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The lucrative business of America’s opioid crisis

nytimes.com

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Re: The lucrative business of America’s opioid crisis

#121

Post by BurningFrog »

rayiner wrote: post #99
emodendroket wrote: post #87

Earlier quoted context omitted.

America has plenty of successful examples of government programs; the problem is ideological blinders rather than a uniquely ineffectual government.

I think there is a lot of reason to believe that we have a uniquely ineffectual government. Excluding defense expenditures, and counting all levels of government, Canada spends less public money per capita, while having cheaper healthcare, education, better transit, etc. For example, we spend more per capita on education than any OECD country except Switzerland, and get worse results. Our federal system (where states…

Of course, looking only at OECD countries is serious cherry picking good governments to begin with.

Re: The lucrative business of America’s opioid crisis

#122

Post by quantumofmalice »

geofft wrote: post #120
quantumofmalice wrote: post #112

Earlier quoted context omitted.

I don't believe there is strong evidence that a metaculture (really, multiculturalism) will survive and not devolve into squabbling ethnoses, particularly on the scale of the north american continent. It seems like smaller, more homogonous political units is the best way to avoid conflict, and I don't see why that has to be malicious. My main problem with most of the ethno-nationalists that I read is that they are re…

> I don't believe there is strong evidence that a metaculture (really, multiculturalism) will survive and not devolve into squabbling ethnoses, particularly on the scale of the north american continent. Doesn't the empirical reality of large cosmopolitan cities provide evidence that multiculturalism will work just fine? New York City, for instance, has 8.5 million people of every race, color, creed, citizenship, lang…

I expect there to continue to be multi-ethnic cities and neighborhoods within cities, which is a fairly common occurrence throughout history, particular in capital cities of empires, which is what I would describe New York as. There is no doubt that some people (particularly smart people) highly value the diversity and cosmopolitanism that cities of this form provide. On the other hand, people who value high social trust and stronger social identity would probably prefer to living in more homogenous (and less urban) environments.

It seems to me like the american continent, anyway, is large enough to give everyone what they would like, without either interfering with one another politically.

Re: The lucrative business of America’s opioid crisis

#123

Post by sandworm101 »

DanielBMarkham wrote: post #27
sandworm101 wrote: post #13

Earlier quoted context omitted.

Because what they sell isnt on the schedual and does have medical use. Hate opiods addiction and overprescription, but dont forget that these things have a place.

Absolutely yes. We don't want to go back to a world without drugs for chronic and severe pain. For all the hoopla around the addiction problem, we must never forget there are real people who need these things. With some of the treatment options, as I understand it, it's even possible to be an addict and a functioning member of society. I start worrying in public discussions when people ascribe too much good or evil t…

>>> real people who need these things.

That word, need, the the heart of the pain issue. Often they don't need it in the sense that they will not die if they don't get it. Pain itself rarely kills. Conversely, the stats are now pointing to patients living shorter lives on opioid than not. So an argument comes that they really have no medical need. But nobody wants to live in a world with so many people in chronic but treatable pain. That's just mean. I have no medical need for lidocaine but it sure makes having my tooth drilled less horrific. Balances need to be struck. Balance is not an easy word when dealing with addictive substances.

Re: The lucrative business of America’s opioid crisis

#124

Post by harryh »

rayiner wrote: post #99
emodendroket wrote: post #87

Earlier quoted context omitted.

America has plenty of successful examples of government programs; the problem is ideological blinders rather than a uniquely ineffectual government.

I think there is a lot of reason to believe that we have a uniquely ineffectual government. Excluding defense expenditures, and counting all levels of government, Canada spends less public money per capita, while having cheaper healthcare, education, better transit, etc. For example, we spend more per capita on education than any OECD country except Switzerland, and get worse results. Our federal system (where states…

I think you are on to something looking at state governments but I don't find the answer completely satisfying because a lot of US States are similarly sized to European countries. Why should we expect the State of NY (~20M people) to have a worse government than the Netherlands (~17M people)? I don't have a great answer to this question.

Perhaps it's just the separation of government in general. People can only pay attention to so much and the attraction of national politics pulls attention away from state politics. That's just not something that happens in many other places.

Re: The lucrative business of America’s opioid crisis

#125

Post by esaym »

> Then, the new insurance laws in 2008 and 2010 transformed what had largely been a government-funded and charitable-minded field into an enticing for-profit business.

That's freaking discussing and yet another reason I refuse to pay for insurance. I'll take the fines.

Re: The lucrative business of America’s opioid crisis

#126

Post by quantumofmalice »

geofft wrote: post #118
quantumofmalice wrote: post #63

Earlier quoted context omitted.

> Unfortunately one person suppressing their unethical behavior is inconsequential. If an opportunity exists, eventually someone will use it. This isn't solely a feature of capitalism. Any system is going to devolve into the strong eating the weak unless the strong identify with and have solidarity with the weak. I have recently become much more willing to listen to ethno-nationalists of all ethnoses based on this re…

I understand where you're coming from, but the empirical history of America (at least) brings up two problems. The first is that the definition of race/ethnicity tends to shift based on what's politically expedient for the powerful: consider whether Irish people, Eastern Europeans, Arabs, and Jews count as "white" at various points across American history. Race just isn't a solid enough concept to be a reliable way t…

As I said in a sibling comment, I view race as too broad a concept to usefully generate social identity, and the fluidity of the concept makes it slippery to deal with. Your second point is a good one, I will think more about it. That said, it seems to me that in the long run relatively homogenous populations (really, many smaller politically independent homogeneous populations, as well as politically independent hetrogeneous populations for the smarter folks) is the best way to maximize social identity and minimize conflict.

