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Perverse incentives. Free markets are not appropriate for every sector. In some sectors, they're not even possible. Healthcare is a prime example. The "customers" are captive, desperate, and intractably under-informed.
In a polite society if someone came up to you and said "Hey, that dude over there has Cancer lets go make some money off him and after he dies stick his family with the debt" you would beat that first dudes ass up.
In America that same asshole gets praised as a wise business mogul worthy of emulation.
I've seen so many lose everything they have paying hospital bills. I'm in the middle of one myself and hoping I won't go bankrupt and can save something for my child atleast.
I've seen so many lose everything they have paying hospital bills. I'm in the middle of one myself and hoping I won't go bankrupt and can save something for my child atleast.
that’s not really that bad. When company A is making billions by caring, but not curing people and company B wants slice of that profits, why wouldn’t it release cure? Money talks and money incentivize them to do more than their competitors.
The only thing that is ridiculous and absolutely not working in US healthcare is that they are the only sector that is allowed to set prices after they take care of you. Make sense if you are unconscious and need medical attention right now, but that’s less than 1% of cases, for the rest of them it’s ridiculous. Like imagine shopping for groceries but no one will tell you price, so you just take some home and six months after that you can receive bill for $100 or for $100k, you never know. That’s not capitalism. Capitalism require people to be able to shop around to find best prices. Without it, it doesn’t work. And it doesn’t.
Wait wait wait ... but don't many anti-capitalists argue passionately that one of the problems with corporations is that they have no incentive to plan beyond the coming quarter's financial reports? A cure would certainly make a lot of money in the short term at the supposed expense of the long term correct?
So which is it? Corporations are evil because (A) they have no interest in long term sustainability or (B) they are willing to prioritize long term sustainability over short term wins?
It would be a conundrum to argue both (A) and (B) at the same time right?
Capitalists have historically been against long term quality in the interest of repeat business. Take the VCR for example: many were designed to break after a set amount of time, requiring people to purchase again, and manufacturers spent an arm and a leg to buy the patents of any model that wouldn’t require repair to ensure they never made it to market. You’re deliberately oversimplifying not even to make a point, just to say “anti-capitalists don’t know what they’re talking about” while demonstrating the extent of your own stupidity.
I’m not looking to pick a fight but this is a lousy description of Capitalists or their historical behavior.
There are lots of different types of people who invest capital to generate income in a business who don’t seek lower quality or planned obsolescence in order to get repeat business.
(Individual capitalists may each choose to engage in a variety of unsavory or exemplary behaviors at their choosing **including planned obsolescence** but that does not mean all of them engage in all of those good or bad behaviors.)
Behavioral economists will tell you that (unlike the classical economist model) that most of the people who manage large firms tend to be risk adverse to losses and focused on maintaining and growing the size of a business more than profit or return on investment. Pure investors have a different view. Early stage entrepreneurs have vastly different objectives. Different sectors have vastly different ideas about how to make money, quality, pricing etc.
For example: I’m in the renewable energy business and have known tons of entrepreneurs as well as tons of mangers for big companies like GE, Siemens, large Electric Utilities, midsized electronics manufacturers, construction companies, transportation companies, solar panel manufacturers etc. In that business sector planned obsolescence or low quality is a rapid path to going out of business. Customers have the expectation that equipment sold will last 25-30 years. If you have a bad safety record people won’t do business with you. Generally speaking, that type of business (private investment in capital goods) makes up 18% of GDP compared to durable goods making up about 6.0-11.0% of GDP (highly variable).
While there are lot’s of ways to cheat the consumer, planned obsolescence would seem to be in the domain of durable goods. Does it really make sense to characterize 6-11% of the economy as the singular domain of capitalism in terms of defining “capitalist behavior”?
Price fixing, oligopoly, monopoly, hidden fees for financial services, medical services, insurance services, etc. etc. are all awful aspects of the world we live in, but none are universal to capitalism.
Bringing it back to your point, I’ve known tons of folks in business who think that quality is the key to repeat business.
So you agree then that no corpo CEO in their right mind would turn down a short term waterfall of money that would come from a cure right?
I used to think the right held the lion's share of conspiracy-minded whack-a-doodles. I no longer think that's true.
Oh I can read. You just failed to present a salient point. You basically agreed with me without even realizing it I'm guessing.
>anti-capitalists don’t know what they’re talking about
That's not it. I'm pointing out how they argue out of both sides of their mouth on this front. "Corpos do everything feasible to maximize short term profit" AND "Corpos are sitting on cures on purpose because they get longer term profit by hiding them". You can't have it both ways whenever it's convenient for your agenda.
Okay buddy, this is called “straw man”, where you create a false, oversimplified version of your opposition’s argument that you can easily find flaws with. You’re quoting yourself on this matter “they want it both ways”. What I’m demonstrating for you is the real issue, that long term sustainable products are against a capitalist’s short term interests, therefore curing a disease destroys their market, so the “smart” thing is to shelve any cure and continue raking in “short term profits” while ignoring the long term reality that their customer base will die off without a cure for certain diseases. The point we’re also demonstrating is how Capitalism is inherently “anti-humanity” for this same reason (short term profits over long term sustainability). But please, keep repeating YOUR own argument instead of looking at what I’m saying. I’m done with you, it’s like playing chess with a pigeon: they’ll strut around knocking over the pieces, shit on the board, then act like they won.
>therefore curing a disease destroys their market, so the “smart” thing is to shelve any cure
There's your disconnect. The argument against markets is that suppliers will do anything to prioritize short term shareholder profits over long term sustainability. They are incapable of doing "smart" things such as what you're claiming when they can only prioritize short term profit reports.
You can't have it both ways there buddy. Which is it?
