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Dead Reckoning posted:Drug companies probably would have spent a lot of money fighting a ballot proposition to put their California offices to the torch and to throw their shareholders in the stocks so that the poor could pelt them with rotten fruit, but that wouldn't make voting for it out of spite a good idea. I would, though. I'd vote for it.
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Oct 28, 2016 09:28
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Dead Reckoning posted:Drug companies probably would have spent a lot of money fighting a ballot proposition to put their California offices to the torch and to throw their shareholders in the stocks so that the poor could pelt them with rotten fruit, but that wouldn't make voting for it out of spite a good idea. why would that be a bad thing?
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Oct 28, 2016 16:00
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Dead Reckoning posted:a ballot proposition to put their California offices to the torch and to throw their shareholders in the stocks so that the poor could pelt them with rotten fruit Where do I sign?
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Oct 28, 2016 16:42
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Xaris posted:The only thing that ultimately convinced me to vote yes is that drug companies have spent $$$$$$ well over documented 100 million and has probably much more in other ways too As someone who is voting no, my rationalization for the amount of money spent comes from the 100 million dollars being made up of many 1-10 million dollar donations from individual pharmaceutical companies. Most of the companies listed on Ballotpedia have net incomes near 5 billion dollars so setting aside 10 million in an attempt to offset the mess that this could cause is less than I would have expected. In my mind, this amount of money is more indicative of outcomes like a PR hit or multiple legal battles especially since this proposition passing and actually working the way its intended to could set a standard for other states to do the same thing.
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Oct 28, 2016 17:36
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Yeah I thought about that later, and it's true i'm surprised they didn't spend even more money, but at the least if it does cause other states to try their own thing (and hopefully much better than the garbage that is prop 61, because well, it is pretty drat bad and could borderline useless) then that's a good thing too and could lead to pressure at a federal level in a decade as more states try to get onboard, whereas failing would just go "well california can't even do it, why should we bother?"
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Oct 28, 2016 17:47
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Wouldn't it be nice if you could indicate right on your ballot, why you voted no on a measure? Like, there'd be a multiple choice sidebar:
It'd be nice if analysis of failed measures was more than just guesswork and spin.
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Oct 28, 2016 17:58
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Dead Reckoning posted:Drug companies probably would have spent a lot of money fighting a ballot proposition to put their California offices to the torch and to throw their shareholders in the stocks so that the poor could pelt them with rotten fruit, but that wouldn't make voting for it out of spite a good idea. While it's not the law I'd really want, I guess that would be a decent first step, until something more effective could be passed.
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Oct 28, 2016 19:00
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Dead Reckoning posted:Drug companies probably would have spent a lot of money fighting a ballot proposition to put their California offices to the torch and to throw their shareholders in the stocks so that the poor could pelt them with rotten fruit, but that wouldn't make voting for it out of spite a good idea. Honestly I'd rather vote for this than Prop. 61.
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Oct 28, 2016 21:12
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StandardVC10 posted:Honestly I'd rather vote for this than Prop. 61. i really fail to see the downside to that idea
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Oct 28, 2016 21:15
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Leperflesh posted:Wouldn't it be nice if you could indicate right on your ballot, why you voted no on a measure? Like, there'd be a multiple choice sidebar: Back when Russia was almost but not quite a democracy, there was an option on the presidential election forms that said something like: * Candidate A * Candidate B * The CCCP Candidate, because it's somehow still relevant, even today * None of the above I always wondered what would happen is none of the above won the most votes  .Prop 69 next year: None of the above on the governor's ballot.
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Oct 28, 2016 21:44
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A White Guy posted:Back when Russia was almost but not quite a democracy, there was an option on the presidential election forms that said something like: ballot measure numbers reset after this year
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Oct 28, 2016 21:46
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Instant Sunrise posted:i really fail to see the downside to that idea Medi-Cal not being able to buy drugs ever again would probably be bad. Thanks for the "durr, I'm so anticapitalist it hurts" take.
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Oct 28, 2016 22:01
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Well probably medicine shouldn't be sold with a profit margin, but obviously it would take decades to somehow privatize or create a government structure capable of developing drugs as rapidly as the private sector in the US does. So, yeah, literally burning down all the pharma companies would be cathartic but fantastically stupid and self-defeating. But I'm pretty sure everyone is aware of that and just joking as a way of expressing their anger towards companies that put profit ahead of human lives.
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Oct 28, 2016 22:07
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I would be more receptive to that if we didn't actually have people in this state/ITT voting for fantastically stupid and self-defeating things because it makes them feel better.
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Oct 28, 2016 22:18
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"None of the above" is something the Reddit morons were asking for the election this year so good job I guess.
