Slashdot Mirror
Nobel Laureate Attacks Medical Intellectual Property
An anonymous reader writes "Nobel prize-winning economist Joseph Stiglitz, who was fired by the World Bank blasted drug patents in an editorial in the British Medical Journal titled 'Scrooge and intellectual property rights.' 'Knowledge is like a candle, when one candle lights another it does not diminish its light.' In medicine, patents cost lives. The US patent for turmeric didn't stimulate research, and restricted access by the Indian poor who actually discovered it hundreds of years ago. 'These rights were intended to reduce access to generic medicines and they succeeded.' Billions of people, who live on $2-3 a day, could no longer afford the drugs they needed. Drug companies spend more on advertising and marketing than on research. A few scientists beat the human genome project and patented breast cancer genes; so now the cost of testing women for breast cancer is 'enormous.'"
How can you patent something that is a 'naturally' (using that term loosely) occurring genetic abnormality?
Your hair look like poop, Bob! - Wanker.
...the guy who originally lit the candle didn't spend millions of dollars figuring out how to light it. I'm all for equal access, but if you're going to spend all this money doing something then it's only fair to be given the chance to reap the rewards.
Things haven't changed all that much since the days of theChamberlen family.
While I am no expert, nor am I really FOR these kinds of patents there is a valid reasoning TO have them. Primarily, it is reasoned that patents, including intellectual, drive innovation as people can actually make a profit on their discoveries as opposed to just being copy-catted. Of course, in practice, it doesn't quite work that way.
If there's one area where I think Eminent Domain applies, it is to this sort of "property." If the pharmaceutacals "own" a cancer drug, an AIDS drug, a heart valve palsy drug, then fucking TAKE it from them and give it to the world. If they have to be compensated under eminent domain laws, then give them a twenty year extension on their stupid penis pills, their fat-buster pills, or their toenail fungus cures. If they can do it with your house to make a bypass, then they should be able to do it with something that will really benefit society.
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Yes its pulled from there. And the value does not matter, what matters is those with the gold rules, and continue to make their own rules, to control the rest of us meager hard workers just making a living.
Why not? If you can forcefully let individual "sell" his property for the greater good, why not a corporation? What is the difference between taking a property from a house- or landowner and a pharmaceutical company?
The real question is what would be a better way to reward inventors than intellectual property arrangements. IP doesn't reward creation of an invention-but its restriction. It is clear that major corporate interests have abuse IP protection in various ways. The problem is that an alternative system isn't exactly obvious. The economist Henry George proposed replacing the system of patents and copyrights with a system of prize awards over 100 years ago. However, determining what inventions should be rewarded is still going to be difficult.
>>'Knowledge is like a candle, when one candle lights another it does not diminish its light.'
Apparently he was also a Girl Scout at some point...
The entire medical industry is broken. Probably to the point where it cannot be fixed. Government regulation could go a long way, but who really wants a bigger government?
1. Stop advertising drugs on TV and in magazines. You are not a doctor. You shouldn't be "asking your doc" if zotramiphil is right for your itchy ass.
2. Stop developing drugs for stupid shit. Yes, lots of people have Type2 diabetes. We already have a cure for that; a treadmill. Stop wasting money to develop a drug *just* to make money off a stupid disease.
2a. Why can an old guy take a drug to make his dick hard when I can't smoke a joint?
3. If a company develops a truly amazing cure/drug, the government should step in and buy it for the cost of development. The drug should them be distributed for the cost of production inside the US and for twice the cost of production outside the US. Once the costs are recouped, it should be just the cost of production inside and outside the US.
4. Get rid of medical lawsuits. A judge and jury have no idea if what a doc did was right or wrong. Appoint a commission of well-respected docs and have all medical complaints go through that office. If the commission decides the doc was wrong, then the doc should be fired and the patient recouped in a fair way.
4a. Make hospitals stop charging so much. Why does it cost $200 for an x-ray and $10 for a tylenol? Because of lawsuits.
5. Make US employers provide health insurance. Yes, all of them. Call it the cost of doing business in the USA.
5a. For every non-US employee a company contracts or subcontracts, make them pay money directly to the federal government's unemployment fund. In other words, a non-US employee working for a US company still gets taxed at the same rate as a US employee would.
6. Identify the hypochondriacs and truly sick people. Fix them. I go to the doc, on average, once a year for a checkup. Maybe once every 3 years for an illness. My kids get checkups and rarely go to the ER for being sick or hurt. If you or your family member is going to the hospital every week, something (lifestyle or mental) needs to be fixed.
7. Pay for any improvements by taking money out of the DoD. Stipulate that the DoD has to maintain current manning levels and quality of life. All money taken from their budget should be from cruft (how much does DoD spend on office supplies) or from special projects (Do we really need the JSF right after the F-22).
7a. Reduce the funding to every government agency by 2% per year until the customers start complaining. Then, analyze the complaints to see if better customer service could fix the problem. Fire assholes and slashdoters. We pay for 8 hours, fucking work them.
