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Classon Ave. Robot posted:I really don't see any path forward for progressive politics in America if Biden is elected. He openly opposes medicare for all and any attempt to make it affordable or available to poor people. If the liberals are appeased by having a guy in the white house who doesn't say stupid things on twitter then there will be no room left for progressive candidates at all. Trump will do the same things Biden would, but he would keep people angry enough that positive change remains possible. I've never actually heard a convincing argument that this is not the case, but if you'd like to present one I'm listening. Step 1: Keep a fascist in power Step 2: ??? Step 3: Leftist agenda realized. Step 2 is where folks seem to get hung up. While Trump certainly gets people upset, he also has largely unchecked political power and can actively make things worse in many areas, which he has. There's basically no world in which a continued Trump presidency makes a leftist agenda easier to implement. The whole thing hinges on the mushy part in the middle about how he'll somehow make people angry and the Revolution comes, which never gets any more detail than that. This same argument was made early on in Trumps time in office, and that resulted in Biden, essentially an 80's republican, looking good compared to him to most voters. The idea that somehow step 2 is "actually leftism makes huge gains and sweeps into power" is largely a fantasy. You're just going to normalize farther right Democrats. As for Obama's only legacy, that's clearly the ACA, which helped a poo poo-ton of people even if it's not remotely as good as single payer or any sort of real healthcare system. And that's a lot more pertinent to this thread than this election BS.
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Aug 18, 2020 00:53
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Ytlaya posted:While there's certainly room for disagreement, there are several easily understandable rationales for this. The biggest and most obvious are: I'm aware of the rationale for a party switch after a 2 term, I'm saying that assuming it ends up with a more leftist administration is a bit of magical thinking. Especially since a strong election for the Republicans in 2020 means another entire decade of gerrymandering and 4 more years to dismantle voting. doverhog posted:The US political system is fundamentally broken, as you can see for example in how the DNC and Obama fixed the primary against Medicare for All. It will take a complete dismantling of the political establishment, in both parties, to achieve any real change. Yeah, I'm fine, burn it to the ground. I just don't get how giving Trump more power gets one there. He may burn it to the ground but it won't be in our favor and a lot of people will die, moreso even than now.
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Aug 18, 2020 01:18
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doverhog posted:I didn't say vote Trump, just that Biden is not going to do much improve things even if he wins. He literally can't, because he's a puppet of the same people that owned Obama and made the last health care reform a handout to the insurance industry. Yeah the prospects don't look god for Biden doing much on healthcare and people will die. I just don't see how trump getting a second term makes change more likely.
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Aug 18, 2020 23:23
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AlexanderCA posted:Is there anything going on with uhc wise in the US that isn't m4a? I've only seen medicare for all mentioned but I only read a few threads. The reason the US talks about single-payer is that it's the most likely way it gets done here. While pretty much nothing is currently viable depending on how cynical you are, the US currently has 4 different single payer systems already in place. Medicare(olds), Medicaid(poors), VA(veterans), and Tricare(soldiers). Medicare, in particular, is literally based on the Canada's single payer system. A system like Germany's, for instance, with private mandated non-profit but highly regulated providers, is probably even less likely than a massive expansion of the existing well-loved Medicare program. Nobody is seriously talking about any systems that aren't as simply explained as "we expand the program that everyone gets when they get old", because the state of healthcare discussion in the US is incredibly bad. The vast majority of people have no idea how healthcare works in any other country other than the vague idea that the US system, while lovely, is still the best option. That's slowly changing, and the US system is so bad that just outright saying M4A is popular, but nobody is trying to say "what about if we make all the private insurers non-profit and regulated out the rear end".
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Aug 19, 2020 01:29
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Edgar Allen Ho posted:small critique-basically no one believes this but grandparents and hardcore chuds. hahah I wish
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Aug 19, 2020 22:55
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I've been to a few countries outside the US at this point and yeah the US is highly and concerningly nationalist.