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Oct 28, 2016 22:18
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Dead Reckoning posted:I would be more receptive to that if we didn't actually have people in this state/ITT voting for fantastically stupid and self-defeating things because it makes them feel better. But enough about people who vote the way I personally don't like.
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Oct 28, 2016 22:41
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Dead Reckoning posted:Drug companies probably would have spent a lot of money fighting a ballot proposition to put their California offices to the torch and to throw their shareholders in the stocks so that the poor could pelt them with rotten fruit, but that wouldn't make voting for it out of spite a good idea. Can we vote for this instead? I feel like it's much less ambiguous.
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Oct 28, 2016 22:44
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Some additional food for thought. I don't have a dog in this fight. https://theintercept.com/2016/10/28/lgbt-drug-price/
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Oct 28, 2016 23:22
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Leperflesh posted:Well probably medicine shouldn't be sold with a profit margin, but obviously it would take decades to somehow privatize or create a government structure capable of developing drugs as rapidly as the private sector in the US does. Megaman's Jockstrap posted:Some additional food for thought. I don't have a dog in this fight. cheese fucked around with this message at 00:12 on Oct 29, 2016 |
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Oct 29, 2016 00:09
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FCKGW posted:"None of the above" is something the Reddit morons were asking for the election this year so good job I guess. Nevada has it on their ballot already. https://en.wikipedia.org/wiki/None_of_These_Candidates
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Oct 29, 2016 00:16
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That's a surprisingly complicated question to answer. The truth is that there's an interlocking network of public, semi-public, and private organizations, public money that can go to any of them, standards imposed by the government that control and regulate testing and approval for use on humans, and so on. A huge number of possible drugs fail during the three levels of trials. Tons of small start-up pharma companies fold when their one promising therapy doesn't survive phase three trials. Speculation on small startup pharma companies on the stock market is rampant. What is clear, though, is that the biggest pharmas spend billions directly marketing their products to doctors and to the public. We've all seen the relentless "ask your doctor about pgythlgyg" ads on TV: those are expensive as gently caress. Every penny of that advertising comes from sales, and the sales have big margins because we let them. The profit motive is supposed to encourage companies to develop new therapies, and boy howdy does it... but as you poitned out, Viagra has way more potential for profit than curing some rare disease. This is also why drugs for <some rare disease> often cost a thousand dollars a pill or whatever: the company making it is trying to recoup its hefty development costs and make a profit. Some treatments just wouldn't exist if the government didn't pay for them to be R&Ded because of the lack of a likely profit. Arguably, the government could develop all drugs for a lot cheaper than the private sector, because the government would not be trying to sell those drugs at a profit, nor would they be advertising them. Also arguably, marketing serves a useful purpose of informing doctors and patients of treatment options they might not know about. On the gripping hand, doctors should be loving educated about treatment options regardless of how much money the treatment options' maker is spending on marketing, and patients should be well-informed about their options by well-informed doctors, who can put the available therapies into the context of that specific patient's particular health, diagnosis, prognosis, complications, tolerance for side effects, etc. What is definitely true is that the US leads the world in developing new medicines. Our capitalist, for-profit system is "working" if you measure it only that way. But other countries successfully buy American-made drugs and provide them to their patients for less money - often a lot less - because the entire national healthcare systems of those countries can both negotiate for lower prices, and simply pass laws capping costs. But also maybe some drugs just aren't available in some countries because an American company isn't under any special obligation to sell its drugs for cheaper than it wants to, just because those kids in Botswana have AIDS or whatever. Personally, I believe the system can and should be greatly improved. I think there should be a legal barrier to the sort of freewheeling marketing direct to doctors and hospitals and insurance companies that drug makers are allowed to do right now, and probably a barrier to advertising drugs to the public, too. Maybe drug companies shouldn't be allowed to do anything more than submit their clinical trial results to a national database of clinical therapies, to which every doctor would refer whenever deciding on a treatment for a patient. Maybe there should be a hard cap on drugs that treat life-threatening illness, and if a company can prove it would take a loss selling a specific drug for under that cap not including marketing costs, the government could subsidise the purchase of those specific drugs. Along side that, we should have a national healthcare system where everyone has a guaranteed, totally free to them, baseline level of care that includes prescription drugs, and then people can buy luxury health care insurance and plans through their work or privately as they like. Even under that system, though, there is probably a role for private biotech companies to operate at reasonable profit margins.
