowered the price. At least the chance of that i…

>even without any government protection remaining on the generics in question

Go try to make and sell some generic drugs and see how far you get. Spoiler: you're very wrong.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#243

Post by not_kurt_godel » Sat, Oct 14, 2017, 9:05 AM UTC

alexanderstears wrote: post #229

dv_dt wrote: post #219

Earlier quoted context omitted.

Healthcare often isn't billable in consistent units. Someone goes in for surgery, and they get opened up, despite pre-imaging, there are complex things that can go wrong and instead of a 1 hr 10k effort, you need to put in a 6 hours 100k effort? how is that billed? are you going to require statistics of probabily of going wrong too? By the time you get all these 'consistent billing units' figured out for all the mult…

how is it billed? Go ask the people who get jobs as billers - most hosptials have more billers than beds, they can sort it out. Before you go to surgery agree on the price of everything and ask for a video so you can verify the work was done as billed and there wasn't any padding. In an emergency situation, you're entitled to the price they advertise. IF you can't afford it, the government picks up the bill and maybe…

That's not how it works. Have you ever had a major medical procedure? You're out of touch and talking about things you don't really know about.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#244

Post by jaggederest » Sat, Oct 14, 2017, 9:52 AM UTC

Mz wrote: post #239

jaggederest wrote: post #237

Earlier quoted context omitted.

I suspect that at some point there will be a backlash in the form of someone or some people with nothing to lose becoming violent in the face of an effective death sentence in the form of unaffordable healthcare. "Ultima ratio regum" is an appalling way to enforce fairness, but it doesn't seem to me that greed in general will stop short of a true class war or an external threat ala a World War. Also to be clear I am…

I'm trying to figure out what anyone can do to prevent it and thus far I am at a loss. You quietly find another path and make these insanely expensive drugs vastly less relevant. The real challenge is effectively spreading the word. Something truly disruptive in this area seems to be about the most offensive thing a human being can do.

The funny thing is that pharmaceuticals are simply one of a number of unconscionable negative-sum-games that are being played these days.

I just don't understand how people can make such a blatantly destructive set of choices when it's really clear that it will come back and bite them in a way even the most psychopathically mercenary people should understand, let alone anyone with a more advanced morality than "I got mine".

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#245

Post by flour_power » Sat, Oct 14, 2017, 12:04 PM UTC

only in america...

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#246

Post by losername » Sat, Oct 14, 2017, 12:19 PM UTC

leggomylibro wrote: post #2

That seems both super dangerous, and super awesome. It's not something that we should have to consider. But this is the world we live in, now; legitimate supply lines of life-saving medicine have collapsed for a fair number of people. I understand why people might be troubled by someone actively going out and advocating this as opposed to simply making the information available, but if you're offered medicine with 95…

If this is anything like open source in software (in the beginning) then many either never get to compile the dependencies needed to build from the source or run into hardware incompatibilities and incompatible derivate packages with all the ensuing bugs like blindness, deafness, and more serious malfunctions. And when it works the functionality will be severely limited. I'm half joking, but this will need a huge caveat emptor.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#247

Post by dv_dt » Sat, Oct 14, 2017, 3:44 PM UTC

AnthonyMouse wrote: post #235

dv_dt wrote: post #230

Earlier quoted context omitted.

Did you read the linked article? A generic maker of generic drugs in dramatically increasing prices with no sign of the entrance of competitors. Competition can enter but the barriers are too high - even without any government protection remaining on the generics in question. The competition doesn't pay the cost of duplicating production - not after the competition has lowered the price. At least the chance of that i…

> Competition can enter but the barriers are too high - even without any government protection remaining on the generics in question. But that's the whole point -- what is causing the barriers to be so high? Regulatory capture isn't just patents. Drug companies like the fact that a would-be competitor has to pay millions of dollars in regulatory compliance costs to enter the market. Because it should cost them $1 to…

Those costs don't go to zero without compliance - there would either be costs to manufacture with sufficient medical quality or people would be getting shoddy drugs (which is a human cost). Blackmarket drugs get cut or replaced or just have random terrible things mixed into it all the time so I am skeptical of zero-compliance cost drugs.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#248

Post by dctoedt » Sat, Oct 14, 2017, 4:04 PM UTC

rayiner wrote: post #60

> “To deny someone access to a lifesaving medication is murder,” he said. And “an act of theft [of intellectual property] to prevent an act of murder is morally acceptable.” I agree with the conclusion, but for a different reason. "Theft" is the wrong way to think about IP. The economic function of IP is not to protect producers from consumers, but to protect producers from free-riding by other producers.[1] Thus, fo…

IP lawyer here. Rayiner is correct, but he left out one piece of the explanation of why it's thought to be important to keep out free riders: The rationale is that, when innovators make significant investments in R&D, those innovators need a period of time in which to be the only ones able to sell the benefits of the innovation. Otherwise, free-riding copiers, unburdened by the innovators' R&D costs, would compete on price, which would drive prices down to competitive (i.e., marginal) levels that would not allow the innovators to recoup those R&D costs.

And here's the important part: Such rapid price reductions, it's said, would discourage future investment in R&D, because innovators and their investors would think "why bother; I'm not going to donate my time and/or my capital for no return, just for the sake of being a benefactor to humankind."

A simple analogy: Why bother spending the time and money to plant and raise a crop if your neighbors can come in and harvest the crop without paying you — among other problems, you'll be far less inclined to pay for the seeds and fertilizer it would take for you to raise the next crop.

So goes the theory; the extent to which that theory adequately models reality is something on which I'm not competent to opine.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#249

Post by amyjess » Sat, Oct 14, 2017, 4:46 PM UTC

rightos wrote: post #105

amyjess wrote: post #99

Earlier quoted context omitted.

Ideally, the government should just straight-up pay companies to do drug discovery using something similar to cost-plus defense contracts (and establish DCAA-style auditing practices to keep them honest). Establish strict price controls, ban drug patents, and make production volume guarantees a hard condition of receiving federal drug discovery money. And the money should be large enough to be worth it. Ideally, 90%+…

That's a very left-wing view of things - I don't necessarily disagree with it, but I think there are far less drastic changes that can be made to achieve a comparable result. You'll have a hard time selling a plan like that to anyone even slightly right leaning - think about it politically for a second. The government decides what drug development gets priority? Remember the death panels talk from a few years ago? It…

> The government decides what drug development gets priority?

This might become necessary if we're to avoid an antibiotic crisis. Bacteria are becoming resistant to antibiotics at a greater rate than antibiotics are being developed. The problem isn't that we've tapped out what antibiotics can do, but rather that drug companies have little to no interest in developing antibiotics because there's very little money in it. Antibiotics are un-sexy drugs that don't make for good marketing campaigns.

Ultimately, if we want to continue to have effective antibiotics, a large entity with no profit motive, nigh infinite money, and a monopoly on force (i.e. the government) will have to get involved.

Re: An anarchist takes on Big Pharma by teaching patients to make their own meds

#250

Post by tormeh » Sat, Oct 14, 2017, 4:48 PM UTC

alexanderstears wrote: post #233

hacking_again wrote: post #196

Earlier quoted context omitted.

This doesn't mean property exists in the same way that objects exist. A piece of property is just a protected object.

Go try to wrestle a caveman for his fur pelt and see if he considers it to be a protected object. Force protects the object, sometimes the government exerts the force sometimes not.

>Go try to wrestle a caveman for his fur pelt and see if he considers it to be a protected object.

But if I show up with a better club then all his stuff is now mine. A third party enforcing certain resource allocations with overwhelming force is different to everyone defending their own stuff.

Government is the difference between property rights and might-makes-right.