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Aug 20, 2020 00:50
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Yeah that's called nationalism that's what the US does its part of fascism
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Aug 20, 2020 01:35
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Mercury_Storm posted:I don't think anyone disagrees that the US healthcare system is absolute garbage and a complete travesty for human rights. I find it unbelievable that there are still a lot of states that haven't accepted the Medicaid expansion, when Medicaid is by and large a fuckton better than private insurance and anything on the state exchanges, and should be the default option for everyone. It's an obvious and effective play. A lot of the people in those states don't realize their politicians blocked them from getting healthcare and think they DO get Obamacare and that it just sucks. Jaxyon fucked around with this message at 22:06 on Sep 30, 2020 |
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Sep 30, 2020 21:47
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doverhog posted:You cannot solve healthcare without first solving money in politics. All the politicians are bought and paid for, that's why Obama refused to even consider a public option. It's why Biden says he would veto medicare for all. Not really. Every single developed nation has universal care and all have money involved in politics to some degree.
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Oct 21, 2020 00:12
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doverhog posted:It's all a matter of degrees, yeah. The US has proven that they cannot do it, so I don't really have to argue it, just point to the evidence. The US will never allow miscegenation, I say, in 1965. Just look at the evidence.
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Oct 21, 2020 00:17
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M4A literally has a funds allocated to deal with potential layoffs. It's not some sort of new idea and obstacle. And that's not counting the surge in the economy once people aren't dumping money into healthcare and can spend it on consumer goods and services. or like, food.
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Oct 21, 2020 01:23
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KingNastidon posted:Hospitals and long term care centers are where the vast majority of healthcare dollars are currently being spent. You can burn for profit insurance companies to the ground, cool, but that alone isn't going to make a meaningful dent in aggregate healthcare expenditures per capita relative to other countries. Don't vast majorities generally total vastly more than 50%, instead of around 40% combined as your link shows? Also hospitals can also be profit centers.
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Oct 21, 2020 01:29
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KingNastidon posted:They do sum to >50%? Here's another source from CMS. Hospitals + long term care facilities is about 38% on your second link, matching your first link. 3 of the countries in the top 10 lowest population density have healthcare systems that are universal and cost a fraction of what the US does. Australia, Iceland, and Canada.
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Oct 21, 2020 01:47
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KingNastidon posted:Hospital Care (33 percent share) OH I see if you include things that aren't what you claim like dental, non-hospital doctor visits, "other services" and devices", you make the number go up! lets see what you said earlier: KingNastidon posted:Hospitals and long term care centers are where the vast majority of healthcare dollars are currently being spent. But I do agree that if you include numbers which aren't the two things you mentioned, you can maybe make yourself not be incorrect. quote:What percent of the total population of Australia, Iceland, and Canada are centered around a few major metros? I'm not saying US having a sizeable rural population is the primary barrier to lowering healthcare costs, but it's a unique consideration when comparing us against peer countries. I'd imagine that if you were making the argument that it's a major obstacle(which is not one that most experts on single payer plans in the US make), you'd have knowledge of your own argument. Do you want some time to go gather that?
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Oct 21, 2020 02:03
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KingNastidon posted:I'm was assumption that "physician and clinical services" are provided in some sort of hospital, clinic, or other healthcare center. I apologize for not being more precise. Literally no other nation in the world bases their UHC system around a for-profit system. But you don't think that's relevant?
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Oct 21, 2020 02:14
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KingNastidon posted:You could switch every single entity that touches the US healthcare system over to non profits and it wouldn't solve the problem. You're going to need cuts in infrastructure, headcounts, salaries, price controls on reimbursement, rationing, etc. I'm not saying that's a bad thing, for reasons many people here have pointed out, but just be honest about it. Payroll yes. The US pays vastly too much to healthcare workers, insurance workers, hospital admins, etc. But the rest of that? US tends to rank lower in terms of all other healthcare metrics like bed availability, doctor to patient ratio, procedures done etc compared to any other OECD country and pays about twice as much as most. The idea that somehow there would be less access to care is what it sounds you're saying and that's basically the opposite of reality.