8. Threaten corporate shareholders with jail for withholding good drugs at low cost.
9. Mandate one special project for major companies. Wanna do business? Then you have to work on a cure for AIDS.
I'd rather you do it wrong, than for me to have to do it at all.
Very nice, although I think the list of citations is a little short. Dean Baker has been saying much the same thing for some time - but he doesn't have a nobel prize. Still I think he makes a more interesting case for much the same thing and Stiglitz ought to have cited him (among others, but I prefer Baker's writings based on clarity and style.)
I write a new edition of this essay every time the topic comes up (and it has no citations at all, which should not be interpreted as a statement that these are entirely my ideas):
Let us say, just for the sake of argument, that a method of extracting or purifying a gene, or a gene product (a protein) consists of an invention, worthy of patent, in and of itself. This is distinct from patenting the gene itself - if I can do that, I am patenting an end, and not a means to achieving that end. If I come along and purify the same gene product, by some other technique, I'm violating their patent. Crucially, I will violate their patent even I use none of their actual inventions at all! I am violating their patent because I am seeking the same end.
At first glance, this might seem similar to product patents as applied to synthetic molecules. However, in those cases the molecule itself is a unique invention. If I develop a particular technique for tending an orchard, I cannot patent trees! Patenting genes that cause diseases is a separate intellectual fallacy that deserves coverage in it's own right.
This is like patenting the act of killing germs. If a disease is caused by an abnormal (mutant) protein, than the only true cure is to fix that protein - replace it with functional protein, or remove those cells generating the harmful protein, according to the particular condition. The same argument applies to gene-products (proteins) that cause elevated risk for cancer, heart disease and the like. A patent on the gene is basically a patent on all possible cures for that condition/predilection. A gene that causes a predilection for breast cancer should be viewed as a condition in and of itself (which needs to be at least treated,) and not as some part of a particular treatment for breast cancer.
Finally, I should say our genomes, not just collectively, but individually, are the property of the human race. In a biological sense, they are the human race.
Bees are generally black and yellow, and have poisonous stingers. Individual bees, however black or yellow they may be, and poisonous their stingers may be, are all 100% bees - they all possess an equal allotment of beeness. Likewise, the quality of humanity is 100% endowed to each of us.
However, it does not arise from any of us individually. We are all human only because the entire human species exists. The genome of any individual person is not sufficient to specify the human race; the genetic diversity of your fellow human beings is part and parcel of your fundamental human identity.
The same is true, in fact, of the genetic diversity of all known living things, which are our cousins.
Many people have a visceral objection to the idea of a gene being owned. Certain of my colleagues are fond of implying that the objections of laymen arise from some degree of scientific ignorance, or a lack of appreciation for the effort that goes into doing molecular biology. I am a molecular biologist myself, fully cognizant of the hard work that is done. I understand all of that quite well, but I come to the same visceral conclusion: you cannot own that which makes us human.
The good and new comes from no quarter where it is looked for, and is always something different from what is expected.
Complaints about the patent system in drug development typically founder on one sticking point. Without patents, who is going to come up with the immense sums required to bring a drug from investigational status to clinical reality? One alternative, of course, is a national drug discovery enterprise, funded by tax money. The problem with that, however, is that the funds required are immense, and the risks are high. Who is going to take the blame if the product of a billion-dollar drug discovery effort fails in Phase III trials, something that happens rather frequently to pharmaceutical companies? Not to mention the risks that such an effort would turn into another pork boondoggle, with money being expended in response to political rather than medical needs.
Stiglitz's proposal offers an intriguing compromise--a system of federally funded prizes for private development of "open source" pharmaceuticals. Moreover, it could potentially coexist with the current patent system, perhaps initially focusing on areas that are underserved by the pharmaceutical industry, such as development of new antibiotics. Of course, the prizes would have to be very large to attract private development, given that the open source requirement would greatly limit the profit potential of the drugs discovered. However, the prizes could reasonably be staged--so much for successfully passing Phase I, so much for successfully passing Phase II, etc. etc.
1. If a researcher looses a monopoly on one patent, but in turn gains access to 10 million other patents - then that is a net gain for invention and for business, not a net loss. The facts bear that out. For example, how most the new drug innovation was happening in India where they don't have patents on drugs, or the less proprietary x86 architecture that took the market by storm in spite of it's design flaws.
2. Patents do not change the demand for invention and R&D, they only distort the market and cause it to center around invention controls instead of invention related services. Well, large companies, lawyers, and government are good at controlling things. Inventors are good at inventing things, so patents do really not help inventors or small lean innovators.
3. To control inventions requires physical coercion and violence, and patents are very violent. Like how they arguably held back safety devices in cars for 20 years while millions died needlessly, and like how attempts of patent enforcement in Africa have likely led to over a million unneeded AIDS related deaths. Also, DDT was banned within months of its patent running out, freon too, to make room for bigger markets. But at least the freon one can't be attributed to 50 million malaria deaths.
