I think the crux of our disagreement is that you think what I am saying is that “pharma companies are not critical” when what I’m actually saying is that “pharma reps (i.e. the kind that visit docs and try to persuade them to use their drug) are not critical”.
Thanks that’s helpful because I’ve been trying to respond to everyone rapid fire on my phone and haven’t made time to differentiate who’s saying what to me but I should have been doing that.
I don’t have a strong opinion on the need for sales reps. I do believe the industry needs something like what we have today with medical science liaisons and some model for launching a product. Publishing the data and expecting prescriptions to follow doesn’t work. And companies are trying to drive uptake quickly partly because they have a limited time window of exclusivity and need to maximize that.
I’m going to sign off for the night but will try to slow down and respond to other posts tomorrow with a little more thought to who I’m responding to.
I’m imagining your #1 vs something like the inequality we have now in the US combined with how we think it would evolve under late-stage capitalism. I’m not convinced #1 wins in a vote of the American people.
#2 is different from what we have now. First of all, in our reality, nowhere near 99% of people have easy, cheap access. Secondly, in our reality, the people with good insurance will get access to the better treatments first, but eventually those trickle down to everyone else, at which time, invariably, even better stuff is developed. In #2, the 99% are frozen at 2024 forever, which would be terrible, except that this feature is the same as #1.
I wanted the comparison to be between the status quo marching through time vs a world where we stop medical advances and instead make the best of what we can do now available to everyone.
Why wouldn’t one of the acceptance criteria for drug research by the government be profit? Where capitalism runs into its worst problems is when it ONLY thinks about profit.
The problem with that is the wonder drugs turn out to be boner pills or oxycontin which are given away like skittles while drugs for actual problems like Tuberculosis are so expensive it is still one of the deadliest diseases in the world despite being fairly easy to cure.
To answer that I would need you to explain who the government would sell to, how that market would find an equilibrium price, and how things would work across borders. I don’t really get how profit would work because there’s a general concept of government developing drugs but no details whereas we can go into as much detail we want about the status quo and nitpick.
Are you talking about a regime where we still have private payers (e.g. Aetna) but government as single supplier of new medicines? What about foreign Pharma companies, would government compete with them, not allow them at all, or not respect their intellectual property? Would the government give the medicine for free domestically but then market it internationally? Would they charge the same price to say France and Afghanistan? Would the government share profit with employees to prevent brain drain or only pay high salaries?
I don’t see what insurance companies bring to health care other than higher prices and worse services, I’d love to get rid of them, but realize that’s not practical. I don’t see why we would do anything different with foreign Pharma companies. I think we could figure out a way for the government to manufacture pharmaceuticals without prioritizing popular drugs over necessary drugs.
Probably more practically, what I’d like to see is a government body that gives tax incentives to pharma companies to do research in directions the government body wants. Likewise, I’d like to see price fixing of life saving drugs capping at some % profit, like 15% or 20%, in exchange extend the patent on those drugs a few years to the pharma companies can extend the profit life of the drug.
I think defining profit for a single drug would be impossible due to Hollywood type accounting and lack of global standards. Additionally capping the profits of life saving drugs but not capping profits of other medicine would probably create a market distortion which has the opposite effect. Pharma would direct resources towards medications that aren’t life savings where they can get higher margins. And it’s hard to define what life saving truly means. I have 2 uncles and my grandfather on my mom’s side who died of heart attacks before age 50. Is my cholesterol medicine life saving? I could probably live a lot longer than that on just a statin, and could maybe live another 10-15 years without any medicine, but it is certainly improving my chances at a longer life. Same with these miracle weight loss drugs. Is that really life saving? Certainly in the actuarial sense, but hard to say an particular patient would die without it.
But yeah I agree in principle that government should ensure patient access to life saving medication (or other medical treatment) is not restricted due to financial situation, whether that’s through Medicaid, stricter regulation round patient support programs, single payer negotiations, limits to patent protection or whatever. Ideally there would also be increased incentives to develop life saving medications, or the government developing them for diseases that are not economically feasible for private industry (e.g. really rare diseases with really small patient populations)
I’m still confused as to why you all think private researchers are magically better than public researchers just because their money comes from a company instead of the government, or why there needs to be some complex technocratic solution rather than the obvious.
I’m guessing but nvidia is selling way more stuff to AI than to crypto currently, huge difference. Crypto miners have a head start but there is probably 2 or maybe 3 orders of magnitude more investment in AI than crypto right now.
I tried looking it up and it’s not really easy to find, but I think crypto is still relatively far ahead of AI in power consumption, but yeah, AI is growing way way faster. AI will use more in just a couple years if it’s behind at the moment.
A functioning global government powerful enough to control huge corporations and investors and somehow still not controlled by them and also completely preventing military development and research?