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Oct 21, 2020 02:36
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silence_kit posted:I think KingNastidon's posts are helpful and informative. SA Politics Posters have a problem where they are totally unwilling to acknowledge drawbacks to their favorite political policies, and in the few cases where they do acknowledge the drawbacks, they attribute the drawbacks to external factors, which at least in SA Politics Poster Ideal World, would not exist. I'm actually pretty well read on UHC and I think that you simply have no idea what you're talking about. The drawbacks of UHC aren't what you think they are. quote:I think UHC providing more equal access to health care at the cost of maybe fewer innovations in drug developments & medical treatments, and maybe worse quality of care for wealthy people is a worthwhile tradeoff. The US ranks in maybe the 30's in overall care vs OECD countries in terms of quality of care, costs roughly twice as much as most. Simply put UHC, for every other country in the world, means more equal access to care AND better care. I can post charts if you want but it's extremely easily accessed information. US drug innovation is almost entirely funded by the government so why do you think it would change with single payer? There's a good chance it would go up.
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Oct 21, 2020 02:57
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silence_kit posted:I want the US government to grant its citizens immortal life. Anybody who is emphasizing the complexities/difficulties of this goal is not on my side. Hey if you want to actually talk substance rather than shitpost on things that are really easily understood and prevalent in every other developed country like UHC, that would be great.
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Oct 21, 2020 03:04
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silence_kit posted:Aren't you confusing basic research with product development here? I can't speak personally about drug development, but in other kinds of technologies, there is a huge amount of effort & spending needed to translate basic research to real technology. Technology development is most certainly not the following series of events: a university professor comes up with an idea and performs a basic proof of principle demonstration and companies just copy his formula and create a useful product one month later. Nope, you're confusing it. The actual innovation is almost entirely done on public funds, and then essentially given away to private companies to walk through the approvals process and market, and frequently Pharma companies will through their marketing budgets into their R&D costs to hide the fact that they're really just giant marketing firms pitching things that the taxpayers paid to come up with. They spend way more on advertising than they do on research. Also the US government is legally barred from negotiating price with them, after we give them monopoly rights on drugs we paid to develop. silence_kit posted:Like the drug trial success rate is really low. You'd think that if all of the basic research ideas in medicine were well-formed ideas, drug trial success rate would be nearly 100%. I have no idea why you'd think that, you may not be familiar with how science works. I never said anything about it all being cant-miss, I said it's government funded.
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Oct 21, 2020 03:11
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silence_kit posted:I don't think this is true. If it was really this easy, then why do so many drug trials fail? Who said it was easy? Do you want to engage with actual arguments or what quote:This is also totally opposite of my personal and professional experience with applied science & technology in other areas. There is a huge gulf between basic research and real technologies. That's great and when we talk about whatever area you work in that will be relevant but here's a study that was literally funded by the pharmaceutical industry that says they basically rely on NIH for everything. https://www.pnas.org/content/115/10/2329 Also for a bonus data, since you just post things and don't back any of them up, here's a study that says your'e wrong about spending less on healthcare bringing down innovation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866602/
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Oct 21, 2020 03:22
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silence_kit posted:You did. If almost all spending was from the government, like you say, and if all drug companies do is slap a sticker on the government product, then why do most drug trials funded by drug companies fail? Nope, didn't say any of that. I said the innovation is accomplished by the government and the companies walk them through the approval process. That doesn't mean that the drug companies don't do work, I just aid they aren't responsible for the innovation. This is with in argument that somehow our for-profit system creates innovation, which you've been completely unable to backup, so now you're trying to poke holes in my argument, while I specifically have posted a reviewed study that says you're wrong in my last post.