4. In the future, technology is likely to bring production back into the home thru 3d printers and nanotechnology. IMHO, patents will require more violence and more government micro-regulation than ever in order to be secured.
5. A side effect of the patent system is that researchers who share research and innovation between companies are punished. It creates a strong disincentive against collaboration. It forces innovators to spend orders of magnitude more on R&D and causes them and their research to be micromanaged. So patents drive up the cost of R&D by orders of magnitude, drive down quality, and then now they say "well, we need patent monopolies to recover all these costs".
6. People tend to think that having all these incompatible parts and all these incompatible interfaces on every single car, cell phone, and consumer product - is just a normal part of a free market economy. I speculate that it is not, and that patents encourage these distortions in addition to all the waste and unneeded obsolescence that goes with it.
7. People tend to think that having expensive pharmaceuticals with all sorts of strange chemical side effects is just a normal part of a free market economy. In addition they think that the shunning natural cures, herbs, and vitamins is a normal function of modern medicine and science. I speculate that it also is not, but another distortion caused by patents.
8. Patents are not property anymore than slaves on the plantation are. Just cause someone calls something a property doesn't mean that it is.
In sum, patents don't help inventors, but distort markets to work against them and even punish and isolate them. They are violent, genocidal, coercive, unproductive, inefficient, and drive down profit, quality, and compatibility across markets everywhere. The future for patents does not look promising, but rather to be one of millions of US elderly suffering from high costs and strange chemichal side effects on their medication, and one of a military police state required to enforce them as things like 3d printing and nanotechnology force the commoditization of invention.
So, what? We're argueing in favour of grossly disproportionate incomes for the wealthy and poverty in the third world.
It's easy to misrepresent what people are saying. There's even a name for it; the Straw Man logical fallacy. Bear in mind that people who point out the "1% population, 90% wealth" statistic do so because it is shocking, scary and unsettling. Not because they advocate communism.
Personally, I'd rather live in that world where I can move as high as my talent can take me, than live in a world of enforced "equality" that really means transferring money from the doers to the takers.
I certainly agree with your preferences, but we don't really live in that world. Becoming extremely rich and/or powerful usually means being born into that position, or some combination of luck and breaking the law without being caught.
All most people want is the corruption from the top removed, and a little safety net at the bottom so that a string of bad luck doesn't destroy your life.
But you see, those who are there, have built barriers where your talent will not allow you to get there. Patents on things like this are an excellent example of the barriers.
I felt the same way as you, that nothing in the world could stop me, but this started to fade away after 40.
Becoming extremely rich and/or powerful usually means being born into that position, or some combination of luck and breaking the law without being caught.
I'm not saying I'm "extremely" rich, but I've done pretty well in life by most standards. It had nothing to do with luck or breaking the law (nor being born wealthy). In fact, of all the rich people I know, I only know one that inherited their wealth (four kids split $160 million). I venture to say that, at least here in the US, that's far more typical.
Generally speaking, rich people are rich because they chose to be that way through hard work and sacrifice. But, for whatever reason, no one believes that. Maybe because the media only shows the Paris Hiltons of the world, when most of the working rich do their thing in obscurity.
Sometimes it's best to just let stupid people be stupid.
"In medicine, patents cost lives."
Patents cost lives in more than just medicine. I remember hearing about an African country that turned down a shipment of grain because it had been genetically altered. The fact that it was genetically altered wasn't the problem. The problem was that there were patents on the alterations and the government knew that farmers would use some of the grain to raise new crops. That country chose to let their people starve rather than face the consequences of patent infringement.
Corporations don't give a shit about people. They could care less if you as an individual lived or died. You and I are nothing but prospective customers, a possible source of profit and it is only to that end they care.
The race isn't always to the swift... but that's the way to bet!
Do you honestly believe most innovators are fueled by the enticement of economic wealth, and not by the reward of doing something great for society?
I think some kind of limit on royalties should be explored. We can give inventors some rewards without grinding everything to a hault. Some kind of compromize is needed.
Table-ized A.I.
and I say to the poor, "Let them eat cake".
Your right to live should depend entirely on how much money you have.
[neo con parody off]
--- Grow a pair, liberals... stop letting the Republicans bully you!
... may well consider spending some of its billions buying out critical patents?
FTA:|The chief executive of Novartis, a drug company with a history of social responsibility, said "We have no model which would [meet] the need for new drugs in a sustainable way ... You can't expect for-profit organizations to do this on a large scale."|
I haven't looked at the cost to bring a drug to market (from discovery to preclinical work through to NDA filing) recently, but last I saw it was in the region of $800 million US. Most big pharmas are tweaking the winning compounds they already have rather than pushing riskier candidates through the later stages towards approval. If you can play with the other enantiomer of your already approved product rather than mess with a new molecule, you do that first, assuming you own the rights :) Most of the big pharmas do R&D and spend enormous sums, but the biotechs and biopharmas still do the work on the less favored sons, hoping for a wedding or at least an invite, but as the man from Novartis indicates, it's a business fraught with peril, not many compounds make it through the regulatory authorities like the FDA, EMEA, etc. Pfizer and Lilly and the others do their due diligence and throw seed money at the little guys along with venture capitalists, but sustainability is a big ask when the percentage of compounds receiving approval is as low as it is.