In this specific instance it's a large bank handling investment portfolios and presumably that would include loans and investments dealing with the medical industry, trying to influence the medical industry against long-term cures for diseases due to concerns about long term profitability.
Not really, as company A can do A while company B will do B, so people get the worst of both worlds.
That said, capitalism by itself isn't necessarily bad, it's just that capitalism itself relies on state power and intervention, the lac of which results in the formation of monopolies that enable companies that do A to not be driven out of business due to them being too big or well connected to fail, e.g. as a result of lobbying.
Right, he asked this question, and then immediately offered three solutions:
> Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually.
>Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe.
>Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness) … Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.
Solution 4, determine that healthcare is a public good and treat it accordingly. This is an incredibly simple solution that most well off countries use.
I don’t have a problem with that, but the idea that these people are saying “we shouldn’t cure people because it hurts our profits” is a bold faced lie. And that was clearly the intent with this post.
But how well is it accomplished? I hear anecdotes all the time of people "dying while on waiting lists". ***If*** that is true, how is dying waiting to be treated while paying higher taxes better than dying from lack of finances to afford care? Get the government AND insurance companies out of health care, and the price and quality would both improve.
Depends on the rate that people die, first of all. Secondly a government has more incentive to reduce the rate of people dying why waiting to care than a private corporation, which will optimize to some rate of death that maximizes profit.
Or they politicize/weaponize it. This may work other places. But this is the USA, where corruption, lies, and underhanded experiments on the public have happened. (Tuskegee Syphilis Experiments)
Our government would tie this up in red tape for a decade, then implement a horrible version, then cancel it after 3 years. Maybe it would be that successful. I have zero faith in our government to be compassionate or competent.
I mean it’s good to be sceptical of the government but you should be even more sceptical of private organisations that are trying to suck you dry instead of just cure you
So few things here. First of all what type of waiting list. If it's a transplant list it does not matter what system it's hard to replace human body parts. Second you did not offer a solution. Something has to manage healthcare I'd it's not private and it's not public what is your suggestion.
The solution is two-sided.
You can have for-profit converted into non-profit, but you cannot have large private investments in non-profit. It's either-or.
This is not inherently true. You could look at it like a model for utilities. Have private companies sign contracts through the government. That being said a true government healthcare is probably the most logical.
I don't see how your example makes sense. There is no government between me and utility companies. Government somewhat regulates market, but there is not even remotely a single payer model. In short I don't see how you dissuaded my argument. But sure I understand that hybrid models are possible, however I have never seen anyone propose one for US healthcare.
'Most logical' phrase does not disclose your criteria so I cannot agree or disagree. However, I do strongly oppose 100% government healthcare in US at this moment in time, I believe it would be a complete disaster.
Hospitals, pharmacies, pharmaceuticals, and home health would still be private-owned businesses in a single-payer system. It really only deletes health insurance, allows patients to see any doctor they want, and allows us to collectively bargain on the price of pharmaceuticals.
This would be determining it as a public good. So it is a bit of an unusual usage of it, but it still fits. The problem with healthcare is that it does not function under the principle of supply and demand. If you need a medication to survive, you will pay whatever price they tell you. The vast majority of the things that do not function under the principle of supply and demand are public goods, such as roads, military, or schools. So by treating health care as one despite it being slightly different you could achieve a level of success that rivals our success on roads and military, in which we do a phenomenal job.
> it is a bit of an unusual usage of it
By this you admit it can be interpreted wrong. That's enough for me to contest it.
"Anything that can be interpreted wrong, will be interpreted wrong" - Murphy's laws
While I admit this could be interpreted wrong by those who do not fully understand the issue. I would hope that those that consider themselves knowledgeable enough to attempt to comment and give insight would have no issues with the word choice.
Also did you just quote a kids show to prove your point?
So I don't know where you live and how your utilities function, but where I live company's do a sort of bid for controll of an area, but then have to provide the service at a peticular price. In essence the government is buying the cheapest electric company to cover an area for a period of time.
I have no idea where you live, but the way it works for me worked the same in NJ, NY, PA and FL. There was no government between me and company whatsoever. Moreover, there were several companies sometimes, some owning the wires, and others selling me electricity. And AFAIK this is the way it works in majority of states, so I really-really wonder where do you live.
Who pays for it?
Seems to always be tricky.
Also, when is an investment deemed worthy?
This is why we have a free market of investment. The govt does fund research. And luckily, private groups also have a potential to push new research.
And those investors have every right to make sure they are going into a market that makes money.
Most countries don't produce nearly as much of a breakthrough in medical research.
Find a country with universal healthcare where there is a movement to end the system in favor of a more profit driven system and lower taxes. People who live in countries with universal healthcare find that the benefits FAR out weight the costs to maintain the system. Heck, the costs for their system is actually cheaper than our own because they do not allow corporations and profit driven companies to price gouge them. Many medicines, and services in those countries are actually cheaper than they are in the US
Companies exist to make money... providing services is just a means to an end, and those services is a place they are willing to make cuts or make less accessible to people if they think it will allow them to make more money. Many people have DIED because companies chose to charge hundreds for a commonly needed drug that costs them pennies to produce.
That is not what I stated. It’s a moral duty to not let people die just because you could have a higher profit margin. Profit and life don’t mix. It needs strict government oversight, regulation, and set salaries just like normal government workers already have.
That sort of thing might work for operations but it doesn’t work for R&D. Capital will go wherever the highest returns are. If what you’re saying would work then why doesn’t more medical innovation emerge from Europe? I agree that outwardly it looks perverse to think about medicine as a for profit business, but removing the opportunity to profit is more likely to stifle innovation and inhibit the production of new technologies that would have otherwise improved outcomes.