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Oct 21, 2020 03:32
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silence_kit posted:If what drug companies do is just a layup, then why do they miss all of the time, and why do they spend huge amounts of money on all of these misses? You are totally dodging the question. Yeah I'm gonna go eat dinner, let me know when you want to talk about actual poo poo instead of thought experiements and strawmen. Meanwhile the industry itself said that the taxpayers funded basically every new drug of the past decade and I posted a study but cool you do you
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Oct 21, 2020 03:45
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Sharks Eat Bear posted:Full disclosure, I work in pharma. I’m basically a grunt and am deeply conflicted about the industry and have no ambition to advance my career at this point and I’m constantly thinking about finding a job in a different industry and one of these days I’ll actually do it. I understand if that makes me untrustworthy but I’m coming at this from the lens of “sharpening your arguments against the current US healthcare system”, not from a place of disagreement or opposition. And fwiw I will vote in favor of M4A and just about all progressive healthcare reform 10 times out of 10 even if it means i could lose my job or otherwise jeopardize my personal finances, because that poo poo is way more important than me. In other words, maybe I can be in like the middle of the line once the guillotining commences? I'm not aware of any plans to significantly change NIH funding and the drug development process in the event of single payer in the US, and given that most developed nations publish even more basic research than the US does(adjusted for population), I don't really see how drug development would change much. As for drug company financials, we both know that drug companies are more accurately described as marketing companies than researchers, spending twice as much on it. Getting a drug through FDA approval requires a lot of spend, and so does that dinner with "thought leaders" at the steakhouse. I have to imagine that without spending billion on stock buybacks and advertising that is only legal in 2 countries in the entire world, they could be a lot more efficient about research. And that's with the taxpayer covering all the actual developments and giving them more or less free to the industry. It should be noted that the original argument that was made here, among others, was that quality of care and medical innovation would suffer under single payer. And that was backed up by....nothing at all. I appreciate you putting in far more work than silence_kit in a fraction of the posts.
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Oct 21, 2020 08:39
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I'm aware of the process by which drugs are approved, how long they take, and how much it costs. I also believe that drug companies are amply able to cover that, and will specifically fail to innovate on types of drugs that are not likely profitable, nor are they willing to to significant basic research. knox_harrington posted:The health system in the USA would actually be very straightforward to solve (though of course complex in implementation). Even here in ultra-capitalist Switzerland there is a way better system, and it is for-profit. I personally can't see the problems being solved until there is a shake-up in how politicians are paid and funded. Notably, Switzerland is I believe the only country that comes close to the US in per capita healthcare spending.
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Oct 21, 2020 17:58
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BiggerBoat posted:Color me shocked that the net profits for the HCI were only 3%. I would have assumed much higher than that. At least double. Don't forget the incredible salaries to executives.
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Oct 21, 2020 18:01
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Antibiotics are similar. So we have the industry making piles of cash where the profit motive specifically interferes with innovation, while we have a bunch of slight reformulations of existing drugs and that counts as "innovation".
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Oct 22, 2020 01:12
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Sharks Eat Bear posted:Going to have to disagree with your first point. Completely agree with your second point though. I already posted a study that says you're wrong on this. You disagreed because of your belief, restated here, that the US drug imbalance funds the innovation of other countries as well. However, if that were the case you'd think that US drug companies would disproportionately benefit from the arrangement(via political proximity to the regulatory apparatus and revenue streams), yet the US is more or less exactly in proportion with it's wealth and population, while several countries on that list perform disproportionately better than the US. Right now pharma R&D is a distant second fiddle to marketing, acquisitions, and stock buybacks, financially speaking. And pretty much all drug innovation has come from basic research done on the public dime, including basically every novel drug in the past 10 years(see my earlier citation). R&D may be developing new products, but it's not developing innovation.
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Oct 22, 2020 17:58
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KingNastidon posted:Drug R&D is largely an international project where revenues are pooled together and used to meet clinical development and regulatory approval needs across the world. Clinical trials predominately run in the US can be used as the basis for approval in Europe. Only certain countries like Japan require clinical trials in their own population for approval. US based companies are going to have better access to the source of revenue, which is the US's lack of ability to regulate drug prices, which has been given by you and others as a driver in drug development. I am pointing out, with a study to back me up, that one would expect any disproportionate contribution to innovation to be going to the US int hat situation. Yet it's not. The US is in proportion, and other countries with less access to the US government and market are disproportionately better. So I'm using a research study to say that argument is not well supported. quote:Maybe? It depends on what specific metric you're talking about. For example, UK has lower cancer survival rates than peer countries based on a Lancet study. Is this because NHS/NICE rations care and fewer patients receive expensive novel therapies compared to peer countries that spend more per capita? Maybe, maybe not, but it's dangerous to fall into univariate explanations on these things. By this logic, the US, which spends around TWICE as much as similar OECD nations, would be perhaps a top 3 in many or most metrics. But it isn't. It's above average in some metrics, at best. As an overall healthcare system. it's ranked below most developed nations. The conclusion you can draw is that past a certain point, per capita spending is at best only vaguely related to healthcare quality. Also, you describe the NHS as rationing care, which they do. The US also does, and moreso than the NHS. quote:There are too many things to unpack here, some of which others have already been addressed. "R&D may be developing new products, but it's not developing innovation" doesn't make much sense. A Ph3 trial that doesn't meet its endpoints (e.g., statistically superior efficacy/safety) isn't going to spend money on regulatory approval and commercialization because it won't be used. The pharma industry funded the study I cited above which says that just about every novel drug in the past decade is due to publicly funded research. I don't know how much to unpack there is there.