Public funding for successful cures. Not treatments, cures. No cure, no loot, and that makes it perfectly clear what should or should not be tried for, by public pressure. Winner take all. Smartest guys win. Make the cash payout large enough, you'll get teams trying, and they won't have to waste money on advertising/marketing/fancy offices/corporate jets/lobbying/bribing, any of that crap they do now, just the lab and the brains... No suits or skimming needed or even applicable. The winners take their payout and try for the next prize or whatever else they want to do, because the winning formula gets public domained,it gets the anti-patent treatment in other words, then any generic company can offer it so the cost will be low over all and instant competition to keep it low.
An alternative from the private sector (this is wild but might work and I think millions of people would participate) would be a 50/50 split, using a lottery. 50% for lottery prizes, the other 50% going to the medical x-prize. No tax money needed that way, no institutional money, and it's been proven that lotteries attract cash. Again,let the people, the potential customers for medical "stuff" we are talking about, determine what gets funded or not based on their own self interest.
Another way is just a private bounty system to fund the x-prize, interested people, other businesses (I have mentioned insurance companies before in this regard as one such business), etc. are free to donate to the winners purse, these monies also possibly coming from what is normally donated for "research" anyway, you see them now, this society, that society, this medical foundation, that one, jerry's kids, etc. Cut to the chase and fund only cures,and things will change. Keep it the way it is now where we give patents for mostly treatments-and it will stay the way it is now. Nothing will change. You can't get different results until you first change the way you go about what you are doing, doing the same thing over and over again will just get you..the same thing.
Generally speaking, rich people are rich because they chose to be that way through hard work and sacrifice.
Working hard and sacrificing certainly helps you get rich, but for the vast majority of people, that'll lead to a comfortable middle class life.
Maybe because the media only shows the Paris Hiltons of the world, when most of the working rich do their thing in obscurity.
It's not the working rich that people dislike. It's the Kennedy's and Bush's with their shady fortunes, Microsoft making a mockery of the law to build a monopoly, Halliburton and their no bid war contracts, Carly Fiorina and her giant severage package reward for destroying HP, etc.
It's not that people dislike the working rich, it's that they're essentially invisible in the scheme of things. They don't have the money to influence things like the non-working rich do, and there aren't enough of them to influence things like the middle class does.
The (slashdot) article content is incorrect. there is no restricted access to turmeric (and its derived anti-cancer products) for Indians.
Even the original article mentions "had it been enforced"
Advertising for prescription drugs used to be illegal. After that was "deregulated", it grew to twice the cost of drug R&D. There is now one pharmaceutical sales rep for every four doctors in the US.
Until the 1980s, drugs developed at Government expense went into the public domain immediately. Now, pharmaceutical companies can buy rights to government-developed drugs.
Big Pharma has negotiated several special deals to extend patent lifetimes. Patents are extended by the time the FDA spends evaluating the drug. And then there's a "proprietary rights in drug testing data" thing, which means that the company which did clinical testing gets an exclusion right against generic makers which can outlast the patent. And then there's a special extension of exclusivity deal if a drug company pushes an existing drug through clinical testing for children, which can extend the patent life.
But when the patent runs out, the price goes way down. Claritin used to be over $1/tablet; now the generic version is about $0.12 each.
Even IF you're in great shape, High Fructose Corn Syrup, the stuff that they've adulterated every
bit of your food supply with, will dramatically increase your chances of getting Type II Diabetes
ANYWAY. It causes nasty, ugly swings of blood sugar levels because it resides in your blood stream
because it is present there, insulin doesn't get rid of it, but your pancreas senses sugar, and
the only organ in your body that can directly USE it is your liver. You end up getting fat if you
take in too much Fructose- even if you're fit. You end up with Insulin resistance in spite of you
being fit because of the insulin spikes induced by the sugar in question.
It's a handful of things really- and telling someone to just get on a freaking treadmill isn't
the answer. It's a BUNCH of things, including some that actually DO need a pill to fix the
problem.
I am not merely a "consumer" or a "taxpayer". I am a Citizen of the State of Texas
Right now the cost/benefit analysis of any medical research strongly favors treatments over cure. If investors see two projects with two possible outcomes, one with an expensive and inconvenient regimen for the rest of someone's full life, or a project that plans to have a 30-day cheap pill cure, the investors will lean toward the one *obviously* suboptimal for society, because ROI is higher.
If something like what you are talking about is done, more measures can be taken to level the playing field so that cures are financially as well as socially are better than treatments.
XML is like violence. If it doesn't solve the problem, use more.
"He who receives an idea from me, receives instruction himself without lessening mine; as he who lights his taper at mine, receives light without darkening me." - Thomas Jefferson
Murderous Monsanto should never be trusted with our food supply. Not any part of it. Previous links just the tip of the iceberg.