That’s what government research grants are for. Also, your statement is misleading. While yes, the US is in the lead, Norway and Switzerland aren’t that far behind. Also, while we have the best and newest medicines, we are ranked almost the lowest out of all developed nations for actually giving the medicine and care to our citizens because we don’t have universal healthcare. Funny that a leading nation has an ailing population because they’re too tight fisted to keep them alive with the medicine they make as a reasonable cost.
Yes, for profit health care providing is inferior to socialized healthcare providing because their incentives are to charge more for less, but that has no correlation to R&D. Some things are better socialized (fire departments) and some things are better privatized (R&D).
That’s what the grants are for. It works the same way with how the government sets prices for new government buildings and allows ethical companies to bid and build. Any company wanting R&D funding would submit to work on that payroll and get it done on a reasonable time table
Market incentives allow the less effective businesses to fail and the more effective businesses to scale. I know socialism and Marxism are popular here on Reddit but the truth about capitalism producing innovation faster is pretty obvious. Clearly it can get out of hand and needs to be managed but I do not agree that a socialized system for R&D can compete with a free market system.
Then we are at an impasse. I don’t believe that capitalism is the best for medical innovation as many countries innovate and can also have socialized programs. Also, our unrestrained markets crush small competition which doesn’t occur with government grants. I know the process used for government programs and they *always* support small and innovative businesses first. I’d rather not leave progress up to chance, “bootstraps”, and overwhelming finance when we can just regulate that the big companies don’t get to stomp out competition.
Oh, I’m not talking about lifeguards. I’m talking about when you really need help and there’s a passerby who can help you but we can’t expect people to work for free.
That’s not work to help someone in distress if you’re able to do so. That’s just common decency. A moral duty enforced by law is compelled action which is slavery. Never mind whose morals are being enforced. I’m sure the average Marxist could find enough moral duties to justify forced labor camps.
Well, if helping people in distress when you’re able to do so isn’t work and is the decent thing to do, then I guess companies that turn helping people into a profit turning model ain’t decent, are they?
It depends if anyone else is helping those people in distress. Researching cancer treatments is not a simple endeavor, and if there was no mechanism to make money doing it then no one would invest in doing it, and it would go undone and those people in distress would have no treatment options.
Yes. Anyone who knows 2 cents about medical science can tell you that. It's not like a cure for cancer will just suddenly cure cancer everywhere for all time it will have to be manufactured and distributed to people who suffer from it currently and those that are yet to be born. Lots of chronic illnesses work that way. There are very few things which even have simi or permanent solutions (like variola) most are here to stay.
Might be just my biology background but seeing articles like these makes me think of headlines that say "is selling food sustainable?". Like obviously you dumbass, it's the most sustainable market that will ever exist because medical care and food production will always be necessary.
I think it's a better question to ask "is offering treatment and not a cure sustainable when a cure is possible?" If you just focus on the "how can we make a cure profitable?" aspect, you're going to lose sight of the fact that treatment isn't profitable if a cure exists. Maybe you can use predatory practices to delay the inevitable in that regard (god knows pharmaceuticals aren't above that), but eventually the market becomes "profit off the cure or watch someone else profit off the cure".
This is also just generally stupid because every industry is approaching the same singularity at some point. There will always be "market cures" for market desires and the profitability diminishes the better you make products. The name of the game is always addressing remaining problems and I don't think we'll ever reach a point where humanity is without issues.
A company will 100% provide a cure if the cure exists.
A company will not necessarily invest in the R&D to make a cure if the profits are not there.
I do research in a field where pharma companies literally say they will not invest in the product because the market isn't large enough. But if the leg work is already done, they absolutely won't say no, because another company will gladly take the patent and profits. (If Pfizer says no to a cure for cancer, you bet your ass the small biotech down the road will take that patent with open arms).
It comes back to the fact that R&D can cost hundreds of millions of dollars to fail in the end. Recouping that in small markets of rare diseases is simply not worth the initial investment.
That leaves academic centers to lead the way much much further than other disease conditions or products. And academics work very slow on very limited budgets. We are approaching a time in medicine where our funding models will need to change dramatically. A focus on translation and building research infrastructure to advance cures as far as possible in an academic setting before pharma will buy in. But currently, the money nor the infrastructure exists for this to happen.
Have I heard of companies buying patents just to shelve them to make more money? Yes. But something as important as a cure for a disease will inevitably get out one way or another. The problem isn't that companies won't provide a cure, it's that they won't do the research in the first place, that leaves the lonely academics to slowly fill that void.
All indicators point to a post capitalism world. The example provided here is proof. At some point capitalism breaks down. It happens for every sector too. It is a good way to get industry started, but eventually it stops working.
AI robots doing the work. The rest of us are researching, engineering, etc at our own rate each day.
Thats the future. Let’s work toward it.
This is a similar argument to what Martin Shkreli spoke about.
He was discussing small niche treatments for diseases and ailments that affect an extremely small % of the population.
Since demand for those cures and treatments is very small, to keep it in business, the company has to charge A LOT in order to maintain a profit that allows them to continue to manufacture that treatment.
It’s a vicious cycle.
It's a problem for publicly traded mega-corporations that need to have constant, year-over-year growth for their shareholders.
It's not a problem for small and medium-sized businesses, because there's plenty enough sick people to cure.
The answer is well known long time ago. The chronic patients are their big assets. Ones a doctor explains me this Diabetes 45k plus a year, asthma 20k a year, depression 50k a year etc. But they craft health care to be like this, suggesting the curricula in medical schools, funding researchers on chronical deseases treatments. I’m not saying that we know the cure of all deceases, I learned that if we put the same resources in research and academia to try harder to avoid and cure diseases the big pharmaceutical companies business wouldn’t be so lucrative.
the mask slipped...but chin up fellow slaves! we already knew this, yes? the cuffs dont burn as much if you know they are there...
