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Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

mattstoller.substack.com

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Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#351

Post by jdlshore »

freeone3000 wrote: post #347
jdlshore wrote: post #285

Earlier quoted context omitted.

Counterintuitive as it may be, the Oregon Experiment showed increased costs. It did show an improvement is psychological outcomes, I presume due to peace of mind, because their wasn’t a corresponding increase in psychiatric medication.

Did the increase in cost also come with an increase in outcomes? I don't think it's counterintuitive that people who couldn't afford healthcare see a doctor, you'll see a lot of issues; did we see a decrease in medical issues across the population?

No, there was no increase in health outcomes.

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#352

Post by vletal »

unishark wrote: post #345
dantheman wrote: post #306

Earlier quoted context omitted.

Yet emergency care is relatively small portion of health care costs - so maybe deal with that last. It'd be hard for hospitals to make the case that emergency care is substantially more costly than similar procedures they offer.

Even for ER visits alone, it's not true that patients are "usually" incapacitated or on the verge of death. Something like a third aren't even urgent and only a small percentage are admitted to the hospital. And the most common reasons for visits are mostly pain complaints with a conscious patient. On average people get triaged to the waiting room to wait for 40 minutes or whatever. There was a thread here a while ba…

In Czechia we have sufficient capacity of ambulances and other emergency services. What happens is that off peak they serve to help move old people to hospital, like a super expensive taxi. In these cases I can see how "emergency Uber" could help. On the other hand the doctors serving in these ambulances are usually extremely well prepared, the best MD students go to study to serve there. Even if it is one in a hundred cases, they will recognize the stroke from a random chest pain. Replacing them would surely increase the death rate in these cases...

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#353

Post by viraptor »

AnthonyMouse wrote: post #319
wvenable wrote: post #313

Earlier quoted context omitted.

In 2018, the average insulin price in the US was $98.70, compared to $6.94 in Australia, $12.00 in Canada, and $7.52 in the UK. This is a 100 year old drug.

It isn't a 100 year old drug. There are newer formulations that are faster acting, longer lasting, easier to administer, etc. They're newer so they're still under patent so they're a lot more expensive (because the rest of the world makes the US pay to develop the newer formulations). When insurance is paying for it, people prefer the newer formulations. Then, since most people have insurance, there wasn't enough of…

> Then, since most people have insurance, there wasn't enough of a market for the older formulations for anybody to bother making them for the margins you get for making a generic.

Is there some research confirming that? It doesn't quite match my out-of-us experience with other drugs. I get a choice of 2-3 brands of ibuprofen and another 1-2 generics for it. Why wouldn't the same apply to insulin? I expect that it's also not 100% covered? (please correct me here)

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#354

Post by s1artibartfast »

warglebargle wrote: post #192
s1artibartfast wrote: post #180

Earlier quoted context omitted.

Wanting to avoid companies that are "too big to fail" is a perfectly valid reason to favor smaller companies. Most of the reasons above are not.

a lot of it can be rolled into “diversity is better” IMO - lots of diverse types of leaders, diverse strategies, perspectives, risks, failures, etc… mega large companies don’t give us as much benefit as they’d like us to think… I’d even argue that they’re worst in most ways for 99% of the people involved

I prefer a more competitive, dynamic, and diverse market for almost all products as well. However, most of this thread is pie in the sky wishful thinking that busting big corps will solve all of societies ills. Attribution of these ills to mega corps often ignores the actual problem and obfuscates the real solutions.

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#355

Post by benrbray »

R0b0t1 wrote: post #300
asdff wrote: post #286

Earlier quoted context omitted.

Some people do though. Imagine someone who just lets this stuff lapse and they are still being regularly prescribed stuff that should have been cancelled 8 years ago.

People already die quietly alone all the time. How far do we need to go to have everyone have a babysitter, especially at their own expense?

I think the idea is that the doctor is actively intervening in your medical treatment, so they have a responsibility to make sure they're getting it right. This person is free to stop taking their meds and die alone whenever they like.

Visits to the doctor should be cheaper and more efficient, but people shouldn't stop going to the doctor.