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Oct 29, 2016 00:29
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Has there been any discussion on prop 57? I saw the facebook posts talking about how if it passes a whole list of violent offenses would be made eligible for early parole. I wanted to poo poo on the people sharing it because it seemed like scare mongering bs but after going on ballotpedia and reading the full text of the measure it is true. California only classifies 23 felonies as violent. After reading the full text this has gone from a sure fire yes vote for me to something I am wavering on. Would love too see some for and against on it.
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Oct 29, 2016 03:29
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Mandatory minimum sentences are really dumb and super long prison sentences accomplish absolutely nothing. Nobody is sitting around going "Hmm, if I beat the poo poo out of this guy with a tire iron, will I get 15 years, or 25? And with or without parole, depending on whether I qualify for reduction based on good behavior and attending therapy sessions etc? Perhaps I should commit some lesser felony instead, I can deal with 10 years but not 20." Most people who commit violent crimes either don't think they'll be caught at all, or aren't thinking about consequences beyond the immediate crisis. Meanwhile, California's prisons have been under federal control for 10 years due to overcrowding and inhumane levels of treatment, including totally failing to get medical care for very sick prisoners. and while a couple prisons are now back in CA control, it's not clear we've actually fixed the issues at all. quote:While these three prisons received passing grades last year, about a third of the dozen prisons the inspector has evaluated are still not providing adequate care. Some conditions are similar to the ones that Henderson found when he initially determined that the facilities were unfit in 2006, according to the Associated Press. I would vote for shorter sentences for all prisoners if I could. If the state can't lock people up without putting them in basically third-world level shitholes, then the state should have to let people go. And of course, NIMBYism prevents building new prisons, but really we shouldn't need more prison space because our big problem isn't that we're lacking space, it's that we're extremely stupid about criminal justice in general and punitive vs. rehabilitative incarceration in particular.
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Oct 29, 2016 03:59
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Trabisnikof posted:But enough about people who vote the way I personally don't like. There is literally not a single good justification for voting yes on Prop 61. Plenty of people smarter than I have explained in multiple ways why it won't work and is bad. It's not like the soda tax where I disagree with it philosophically but it may achieve the aims it sets out, and do some good. The only reasons for voting yes on 61 are if you're one of the half dozen or so idiots who posted "hurr, why can't we actually burn down big pharma?" and you want to take your dipshit edgelord persona all the way to the ballot box, of if you're Shbobdb and think you're some sort of retard Frank Underwood.
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Oct 29, 2016 04:55
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You're not seeing major donation spending on this, relative to the scale of the industry's coffers, because it doesn't really matter. It's nice if it doesn't pass, but it doesn't exactly hurt the industry if it does. Whether it passes or not, give it two or three years and you're going to see a promotional push by the industry to "simplify drug pricing and the complex legal code and red tape that prevents people from getting their necessary medications" by consolidating VA/DOD prescription formulary with Medicare Part D. Under Medicare Part D, the government is forbidden to negotiate drug prices for medications and must either accept the price from the manufacturer or decline coverage of the drug entirely. Typically, the industry charges Medicare about 3X the public rate for an uninsured individual, so if we can tie the VA/DOD pricing to that model, we can cut off every state's CA-style laws before they pass them (or in fact, even tie them to the tracks and then railroad them with their own laws once they've passed). If you want to make a difference in this particular scope of the problem (nationalizing the industry or going full UHC isn't going to happen any time soon, so I'm talking baby steps here), the best thing you can do (no idea how) is to find a way to kill the part of Medicare Part D which prevents any negotiation on drug pricing. If the largest customer in the nation can't negotiate prices, nobody gives a gently caress if California thinks it can. I'd love to see some control in pricing for my industry, but 61 isn't going to do poo poo except give us even more reason to try to kill the VA's pricing control. Kill that, and now we get the richest state in the nation as a freebie! 
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Oct 29, 2016 07:44
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Leperflesh posted:
Not just marketing. There are a lot of direct payments made to doctors in what amount to broker fees for connecting clients with products. Those fees are essentially invisible to patients and they either affect care or cost or both in really pernicious ways.
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Oct 29, 2016 08:12
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El Mero Mero posted:Not just marketing. There are a lot of direct payments made to doctors in what amount to broker fees for connecting clients with products. Those fees are essentially invisible to patients and they either affect care or cost or both in really pernicious ways. I love how people go on and on about the sanctity of the medical profession and how you should just pay doctors whatever they ask and allow them to cartelize medicine and artificially restrict the supply of doctors to jack up the cost of health care--they are doing God's work--and then you learn that doctors get kickbacks for prescribing drugs to patients.