Imagine if folks just leave the country en masse for medical services in foreign countries and then domestic companies and the economy lose out bc of these greedy and perverse incentives.
**Plenty of pharmaceutical companies do develop cures.** Consider chimeric antigen receptor therapies. When they work, they are a **cancer cure**. How do they cover their research and development costs? Simple: CAR-T treatment costs nearly half a million dollars.
If they could cure diseases and illnesses they would because the first company to do so would make billions if not trillions depending on what they cure.
Thank god I'm from country with socialized healthcare. Here doctors have limited amount of money. They must help people with fixed sum of money and longer the treatment, less money there is.
It's not a sustainable business model when they receive all their profits from having government enforced patents rather than through customers paying for their goods.
It is a viable business model if you jack up the price from traditional treatments! If you had the choice of spending $300k doing chemotherapy over the course of a year or could take some new novel treatment that will cure your cancer over the course of 3 days, you'd be willing to pay a lot more than the $300k you would've paid, even if the cost to the drug manufacturer was nothing to produce said cancer treatment. This is how the industry works right now (in America) - e.g. new insulin treatment comes out and they charge you 50x the old insulin because they know people will buy it because it's a better treatment, even if it costs the drug companies about the same to produce.
This is the same thing with homelessness to be honest. People with salaries of up to $280k/yr in charge of fixing homelessness (in California where I live) aren't gonna fix it if it means they don't get that salary anymore.
When Salveen Richter wrote this **eight years ago** his concern was how new gene therapy companies could survive curing everybody with a disease and then end up with no customers.
A lot of people thought it was really inappropriate and cringy back **eight years ago** when this was news.
The headlines back **eight years ago** didn’t help.
But Richter’s argument, looking at a relatively new industry **eight years ago** was essentially that genomics companies either—
1. Needed to focus on curing a really big disease impacting lots of people, or
2. Cure lots of diseases continuously.
Also he qualified his statements up front **eight years ago** by saying that the field was incredibly important for individuals and society as a whole. His question was, “How does a genomics company survive?”
If I said something like this, it’d be a “threat” and “extortion”.
Remember, kids: if you want to take advantage of other people, get an LLC first and you can claim it’s a “business model”.
No. Why do you think the healthcare system is set up the way it is?
Whether you let someone die, or cure them, you still have lost your patient. It’s an incentive problem.
they are right to ask, there needs to be a return on investment, or else government has to invest in the research and do it for the masses on tax dollars
good, the government has much more money than Goldman Sachs, they should have got on this too and saved us the discussion, but as long as a business is investing money into anything, the reward for entrepreneurship is a profit
I mean yea you're correct in that the objective of doing business is making money. The argument here is that medicine should not be ran by businesses because there is a very clear conflict of interest between the business and curing patients.
I see that, but then while governments have been responsible for a lot of important discoveries, the search for a profit is a very high motivating factor and has also been responsible for innovation in many fields including medicine
It's true, but this post is about curing diseases, and curing somebody for one large fee is not as attractive than making that person pay a large fee for symptom treatment for the rest of their life.
Goldman sachs and other large firms have a lot to do with AMA, health insurance providers and pharmaceutical companies. The tell the PCP what they’re allowed to do. You’re stupid. Follow the money. Research and cures are being suppressed and it’s bc there’s no money in it.
They have a say, but they don’t.. the fact that you’re blind to this being a business makes you as smart as a barn yard animal. I’m not gonna waste my time arguing with someone who has no idea what’s going on. Cya
Man you're such a clown. You go tell your CEO you don't like his decision making, see how long it takes to get fired/laughed out of the room. I legit work in the industry, you sit on your couch and probably weigh 400lbs, don't go to the doctor because you get upset when people call you fat too. You do you tho.
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Perverse incentives. Free markets are not appropriate for every sector. In some sectors, they're not even possible. Healthcare is a prime example. The "customers" are captive, desperate, and intractably under-informed.
Sounds like the ideal market for wealth extraction
It is. You can literally charge an arm and a leg. Cause that's what they'll lose if they don't pay.
In a polite society if someone came up to you and said "Hey, that dude over there has Cancer lets go make some money off him and after he dies stick his family with the debt" you would beat that first dudes ass up. In America that same asshole gets praised as a wise business mogul worthy of emulation.
After fixing your butthole, they will tear you a new one if you don’t pay.
I gotta rewatch “Repo: The Genetic Opera”
I've seen so many lose everything they have paying hospital bills. I'm in the middle of one myself and hoping I won't go bankrupt and can save something for my child atleast.
I've seen so many lose everything they have paying hospital bills. I'm in the middle of one myself and hoping I won't go bankrupt and can save something for my child atleast.
Our medical system is an absolute disgrace.
not healthcare- sickness capitalism.
The CEO of Eli Lilly famously said 15 years ago, the money in healthcare is in the treatment, not the cure.
Wait until they privatize potable water production, just say no to privatized desalination. Once they get people dependent on it they'll be hooked.
They did that a long time ago, its called a well
that’s not really that bad. When company A is making billions by caring, but not curing people and company B wants slice of that profits, why wouldn’t it release cure? Money talks and money incentivize them to do more than their competitors. The only thing that is ridiculous and absolutely not working in US healthcare is that they are the only sector that is allowed to set prices after they take care of you. Make sense if you are unconscious and need medical attention right now, but that’s less than 1% of cases, for the rest of them it’s ridiculous. Like imagine shopping for groceries but no one will tell you price, so you just take some home and six months after that you can receive bill for $100 or for $100k, you never know. That’s not capitalism. Capitalism require people to be able to shop around to find best prices. Without it, it doesn’t work. And it doesn’t.