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#356

Post by adrianN »

AnthonyMouse wrote: post #301
hyperhopper wrote: post #293

Earlier quoted context omitted.

There is also a third issue: The high cost of medicines that are low cost to produce, and are sold at low cost elsewhere

This one is particularly prickly because the high cost paid in the US funds medical R&D and extremely expensive clinical trials which other countries are free riding on by imposing price controls. We still need to fund the R&D and clinical trials (unless they could be made less expensive somehow), so the most obvious solution would be to have other countries pay their fair share so the US could stop subsidizing every…

I wonder why we don't fund drug development directly, using tax money and then let companies produce the drugs for a reasonable fee. I feel like drug development shouldn't be prioritized by the estimated amount of profit one can get from the drug.

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#357

Post by t-writescode »

ak217 wrote: post #267
t-writescode wrote: post #259

Earlier quoted context omitted.

It is my understanding that obligatory routine care is a major component of Kaiser’s model. In the experience of those I know who use Kaiser, effectively, if they come in for something and their routine checkups are out of date, they’re obligated to get that routine checkup (at the same time due to streamline of service), before they can get what they came in for. From this, I derived the argument that routine checku…

Kaiser has no specific preventative care requirements and does not withhold care if you are not up to date on some schedule. In fact Kaiser works pretty much exactly like any other HMO with the main difference being that insurance is in-house (but a different department, so insurance screwups still happen, but at least the hospital and the insurance are not constantly fighting each other with you stuck in the middle)…

That's interesting. The person I'm familiar with wasn't allowed to get meds for their strep throat until they went through their regular exams since it had been a year or over one or something. It was all very, very quick, but they were quite serious about getting their regular checks in. The patient in particular was in her 50s at the time, so perhaps that's where the difference comes in?

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#358

Post by spicyramen »

fennecfoxen wrote: post #322
pkphilip wrote: post #316

Earlier quoted context omitted.

Correct. The price of Insulin has nothing to do with "funding research." It is simply price gouging - that's it.

The price of insulin specifically is largely a consequence of perverse regulatory incentives, particularly the Obamacare-related expansion of the 340B Drug Pricing Program and its mandatory, byzantine, opaque rebate structures. Don't think it's just the manufacturers who are at the center of this price gouging, not by a long shot; hospitals and pharmacies are all too happy to ride that gravy train.

Where can I find out more information about it.?

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#359

Post by unishark »

vletal wrote: post #352
unishark wrote: post #345

Earlier quoted context omitted.

Even for ER visits alone, it's not true that patients are "usually" incapacitated or on the verge of death. Something like a third aren't even urgent and only a small percentage are admitted to the hospital. And the most common reasons for visits are mostly pain complaints with a conscious patient. On average people get triaged to the waiting room to wait for 40 minutes or whatever. There was a thread here a while ba…

In Czechia we have sufficient capacity of ambulances and other emergency services. What happens is that off peak they serve to help move old people to hospital, like a super expensive taxi. In these cases I can see how "emergency Uber" could help. On the other hand the doctors serving in these ambulances are usually extremely well prepared, the best MD students go to study to serve there. Even if it is one in a hundr…

Sure but you can make such an argument about every single medical issue. People can drop dead in a few days due to an unexpectedly aggressive toe infection. At some point we need to compare risks to costs.

There will always be a trade-off between quality and cost. If you accept nothing less than highest quality (enforced by law and an extremely litigious society), then you get the US hyper-inflation of healthcare prices.

Also in the US, I think ambulances typically only have EMT's and paramedics. Though sometimes it can cost as much as the ER itself.

Re: Biden launches action on "Big Tech, Big Pharma, and Big Ag" – can it be real?

#360

Post by Auracle »

prestigious wrote: post #340
AnthonyMouse wrote: post #319

Earlier quoted context omitted.

It isn't a 100 year old drug. There are newer formulations that are faster acting, longer lasting, easier to administer, etc. They're newer so they're still under patent so they're a lot more expensive (because the rest of the world makes the US pay to develop the newer formulations). When insurance is paying for it, people prefer the newer formulations. Then, since most people have insurance, there wasn't enough of…

At least give the option of the old shit

Walmart sells vials of the generic “old shit” for cheap.
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