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Data Graham posted:Ignorant question here, but what is inherently "capitalistic" about this phenomenon? Seems to me any economic system would make use of this kind of tech once it becomes available. yeah it's not so much a capitalist idea so much as a dystopian one. the part where it will inevitably become monetized, that part is capitalism
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Nov 25, 2018 14:41
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And you bet it's absolutely going to reinforce existing prejudices hard.
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Nov 25, 2018 14:43
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The Glumslinger posted:Lol, ok, where are you getting this wild idea that they're gonna cancel primaries? I don't have the idea. I'm using it as an example of something unambiguously worth either voting third party or casting an "Ultimatum" vote in order to remove the complications of debating whether a certain Democratic Party action means the Democratic Party is no longer democratic.
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Nov 25, 2018 14:47
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knox_harrington posted:On top of generally trolling about NICE / NHS I think you are being intentionally misleading about what's going on in the US and UK. CAR-T treatments are commercially available in the UK under the status quo and would likely be covered if a patient has supplementary (private) insurance. Considering that insurers in the US will require a co-pay, if they will cover at all, and CARs are not covered at all under medicare I think you're being disingenuous. The NHS payer situation does have some nuance, i.e. in the Yescarta vs Kymriah pricing negotiations and how that relates to their EU-wide pricing and rollout strategies. But yeah, NICE obviously makes determinations based on QALYs, and have determined that CAR-Ts would make economic sense at twice their current market price ($373k for Yescarta vs $475k for Kymriah, although both well over a million when you include hospital resource utilisation and CRS management). It's ridiculous to think a market as large and wealthy as the US would be deprioritised, or that a government-administered healthcare system wouldn't have an insane amount of leverage in pricing negotiations.
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Nov 25, 2018 14:54
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The Glumslinger posted:Lol, ok, where are you getting this wild idea that they're gonna cancel primaries? If they could do so without any backlash, then why wouldn't they?
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Nov 25, 2018 14:59
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Cerebral Bore posted:If they could do so without any backlash, then why wouldn't they? And if your mother had wheels, she'd be a garbage truck. You can posit all the hypotheticals you like but don't be ridiculous.
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Nov 25, 2018 15:02
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Rust Martialis posted:And if your mother had wheels, she'd be a garbage truck. You can posit all the hypotheticals you like but don't be ridiculous. Do you think that primary elections are caused by some kind of immutable natural law, or do you have some other reason for not wanting to answer the question?
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Nov 25, 2018 15:07
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Rust Martialis posted:And if your mother had wheels, she'd be a garbage truck. You can posit all the hypotheticals you like but don't be ridiculous. don't doxx me (also that's a great line) Ripoff posted:This social credit poo poo is 100% coming to the US as soon as the 1% and corporate boards of directors realize you can monetize it via tying your social credit to the rent you pay and/or interest rates you receive and pay. Not to mention the money that “fixers” will make to improve Skylyr’s score when he was caught stealing or vandalizing something at school, so he can still get into an Ivy League (while the other kid that was present gets hosed out of attending college for the rest of their life). realtalk, as much as I love* this hilarious Shadowrun dystopia poo poo, I'm curious whether there are any obvious constitutional issues with the thing (if implemented by a private entity)
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Nov 25, 2018 15:09
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This tweet is just ...  https://twitter.com/realDonaldTrump/status/1066689688600281088 thank u President T
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Nov 25, 2018 15:12
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knox_harrington posted:On top of generally trolling about NICE / NHS I think you are being intentionally misleading about what's going on in the US and UK. CAR-T treatments are commercially available in the UK under the status quo and would likely be covered if a patient has supplementary (private) insurance. Considering that insurers in the US will require a co-pay, if they will cover at all, and CARs are not covered at all under medicare I think you're being disingenuous. Yes, CAR-Ts are [partially] covered under Medicare for use in NHL/DLBCL. For inpatient there is DRG + NTAP: https://www.ajmc.com/newsroom/cms-approves-extra-payments-for-car-t-increases-other-payments-in-final-rule https://www.mdedge.com/oncologypractice/article/173086/practice-management/cms-finalizes-car-t-cell-therapy-inpatient This is often insufficient given total cost of care, but potential for future outpatient use with Kymriah (lower CRS/neurotox) at WAC + 6% would help: https://www.mdedge.com/hematologynews/article/164403/business-medicine/medicare-sets-outpatient-car-t-cell-therapy-rates e: NHS is only approving commercial use for Kymriah's pediatric ALL indication. They've rejected Kymriah for adult ALL+DLBCL and Yescarta for DLBCL. KingNastidon fucked around with this message at 15:28 on Nov 25, 2018 |
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Nov 25, 2018 15:13
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trump's obsession with the federal reserve interest rates would be weird to me and almost charming if it was another president, but with trump i'm absolutely certain it's just "me want cheap loans for me" i despise our big dumb baby president
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Nov 25, 2018 15:15
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GreyjoyBastard posted:trump's obsession with the federal reserve interest rates would be weird to me and almost charming if it was another president, but with trump i'm absolutely certain it's just "me want cheap loans for me" Especially if you make you money in real estate. Cheap loans means you can gently caress up a lot and not have to pay out the nose.