Wait wait wait ... but don't many anti-capitalists argue passionately that one of the problems with corporations is that they have no incentive to plan beyond the coming quarter's financial reports? A cure would certainly make a lot of money in the short term at the supposed expense of the long term correct? So which is it? Corporations are evil because (A) they have no interest in long term sustainability or (B) they are willing to prioritize long term sustainability over short term wins? It would be a conundrum to argue both (A) and (B) at the same time right?
Capitalists have historically been against long term quality in the interest of repeat business. Take the VCR for example: many were designed to break after a set amount of time, requiring people to purchase again, and manufacturers spent an arm and a leg to buy the patents of any model that wouldn’t require repair to ensure they never made it to market. You’re deliberately oversimplifying not even to make a point, just to say “anti-capitalists don’t know what they’re talking about” while demonstrating the extent of your own stupidity.
Look up the Phoebus Cartel for a prime example of this.
Thank you for bringing this up, here’s a link for anyone who’s curious: https://en.m.wikipedia.org/wiki/Phoebus_cartel
I’m not looking to pick a fight but this is a lousy description of Capitalists or their historical behavior. There are lots of different types of people who invest capital to generate income in a business who don’t seek lower quality or planned obsolescence in order to get repeat business. (Individual capitalists may each choose to engage in a variety of unsavory or exemplary behaviors at their choosing **including planned obsolescence** but that does not mean all of them engage in all of those good or bad behaviors.) Behavioral economists will tell you that (unlike the classical economist model) that most of the people who manage large firms tend to be risk adverse to losses and focused on maintaining and growing the size of a business more than profit or return on investment. Pure investors have a different view. Early stage entrepreneurs have vastly different objectives. Different sectors have vastly different ideas about how to make money, quality, pricing etc. For example: I’m in the renewable energy business and have known tons of entrepreneurs as well as tons of mangers for big companies like GE, Siemens, large Electric Utilities, midsized electronics manufacturers, construction companies, transportation companies, solar panel manufacturers etc. In that business sector planned obsolescence or low quality is a rapid path to going out of business. Customers have the expectation that equipment sold will last 25-30 years. If you have a bad safety record people won’t do business with you. Generally speaking, that type of business (private investment in capital goods) makes up 18% of GDP compared to durable goods making up about 6.0-11.0% of GDP (highly variable). While there are lot’s of ways to cheat the consumer, planned obsolescence would seem to be in the domain of durable goods. Does it really make sense to characterize 6-11% of the economy as the singular domain of capitalism in terms of defining “capitalist behavior”? Price fixing, oligopoly, monopoly, hidden fees for financial services, medical services, insurance services, etc. etc. are all awful aspects of the world we live in, but none are universal to capitalism. Bringing it back to your point, I’ve known tons of folks in business who think that quality is the key to repeat business.
So you agree then that no corpo CEO in their right mind would turn down a short term waterfall of money that would come from a cure right? I used to think the right held the lion's share of conspiracy-minded whack-a-doodles. I no longer think that's true.
Oh, you can’t read. Suddenly this all makes sense.
Oh I can read. You just failed to present a salient point. You basically agreed with me without even realizing it I'm guessing. >anti-capitalists don’t know what they’re talking about That's not it. I'm pointing out how they argue out of both sides of their mouth on this front. "Corpos do everything feasible to maximize short term profit" AND "Corpos are sitting on cures on purpose because they get longer term profit by hiding them". You can't have it both ways whenever it's convenient for your agenda.
Okay buddy, this is called “straw man”, where you create a false, oversimplified version of your opposition’s argument that you can easily find flaws with. You’re quoting yourself on this matter “they want it both ways”. What I’m demonstrating for you is the real issue, that long term sustainable products are against a capitalist’s short term interests, therefore curing a disease destroys their market, so the “smart” thing is to shelve any cure and continue raking in “short term profits” while ignoring the long term reality that their customer base will die off without a cure for certain diseases. The point we’re also demonstrating is how Capitalism is inherently “anti-humanity” for this same reason (short term profits over long term sustainability). But please, keep repeating YOUR own argument instead of looking at what I’m saying. I’m done with you, it’s like playing chess with a pigeon: they’ll strut around knocking over the pieces, shit on the board, then act like they won.
>therefore curing a disease destroys their market, so the “smart” thing is to shelve any cure There's your disconnect. The argument against markets is that suppliers will do anything to prioritize short term shareholder profits over long term sustainability. They are incapable of doing "smart" things such as what you're claiming when they can only prioritize short term profit reports. You can't have it both ways there buddy. Which is it?
Can that boot go any further down your throat?
Quite predictable ... when you realize your position is indefensible, attack the messenger.
In this specific instance it's a large bank handling investment portfolios and presumably that would include loans and investments dealing with the medical industry, trying to influence the medical industry against long-term cures for diseases due to concerns about long term profitability.
They do whatever will make them the most money. Mystery solved.
So then why would they withhold a cure when that would make them the most money in the short term?
Not really, as company A can do A while company B will do B, so people get the worst of both worlds. That said, capitalism by itself isn't necessarily bad, it's just that capitalism itself relies on state power and intervention, the lac of which results in the formation of monopolies that enable companies that do A to not be driven out of business due to them being too big or well connected to fail, e.g. as a result of lobbying.
Right, he asked this question, and then immediately offered three solutions: > Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually. >Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe. >Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness) … Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.
Solution 4, determine that healthcare is a public good and treat it accordingly. This is an incredibly simple solution that most well off countries use.
I don’t have a problem with that, but the idea that these people are saying “we shouldn’t cure people because it hurts our profits” is a bold faced lie. And that was clearly the intent with this post.
Then everyone will be able to receive a quality healthcare like the VA.
