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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

#161

Post by rayiner »

euroclydon wrote: post #137
harryh wrote: post #124

Earlier quoted context omitted.

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…

I never fully realized it until now, but the US, with it's federated structure is putting itself at a competitive disadvantage to other countries. It's the worst of both worlds, where states have a flaccid independence (they can legislate but not control their borders, thus cannot avoid the free-rider problem). Nation-wide standards that don't fall under the commerce clause have to be bribed into half-ass existence,…

We also suffer internal transaction costs by having to deal with 51 different legal systems.

Re: The lucrative business of America’s opioid crisis

#162

Post by aseriu91l »

sidcool wrote: post #7

I cannot understand why the Government is not acting against the pharmas profiting from this crisis. And why people are not revolting. There is a clear nexus between pharmas and doctors. Something should be done.

I cannot understand why people are not revolting against the health care system in general.

This crisis is not about pharma in particular, it's about the entire system. In fact, the opioid crisis illuminates a lot of the problems with the system at once.

Pharma benefits because it creates a market for their drugs.

Physicians benefit twice, because the initial prescribers get the seekers and then the "addiction specialists" get to profit when someone tries to come clean and are required to go to them to do so.

There's no oversight because the foxes are in charge of the henhouse. I.e., we say "physicians are the only ones who are really positioned to understand and regulate the system."

The criminal justice system benefits because they get to treat everyone as a criminal. Cause that's the right way to approach the drugs, right? Oh, and cracking down on drugs has really improved society in the US and elsewhere right?

The FDA is revealed to be useless because it's banning harmless drugs like cannabis and kratom while allowing harmful drugs to be used under the assumption that the monopolies they're granting (to pharma, physicians) are selfless, competent experts who only have the patients' well-being in mind.

And I'm sure all this is being charged and reimbursed appropriately?

The US healthcare system is a protection racket enabled by the government.

Re: The lucrative business of America’s opioid crisis

#163

Post by Feniks »

neandrake wrote: post #148
Feniks wrote: post #107

I find it endlessly hilarious that nobody in the US is asking WHY Why are people taking drugs? The country needs to do some serious soul searching. Won't happen though.

I've been reading Dreamland by Sam Quinones, which goes into detail and background of the past ~50 years or so about how we got into this situation. A large part of the WHY you're referring to I'll summarize as 1. Pain being identified as a vital sign and hospitals/institutions new-found focus on tracking and treating pain 2. Deceptive pharmaceutical marketing that painkillers are a be-all solution to pain and also n…

Maybe one day instead of prescribing sleeping pills GPs in the US will try to find out why someone has trouble sleeping. It will even save money.

Re: The lucrative business of America’s opioid crisis

#164

Post by highd »

nwah1 wrote: post #152

This one is interesting because it deals with a young short seller, Chris Drose, that caused a lot of share price decline in a stock I once held, likewise by writing an article for SeekingAlpha. https://www.nytimes.com/interactive/2017/12/27/business/drug... This is the other stock he did that to, but his article was retracted... of course, only after the stock tanked huge, and continued to tank more afterwards. He m…

Investors that investigate companies, identify hidden problems and report on them to the public help enable more accurate price discovery. This wouldn't happen at all if they couldn't trade against it.

For instance, I recall a story where a hedge fund sent PIs to determine that a factory reported running was actually closed down. They can't just trade against that info - it also has to be made public for them to realize gains. I can't imagine how you'd consider activity like this "getting away with it", when the alternative is companies performing unscrupulous acts in secret.

Re: The lucrative business of America’s opioid crisis

#165

Post by nwah1 »

highd wrote: post #164
nwah1 wrote: post #152

This one is interesting because it deals with a young short seller, Chris Drose, that caused a lot of share price decline in a stock I once held, likewise by writing an article for SeekingAlpha. https://www.nytimes.com/interactive/2017/12/27/business/drug... This is the other stock he did that to, but his article was retracted... of course, only after the stock tanked huge, and continued to tank more afterwards. He m…

Investors that investigate companies, identify hidden problems and report on them to the public help enable more accurate price discovery. This wouldn't happen at all if they couldn't trade against it. For instance, I recall a story where a hedge fund sent PIs to determine that a factory reported running was actually closed down. They can't just trade against that info - it also has to be made public for them to real…

I wasn't criticizing the act of short selling itself. I was criticizing the concept of an individual writing what amounts to a hit piece that was later retracted, and yet profiting off it despite the fact.