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Nov 25, 2018 15:23
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GreyjoyBastard posted:don't doxx me (also that's a great line) if there was, wouldn't credit ratings have been caught by it by now? i mean, i feel like we're already halfway there with this poo poo, it's just a matter of plugging ~big data~ in
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Nov 25, 2018 15:25
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AriadneThread posted:if there was, wouldn't credit ratings have been caught by it by now? it feels like there's a tangible difference between this and credit ratings, but my feelings are not a substitute for the law i'm not John Roberts, after all
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Nov 25, 2018 15:28
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Failed Imagineer posted:This tweet is just ... I pity the fool who voted for President T!
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Nov 25, 2018 15:31
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Failed Imagineer posted:This tweet is just ... https://mobile.twitter.com/realDonaldTrump/status/1066682146683846657 https://mobile.twitter.com/realDonaldTrump/status/1066478927143677952 https://mobile.twitter.com/realDonaldTrump/status/1066480700046655488 lots of fun trump tweets today.
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Nov 25, 2018 15:37
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KingNastidon posted:
This is only temporary
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Nov 25, 2018 15:39
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I don't know how you look at 2016 where Clinton effectively was running unopposed in the primary until Sanders entered in order to push her to the left of some issues to which to narrative turned into "he's weakening the general election by being in this primary when she's obviously going to win" and not see there are some people not loathe to the idea of candidates being selected in back rooms by serious people. That's not happening now obviously but if your strategy is always vote Democrat no matter what and that actually because the standard amoung the public the reasonable result by party leaders would be to make sure that their favorites were the only option in the general. The Democrats have already argued that as a private organization they are free to conduct themselves how they wish and super delegates are inherently undemocratic which they are still defending the use of. Democrats certainly aren't getting rid of the primaries since that would be electorially disasterous but the point that primaries would go away was made regarding the logical result of everyone voting Democratic by default not an actual plan that they are currently considering.
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Nov 25, 2018 15:40
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Failed Imagineer posted:It's ridiculous to think a market as large and wealthy as the US would be deprioritised, or that a government-administered healthcare system wouldn't have an insane amount of leverage in pricing negotiations. They would have insane leverage in pricing negotiations, which would make development of therapies like CAR-T less attractive relative to small molecules or non-personalized ADCs like polatuzumab. CAR-Ts have sizable manufacturing costs and additional overhead. The NPV relative to other portfolio assets becomes a lot more risky given uncertainty of dictated price/margin post launch. Pharma will *always* cynically use pre-clinical R&D and clinical trial + regulatory costs to justify WACs, but there is some truth to it. Especially when the US is the current profit center and drives most development/commercialization prioritization. Failed Imagineer posted:This is only temporary I'm not as familiar with the space ex-US -- have they publicly said when they will revisit reimbursement for the NHL indications? KingNastidon fucked around with this message at 15:47 on Nov 25, 2018 |
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Nov 25, 2018 15:44
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Your Taint posted:I pity the fool who voted for President T! Man, it’s a good thing PPJ and LK love to keep changing thread titles lately *hint hint boys*
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Nov 25, 2018 15:46
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KingNastidon posted:Yes, CAR-Ts are [partially] covered under Medicare for use in NHL/DLBCL. For inpatient there is DRG + NTAP: So patients on Medicare are not actually fully covered. What happens when they get CRS/CRES and have to go back to ICU, do they just go bankrupt? Anyway my point is that even under the artificial constraints of the current NHS funding system the treatments are already available and fully funded in some cases, and are certainly commercially available for people who have BUPA or whatever additional insurance (in contradiction of your previous claims). Given that this is already possible under the UK system there should be no problem in the US given the vastly higher per capita spend - provided the politicians can resist the bribes to hamstring a single payer system. Not sure whether you are a clinician but I wince a bit when I see doctors opposing a switch to a system that would dramatically improve healthcare for their patients. Failed Imagineer posted:The NHS payer situation does have some nuance, i.e. in the Yescarta vs Kymriah pricing negotiations and how that relates to their EU-wide pricing and rollout strategies. But yeah, NICE obviously makes determinations based on QALYs, and have determined that CAR-Ts would make economic sense at twice their current market price ($373k for Yescarta vs $475k for Kymriah, although both well over a million when you include hospital resource utilisation and CRS management). It's ridiculous to think a market as large and wealthy as the US would be deprioritised, or that a government-administered healthcare system wouldn't have an insane amount of leverage in pricing negotiations. I went to a talk by the founder of Autolus a few weeks back who was decrying the absolute focus on cost by NICE but was also suggesting there will be new costing methods that will enable better access - e.g. there is no charge unless the patient reached CR, costs spread over a year post treatment provided the pt remains in remission.