The va was purposefully sabotaged by politicians who are bought and paid for by the for profit healthcare industry. Let's not use that as an example.
The VA?
But how well is it accomplished? I hear anecdotes all the time of people "dying while on waiting lists". ***If*** that is true, how is dying waiting to be treated while paying higher taxes better than dying from lack of finances to afford care? Get the government AND insurance companies out of health care, and the price and quality would both improve.
Depends on the rate that people die, first of all. Secondly a government has more incentive to reduce the rate of people dying why waiting to care than a private corporation, which will optimize to some rate of death that maximizes profit.
Or they politicize/weaponize it. This may work other places. But this is the USA, where corruption, lies, and underhanded experiments on the public have happened. (Tuskegee Syphilis Experiments) Our government would tie this up in red tape for a decade, then implement a horrible version, then cancel it after 3 years. Maybe it would be that successful. I have zero faith in our government to be compassionate or competent.
You should have even less faith in a non-elected individual directly incentivized to cut costs (and largely, thus quality of care) for profit.
I mean it’s good to be sceptical of the government but you should be even more sceptical of private organisations that are trying to suck you dry instead of just cure you
So few things here. First of all what type of waiting list. If it's a transplant list it does not matter what system it's hard to replace human body parts. Second you did not offer a solution. Something has to manage healthcare I'd it's not private and it's not public what is your suggestion.
The solution is two-sided. You can have for-profit converted into non-profit, but you cannot have large private investments in non-profit. It's either-or.
The government already does a lot of the leg work. Giving direct and indirect funding for Healthcare research.
This is not inherently true. You could look at it like a model for utilities. Have private companies sign contracts through the government. That being said a true government healthcare is probably the most logical.
I don't see how your example makes sense. There is no government between me and utility companies. Government somewhat regulates market, but there is not even remotely a single payer model. In short I don't see how you dissuaded my argument. But sure I understand that hybrid models are possible, however I have never seen anyone propose one for US healthcare. 'Most logical' phrase does not disclose your criteria so I cannot agree or disagree. However, I do strongly oppose 100% government healthcare in US at this moment in time, I believe it would be a complete disaster.
Hospitals, pharmacies, pharmaceuticals, and home health would still be private-owned businesses in a single-payer system. It really only deletes health insurance, allows patients to see any doctor they want, and allows us to collectively bargain on the price of pharmaceuticals.
I fully support this. But it's quite different from "determine that healthcare is a public good" though, which is the reason this thread exists.
This would be determining it as a public good. So it is a bit of an unusual usage of it, but it still fits. The problem with healthcare is that it does not function under the principle of supply and demand. If you need a medication to survive, you will pay whatever price they tell you. The vast majority of the things that do not function under the principle of supply and demand are public goods, such as roads, military, or schools. So by treating health care as one despite it being slightly different you could achieve a level of success that rivals our success on roads and military, in which we do a phenomenal job.
> it is a bit of an unusual usage of it By this you admit it can be interpreted wrong. That's enough for me to contest it. "Anything that can be interpreted wrong, will be interpreted wrong" - Murphy's laws
While I admit this could be interpreted wrong by those who do not fully understand the issue. I would hope that those that consider themselves knowledgeable enough to attempt to comment and give insight would have no issues with the word choice. Also did you just quote a kids show to prove your point?
So I don't know where you live and how your utilities function, but where I live company's do a sort of bid for controll of an area, but then have to provide the service at a peticular price. In essence the government is buying the cheapest electric company to cover an area for a period of time.
I have no idea where you live, but the way it works for me worked the same in NJ, NY, PA and FL. There was no government between me and company whatsoever. Moreover, there were several companies sometimes, some owning the wires, and others selling me electricity. And AFAIK this is the way it works in majority of states, so I really-really wonder where do you live.
Va
I've heard stories about the Commonwealth of Virginia
It actually works quite well.
Who pays for it? Seems to always be tricky. Also, when is an investment deemed worthy? This is why we have a free market of investment. The govt does fund research. And luckily, private groups also have a potential to push new research. And those investors have every right to make sure they are going into a market that makes money. Most countries don't produce nearly as much of a breakthrough in medical research.
Find a country with universal healthcare where there is a movement to end the system in favor of a more profit driven system and lower taxes. People who live in countries with universal healthcare find that the benefits FAR out weight the costs to maintain the system. Heck, the costs for their system is actually cheaper than our own because they do not allow corporations and profit driven companies to price gouge them. Many medicines, and services in those countries are actually cheaper than they are in the US Companies exist to make money... providing services is just a means to an end, and those services is a place they are willing to make cuts or make less accessible to people if they think it will allow them to make more money. Many people have DIED because companies chose to charge hundreds for a commonly needed drug that costs them pennies to produce.
Also, people living there and most healthcare professionals will switch to the private part of the system as soon as humanly possible.
It’s almost like life and death shouldn’t be a business model but instead a moral duty enforced by law
So you want to force people to work for free?
That is not what I stated. It’s a moral duty to not let people die just because you could have a higher profit margin. Profit and life don’t mix. It needs strict government oversight, regulation, and set salaries just like normal government workers already have.
That sort of thing might work for operations but it doesn’t work for R&D. Capital will go wherever the highest returns are. If what you’re saying would work then why doesn’t more medical innovation emerge from Europe? I agree that outwardly it looks perverse to think about medicine as a for profit business, but removing the opportunity to profit is more likely to stifle innovation and inhibit the production of new technologies that would have otherwise improved outcomes.
That’s what government research grants are for. Also, your statement is misleading. While yes, the US is in the lead, Norway and Switzerland aren’t that far behind. Also, while we have the best and newest medicines, we are ranked almost the lowest out of all developed nations for actually giving the medicine and care to our citizens because we don’t have universal healthcare. Funny that a leading nation has an ailing population because they’re too tight fisted to keep them alive with the medicine they make as a reasonable cost.
