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

mattstoller.substack.com

571–580 of 595 posts

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

#571

Earlier quoted context omitted.

"I don't see how the absence of licensure would prevent courts from issuing restrictions on individuals found guilty of criminal misconduct." That might cover fraud, but that doesn't cover incompetence or other harm. "The government requiring a conviction in court before restricting someone's right to free association is how it should be." That is one way to look at it, yet is is not how the legal system works today.…

>>That might cover fraud, but that doesn't cover incompetence or other harm. If someone acts non-fradulently, and honestly conveys their lack of experience, their lack of competency in carrying out the service is no one's fault than the consumer. >>The courts have determined that licensure is a lawful restriction on association. I'm arguing this legal framework, not saying that's how it currently is. >>It may have a…

"If someone acts non-fradulently, and honestly conveys their lack of experience, their lack of competency in carrying out the service is no one's fault than the consumer."

You're ignoring the part where it cannot be conveyed, like when people are mentally ill, incapacitated, etc.

"But the remaining ~92% of healthcare spending is made through non-time-sensitive decisions where an individual has plenty of to assess the market options."

Just because it's non-emergency does not mean the person is capable if choosing. You have people who are mentally ill and incapacitated who are treated in settings other than the ER. The highest spending happens at the end of life stage.

"I'm arguing this legal framework, not saying that's how it currently is."

Do you actually have more details for how that framework would work? So far all I'm hearing is that we should nor have licenses for medical professionals. How does that work with medical professionals powers to suspend drivers licenses, commit people, help in emergencies (good samaritan laws), etc. How does this affect malpractice insurance and torts, especially if you're saying that any incompetence can simply be stated by the provider to avoid court intervention? How would this system work in relation to controlled substances and expensive equiptment maintenance/procurement? How are the safety programs legally enforceable or logically possible without training? We already see that VEARS has terrible quality data. There are many adverse events that go unreported, especially by the lower trained PAs/NPs (my experiences).

"Just as people delegate this analysis to a cadre of politicians in the current monopolistic system, people would be able to delegate analysis to reputable experts in a free market."

You keep calling this a monopoly, but it is not a monopoly. There are numerous providers competing with each other. There's simply a training/licensure requirement. How are reputable experts foing to be any different than the current system? My guess is that they will create their own license system and force people through that too. Insurances, which cover the vast majority, will still require licenses to ensure that people aren't getting care that will be ineffective and cost them even more. This includes stuff like Medicare and Medicaid that the government controls.

Do you have a thesis paper or something that we can see? We really need more information about what exactly you are proposing beyond 'remove licenses, free market will work', how that will affect the numerous aspects of the system as well as it's integration with other systems, and what research there is to support it.

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

#572

Earlier quoted context omitted.

Europe does drug R&D and still manages to sell their drugs at a reasonable price to sick people (generally because their governments utilize their buying power for the good of their citizens). It seems to me that US people have been sold FUD by there own pharma companies, if I’m honest.

> Europe does drug R&D and still manages to sell their drugs at a reasonable price to sick people Most novel R&D, in America and Europe, happens in biotech. (“Big” pharma does trials, manufacturing scaling and distribution.) The investment thesis for most of this research does not work without the American market. This doesn’t mean high drug prices are a necessity. Just that the funding needs to be replaced if we wan…

Do you have a source for that? It's kinda hard to believe that America happily is paying the research for the world for so long without trump (or anyone) making a huge deal out of it.

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

#573
post #468
post #447

Earlier quoted context omitted.

I’m not an expert on the import/export side. When I used the term ‘pricing control’, I was referring to the systems that some countries (eg UK, Germany) have in place for determining the price they’ll pay for a drug based on (roughly) the value it brings to patients. (The best known of these is probably NICE in the UK; it’s not a perfect system, but it’s a pretty good attempt.) Other countries in turn ‘reference’ the…

Well, ok. But the reason it costs more in the US is because it is illegal to go to Germany, buy drugs, ship them to the US & sell them. If that was legal, someone would do it and make bank. And it is the US that is responsible for those laws.

I doubt that is legal anywhere tho. I for sure can't legally sell meds I imported from somewhere else.

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

#574

Earlier quoted context omitted.

Since this month - and it is headline news all over the country... It shouldn't be extraordinary that cheap drugs needed by millions are available cheaply. (See also: Epi Pens.)