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Nov 25, 2018 15:52
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GreyjoyBastard posted:don't doxx me (also that's a great line) In an ideal world it would slam against anti-discrimination laws because there's absolutely no way that white cis tech/finance/VC bros don't come up with a system that just so happens to hold themselves as the best ever and would exhibit an extreme disparate impact on people of color, LGBT folks, and women with intersections between those groups getting hit especially hard. But I expect that Federalist society people would be huge fans of the idea that an algorithm can't be racist unless you can prove a particular variable was massaged with discriminatory intent (which just so happens to be effectively impossible with current deep-learning based poo poo). Probably our best hope of not getting that result is if the case being brought was some fundy Christian getting screwed by a neural network decision.
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Nov 25, 2018 15:55
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https://twitter.com/ZoeTillman/status/1066704353732501504?s=19 Womp womp
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Nov 25, 2018 15:55
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Fulchrum posted:Really didnt take long to drop the pretense, but good job actually admitting you hate liberals more than you hate fascists.  I hate both about equally. At least fascism is an ethos.Like there's something to be admired for picking a side. Owlofcreamcheese posted:I think calls for violence against nazis and fascists are 100% justified and the part that makes it creepy and gross is the people trying to expand those terms more and more. Like first nazis were nazis (of course), then other groups that were only not nazis in name only (of course), then groups with similar ideology (again, of course), then like, all republicans are nazis (republicans are pretty bad! so sure), then like, centrists are nazis (I guess mr luther king said so if you squint) and like, you can see people in this thread trying to move on to like all liberals are nazis and like, maybe social democracy is maybe nazis and it seems like a certain type of person figured out just calling everyone you disagree a nazi is a magic code to not worry about posting weird bloodlust stuff about killing people that disagree with you to finer and finer amounts. I see way more people pretty much everywhere whining about being misclassified as Nazis than people actually doing it. Ate My Balls Redux fucked around with this message at 16:01 on Nov 25, 2018 |
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Nov 25, 2018 15:59
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Owlofcreamcheese posted:I think calls for violence against nazis and fascists are 100% justified and the part that makes it creepy and gross is the people trying to expand those terms more and more. Like first nazis were nazis (of course), then other groups that were only not nazis in name only (of course), then groups with similar ideology (again, of course), then like, all republicans are nazis (republicans are pretty bad! so sure), then like, centrists are nazis (I guess mr luther king said so if you squint) and like, you can see people in this thread trying to move on to like all liberals are nazis and like, maybe social democracy is maybe nazis and it seems like a certain type of person figured out just calling everyone you disagree a nazi is a magic code to not worry about posting weird bloodlust stuff about killing people that disagree with you to finer and finer amounts. Violence has a funny way of spiraling out of control, which is why it should always be the last resort. Thankfully -with politics at least- violence being the last resort is usually the case.
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Nov 25, 2018 16:00
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while this is by no means a friendly opinion, i'm kinda impressed this judge managed to restrain himself from including any "but seriously, gently caress you for lying to the court about how sorry you were and then turning around and telling everyone pleading guilty was the biggest mistake of your life" bits
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Nov 25, 2018 16:01
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knox_harrington posted:
That is already the pricing model for Kymriah. (indication-dependent) KingNastidon posted:I'm not as familiar with the space ex-US -- have they publicly said when they will revisit reimbursement for the NHL indications? These type of decisions are always seen as a jumping-off point for negotiation - especially when NVS has a competitor like Kite/Gilead and they're eager not to cede market share or first-to-market advantage in any indication Failed Imagineer fucked around with this message at 16:16 on Nov 25, 2018 |
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Nov 25, 2018 16:02
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tehinternet posted:Violence has a funny way of spiraling out of control, which is why it should always be the last resort. Thankfully -with politics at least- violence being the last resort is usually the case. Political violence is currently being employed every single moment, every single day, buddy. It's just that when it's the upper classes doing it against everybody else we're supposed to pretend like it's normal and OK.