Or, in the first case, alleging that a company led to the death of an individual, when later the charge of murder was dropped.

It piqued my interest that in both cases, the meat of his allegations are at least highly ambiguous.

As someone whose job is not nearly as difficult as working with opioid addicts, it would be difficult to condemn such people without damning evidence.

That a person having respiratory issues might not be thought of as requiring hospitalization to me seems like something that could happen without negligence on the part of a rehab facility.

And the idea that rehab facilities are inherently motivated by greed when compared to cheaper outpatient programs based around prescriptions seems to infer malice when the obvious conclusion is that some people really believe that approach is superior. This claim is the type of thing that a competitor might believe but nobody else should.

Re: The lucrative business of America’s opioid crisis

#166

Post by euroclydon »

rayiner wrote: post #161
euroclydon wrote: post #137

Earlier quoted context omitted.

I never fully realized it until now, but the US, with it's federated structure is putting itself at a competitive disadvantage to other countries. It's the worst of both worlds, where states have a flaccid independence (they can legislate but not control their borders, thus cannot avoid the free-rider problem). Nation-wide standards that don't fall under the commerce clause have to be bribed into half-ass existence,…

We also suffer internal transaction costs by having to deal with 51 different legal systems.

And what to do about it? Most conservatives want smaller federal government, which reduces the aggregate size and expenditure for government, but exacerbates fragmentation. On the other hand, progressives want larger federal government, which introduces standardizing layers, but spends way more on aggregate government.

Re: The lucrative business of America’s opioid crisis

#167

Post by trhway »

cr1895 wrote: post #160
trhway wrote: post #156

Earlier quoted context omitted.

Hard to find a person/family devastated by marijuana use. At least devastated beyond what alcohol does.

It’s not hard to find lives devastated by the illegality of it.

It is devastation by police and/or by trafficking mafia, not by marijuana itself.

Re: The lucrative business of America’s opioid crisis

#168

Post by throwanem »

nwah1 wrote: post #165
highd wrote: post #164

Earlier quoted context omitted.

Investors that investigate companies, identify hidden problems and report on them to the public help enable more accurate price discovery. This wouldn't happen at all if they couldn't trade against it. For instance, I recall a story where a hedge fund sent PIs to determine that a factory reported running was actually closed down. They can't just trade against that info - it also has to be made public for them to real…

I wasn't criticizing the act of short selling itself. I was criticizing the concept of an individual writing what amounts to a hit piece that was later retracted, and yet profiting off it despite the fact. Or, in the first case, alleging that a company led to the death of an individual, when later the charge of murder was dropped. It piqued my interest that in both cases, the meat of his allegations are at least high…

> That a person having respiratory issues might not be thought of as requiring hospitalization to me seems like something that could happen without negligence on the part of a rehab facility.

That a person having respiratory issues might not be thought of as requiring his oxygen tank refilled strikes me as pretty clearly passing the "reasonable person" test for negligence, on the grounds that if I - with no first aid training to draw on - happened upon someone in such a strait, that would be among the first things I thought to check, once it was evident the person's airway was patent. It seems like an obvious enough concern, after all.

On the other hand, I do carry glucose tablets in my satchel against the possibility of happening on another person with diabetes in severe need of a blood sugar boost, so perhaps I am simply not in all respects a reasonable person.

Re: The lucrative business of America’s opioid crisis

#169

Post by emodendroket »

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 mean I'd blame the role of privatization more than government incompetence for most of those.

Re: The lucrative business of America’s opioid crisis

#170

Post by emodendroket »

euroclydon wrote: post #137
harryh wrote: post #124

Earlier quoted context omitted.

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…

I never fully realized it until now, but the US, with it's federated structure is putting itself at a competitive disadvantage to other countries. It's the worst of both worlds, where states have a flaccid independence (they can legislate but not control their borders, thus cannot avoid the free-rider problem). Nation-wide standards that don't fall under the commerce clause have to be bribed into half-ass existence,…

The United States is not the only federal system on Earth and it is in some ways an outlier among those.
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