By the way, I appreciate you taking the time to thoughtfully respond to my comment. It is difficult to say what I think may be the truth (with, I hope, no maliciousness) in todays environment, so thank you.

Re: The lucrative business of America’s opioid crisis

#127

Post by coliveira »

vanderZwan wrote: post #61
StreamBright wrote: post #57

Earlier quoted context omitted.

Actually the opposite. Government regulations outlaw cheap non-dangerous alternatives (like cannabis) and create a monopoly by granting patents to a single entity. https://qz.com/1125690/big-pharma-is-taking-advantage-of-pat... http://www.washingtonexaminer.com/outdated-treatments-and-dr... The solution is to make cannabis legal for everybody in every state for medical use and since it cannot be patented there will b…

> Actually the opposite. Government regulations... I'm from the Netherlands so you won't hear me disagree with the argument that criminalizing cannabis and drugs is not the solution[0]. Having said that, the typical undertone on HN of "regulation is bad by definition" really irks me. I can imagine that if the only perspective one has is a dysfunctional government, one might think that, but please take a look abroad a…

> typical undertone on HN of "regulation is bad by definition"

This is pure ancap, "Austrian school" ideology. They define regulation as bad by definition, because supposedly it goes against "freedom". This works as a clutch so that if you say anything bad against capitalism they will retort "it is regulation", even thought nobody ever saw (and never will see) an economic system without laws and regulations.

Re: The lucrative business of America’s opioid crisis

#128

Post by geofft »

quantumofmalice wrote: post #122
geofft wrote: post #120

Earlier quoted context omitted.

> I don't believe there is strong evidence that a metaculture (really, multiculturalism) will survive and not devolve into squabbling ethnoses, particularly on the scale of the north american continent. Doesn't the empirical reality of large cosmopolitan cities provide evidence that multiculturalism will work just fine? New York City, for instance, has 8.5 million people of every race, color, creed, citizenship, lang…

I expect there to continue to be multi-ethnic cities and neighborhoods within cities, which is a fairly common occurrence throughout history, particular in capital cities of empires, which is what I would describe New York as. There is no doubt that some people (particularly smart people) highly value the diversity and cosmopolitanism that cities of this form provide. On the other hand, people who value high social t…

I am getting the sense that you're saying that New York City is primarily a city of smart people who value cosmopolitanism and not of people who value high social trust and strong social identity. That might be the stereotype of certain parts of Manhattan (especially of people who - and I admit I'm one of them - have voluntarily moved to the city for work), but that's not the majority of New York City at all. Come and visit Harlem or Crown Heights or Flushing. Come and walk through the parts of Brooklyn with storefront signage in Hebrew and not English. Come and take a taxi and talk to the driver about social trust or social identity. Come and talk to people who have had family living here for generations.

The evidence, as far as I can tell, is that multiculturalism is a perfectly stable approach, and people who say that we need cultural isolation are only saying that because of belief and not evidence. Of course the continent is big enough to support giving people what they want, whether or not they're rational to want it. But to the original topic of how to prevent the strong from taking advantage of the weak, I don't think there's any reason to believe that dividing people by race to force an alliance of each race's strong and weak is going to be successful, or that avoiding multiculturalism is going to be necessary.

Re: The lucrative business of America’s opioid crisis

#129

Post by ams6110 »

Broken_Hippo wrote: post #85
StreamBright wrote: post #57

Earlier quoted context omitted.

Actually the opposite. Government regulations outlaw cheap non-dangerous alternatives (like cannabis) and create a monopoly by granting patents to a single entity. https://qz.com/1125690/big-pharma-is-taking-advantage-of-pat... http://www.washingtonexaminer.com/outdated-treatments-and-dr... The solution is to make cannabis legal for everybody in every state for medical use and since it cannot be patented there will b…

I don't know, dude. If you are talking of using camnnabis for medical use, I'm gonna want a dosage guideline and strength/purity promises. I'm pretty sure for medical use, it will more closely resemble ibuprofen or cough medicine if it is without prescription. With prescription it'll be more like generics. It might still be a monopoly, since these drugs have to go through all the FDA testing. Heck, if you want fluori…

It's a freaking plant. Why should it be more regulated than parsley?

Re: The lucrative business of America’s opioid crisis

#130

Post by ams6110 »

QAPereo wrote: post #110
unabst wrote: post #52

Capitalism is sinister like this. It doesn't intentionally do it, because capitalism isn't a person, but when everything is monetized by our creative entrepreneurs, it grows; our problems being no exception. Once someone makes money, they want more of it. Capitalism demands more of it. And we stretch every line of the law, even cross it, just to get more from where that came from. Unfortunately one person suppressing…

Nothing about capitalism demands an ugly lack of proper legislation, regulation, and enforcement. I would not like to write off capitalism on the basis of a rigged system that just uses the name for ideological purposes.

Indeed, rule of law is essential. As is some level of regulation because history has shown that some people are bad actors. The challenge of regulation is how to control the tendency of its bureaucracies to grow and become burdensome.
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