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Oct 22, 2020 20:49
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KingNastidon posted:Sharks Eat Bear already pointed out the limitations of that study. It's silly to attribute R&D achievements as US or ex-US. Sanofi/Ipsen are headquartered in France, Novo/Lundbeck in Denmark, Takeda/Astellas/Eisai in Japan, Roche/Novartis in Switzerland, AstraZeneca/GSK in UK, Bayer/Merck in Germany. All of these companies employees employee hundreds of thousands of people in the US, working on R&D and whatever else. Biopharmaceutical R&D is a global project, of which the US contributes an outsized share of funding because of the outsized revenue due to the outsized costs. Yes I understand you and they do not like that study. This continues to be you and them picking at my argument which I have supplied data for to back up an argument that nobody has really supported, that somehow fixing pharmaceutical costs is going to stifle innovation. quote:Sure maybe, but it's extremely dangerous and often intentionally misleading to do a univariate analysis between some random healthcare measure and per capita healthcare costs because you aren't controlling for confounding variables. The high obesity rate in the US is a good example of this. Not really a maybe, it's not exactly debated that the US massively overpays for broadly worse healthcare than similarly developed nations. For instance, Canada and the UK are similar to the US in obesity rate(with the US being slightly higher), yet UK metrics broadly trounce the US in healthcare metrics. Canada does better too. Overall, the US ranks at around 35 or so. The US is at the top of very very few metrics, unless you want to talk per capita spending. The US is slightly more obese than those two, but it spends twice as much. But traditionally, the way to defend the US healthcare system has been to cherry pick specific metrics rather than overall results, because that's basically the only way you can make it look good. quote:Agree. The US rations care based on who can personally afford premiums/out of pocket costs. NHS rations care by setting a fixed pool of healthcare dollars and trying to optimize for aggregate outcomes. There's absolutely nothing wrong with NHS approach, but I wish US single payer advocates would at least honestly acknowledge there are trade-offs. What would you say the trade-offs are? The fact that you can be rich and jump the line in the US and pay for things that might not actually work is not really a relevant argument in terms of public health. Because most of us aren't rich. quote:knox_harrington and wins32767 already explained the difference between initial drug discovery (research) and clinical development. Sure have, and it doesn't particularly disagree with what I've said.
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Oct 22, 2020 21:48
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I see youve dropped the part of the discussion where you were talking about actual researchable metrics and focused on thought experiments.KingNastidon posted:We aren't making much progress here. Let's try a thought experiment. If both US and Ex-US decided to not reimburse pharmaceutical companies for their existing therapies do you believe this would have any future impact on the number of therapies progressing to Ph3 studies or are eventually approved by the FDA? Yes I believe that the if people stopped paying for drugs altogether that would change things. This is a real thing that will happen and is worthy of discussion.