With that, people don't bother to shop around.
The law ought to be as follows:
For non-emergency, all costs must be disclosed as early as possible. Individuals pay out of their pocket. There is no mandate to treat people who can't pay. Insurance is prohibited, because it acts to reduce price competition.
For true emergency, the government pays until the emergency has passed. All people get treated as needed. (excepting unusual mass-casualty situations, where the hospital should pick people likely to survive and people who are needed to support families)
Simple broken arms are not true emergencies. Normal childbirth is not an emergency. To be an emergency, the person must be in immediate danger of preventable harm. In other words, your end result will be worse if you don't get immediate treatment. Anything that can wait a few hours is not an emergency.
you are a colossal moron.
if you get a deadly ailment that requires one of these designer drugs, you will end up paying $70 per pill because the company has patented the formula. Without patents, a generic can be made at probably $2 per pill. While that is still expensive, it's manageable for an impoverished family of someone who has a deadly ailment curable by the designer drug.
pharmaceutical companies are businesses who have publicly owned stock. They are spending more on advertising than on research.
Merck, Phizer, EJ Lily and other ticks could be curing fucking plagues with that money. but then they wouldn't be in business.
cholera could be inert. malaria could be inert. smallpox could be inert. rubella could be inert. horrible diseases like cancer and leukemia could one day not be life threatening.
HIV could be inert. HPV could be inert.
To say, we found this life-saving formula and you have to pay us exorbitantly to save your life, is a crime against humanity.
These pharmaco's research is mostly based on tribal wisdom. Patents prevent those tribes and shamans from benefiting from their discoveries.
the first safe general anathesia is made with D-tubocurarine from an adapted curare serum. curare is a mixture that tribal cultures in the amazon basin use to tip their arrows and darts with so they can hunt effectively. They discovered the formula.
patents can be a good thing for certain industries. They protect inventors and the like. but they are misused as a free pass for exploitation today.
They're using their grammar skills there.
In the USA, people expect perfection. They demand it. If they don't get it, and even sometimes when they do, they file a lawsuit. Sometimes this is a multi-million-dollar jackpot. Other times, the insurance company quietly settles for a damn fine chunk of change.
This means the doctors have to pay for insurance. Some need to pay over a million dollars per year. Guess how they get the money.
The fix is easy: eliminate all medical liability. If the doctor is incompetant, he should just lose his license. If the doctor is evil, he should just go to jail. If the patient wants a payout upon injury, let them buy their own insurance to cover such injuries.
Winners: nearly all patients and nearly all doctors
Losers: trial lawyers, incompetant doctors, and evil patients
Mixed: insurance companies
If nature has made any one thing less susceptible than all others of exclusive
property, it is the action of the thinking power called an idea, which an
individual may exclusively possess as long as he keeps it to himself; but the
moment it is divulged, it forces itself into the possession of everyone, and
the receiver cannot dispossess himself of it. Its peculiar character, too, is
that no one possesses the less, because every other possesses the whole of it.
He who receives an idea from me, receives instruction himself without lessening
mine; as he who lights his taper at mine, receives light without darkening me.
That ideas should freely spread from one to another over the globe, for the
moral and mutual instruction of man, and improvement of his condition, seems to
have been peculiarly and benevolently designed by nature, when she made them,
like fire, expansible over all space, without lessening their density in any
point, and like the air in which we breathe, move, and have our physical being,
incapable of confinement or exclusive appropriation. Inventions then cannot, in
nature, be a subject of property.
-- Thomas Jefferson
"When in doubt, use brute force." Ken Thompson
The most people are guilty of only one thing; being powerless. What a fine comment you make. "They deserve to die."
Have a nice Christmas.
The race isn't always to the swift... but that's the way to bet!
I explain this idea in more detail in my article Published Digital Information is a Public Good: The Case for Voted Compensation.
Music: a super-stimulus for the perception of musicality. Musicality: a perceived aspect of speech.
This is true, but it is also part of the problem. There is far less private investment into serious medical problems of the third world (parasitic diseases, for example), because the profit potential for such drugs is so limited, even though the potential for relief of human misery may be very great.
The main reason that a small percentage of the population shouldn't own a large percentage of the wealth is that such a situation tends to lead to civil unrest. Basically, in such situations the uspet and restless poor can take action either through a revolution (often Marxist--see Namibia or Nicaragua or Cuba) or a democratic process (election of Hugo Chavez in Venezuela). For examples of countries with very even income distribution, see pretty much any part of Scandinavia--safe, highly educated, politically stable. Effectively, the more people that have satisfactory living conditions (however that's defined in that place and that time), the happier and more invested in their society they feel and the less likely they are to become angry and restless.
words..words... women..breast..enormous.. whoa!
