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Goldman Sachs questions whether curing patients is a sustainable business model

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

#311
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…

Thomas Aquinas defines( over simplifying here) evil as an absence of good. Works well in this case.

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

#312
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 m…

> What are absolutely dismal are the conditions that make it a reasonable question

I'm a pretty free-market kinda guy, but all systems have flaws. Biotech and capitalism seem to have a fair few chasms between them, and this GS report illustrates one of them quite well. Capitalism is not a 'complete' theory, holes exist in it, as they do in all things. If anything, as the GP states, GS is pointing this one out. Suggestions for what to do about this 'hole in theory' are needed though; likely it's government funding (in a 'lighthouses' manner).

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

#313
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 do…

> very civilized nations, such as Persia and Greece

Eh, maybe back then, but today they would be seen as worse than ISIS. Pederasty and slavery are wholly intolerable. We've taken their good ideas and run with them, leaving the vast amount of horrible ones behind.

That said, you are totally correct. The modern corporation would be anathema to people from 150 years ago. Corporations were very tightly controlled by the state for a very long time due to the potential for vast profits to warp politics (also due to antisemitism, class-ism, and racism; the usual)

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

#314
post #183

Earlier quoted context omitted.

"Universal Credit" is a horrendous scheme that manages to combine (malicious) ignorance of the needs of its beneficiaries with ignorance of how to run a large software project. The idea sounds great on paper - there are a lot of different benefits, why not reduce duplication by merging them into one scheme then only asking for personal information once - but it ignores cashflow . People can be left without money to l…

Sounds like the Phoenix payroll project here in Canada, except for social services. There is no way this will end well, and I wouldn't be surprised if it leads (indirectly) to the death of clients.

Oh Phoenix is just a incomplete system rolled out too early. Universial Credit is pure evil. The person-gets-benefits-cut-for-having-heart-attack-at-appointment evil. The months-deceased-claimant-gets-invited-for-appointment evil. The benefit-cut-because-assessor-didn't-show-up-for-house-visit evil. The no-benefit-payouts-in-the-first-six-weeks evil.

(those are all real cases you can find in UK newspapers, mostly the Guardian)

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

#315

This might be going a bit off topic, so I apologize if this isn't allowed here, but I recently wrote an article about a chemical used in dental health that was bought by GSK and pulled off the shelves in the United States. I was just reminded by the topic of this post. Because it's an effective product in treating tooth sensitivity(by occluding exposed dentin tubules), but it is also effective in preventing tooth dec…

If you're interested in this check out Jeffrey Hillman's work at Oragenics[1]. Wired wrote about his work in 2002, which is how I found it[2]. SMarT is the amazing futuristic put dentists out of business almost tech[3], but there's a current 'ProBiotic' consumer version called ProBiora[4] sold as well, however that's a continuous delivery version. Far more profitable it would seem. Unfortunately, they discontinued FDA trials of SMarT for now.

1. https://www.oragenics.com/about/history 2. https://www.wired.com/2002/06/better-teeth-through-biochemis... 3. https://www.oragenics.com/technology-pipeline/lbp/smart 4. https://probiorahealth.com

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

#316

Earlier quoted context omitted.

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 do…

> very civilized nations, such as Persia and Greece Eh, maybe back then, but today they would be seen as worse than ISIS. Pederasty and slavery are wholly intolerable. We've taken their good ideas and run with them, leaving the vast amount of horrible ones behind. That said, you are totally correct. The modern corporation would be anathema to people from 150 years ago. Corporations were very tightly controlled by the…

One of my favorite college professors gave me the expression "I am the primitive of my way."

Whatever else was going on in Persia and Greece, there are reasons they were considered shining beacons. I think one of those reasons was their concept of trade as a civilizing force, superior to, say, raiding your neighbors and just taking whatever you could get.

That concept of trade as a civilizing force seems somewhat lost these days and I think we are worse off for forgetting it.

I realize you are mostly agreeing with me. This would no doubt go better in person. Conversational tone is really hard to convey online.

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

#317
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…

Even if focusing on currently uncurable conditions like cancer isn't a bad thing in itself, it means that a cure for cancer would be disastrous for the bottom line of biotech companies that follow this strategy. It's not just a different allocation of resources, it's an incentive to deprioritize cures in general. Any plan to maximize healthcare profit will result in perverse incentives, which is what those "knee-jerk Goldman Sachs is Evil" comments are largely criticizing. Obviously Goldman Sachs is stating the facts, but the assumption is that the choice with greater profitability is the correct one. That that assumption underlies medical research and development is the evil part.

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

#318

The health industry has no reason to cure patients. On the contrary, they have reasons to create new patients. And it's across the board. I tell myself exactly that when I look at my toothbrush. A toothbrush lasts about ~3 weeks before needing replacing. I'm sure someone in the industry will tell me that it's because it's made of unobtainium unicorn hair specially designed to make my teeth whiter and all that. I also…

Your toothbrush needs replacing every 3 weeks?

I had never heard that before either. I've been using the same one for like a year now, which is definitely too long now that I think about it, but 3 weeks?

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

#319
post #278

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.

Only if cures are equally expensive to develop as ongoing treatments. If cures are substantially more expensive to develop, then the system never gets over the activation energy (or it takes an extremely long time).

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

#320
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.

I think it's totally ok, and it should be accepted. Public services are meant to be cost centers. If they bring in profits, they do so indirectly (e.g. better health of citizens -> better GDP -> more money in taxes). The trick is to still find ways to apply pressure so that a service gets better and more efficient in time, instead of attracting parasites that'll use it as money drain. Like a lot of healthcare-related…

> The trick is to still find ways to apply pressure so that a service gets better and more efficient in time, instead of attracting parasites that'll use it as money drain.

A huge part of the problem is the public reaction to how for-profit research is supposed to work.

In theory a cure is highly valuable. People should be willing to pay as much for it as the alternative, meaning as much as it would cost for multiple years of ongoing treatment, plus the value of the inconvenience the cure avoids in participating in the ongoing treatment for all those years. A cure should be more profitable than a treatment because patients prefer it to continuous treatment and are therefore willing to pay more for it.

But a treatment that costs $500/week and continues for 40 years is business as usual. Someone offering a cure with a one-time price in excess of a million dollars is derided as a soulless profiteer taking advantage of the sick, insurers refuse to cover it and everyone starts calling for Congress to pass a law against it.

So the market develops treatments instead of cures.

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