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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?

#531

Post by WalterBright »

oblio wrote: post #520
jpadkins wrote: post #517

Earlier quoted context omitted.

vitamins are pretty much unregulated for decades, but doesn't have this lead or toxic chemical problem. Why do you feel so strongly this would happen in medicine? Do you really think companies (who spend a lot of capital building a business) will knowingly waste it all away by selling medicine that poisons people?

> vitamins are pretty much unregulated for decades, but doesn't have this lead or toxic chemical problem. Check out John Oliver and see how many problems we're having due to unregulated vitamins. Also vitamins are used by a ton fewer people than medicine, and for purposes far, far less risky than medicine. > Why do you feel so strongly this would happen in medicine? Because it would happen for sure without regulation…

> vitamins are used by a ton fewer people than medicine

Really? Every supermarket has plenty of them for sale. The local drug store has whole aisles devoted to them. They don't stock items that don't move.

> Because it would happen for sure without regulation.

Poisoning people is not something allowed by the free market, any more than hitting people with a baseball bat is. Free markets require government to proscribe fraud and abusing peoples' rights.

> Regular people don't really know who makes their specific medicine anyway

They do when it turns out to be a problem, like the Tylenol murders.

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

#532

Post by dudul »

stjohnswarts wrote: post #482

Why don't they allow insurance companies to operate in all states so people can shop around more? Currently they have regional rackets.

This would be a good move, but don't most people get insurance through their employer? To me that would really be the thing to break asap. Can people really shop around? It's either getting an expensive insurance on your own or a much cheaper one via employment but extremely limited choice.

The main barrier to getting rid of insurance via employment seems to be the very high cost of premiums. Employers are able to get much better deal for their employees than a single individual would be able to negotiate with a carrier. Maybe we would need an electroshock including banning employment based insurance and allowing carriers to operate anywhere. This would immediately kickoff the competition between carriers.

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

#533

Post by dudul »

GeneralMayhem wrote: post #277
jimbob45 wrote: post #246

Earlier quoted context omitted.

Obama dwarfed Trump’s number of EOs. Bush Jr. and Clinton were extremely high as well. This seems to be a response to congressional stonewalling (with varying outcomes). https://www.presidency.ucsb.edu/statistics/data/executive-or...

>Obama dwarfed Trump’s number of EOs. By your own source, this is so misleading as to be blatantly false. Trump issued 220 EOs in 4 years. Obama issued 276 in 8 years. I wouldn't call that "dwarfing" even looking at the raw numbers, and as a rate, Trump was the highest in history, nearly twice Obama. Of course, that's only relevant if you believe a priori that (a) EOs are a bad thing, and (b) that all EOs are created…

> Trump was the highest in history

Looks like Trump's average is lower than a lot of previous presidents'.

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

#534

Post by jfengel »

Notanothertoo wrote: post #145
annadane wrote: post #36

Earlier quoted context omitted.

No, this is Hacker News, where we have to gripe about every single little thing until it loses all fucking meaning Edit: you downvote me because you know this is exactly how it goes around here

Yes and that's a good thing. Politics is mostly a game of pretend and therefore bullshit, as uhh.. engineers we like to be more practical. We simply see the bullshit they are selling regardless of political affiliation. If they wanted to actually solve problems the approach and results would be totally different.

Politics is mostly a game of pretend and therefore bullshit, as uhh.. engineers we like to be more practical.

I've found that when engineers talk about politics, they're no more practical than anybody else. On HN I see a ton of uninformed and simplistic overbroad solutions. They imagine it's pragmatism, but they don't actually know any of the real problems.

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

#535

Post by pradn »

fallingknife wrote: post #270
koheripbal wrote: post #260

Earlier quoted context omitted.

Having a doctor verify that you're not having any issues with your prescription medication is pretty normal. Maybe you can find someone that'll do telehealth.

If I'm having issues I'll call the doctor. I don't need a babysitter.

I personally prefer a proactive doctor. Life gets busy and I don't always find time to get checkups and such. A small nudge from the doctor's office to get a checkup pays dividends. People with chronic conditions do need monitoring. It shouldn't be absurdly expensive.

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

#536

Post by VictorPath »

bryanrasmussen wrote: post #344
l33t2328 wrote: post #337

Earlier quoted context omitted.

Are you aware that the US government already spends far more on health care than it does on the military? Half the US defense budget is no where near the amount spent on healthcare in the private sector.