Since 2000. >McInnis explained since 2000, Walmart has sold ReliOn insulin, the only private insulin brand on the market retailing at $24.88 per vial. https://www.wfmynews2.com/article/news/verify-yes-walmart-do... Walmart just started selling analog insulin(the newer formulation) just recently. https://nypost.com/2021/06/29/walmart-to-launch-its-own-low-...

Still 2 to 3 times as much as literally everywhere else.

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

#575
post #442
post #362

Earlier quoted context omitted.

This doesn't pass the smell test. Anyone making the decade-old version of insulin and selling it for 1% of the price would corner a large portion of the market immediately. Anyone without good health insurance, which is a large and increasing part of the population, would immediately jump on the lower priced version. And since when are insurance companies excited to pay for the more expensive drug with limited extra…

> Anyone without good health insurance, which is a large and increasing part of the population, would immediately jump on the lower priced version. Medicine isn't like a supermarket, people usually just take what their doctor/hospital prescribes. In addition, I think it's likely that those with no/worse health insurance are on average less informed.

I often talk about costs with doctors. Sometimes they offer things my health care does not (fully) cover, sometimes it's about pure luxury (like a arm bandage that is super nice to wear). Or my dentist, I can choose between different pain killers, one of them costs a little extra but goes away way faster.

I would think it's weird if my doc assumes I just want the cheapest available option.

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

#576

Earlier quoted context omitted.

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…

Then why is every covid vaccine ouside the US, if other countries are "free-riding" the US R&D?

Is that a thing? Any source on that?

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

#577
post #291
post #272

Earlier quoted context omitted.

Are you kidding? https://www.rand.org/news/press/2021/01/28.html > Prescription Drug Prices in the United States Are 2.56 Times Those in Other Countries

So are the nannies and the landscapers. Are these also a racket?

You never been to Switzerland I guess. Cheap meds and WAY MORE expensive manual labor.

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

#578
post #444
post #440

Earlier quoted context omitted.

In the context of this discussion, ‘Europe’ doesn’t do ‘R&D’. Biotech/Pharma are international. Irrespective of the home location of the organisation, virtually every drug trial from phase I onwards will be run in multiple countries. Further, virtually every drug found to work and filed with regulators for a license, will be filed internationally: Europe (EMA), US (FDA), and a whole host of smaller independent countr…

> Drugs are more expensive in the US simply because there aren’t any pricing controls... There aren't any other markets where "pricing controls" are needed. Drugs are more expensive in the US simply because it is illegal for a 3rd party to sell them. If it were legal, anyone could buy the drugs where they are cheapest and ship them to America. The problem is obviously that competition is banned. If that isn't the pro…

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

#579
post #459

Earlier quoted context omitted.

But to be fair, the US pharma sector spends roughly as much on marketing as it does on R&D. And a huge chunk of that R&D budget goes into analogue drugs to either sidestep patents from rivals or maintain profit margins when their own patents expire (they can then use that huge marketing budget to get the newly patented drug to take over for the old one with the nearly-expired patent, despite small or non-existent ben…

> But to be fair, the US pharma sector spends roughly as much on marketing as it does on R&D. Spending money on marketing lowers prices by increasing volumes. If you spend a billion dollars on R&D and then spend nothing on marketing and sell to 200,000 customers, they would each have to pay $5000 to fund the R&D. If you spend a billion dollars on R&D and two billion dollars on marketing and sell to a million customer…

> Spending money on marketing lowers prices by increasing volumes.

Do you have any proof of this - had you said it increases profits - I'd have readily agreed with you.

> If you spend a billion dollars on R&D and then spend nothing on marketing and sell to 200,000 customers, they would each have to pay $5000 to fund the R&D. If you spend a billion dollars on R&D and two billion dollars on marketing and sell to a million customers, they would each have to pay $3000 to fund both the R&D and the marketing.

Or, in line with their "fiduciary duty to shareholders", the company still sells at $5000 to a million customers: see Martin Shkreli, Epipens, or dozens of other real-life examples that prove your lower-price hypothesis wrong. Without competition, drug manufacturers have no incentive to lower prices when they can make more profits instead.

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

#580

"Big Pharma" in the eyes of the public is two related but separate issues; 1) the weird employment-insurance-hospital loop that has developed in the US, and the terrible second-order-consequences of all the open-high/settle-low insurer carer system it led to, and 2) the medicine advertisements, and all the terrible consequences thereof. The second one seems like a much easier thing to get rid of using hard government…

Why not just decouple health insurance from employment?
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