In 2007 an oral surgeon gave me a prescription for opioid painkillers after a wisdom tooth extraction, just in case I needed it for pain. The pain wasn't very bad and I never filled the prescription, but in retrospect giving me that prescription in the first place was just crazy! Another doctor gave my wife an opioid painkiller prescription upon hospital discharge after a normal childbirth, just in case she needed it…
Those 'just in case' scripts are usually combined medications that are short enough in duration that they don't pose much risk of dependency.
It’s a crafty way to pass on the responsibility of making the choice to the obviously oblivious “client”.
[when opening a patients records] a pop-up would appear, asking about a patient’s level of pain. Then, a drop-down menu would list treatments ranging from a referral to a pain specialist to a prescription for an opioid painkiller. Click a button, and the program would create a treatment plan. From 2016 to spring 2019, the alert went off about 230 million times. The tool existed thanks to a secret deal. Its maker, a s…
This is a perfect example of how free markets fail when profiteering is not aligned with the user in mind. Their sole purpose is to increase sales of their pain medication. The best way to do that is to advertise your drug to people who can push them, and even better if you can wear them down into making shitty decisions that involve them buying your drug. The free market can't fix this problem because it's hidden (i…
Fascinating. So your saying the user must be aligned for the free market to work?
How about employers choosing from a set of health insurance plans you can choose from? That’s a misalignment no?
If I could get a coupon to buy my own insurance I may choose something better for me from an entire marketplace of plans. Instead I get stuck with the calculated decisions of people I don’t know trying to optimize their own profits while satisfying a set of people with very different needs and risk profiles than myself.
Or has all white crime been made legal in America? Can you think of a time when it was significantly more likely for something like this to end up with execs in jail?
Martin Shkreli was doomed from the start, never underestimate the power of being the media's boogieman. His crime was essentially using investors funds improperly, all ended paid back in full, many made decent profits.
But it was not a crime to raise the drug price for insurance companies (only).
Would this same logic apply to other jobs? For example, do people who brew beer make the choice to kill others? If the drunk drivers add a level of indirection that prevent blame, then why doesn't the same happen with the doctors in this case? Gun manufacturers? People who build cars that have a known higher fatality rate? People who build swimming pools (look up how many kids die to swimming pools a year)? People wh…
If I brew beer, odds are I also drink beer. If I manufacture guns, odds are I also own guns. If I make sports cars, odds are I also like to drive sports cars. People who build swimming pools swim. People who sell junk food buy junk food. People who make video games play video games. The people in your examples are all selling things they probably want to be able to buy. Perhaps you disagree with their decisions, but…
And the people making/selling pain killers for those in pain don't think the same? That seems highly unrealistic.
Now, the C levels probably aren't the same, but they are the same in that they aren't the same across industries.
I believe opioid addiction is not well understood among general practitioners. Here in the UK, they accept as common sense that your patient won't get addicted if they're taking opioids for pain.
Similarly for ADHD, when I was started on meds my psychiatrist reassured there was no risk of addiction because I had ADHD. In practice, whenever I spend more than 3 days without them I get terrible headaches.
The problem is the US health care system. In a civilized nation, doctor orders a medical test, you get the medical test and you are not charged $1000+ for it. Prices are regulated. US health care system is very predatory. Even if the doctor had the right intentions and you go to scammy place for tests the experience will be negative.Then, if you can't make the payment and are ashamed to call and negotiate the bill it…
Prices are regulated is the problem! Prices should be ‘regulated’ by REAL price transparency and consumer choice! The prices will self regulate based on the market. AND insurance can be privately bought to protect against the chance that you get stuck with something expensive. Just like insurance against your house burning, car crashing, or dealer getting a blackjack. The idea that regulating the price through govern…
I would only add the caveat that under a free market system single-payer may still be more appropriate for emergency care, since you can't make a consumer choice in the middle of having a stroke. The fallacy that healthcare is a monolithic field which can necessarily be equally served across the board by any particular regime is catastrophic to the debate. There are completely different requirements, limitations, time scales, etc. between an ER, a family practice, a specialist pediatric cancer ward, a cosmetic surgery clinic, etc.
More than that. This is unethical design. It's a design that probably killed people.
I think it's safe to remove probably. This went down a chain of people. CEO. VP. PM. Tech Lead. Developer. All of them made a choice to kill people for profit.
I don’t think that’s an accurate statement, and is a misattribution of responsibility.
The responsibility ultimately rests with the person who puts the drug in their own body. You can make an argument that their physician is in a position of trust, and that some responsibility lies with their prescribing it.
Extending it out to the workers of the vendor is as silly as extending it out to the workers of the keyboard vendor.
I think it's safe to remove probably. This went down a chain of people. CEO. VP. PM. Tech Lead. Developer. All of them made a choice to kill people for profit.
I've said this before on HN and I'll say it again. Every C-level exec that was aware this happened and let it happen should be charged with a single count of involuntary manslaughter for every patient who had an opioid overdose that was prescribed pain medication by this system. This is not acceptable, and people's heads should roll.
Nobody forced anyone to put those drugs into their body.