There is no evidence to support the concept that "intellectual property" patents actually encourage innovation. The candle metaphor used in the article is directed exactly at this concept. Anyone conversant with the history of science beginning with Francis Bacon and onward through the formation and growth of the Royal Societies and the other national and international scientific associations knows this. Knowledge leads to knowledge. The very REASON for peer review is to test one's data, methods, and conclusions against other knowledge. Secrecy around "intellectual property" encourages a "small pond" approach to peer review and limits the actual functionality of the scientific method and effectively intellectually isolates the very researchers attempting to benefit from the "secret." Patents, secrets, and "intellectual" property hobble any science, and will force increases in cost at the expense of money, time and efficenicy. At the other end of the scale, incidents such as the "discovery" and patentiang of Tumeric, a substance widely documented as a folk-remedy, is simple theft, pure and simple. It was cynical and can even be construed as greedy and vicious. Certainly the patent didn't support a costly research effort, nor does protect a "discovery." Ultimately the tumeric patent was struck down. One could argue that rather than the government issue patents, business should be required to rely soley on industrial secrecy to protect their "intellectual" property. This would immediately simplify many things. WIth no more patent system the demand and cost of patent lawyers vanishes over night. If an individual wishes to actually benefit from the knowledge of others through peer review, then they bite the bullet and decide whether the lost of the "exclusivity" of their "secret" is balanced by the gain of the insight of others. Each time they seek the response of the community innovation actually WILL be encouraged.
------ The only greater hazard to your liberty than n politicians is n+1 politicians.
You lost your right to say that Americans are free when you didn't butcher Dubya and string up the supreme court for imposing their own opinions on a set of election results that were not even remotely clear, and refusing to even hear the appeals of the tens of thousands of disenfranchised voters that were barred from voting just for being poor and having names that were too similar to those of a convicted criminals in other states. That you don't lynch-mob government officials that engage in gerrymandering is proof enough that you don't even care if your elections are even remotely representative. Even allowing the existence of "lobbying" (AKA bribery) is an embarassment for any nation in which it occurs. America is not free, it is not democratic, and it is by far the stupidest nation in the Western Hemisphere. Consider this: it is the only non-Muslim nation where there are actually a sizable number of people that question the value of literacy... and are willing to elect leaders that lack it.
First of all, there can be no cure. This is a simple fact that would be obvious if you understood how AIDS worked.
Second of all, we know perfectly well how to avoid getting AIDS. Aside from a few extremely unlucky people, only idiots get infected.
There are so many other diseases we could cure, including ones that wouldn't be a total wasted effort. There are normally-communicable diseases like tuberculosis that are coming back to haunt us in drug-resistant forms. There are mosquito-borne diseases. Heart disease kills many, including people who don't make foolish dietary choices. Mental illnesses, such as schitzophrenia and maniac-depression, are common and destructive. Then there are all the numerous injuries, like severe burns.
Sorry, the US constitution hasn't been a meaningful force in US politics since ... well, ever. It's a joke. Lincoln destroyed an last vestiges of meaning that it may have possessed. Dubya treats it like a used sanitary napkin; something too unpleasant to mention in polite conversation.
Perhaps more like you blasting a nobel winning economist?
There are already very effective generic anti-parasitic drugs, such as Praziquantel, available at reasonable prices. There may be human conditions which are not well treated because they are uncommon, but parasites are probably not the best example. In many cases, better access to clean water and increased use of certain pesticides like DDT would be much cheaper and more effective than continued use of drugs.
Of course you know that's an exaggeration, but just out of curiosity, why do you think that (small percentage) should NOT own (larger percentage) of the world's wealth? Personally, I'd rather live in that world where I can move as high as my talent can take me, than live in a world of enforced "equality" that really means transferring money from the doers to the takers.
Where do you think rich people get their money? Trees? Rich people take their money from the profits of things that normal people buy, basically by skimming off the top of everyone else's labor. There's no way to become wealthy in a vacuum, the *only* way is to get a little slice of everyone else's pie.
You assume the United States is the only one with a stupid government.
And you are too ready to call people "stupid" instead of thinking.
Politicians, broadly speaking, are not stupid. The rewards which flow to a successful politician - money and power - are huge. There is therefore a lot of competition. Stupid people have no chance.
Politicians say stupid things pretty often. That's not because they believe what they're saying; it's because saying those things will get them more votes.
Politicians often pass legislation which harms the people they represent. But the majority of voters don't follow complex issues, so that doesn't affect re-electability. In most cases, the legislation is in response to some special interest. The purpose of passing it is usually to get more campaign donations. It is relatively cheap for large corporations to buy the legislation they want in this way (here's an example).
Our pols are not stupid, just unethical. But our political system seems to favor unscrupulous people.
In Soviet Washington the swamp drains you.
Patents expire, but so do people.
People expiring is much worse. I'm fortunate enough to be blessed with the means to provide for (hypothetically) any medical care that I would need, but if I had to sit around and hope I didn't die in the 7 years it takes for a medical patent to expire, I'd be kindof upset about it.
-Bucky
Yeah , why $200 for an xray, when its free at the airport?
... big deal. Its a cost input, doesnt mean you have to recoup the cost with in 12months.