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Oct 22, 2020 22:00
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KingNastidon posted:Okay, if you're willing to concede that reimbursing pharmaceutical companies 0% of US and ex-US status quo, what about 25%? 50%? 75% 90%? At what point do you think there is non-zero future impact on clinical development or the number of novel approvals? "If there exists an endpoint at zero, what hypothetical number reduction would give make you believe my argument that I have no concrete data to support?" This is, as you said, a thought experiment. It's an illogical bit of fluff that exists to justify an assertion("single payer will reduce innovation") in search of a factual basis. If you can't provide data, perhaps you should consider that a weakness in your argument. Rather than asking me to accept your hypotheticals. Especially when the original assertion came from a poster who isn't involved in the conversation and has not provided anything at all(silence_kit) quote:Absolutely no one here is saying that US costs shouldn't be reduced in some way. It's pushing back on magical thinking that there cannot be downstream impacts by making that change. You need to identify the magical thinking and be sure it's not coming from you. Absolutely nobody here is saying that there cannot be downstream impacts by fundamentally changing our healthcare system. In fact, people are counting on their being downstream impacts. quote:If you're convinced that publicly funded NIH research is all that's needed to bring therapies to market then I can understand why you believe there's little correlation between biopharmaceutical revenues and number of novel therapies approved by FDA/NICE/EMA. I never said public funding is all thats needed to bring therapies to market, and your entire counterargument rests on this misunderstanding. My argument is that for-profit pharmaceutical companies are not major drivers of innovation. Due to how little they spend on bringing drugs to market vs simply marketing them, the result of reduced revenues for them is unlikely to make a huge impact on innovation because it's not what's driving innovation. The fundamental disagreement between us probably lies on whether you feel that getting a drug through FDA approval, regardless of whether it's a new treatment or just a slight reformulation intended to make money on an existing treatment, constitutes innovation.
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Oct 22, 2020 23:06
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Sharks Eat Bear posted:My argument is that pharma companies spend MASSIVE amounts on R&D -- this article suggests that the top 10 companies in 2019 spent $82B on R&D, which is 2x the entire NIH budget -- and that reducing their revenues will necessarily reduce R&D budgets which are the primary channel through which publicly funded basic research innovation gets translated into clinical practice innovation This article says several companies spend more on sales and marketing than R&D, and others spend slightly more on R&D, however it also points out that companies play around with numbers quite a bit to head off exactly the criticism I'm leveling, just as banks can shift money around to juice earnings reports. 82b is about 20% of the 400b those 10 companies make in revenue. Interestingly enough, 20% is what the pharma industry has been claiming it spends on R&D for a long time. And it turns out there's a long standing issue of the pharmaceutical industry claiming it spends a ton on R&D and people calling it budgetary bullshit, and here's a study that goes into that. Also there's this article quote:But as Rep. Ron Wyden, D-Ore., pointed out at the hearing, Bristol-Myers spent $11.5 billion on dividends, stock buybacks, marketing, sales and administrative costs in 2017. The company spent only $4.9 billion in R&D the same year, according to S&P Global Market Intelligence data. and quote:Merck, which had over 28% of operating expenses attributed to R&D, expects to see an increase in R&D spending faster than sales over the next couple of years as the company makes investments in combination studies for Keytruda — which account for the bulk of the company's clinical spend — as well as further investment in cancer drugs Lynparza and Lenvima, CFO Robert Davis said on the company's latest earnings call. Look at all that innovation thats happening on the literally 1-3 drugs they are working on that are already invented. But I mean at least they innovated when they came up with Keytruda! Oh wait a company based in the Netherlands did that. Anyhow, relevant the discussion here: quote:"Drugmakers say changes in the status quo will hurt R&D — a quick look at these companies' finances on both sides of the balance sheet shows that isn't the case," Sen. Wyden said. "Revenue generated from American patients alone dwarfs what they spend on R&D worldwide." Moving on Sharks Eat Bear posted:On this I think we're basically aligned, I agree that the industry wants to frame innovation in terms of productivity, but from a societal perspective that's irrelevant if it doesn't result in better health outcomes, which I think in the US we can categorically say that it doesn't Agreed Jaxyon fucked around with this message at 00:42 on Oct 23, 2020 |
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Oct 23, 2020 00:40
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FWIW I suspect, (and have no proof behind this, but I'll admit that) the US pharma industry could innovate much better by simply having the US government take 100b from what it dumps on defense contractors and spending it on nationalizing drug R&D top to bottom.
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Oct 23, 2020 00:47
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silence_kit posted:When people receive medical treatment, they expect the treatment to work not just in principle, but in practice, in reality. Yes, the basic research is more creative and more novel than product development, but the basic research result doesn't really concretely mean much to society without being developed into a real product that people can actually use and is actually proven to work. Hey if you ever want to get around to supporting your argument with factual information like the other posters in this thread do, that would be great. See ya then! 