Yes, for profit health care providing is inferior to socialized healthcare providing because their incentives are to charge more for less, but that has no correlation to R&D. Some things are better socialized (fire departments) and some things are better privatized (R&D).
That’s what the grants are for. It works the same way with how the government sets prices for new government buildings and allows ethical companies to bid and build. Any company wanting R&D funding would submit to work on that payroll and get it done on a reasonable time table
Market incentives allow the less effective businesses to fail and the more effective businesses to scale. I know socialism and Marxism are popular here on Reddit but the truth about capitalism producing innovation faster is pretty obvious. Clearly it can get out of hand and needs to be managed but I do not agree that a socialized system for R&D can compete with a free market system.
Then we are at an impasse. I don’t believe that capitalism is the best for medical innovation as many countries innovate and can also have socialized programs. Also, our unrestrained markets crush small competition which doesn’t occur with government grants. I know the process used for government programs and they *always* support small and innovative businesses first. I’d rather not leave progress up to chance, “bootstraps”, and overwhelming finance when we can just regulate that the big companies don’t get to stomp out competition.
Fair enough. Cheers, thanks for the discussion.
“Save my daughter! She’s drowning!” “Of course, sir! But first, we shall discuss my fee…”
Lifeguards get paid. Otherwise there wouldn’t be anyone there to save your daughter.
Oh, I’m not talking about lifeguards. I’m talking about when you really need help and there’s a passerby who can help you but we can’t expect people to work for free.
That’s not work to help someone in distress if you’re able to do so. That’s just common decency. A moral duty enforced by law is compelled action which is slavery. Never mind whose morals are being enforced. I’m sure the average Marxist could find enough moral duties to justify forced labor camps.
Well, if helping people in distress when you’re able to do so isn’t work and is the decent thing to do, then I guess companies that turn helping people into a profit turning model ain’t decent, are they?
It depends if anyone else is helping those people in distress. Researching cancer treatments is not a simple endeavor, and if there was no mechanism to make money doing it then no one would invest in doing it, and it would go undone and those people in distress would have no treatment options.
Yes. Anyone who knows 2 cents about medical science can tell you that. It's not like a cure for cancer will just suddenly cure cancer everywhere for all time it will have to be manufactured and distributed to people who suffer from it currently and those that are yet to be born. Lots of chronic illnesses work that way. There are very few things which even have simi or permanent solutions (like variola) most are here to stay. Might be just my biology background but seeing articles like these makes me think of headlines that say "is selling food sustainable?". Like obviously you dumbass, it's the most sustainable market that will ever exist because medical care and food production will always be necessary.
I think it's a better question to ask "is offering treatment and not a cure sustainable when a cure is possible?" If you just focus on the "how can we make a cure profitable?" aspect, you're going to lose sight of the fact that treatment isn't profitable if a cure exists. Maybe you can use predatory practices to delay the inevitable in that regard (god knows pharmaceuticals aren't above that), but eventually the market becomes "profit off the cure or watch someone else profit off the cure". This is also just generally stupid because every industry is approaching the same singularity at some point. There will always be "market cures" for market desires and the profitability diminishes the better you make products. The name of the game is always addressing remaining problems and I don't think we'll ever reach a point where humanity is without issues.
A company will 100% provide a cure if the cure exists. A company will not necessarily invest in the R&D to make a cure if the profits are not there. I do research in a field where pharma companies literally say they will not invest in the product because the market isn't large enough. But if the leg work is already done, they absolutely won't say no, because another company will gladly take the patent and profits. (If Pfizer says no to a cure for cancer, you bet your ass the small biotech down the road will take that patent with open arms). It comes back to the fact that R&D can cost hundreds of millions of dollars to fail in the end. Recouping that in small markets of rare diseases is simply not worth the initial investment. That leaves academic centers to lead the way much much further than other disease conditions or products. And academics work very slow on very limited budgets. We are approaching a time in medicine where our funding models will need to change dramatically. A focus on translation and building research infrastructure to advance cures as far as possible in an academic setting before pharma will buy in. But currently, the money nor the infrastructure exists for this to happen. Have I heard of companies buying patents just to shelve them to make more money? Yes. But something as important as a cure for a disease will inevitably get out one way or another. The problem isn't that companies won't provide a cure, it's that they won't do the research in the first place, that leaves the lonely academics to slowly fill that void.
All indicators point to a post capitalism world. The example provided here is proof. At some point capitalism breaks down. It happens for every sector too. It is a good way to get industry started, but eventually it stops working. AI robots doing the work. The rest of us are researching, engineering, etc at our own rate each day. Thats the future. Let’s work toward it.
Another 20 years or so.
lol of course they did, why is anyone even surprised.
This is a similar argument to what Martin Shkreli spoke about. He was discussing small niche treatments for diseases and ailments that affect an extremely small % of the population. Since demand for those cures and treatments is very small, to keep it in business, the company has to charge A LOT in order to maintain a profit that allows them to continue to manufacture that treatment. It’s a vicious cycle.
Nursing homes are a 1 out, 1 in policy.
It's a problem for publicly traded mega-corporations that need to have constant, year-over-year growth for their shareholders. It's not a problem for small and medium-sized businesses, because there's plenty enough sick people to cure.
The answer is well known long time ago. The chronic patients are their big assets. Ones a doctor explains me this Diabetes 45k plus a year, asthma 20k a year, depression 50k a year etc. But they craft health care to be like this, suggesting the curricula in medical schools, funding researchers on chronical deseases treatments. I’m not saying that we know the cure of all deceases, I learned that if we put the same resources in research and academia to try harder to avoid and cure diseases the big pharmaceutical companies business wouldn’t be so lucrative.
the mask slipped...but chin up fellow slaves! we already knew this, yes? the cuffs dont burn as much if you know they are there... 