So the machine cost $450,000
Why not buy in bulk then supply the whole country with 5000 machines.
Liberty freedom are no1, not dicks in suits.
It's interesting that a hospital or Dr. can be sued for watching a patient die and not helping but [Mistlefoot (636417)] do this everyday with no repercussions.
I wonder if this could be winnable in a US court.....probably not....
Why isn't this murder? Watching someone die a slow painful death when you could keep them alive is certainly not something that this country claims is humane.
What prevents you from drawing your checkbook and paying for the fucking drugs? How are you better than the big pharmas? They have developped drugs and made something possible : now ANYBODY (the patient, the govt, any charity, even you...) can buy the drugs for the patients. What have YOU done? You're blasting the big pharmas for not doing enough.
You're such a hero. It's a pity the world is not 100% populated by your type. Nobody would do anything, but everybody would blame the others for not doing enough.
It would be like heaven on earth, wouldn't it?
It would be nice to be sure of anything the way some people are of everything.
There is'nt, never has been, and never will be a Nobel prize in economics.
The award he was presented with was "The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel". It was established in 1968, and not intended to celebrate the memory of Alfred Nobel as the name suggests, but the three hundredth birhtday of the Swedish central bank.
Alfred Nobel only mentions prizes in five categories in his last will and testament: "Literature", "Physiologi or Medicin", "Physics", "Chemistry" and "Champions of peace", and these real Nobel prizes have been awarded since 1901.
An excerpt from the testament
Supposedly, the dems will be pushing similar laws that Colorado just enacted (I found it interesting that a republican leaning paper feels that brakes on corrupt congressmen is not needed). If so, then it will help to stop the corruption. Of course, I suspect that lopeholes will be left, but we will see.
I prefer the "u" in honour as it seems to be missing these days.
... because our government runs by the Golden Rule (i.e., "Those that have the gold make the rules").
The reason that government appropriation of property is on the upswing, is that it is being taken from individual citizens and handed to corporations, corporations having become a class of privileged entities over and above mere individuals. For this to be reversed to allow individuals to appropriate assets of corporations, even for the "greater public good", goes against the Golden Rule -- and thus, is simply never going to happen.
Since the time that the USPTO was founded, there has been a crush of funds motivating the legislators making small (and not-so-small) changes in the laws governing patents, with the intent of making patent law an instrument of wealth hoarding instead of an instrument to protect innovators from established interests.
The established interests now run the game, and all the wailing of the masses is not about to change that.
All they have to do is prove the sequence does what they say it does. RNA science is likely to prove their assertions to be all wrong in the end. And since they cannot say beyond a reasonable doubt the sequence is a cause of cancer, then the patent is useless for all intents and purposes. Patenting RNA by doctors is the real danger in the future.
But if you could patent using tumeric for treating disease isn't that insane? Especially if it has been done for hundreds of years?
You are reading a copy of my copyrighted post.
TFA speaks about an aspect of the support of patents that is often neglected by the /. commentators: the importance of the patents to the US commercial balance.
For me this is the number 1 reason for the existence of an inflated patent system in US, a country which has billions of dollars of yearly benefits from it and which desperately tries to enforce it to the rest of the world (in particular to the European Union and the WTO).
For me anyone trying the understand the behinds-the-scene of the discussion on patents should try to get a good understanding of the importance of the TRIPS to global trade and why it was a major negotiation issue in the Uruguay Round.
We can do without medicines
Eclipse PDE and Me
Rewards and prizes are great and grand, but can we seriously expect to match the amount spent in development, not to mention provide some sort of profit? They spend years developing these drugs and only manage to pull through through the sales thereof. If a drug fails, like torcetrapib just did for Pfizer, who is willing to step up and compensate the company for a billion or so odd dollars? If people really want to solve this problem, they need to either be willing to take on the burden of having to regularly pay medical research taxes, or is more likely, accept that patents can be worked around for cases where the drug is hard to afford, either by forcing the companies to offer huge discounts to those under a certain income level, or offer up tax money to those who buy the drugs, not sell them, so that they can purchase what they need without deciding against food, shelter, or drugs.
Until a system comes into place where compensation for drug development can be made through generics, in a market where the ultimate idea is to not have anyone have to use your product (ideally), or until a magical "third option" comes along outside of capitalist or governmental compensation, patents are an ugly, necessary evil. The best solution, again, would be to prop up those in the lower income bracket with drug money, or better yet, buy the drugs en masse and distribute them. I'm sure something along the lines is going on right now in parts of Africa and maybe the occasional clinic, so why not simply add more funding to this system to compensate while eyeballing the companies to ensure that no one company is getting fat off a drug monopoly?
You like to redefine things to suit your point of view. To define this as a crime against humanity could very well make you a criminal as well. If you have $5 in the bank, and there's a starving child somewhere... Hey you're withholding food from the child you could help, and you're not!
A little socialism can be a good thing. A lot of socialism... society rots from within.