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Nov 25, 2018 16:07
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Cerebral Bore posted:Political violence is currently being employed every single moment, every single day, buddy. It's just that when it's the upper classes doing it against everybody else we're supposed to pretend like it's normal and OK. see https://twitter.com/ProPublica/status/1066709356253769731
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Nov 25, 2018 16:13
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Ripoff posted:This social credit poo poo is 100% coming to the US as soon as the 1% and corporate boards of directors realize you can monetize it via tying your social credit to the rent you pay and/or interest rates you receive and pay. Not to mention the money that “fixers” will make to improve Skylyr’s score when he was caught stealing or vandalizing something at school, so he can still get into an Ivy League (while the other kid that was present gets hosed out of attending college for the rest of their life). We had similar things before. The credit bureaus used to record that type of information, divorced, sleeps around, minor crimes, hearsay social stuff, etc. We had to regulate that crap away once already.
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Nov 25, 2018 16:16
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Cerebral Bore posted:The gently caress is this even supposed to mean? It means you’re arguing a hypothetical and insisting that your hypothetical is fact. It isn’t.
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Nov 25, 2018 16:19
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Holy hell, I just discovered the Twitter account that mashes up Sarah Palin with Erowid trip reports. i don't think I need this thread anymore https://twitter.com/SarowidPalinUSA/status/825904633771995138 https://twitter.com/SarowidPalinUSA/status/827231990776754177 Hell Yeah
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Nov 25, 2018 16:20
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knox_harrington posted:So patients on Medicare are not actually fully covered. What happens when they get CRS/CRES and have to go back to ICU, do they just go bankrupt? I don't believe I ever said they were fully covered -- you said they weren't covered at all under Medicare. The majority of use is inpatient given Yescarta didn't have outpatient in their pivotal trial like Kymriah and their rates of high grade CRS/NT are higher. HCOs are already likely eating costs on the drug alone under DRG+NTAP much less follow-up inpatient care. I doubt most Medicare patients to date are paying the delta between DRG+NTAP and total cost of care out-of-pocket. HCOs are able to eat costs on Medicare patients because they have private insurance patients as the profit maker that justifies the hassle of offering CAR-T therapy at all. This potentially changes in a M4A world depending on the prevalence and reimbursement rates of supplemental private insurance. I believe outpatient could change the game a bit because my understanding is that the drug would be reimbursed under WAC+6% and follow-up care (if needed) wouldn't be reimbursed under a fixed DRG, but normal Medicare hospitalization rates if it falls outside 3-day CMS payment window post CAR-T administration. This would be subject to Medicare Part A/B reimbursement and out-of-pocket max, which is win for patients and HCOs. Not an HCP and I think single payer would improve health outcomes in almost all cases. CAR-T is a situation where commercial insurance, especially with flexibility to arrange single case agreements, currently has the best access for patients and reimbursement for HCOs. Current Medicare reimbursement rates and uncertainty would make commercialization less attractive for pharma and less financially attractive to HCOs outside of the MSK and MD Anderson type institutions that aren't as profit driven. And those institutions will almost always have greater incentive to push patients to clinical trials given the prestige and profitability -- or at least absence of personal cost liability. KingNastidon fucked around with this message at 17:09 on Nov 25, 2018 |
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Nov 25, 2018 16:21
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Logic Probed posted:Decades upon decades screaming about Marks of the Devil from barcodes to credit cards, along with a general fear and hatred for government surveillance, I cannot help but imagine any major platform for introducing this will result in near-riots and Vietnam protest levels of major disobedience.
