Goldman Sachs questions whether curing patients is a sustainable business model • Hacker News Board

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#121

Post by buvanshak » Fri, Apr 13, 2018, 11:31 AM UTC

ta76567656 wrote: post #75

buvanshak wrote: post #34

Earlier quoted context omitted.

> The 'ideal' drug from a business point of view not only not cures the patient long term... There is another one. Vaccines. Or any preventive medicines that does not actually require people to be sick. You just need to inject massive amount of fear of diseases (Statistics is your friend here) into the populace to create a nice, ever increasing demand of your produce...

I rather enjoy never having gotten smallpox or polio.

What part of my comment are you responding to?

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#122

Post by TomK32 » Fri, Apr 13, 2018, 11:32 AM UTC

cies wrote: post #110

arnoooooo wrote: post #103

Earlier quoted context omitted.

Most R&D, in the US as elsewhere, make massive use of public funds.

Which is weird, as that is not factored in the purchase price when buying the product when developed.

yes, you might ask your democratically elected representative about that...

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#123

Post by perpetualcrayon » Fri, Apr 13, 2018, 11:35 AM UTC

I wonder if diseases are patentable. That would probably be a hugely profitable market. If a company obtained the patent on the disease they'd almost certainly be the first to market with a patent for the cure.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#124

Post by TomK32 » Fri, Apr 13, 2018, 11:36 AM UTC

saas_co_de wrote: post #94

psergeant wrote: post #85

Earlier quoted context omitted.

> Creating a public institution with no pressure to make profit is a disaster waiting to happen. This is the model many rich country healthcare runs on, and provides measurably better outcomes for less expenditure than the US.

You are talking about providing health care. Not inventing new treatments. Those countries are all using treatments invented developed and funded by the market model which is mostly paid for by us consumers, which is part of why us prices are so high. The US has the best outcomes in the world if you have money. Which is why rich people from all over the world come here for treatment. We just have lower average outcom…

Saldy when you are in need of healthcare, money is the only negotiation power you can have. An insurance company dealing for you has a lot more power, but if you are on your own you have no power to say "right, this vital heart op is too expensive, I'll drive 300 miles for a cheaper provider. ggrrrrl".

That's why universal healthcare is the better solution for everyone.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#125

Post by scotchmi_st » Fri, Apr 13, 2018, 11:37 AM UTC

Since we're discussing nationalisation of drug development, one more less extreme idea that I think needs more air-time: The creation of government-issued prizes for drug discovery.

Here's how it goes- Government X issues a prize of $10B to whichever company comes up with a new drug for, say, blood pressure. (10B being about as much as a company would get in revenue for a blockbuster drug.)

Companies submit their drugs, which are then tested independently (see http://www.alltrials.net/ if you want to know why that's important), and if they are found to have passed the requirements in a strictly yes/no manner, they get the money.

The IP for the drug then passes to the government, which can then manufacture and sell it at generic rates.

Like everything there are down-sides to this method, but it would sidestep a lot of the issues around companies' incentive alignment with healthcare.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

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Post by fsloth » Fri, Apr 13, 2018, 11:53 AM UTC

ramblerman wrote: post #78

brann0 wrote: post #54

Earlier quoted context omitted.

So we agree medicine cannot be managed as a business, right? It's ok if healthcare losses money, in fact it should be ok for all public sevices to operate and not being profitable.

You are jumping from one extreme to the other. Creating a public institution with no pressure to make profit is a disaster waiting to happen. You can certainly keep a 'competitive' environment which is regulated with incentives. And I do agree healthcare needs this, and shouldn't live purely by the free market.

"Creating a public institution with no pressure to make profit is a disaster waiting to happen."

Why?

Schools are not for-profit institutions (well, not everywhere). Police don't make a profit. Nor does the fire brigade. Or the military, for that matter.

Are all of these disasters waiting to happen?

Re: Goldman Sachs questions whether curing patients is a sustainable business model

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Post by Proven » Fri, Apr 13, 2018, 11:54 AM UTC

Of course it’s not in the fascist Obamacare and single payer model widespread in the West.

The profitable model is to work with the state to milk the taxpayer.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#128

Post by cs702 » Fri, Apr 13, 2018, 12:01 PM UTC

...And there you have it, in seven crisp words: a succinct explanation of why and how "health-care" becomes "health-exploitation" when it is primarily or exclusively a profit-seeking endeavor.

In theory, competitors would step in with cheaper, faster cures, preventing the exploitation of patients.

In reality, many if not most patients find themselves at the mercy of medical offices and hospitals which are themselves seeking to maximize profit and therefore have strong financial incentives to prefer expensive, ongoing treatments over cheap, fast cures.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#129

Post by phkahler » Fri, Apr 13, 2018, 12:07 PM UTC

When you're a business person or a researcher you want to find the big thing that's going to fund your retirement. When you're an engineer you make a career out of building thing after thing. I think this is similar to the difference between US companies and Chinese companies. In the US they want to develop a product and ride that wave for as long as possible, while in China they produce one item and quickly move on to producing the next one in a never ending cycle. This is also why US companies care so much about IP, they want to do something once and retire. One could even frame it as a form of entitlement ;-)

Having said that, I do want people who solve major problems to be reasonably compensated. I'm not sure what that looks like.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#130

Post by smoyer » Fri, Apr 13, 2018, 12:07 PM UTC

If you're in medicine, you should be more concerned with improving the human condition. I think that most doctors truly want to help others, and we obviously need support companies like drug manufacturers. But there's a huge industry built up around maximizing profits in other ways - I'm not sure how this can be reconciled.