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Goldman Sachs questions whether curing patients is a sustainable business model

arstechnica.com

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

#301

Post by hhw »

rusk wrote: post #293
alistoriv wrote: post #229

Earlier quoted context omitted.

In addition, the best healthcare system in the world, according the WHO, is in Cuba, where it certainly isn't run on a for-profit basis. Moving medicine away from the private sector allows for a stronger focus on preventative care, which is significantly less profitable. I think that worrying about removing the profit motive entirely misses that fact that not only is the profit motive not the only motive for doing th…

As much as I wanted this to be true it doesn’t really stand up to scrutiny. Yes “day to day” access to healthcare is far superior but it’s very week on the high end stuff. Even Castro in his final hours was treated in a Spanish hospital. Ideally we would want some kind of reasonable alternative that exists between these two extremes ...

Correlation != Causation

The more likely explanation for Castro seeking treatment in Spain is that Cuba is a relatively small country of only 11 million, and it should be expected that they're not at the very forefront of the world on every area of medical expertise.

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

#302

Post by marssaxman »

rectang wrote: post #167
GiorgioG wrote: post #152

Earlier quoted context omitted.

> Creating a public institution with no pressure to make profit is a disaster waiting to happen. We seem to have no problem with throwing $700 billion per year on the military and nobody is pressuring them to make a profit. Is that a disaster? No? "But that's different!" It's only "different" because that's what we've been led to believe.

The US military is spectacularly inefficient, and the US military-industrial complex is a parasitical behemoth per Eisenhower's critique. It's not like the problem is unknown; the issue is that the state has to have a monopoly on violence, so we live with the inefficiency. Encouraging a marketplace of competing militia would not a viable approach. :)

> the issue is that the state has to have a monopoly on violence

That is not the case in the USA, where the absence of such a monopoly is written into the federal constitution.

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

#303

Post by danharaj »

jfasi wrote: post #300

How do we interpret this heartless-sounding statement? In the absence of original source material, whatever interpretation you apply will inevitably be a projection of your pre-existing views on the matter. If you want to knee-jerk your way to the standard "Goldman Sachs is Evil" view, help yourself to the rest of the top-level comments in this thread. If you're still reading, I think I have a worthwhile point to off…

The Goldman Sachs analysts didn't ask an unreasonable question. What are absolutely dismal are the conditions that make it a reasonable question. And what makes them dismal people is that they are totally cool being part of the system that makes such questions reasonable.

> In the absence of original source material, whatever interpretation you apply will inevitably be a projection of your pre-existing views on the matter.

Literally all interpretation one does about anything is a "projection" of their pre-existing views on the matter.

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

#304

Post by logfromblammo »

sametmax wrote: post #275
logfromblammo wrote: post #263

Earlier quoted context omitted.

Everything developed before science is suspected to be bunk. Everything developed after science is suspected to be bunk until the experiment has been replicated.

I think nobody suspected getting enough sleep was bunk before we did a study on 1000 people.

1000 years of grandmas passing down oral history is a great source of experiment ideas, but the one about only hiring/funding people that can publish a positive result in a high-impact journal needs to get tested ASAP.

Getting rid of the useless cruft lingering around from the past is just as useful as advancing the frontiers of knowledge.

When people can stop waving crystals around and dipping their fingers in oil, they can finally get better results from pushing the big green button on an inscrutably opaque black box that goes "ding".~

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

#305

Post by darawk »

andrepd wrote: post #285
darawk wrote: post #278

Earlier quoted context omitted.

No, because that's an unstable equilibrium. If you are company B, you know you can steal 100% of the business by finding a cure.

You can theorise all you want, but the world is rife with examples of what I said being true. As always, experiment must trump theory.

Name literally one example of that being true. I'll wait.

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

#306

Post by mamon »

rectang wrote: post #167
GiorgioG wrote: post #152

Earlier quoted context omitted.

> Creating a public institution with no pressure to make profit is a disaster waiting to happen. We seem to have no problem with throwing $700 billion per year on the military and nobody is pressuring them to make a profit. Is that a disaster? No? "But that's different!" It's only "different" because that's what we've been led to believe.

The US military is spectacularly inefficient, and the US military-industrial complex is a parasitical behemoth per Eisenhower's critique. It's not like the problem is unknown; the issue is that the state has to have a monopoly on violence, so we live with the inefficiency. Encouraging a marketplace of competing militia would not a viable approach. :)

>> the state _has_ to have a monopoly on violence

I think that the whole point of 2nd Amendment to US Constitution was to prevent government monopoly on violence. The possibility of citizens making successful military rebellion against the state was supposed to keep the government in check.

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

#308

Post by DoreenMichele »

jfasi wrote: post #300

How do we interpret this heartless-sounding statement? In the absence of original source material, whatever interpretation you apply will inevitably be a projection of your pre-existing views on the matter. If you want to knee-jerk your way to the standard "Goldman Sachs is Evil" view, help yourself to the rest of the top-level comments in this thread. If you're still reading, I think I have a worthwhile point to off…

Funny that capitalism and profit motive have such an evil reputation when, historically, bees were revered by several very civilized nations, such as Persia and Greece, for being a symbol of mutually beneficial interaction and how business should be done as a civilizing force.

There are inherent challenges in monetizing healthcare. It isn't better to expect it by default to be "free" as the solution to that. But I don't think that means we can't keep our eyes on the prize. Ultimately, healthcare should primarily improve health and welfare.

I once read a witty piece that I only poorly remember that used the expression the bottom line to make the point that while a business does need to be profitable, profit should be its lowest priority. Accomplishing something useful and beneficial should be the main goal. Money is a necessity to keep the doors open, but you shouldn't actually be in the business of milking your customers for every penny, especially if that means doing other questionable things to get there.

To my mind, that should go double for healthcare.

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

#309

Post by lowbloodsugar »

darawk wrote: post #278
andrepd wrote: post #277

Earlier quoted context omitted.

Not if both company A and B (correctly) assess that they will reap more profits by investing in chronic treatment even when a one-shot cure is possible.

No, because that's an unstable equilibrium. If you are company B, you know you can steal 100% of the business by finding a cure.

Like, if you invented a digital camera and successfully patented it.

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

#310

Post by wdewind »

Bartweiss wrote: post #251
cornholio wrote: post #42

Sure it is. Gilead made 100 billion dollars curring Hep-C with seed research investments that were probably much less than 1 billion. So as long as this strong differential and potential for profit exists, drug companies feel competitive pressure to produce better treatments, irrespective of the fact that "milking" the pathology would yield them trillions collectively. It's effectively a "tragedy of the commons" of s…

Notably, the headline here oversells the actual content. Goldman is rightly pointing out that gene therapy cures require heavy research but don't provide long term revenue streams. It doesn't claim that they shouldn't be pursued, or that people should be kept sick. It doesn't even say gene therapy companies offering cures are bad investments! Rather, it points out that they offer high returns over limited durations,…

In fact, this is a really common thing we see in the market/government dichotomy: the market doesn't, and shouldn't, have a stomach for long term, high risk plays that could possibly benefit all of society. That's not the point. The government handles those levels of investments on a much longer time scale, allowing the market to exploit the technological platforms made by our government. We see this pattern with the space race, the internet etc.: government does the big heavy lifting in the 20-40 year time frame, then VC and the market comes along and "digests" those changes for the marketplace.

Here is an excellent book that describes this relationship in far greater detail: https://www.amazon.com/Doing-Capitalism-Innovation-Economy-S...

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