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Nov 25, 2018 16:24
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Cerebral Bore posted:Political violence is currently being employed every single moment, every single day, buddy. It's just that when it's the upper classes doing it against everybody else we're supposed to pretend like it's normal and OK. Yeah how is the current medical situation where people are told to hope their case is marketable enough to have a gofundme or die, police murdering people to which the justice system says that is absolutely legal and acceptable, families living on scraps while billionaires exist, not to mention our foreign policy of destabilizing nations with thousands of deaths and then complain when the refugees escaping those conditions have the audacity to flee here not extreme violence? Mark Twain posted:THERE were two “Reigns of Terror,” if we would but remember it and consider it; the one wrought murder in hot passion, the other in heartless cold blood; the one lasted mere months, the other had lasted a thousand years; the one inflicted death upon ten thousand persons, the other upon a hundred millions; but our shudders are all for the “horrors” of the minor Terror, the momentary Terror, so to speak; whereas, what is the horror of swift death by the axe, compared with lifelong death from hunger, cold, insult, cruelty, and heart-break? What is swift death by lightning compared with death by slow fire at the stake? A city cemetery could contain the coffins filled by that brief Terror which we have all been so diligently taught to shiver at and mourn over; but all France could hardly contain the coffins filled by that older and real Terror—that unspeakably bitter and awful Terror which none of us has been taught to see in its vastness or pity as it deserves. Eggplant Squire fucked around with this message at 16:34 on Nov 25, 2018 |
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Nov 25, 2018 16:26
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GreyjoyBastard posted:As pleasantly performative as this is, this is not even remotely an accurate answer to the question. Not to mention Hillary making unforced errors like "keeping out immigrants to stop the far-right", which has eaten away her cred with minorities. qkkl posted:An unofficial social credit score already exists in western countries, it's called "connections". And it has already achieved the creation of a permanent underclass. Don't forget that we have an actual credit system already in place, which is even worse. Logic Probed posted:Decades upon decades screaming about Marks of the Devil from barcodes to credit cards, along with a general fear and hatred for government surveillance, I cannot help but imagine any major platform for introducing this will result in near-riots and Vietnam protest levels of major disobedience. "How much have you Made America Great Againtm today, patriot? Now you can with MAGACredtm!"
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Nov 25, 2018 16:26
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Cerebral Bore posted:Do you think that primary elections are caused by some kind of immutable natural law, or do you have some other reason for not wanting to answer the question? I don't know about Rust Martialis, but from an outsider's perspective primaries seem so entrenched in the USA political landscape that even if it's not against the law of physics, I really don't see an American party removing them. Hence why people don't even bother answering your hypothetical, because it's perceived as something that's not going to happen; it may not be strictly impossible, but it's a practical impossibility not worth considering.
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Nov 25, 2018 16:28
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Omobono posted:I don't know about Rust Martialis, but from an outsider's perspective primaries seem so entrenched in the USA political landscape that even if it's not against the law of physics, I really don't see an American party removing them. The concept of people always voting Democratic no matter what in the general (which the idea of Democrats abandoning the primary was in response to) is just as unlikely to happen so both are hypothetical situations. Eggplant Squire fucked around with this message at 16:37 on Nov 25, 2018 |
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Nov 25, 2018 16:33
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Shifty Pony posted:
i can't recall - is it the Federalist Society that's had some rants about how folks should he free to sell themselves in to slavery or is that some other Koch brothers organization?
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CAROL posted:Can’t believe you post this dumb poo poo evoking donald j trumps “many sides” rhetoric instead of spending time with your 10 year old son. Where do you get a many sides argument from this? My only point is that based historical experience attemps to enforce uniformity of opinion has resulted in the oppression, demonization and dehumanization of anyone who bucks the established orthodoxy. And that in every case the scapegoats who are chosen by whomever has the power do so are a minority group. Look at Russia, 60 years of communist rule did not result in a society made up of people who are tolerant of diversity. That's not a many sides argument, it's an admission that this stuff is more complex than just kill capitalism and it will sort itself out. This is why full communism now is not a panacea for all of the world's social ills and also why many minorities are not down with the "let's ignore identity politics so we can focus on economic justice". I'd also suggest that this is why Bernie's message did not resonate with black voters sufficiently to secure the 2016 nomination. Now a wise person might look at that and think "why didn't Bernie's message resonate with POC?" and try to not just determine the answer but try to find strategies to make sure that the message does resonate, but that's a lot harder than just blaming it on the "establishment Democrats" or "liberals" . It's also kind of lovely dismiss the reasoning of those minority voters who are the base of the Democratic Party because you are convinced that you know better than they do when it comes to determining what is in their best interest. I know that it seems like it should be simple and that the right should be obvious to everyone every time, but reality demonstrates quite conclusively that it obviously isn't. And it is not simply "capitalism" otherwise we wouldn't be having this debate because all of these problems would have been sorted out thousands of years ago like you know before capitalism was ever imagined.
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