I wasn't, so I went and looked it up and you were right from what I found - Healthcare: The federal government spent nearly $1.2 trillion in fiscal year 2019. In addition, income tax expenditures for health care totaled $234 billion. https://www.taxpolicycenter.org/briefing-book/how-much-does-... Defense: Defense spending amounted to $714 billion in FY 2020—and is expected to increase to $733 billion in FY 2021. http…

> Defense spending amounted to $714 billion in FY 2020—and is expected to increase to $733 billion in FY 2021.

A soldier whose leg was blown up in Afghanistan and is still in a hospital - is not part of that $714-733 billion. So the US military budget is only that low if your definition of "defense" spending does not cover that.

The reality is the US spends over one trillion a year in military spending.

Your own link says as much. It puts "Veteran's medical care" under the health care entitlement side of the equation, as opposed to the military spending side of the equation.

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

#537

Post by long_time_gone »

giantg2 wrote: post #450
renewiltord wrote: post #282

Earlier quoted context omitted.

You find it hard to believe a thing that the AMA made an overt aim of. Fascinating. Well, I’m out of this conversation.

Then show me a source.

I showed you a source earlier in the thread and you didn't respond. It is the website of AMA, where they celebrate their success in lobbying against any bill that would allow other professionals expanded capabilities.

"For over 30 years, the AMA’s state and federal advocacy efforts have safeguarded the practice of medicine by opposing nurse practitioner (NP) and other nonphysician professional attempts to inappropriately expand their scope of practice."

Here it is again: https://www.ama-assn.org/practice-management/scope-practice/...

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

#538

Post by 1auralynn »

RomanAlexander wrote: post #343
legulere wrote: post #338

Earlier quoted context omitted.

Pharmaceutical companies spend even more on advertising than on R&D and still highly profitable though.

It could easily be the case that without the advertising spend they would not be profitable. Do you think these publicly traded companies are wasting tons of money on advertising? Where is the shareholder outrage?

I worked in pharma advertising for a little bit: There are two sides, consumer and clinical which I believe are about equal spends (might be wrong, but it's significant anyway). Clinical advertising is mostly used to recruit doctors to recruit patients to take part in clinicial trials, and is a necessary component of R&D. Think lots of tradeshows with fancy signage, interactive touchscreens, apps, etc.

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

#539

Post by Nasrudith »

koolba wrote: post #460
Cthulhu_ wrote: post #456

Earlier quoted context omitted.

That does not compute though. If prices are lowered, sales volumes will go up because people (and insurance companies) can afford it. I'm no economic, but we've seen time and time again that lowering prices boosts volume sold to the point where eventual profit is much higher. I mean the government can pitch in via subsidies for medicine R&D if it's really necessary, but honestly the pharma companies are swimming in m…

> I'm no economic, but we've seen time and time again that lowering prices boosts volume sold to the point where eventual profit is much higher. The current system has whoever can afford it pay the high price, whoever can afford less pay a lower price, and whoever can’t pay anything doesn’t pay anything. Lowering drug costs won’t change the number of people taking drugs. That already based on need. All that changes i…

Amusingly I would have expected the opposite in terms of what people find acceptable. Trying to charge say $200 for HIV medication to subsistence farmers in Sudan would be viewed as unconscionable.

In a period of unemployment I found that my medications basically operated on the afford less lower price - they gave coupons usable without insurance to far more reasonable prices. I can see clear brand promption and price discrimination here - they don't want to surrender market mindshare and brand name recognition by giving up the low end or their margins by cutting the cost across the board. So they give discounts that usually only the low end could or would take. Ironically such slightly sleazy behavior fits with one hypocratic oath vow to only charge what was within their ability to pay.

Or course "globally" probably means more charge other first world nations so it would be more "splitting the check among coworkers" than "demand the penniless man in the breadline pay a dollar". Still a position I expect to be US popular only.

As far as I can tell drug prices are driven by mainly one thing, realpolitik. Hepatitis C cures are targetted based upon organ transplant costs because that is the only alternative so it still helps but they make huge profits as say $75k drug treatments are still a big improvement over $150k of transplant costs. Unified blocs can twist arms to a certain degree, tiny blocs pay more for reasons beyond just spikey risk pools and meta-insurance, and companies will accept lower profits from some sales if it helps maintain higher profit sales.

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

#540

Post by passivate »

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…

For vaccines, most major countries want trials repeated with their local population before approving them.

Ironically, in the US, many/most(?) core-science phds and post-docs are immigrants who are used as "cheap labor". For double irony, they're often from countries that have price controls on pharma/biotech products.

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