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Oct 23, 2020 00:57
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silence_kit posted:What claim do you not believe in the quoted post? 100% of it because burden of proof exists and since I've been in this conversation you've provided absolutely nothing. At least other people are trying.
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Oct 23, 2020 01:07
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silence_kit posted:This doesn't address my post at all. I'm just explaining the value of the later stages of technology development to Jaxyon. VitalSigns in the previous healthcare thread didn't get it as well. Ah yes, the Virgin candyland of ideas that I draw my post from with my repeated references to studies, versus the Chad Unsupported Realism from silence_kit
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Oct 23, 2020 01:25
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I appreciate this post but what you've done is explained why for-profit businesses do things that will generate a profit for them. Which wasn't the question. The question was whether this is producing innovation. As previously covered, I don't consider productivity to be the same thing as innovation. Is Merck spending most of it's R&D budget to find new markets to sell Keytruda(a drug they didn't invent) over the next few years creating innovation? Do stock buybacks and dividends create innovation? Or are they things a for-profit business has to do to create profit? wins32767 posted:Because that sort of response is more conducive to a good discussion vs. just ignoring them. You're right it's not, but as you can see from my posts in the feedback thread, contentless shitposting is pet peeve of mine. You're correct that I should ignore them. I'm just going to ignore them past this point because anyone who had knowledge would have posted something by now instead of explaining how they don't need to.
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Oct 23, 2020 01:49
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wins32767 posted:I'd argue yes, though I think we both agree that it's not the best use of innovation. Assuming that the studies are good, being able to prove that Keytruda is an effective treatment for some other disease does actually improve patient outcomes. As an example, I can't take most classes of antidepressants so the fact that there are a half dozen classes means that I actually can get effective treatment. Selfishly, I'm very glad someone did a label expansion study on on the drug I'm on now, because otherwise I wouldn't have blundered into an effective treatment for me when using it for another purpose. Finding novel uses for drugs that are already proven safe is a good use of some amount of funding, though the current system incentivizes it too much. I know what theyr'e doing and why they have to do that. I understand how validations work. The point is they're taking a ton of their R&D budget, most of it in fact, and using that to prove that they can use that same drug they already came up with on other types of cancer, because every single usage has to be researched and proven. And they didn't come up with it. It's an acquisition from a EU company. Are they do that from a sense of innovation, or are they just doing the legwork to justify future marketing?
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Oct 23, 2020 02:29
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The discussion is whether or not single payer would stifle innovation. Given that most of what companies do is revenue generation and product line expansions, it feels like we're a different conversation. Finding out whether a cancer treatment is useful for other cancers is a good thing, but not exactly big innovation. When that's the lions share of the R&D budgets we're using to claim innovation are going to such a small selection of drugs, I don't think we're taking about the same thing. This is way off in the weeds and we're all spending 2 pages to discuss a tangent made from a point in a post by a guy who hasn't even bothered to back up anything.
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Oct 23, 2020 02:59
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wins32767 posted:I think defining innovation will help move that conversation forward because I don't think there is agreement on what it means. Sure, but I don't think we really disagree on innovation in this context. Do you think someone who says "I worry that single-payer will reduce medical innovation" means: a) "I really really hope that this treatment for Mantle cell lymphoma can be proved to be effective for Primary mediastinal B cell lymphoma while also making it possible for the company that produces it to juice it's stocks and get it's C-level execs the highest quality of sex worker on their yacht, via spending far more on those things than my cancer research" or b) "I am worried that some stuffy government bureaucrat will decide that my illness isn't worthy of research compared to looking at how to make DMV wait times longer and raising the price of stamps by 3 cents" I know my quotes are tortured, but we both know the answer is B. That is what people are worried about. Is it important to make a new cancer treatment available for more cancers because cancer sucks? Yeah absolutely that work needs to be done. I fail to see why that would suffer under socialized a universal healthcare system. If the answer is "reduced revenue for the companies and they're greedy so they won't cut stock buybacks before they cut R&D" then that suggests some solutions that are entirely possible. Jaxyon fucked around with this message at 09:36 on Oct 23, 2020 |
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Oct 23, 2020 08:48
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