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Oct 29, 2016 14:30
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silence_kit posted:I love how people go on and on about the sanctity of the medical profession and how you should just pay doctors whatever they ask and allow them to cartelize medicine and artificially restrict the supply of doctors to jack up the cost of health care--they are doing God's work--and then you learn that doctors get kickbacks for prescribing drugs to patients. Leperflesh posted:That's a surprisingly complicated question to answer.
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Oct 29, 2016 17:12
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about drug R&D
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silence_kit posted:doctors get kickbacks for prescribing drugs to patients. this is illegal
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Oct 29, 2016 18:05
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Guy Farting posted:this is illegal Oh, just looked it up. You are right. Still this is the same kind of distinction as 'doctors are not in a union'--for all intents and purposes, their deals with pharmaceutical companies function like kickbacks, just like their professional organizations basically provide a lot of the same functions as a union. silence_kit fucked around with this message at 18:20 on Oct 29, 2016 |
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Oct 29, 2016 18:13
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So you're saying the AMA or whatever does things like collective bargaining, and doctors can strike over grievances, etc?
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Oct 29, 2016 18:22
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Leperflesh posted:So you're saying the AMA or whatever does things like collective bargaining, and doctors can strike over grievances, etc? I never said that they had all of the functions of a union. Doctors also don't resort to those tactics because they don't have to. Their powerful lobby ensures that any new regulations makes sure to look out for the financial self-interest of doctors. Doctors in the US make way more money than doctors in other first-world countries, but they really aren't better here than in other countries. silence_kit fucked around with this message at 18:47 on Oct 29, 2016 |
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Oct 29, 2016 18:42
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Prop 57 is trying to mitigate some of the horrific consequences of the "three strikes" law, which sent people to jail if they were convicted of three "serious" crimes, even if the third one was nonviolent. LA Times analysis herequote:Few California voters likely know much, if anything, about the state Board of Parole Hearings — from the qualifications of the 12 commissioners to their success in opening the prison gates for only those who can safely return to the streets. quote:The governor’s plan, which amends the state constitution, would only allow parole after a prisoner’s primary sentence had been served — applying only to the months or years tacked on for additional crimes or enhancements. And like the current system, a governor could override any parole board decision to release a prisoner.
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Oct 29, 2016 18:44
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silence_kit posted:Oh, just looked it up. You are right. Still this is the same kind of distinction as 'doctors are not in a union'--for all intents and purposes, their deals with pharmaceutical companies function like kickbacks, just like their professional organizations basically provide a lot of the same functions as a union. idk i don't have any "deals" with pharmacy companies and they're not exactly lining my apartment walls with golf clubs or anything classically, pharm companies will give "free samples" of medications to primary care doctors to distribute to their patients, to get them started on these chronic meds. once the samples run out then the insurance company will be on the hook for them. maybe they'll bring some subway sandwiches or maggianos for the office another example is medical device companies hosting dinners and inviting surgeons to come get a free dinner at a nice restaurant and learn about their marginally newer heart valve or joint. the goal being to influence these surgeons to stock these devices at local surgery centers. doctors by and large prescribe based on their understanding of evidence and their own personal experiences with meds and devices. pharma influence mostly comes from trying to change physicians understanding of the evidence (with their own biased studies), and maybe an occasional meal. there's influence to be sure, but not with a literal cash handout. imo direct to consumer marketing of profit driving medications is also an issue, but there's no political will to get that addressed either
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Oct 29, 2016 18:55
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You're telling me that doctors aren't willing to sell their ethics for a 1/3 filled Pfizer clicky pen?
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Oct 29, 2016 19:01
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Dead Reckoning posted:You're telling me that doctors aren't willing to sell their ethics for a 1/3 filled Pfizer clicky pen? they sell their ethics to bang the hot drug company saleswoman.
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Oct 29, 2016 19:03
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Leperflesh posted:So you're saying the AMA or whatever does things like collective bargaining, and doctors can strike over grievances, etc?
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Oct 29, 2016 19:51
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Dead Reckoning posted:You're telling me that doctors aren't willing to sell their ethics for a 1/3 filled Pfizer clicky pen? The people with advertising pens prescribed the advertised products more often. It wasn't a matter of ethics; it wasn't a matter of free will at all. It was a matter of the way the brain works, and how we aren't driving every aspect of the ship.
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Oct 29, 2016 19:59
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silence_kit posted:Doctors in the US make way more money than doctors in other first-world countries, but they really aren't better here than in other countries. CopperHound fucked around with this message at 21:06 on Oct 29, 2016 |
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Oct 29, 2016 20:36
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CopperHound posted:Med students in other first wold countries don't need to spend close to a quarter million in tuition not counting undergrad. Also they only make $50-60k a year for 3-7 years of 60-80 work weeks during residency.
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Oct 29, 2016 20:45
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