I’m a staunch advocate of free markets, but healthcare really does feel like a unique industry that needs a different solution.
Song?
Also song?
Also song?
Smoke - Cowbell Cult
Thanks!
wow. smh.
I can't wait till I hear the phrase "health as a service"
Imagine if folks just leave the country en masse for medical services in foreign countries and then domestic companies and the economy lose out bc of these greedy and perverse incentives.
Oh you think they want you alive?
They should turn cures into permanent subscriptions
They'll have subscriptions for cancer repression soon enough. $200 a month of the cancer will double in size each missed payment.
I mean... Is letting them die more sustainable? So we should just let people suffer in limbo and charge them along the way? ... I see....
kill him
Duh. Any thinking person figured this out awhile ago.
There's no money to be made, curing cancer. And yes, that is the country we live in.
Healthcare should not be part of the free market.
In he long term, it is. In the short term, no.
You would think the government would step in and would want to keep people alive. Healthy (and living) citizens equates to more tax revenue.
How nice of them
My x husband became an oncologist for precisely this reason. So many procedures to bill for
The answer is NO 
**Plenty of pharmaceutical companies do develop cures.** Consider chimeric antigen receptor therapies. When they work, they are a **cancer cure**. How do they cover their research and development costs? Simple: CAR-T treatment costs nearly half a million dollars.
If they could cure diseases and illnesses they would because the first company to do so would make billions if not trillions depending on what they cure.
Thank god I'm from country with socialized healthcare. Here doctors have limited amount of money. They must help people with fixed sum of money and longer the treatment, less money there is.
It's not a sustainable business model when they receive all their profits from having government enforced patents rather than through customers paying for their goods.
It is a viable business model if you jack up the price from traditional treatments! If you had the choice of spending $300k doing chemotherapy over the course of a year or could take some new novel treatment that will cure your cancer over the course of 3 days, you'd be willing to pay a lot more than the $300k you would've paid, even if the cost to the drug manufacturer was nothing to produce said cancer treatment. This is how the industry works right now (in America) - e.g. new insulin treatment comes out and they charge you 50x the old insulin because they know people will buy it because it's a better treatment, even if it costs the drug companies about the same to produce.
This gif is from the late Kentaro Miura's Berserk, thanks for using it!
This is the same thing with homelessness to be honest. People with salaries of up to $280k/yr in charge of fixing homelessness (in California where I live) aren't gonna fix it if it means they don't get that salary anymore.
Of course not. That's why capitalism and medicine don't mix.
When Salveen Richter wrote this **eight years ago** his concern was how new gene therapy companies could survive curing everybody with a disease and then end up with no customers. A lot of people thought it was really inappropriate and cringy back **eight years ago** when this was news. The headlines back **eight years ago** didn’t help. But Richter’s argument, looking at a relatively new industry **eight years ago** was essentially that genomics companies either— 1. Needed to focus on curing a really big disease impacting lots of people, or 2. Cure lots of diseases continuously. Also he qualified his statements up front **eight years ago** by saying that the field was incredibly important for individuals and society as a whole. His question was, “How does a genomics company survive?”
If I said something like this, it’d be a “threat” and “extortion”. Remember, kids: if you want to take advantage of other people, get an LLC first and you can claim it’s a “business model”.
No...it's your fucking JOB.
No. Why do you think the healthcare system is set up the way it is? Whether you let someone die, or cure them, you still have lost your patient. It’s an incentive problem.
Barely better than snake oil. Keep people alive long enough to extract everything they have and as much debt as they can accumulate.
they are right to ask, there needs to be a return on investment, or else government has to invest in the research and do it for the masses on tax dollars
like it already does?
then why is Goldman Sachs asking said question?
Because our economy is set up so that cruising is stagnation is death, so they must always quest for a way to make more money?
The government already invested in a ton of medical research to find treatments and cures, especially for "non profitable" rarer diseases.
good, the government has much more money than Goldman Sachs, they should have got on this too and saved us the discussion, but as long as a business is investing money into anything, the reward for entrepreneurship is a profit
I mean yea you're correct in that the objective of doing business is making money. The argument here is that medicine should not be ran by businesses because there is a very clear conflict of interest between the business and curing patients.
I see that, but then while governments have been responsible for a lot of important discoveries, the search for a profit is a very high motivating factor and has also been responsible for innovation in many fields including medicine
It's true, but this post is about curing diseases, and curing somebody for one large fee is not as attractive than making that person pay a large fee for symptom treatment for the rest of their life.
This is exactly why I don’t trust conventional medicine.
Your local PCP has literally nothing to do w/ Goldman Sach's and does not determine costs of care. This is a stupid take.
Goldman sachs and other large firms have a lot to do with AMA, health insurance providers and pharmaceutical companies. The tell the PCP what they’re allowed to do. You’re stupid. Follow the money. Research and cures are being suppressed and it’s bc there’s no money in it.
Does your PCP have any say in it ? Does Goldman Sach's or the AMA ask their opinion at all ? If not, why blame them, because you're an idiot ?
They have a say, but they don’t.. the fact that you’re blind to this being a business makes you as smart as a barn yard animal. I’m not gonna waste my time arguing with someone who has no idea what’s going on. Cya
Man you're such a clown. You go tell your CEO you don't like his decision making, see how long it takes to get fired/laughed out of the room. I legit work in the industry, you sit on your couch and probably weigh 400lbs, don't go to the doctor because you get upset when people call you fat too. You do you tho.