Having said that... If government funding helped produce the drug, then the government is one of the stake holders in the patent and should exercise it's leverage on behalf its constituents. But this is an arguement against "corperate welfare", and has little to do with "crimes against humanity".
This is comparing apples and oranges. Public health measures are a preventative, not a treatment. Or to put it another way, when somebody shows up in a clinic with a parasitic disease, you can't give them a glass of water and a shot of DDT and send them home. This is not to diminish the importance of preventatives, but a) they require a level of social organization and stability that is not always present, and b) they rarely completely eliminate disease, so you still need effective treatments.
As the saying goes, once you are up to your neck in alligators, it too late to talk about draining the swamp.
It's funny to see that a nobel prize in economics is messing up an euro dollar conversion. From TFA:= EUR&to=USD&amt=130
AIDS drugs might cost $130 (£65; euro 170)
euro130 is $170 not the opposite: http://fr.finance.yahoo.com/currency/convert?from
I hope it's the editor mistake...
I'm sorry but you are distorting the words of the Novartis CEO whether or not you know it. Please read the article. He was specifically referring to the production of cheap drugs for the 3rd world. More specifically, Novartis was pointing out that government and NGO organizations had failed to meet their commitment to purchase enough of Novartis' anti-maleria medication such that it could be produced at economically sustainable levels (Novartis had to subsidize production by 10m/year -- ignoring R&D costs). If anything, this illustrates some of the pitfalls of these centrally planned & non-capitalistic models of drug development (while they may be a necessary evil for drugs which only have 3rd world markets, like malaria,... it does not mean that they are actually effective)
As for your blathering on line-extensions and what not... your reasoning and facts are flawed. Yes, drug companies prefer easy money to hard money, all things being equal (like everyone). However, your belief is based on the flawed premises. First, line-extensions are low-hanging fruit. They are very cheap to develop and market when compared to finding, developing, and proving the clinical efficacy of wholly new drugs. Second, the revenues of line-extensions are much smaller (like 75% smaller) and they tend to only last a limited amount of time. Many consumers know that their original compound is often as good, don't have the funds to pay extra, and HMOs/insurers/socialized medicine and other entities put a lot of pricing pressure on them (if they pay for the extension at all). Third, the line-extensions really only make financial sense with more popular drugs. Fourth, they tend to earn positive returns in a fairly short amount of time. In other words, your belief that drug companies dump most of their available funds into isn't even logical given the facts. They devote a small percentage of their available capital to line-extensions. However, while this may divert some capital in the short-run, it generates profitable positive returns in a few short years which are inevitably plowed back into serious R&D.
* * * *
Novartis chief in warning on cheap drugs
By Andrew Jack in London
Published: September 29 2006 22:04 | Last updated: September 29 2006 22:04
Novartis, the Swiss pharmaceutical group, warned on Friday there was no economically sustainable system that could provide low-cost innovative medicines to the developing world.
Daniel Vasella, the company's chief executive, unve
I was in this industry for 25 years and my father for 25 years before me. I practised in Southern Africa during this period and was an elected representative on the national body of the Pharmaceutical Society of South Africa (PSSA). I can speak on the subject with some authority because I know the background of what it is like for 3rd World economies. Pharmaceutical Companies (PC's) apply differential pricing depending on where they are operating. eg identical medicines are 14% more expensive in the USA than they are in Europe. The major PC's are all in the top 20% of the top 100 listings on the stock exchanges of the world. They give returns of twice as much as their comparative listed companies. Most provide annual returns of over 20% compared to their non-pharmaceutical rivals 10%. An example of the type of tactics they use their patents for could be seen a few years ago in South Africa. The South African pharmaceutical market is divided into 2 categories - State and private sector. The state buys all their medicine on tender. In order to obtain tenders the companies supply at stupid prices and then load the loss on the private sector. Examples shown indicated that some medicines were 1000% more expensive than the tender price. This process led to enormous pressure in the private sector. Over a period of 20 years (1980 - 2000) the component of medicine spend in the total health spend rose from 15% to 34%. The PSSA advocated the importation of pharmaceuticals from the EU or India where they some 30% and 100% cheaper respectively. The Dept of Health formalised this in amendments to the regulations in 2000. They even inspected factories in India and licenced them for supply to South Africa. The Pharmaceutical Industry immediately drew the attention of the Government to their patent rights. The US State Dept was called in to assist. I was a speaker on a panel discussing this legislation in 1998 and seated next to me was this representative from the US Embassy. The threat was made at this discussion that should this legislation be invoked South Afica would be transgressing International Patent Law and the US government would advocate their exclusion from international trade rights. The PC's do not provide anything to their host countries except employment. They utilise a system of transfer pricing for their production. How this works is that the local company calculates the production volumes of a given medicine and the local cost of production. Their parent company then calculates the profit they wish to make and this then becomes the retail price. The local company is then sold the production materials from the parent company. The invoice value is the retail price less the production cost. This in real terms that that they are effectively making no profit in the country of production and therefore pay no tax. This is technically illegal in most countries but is almost impossible to provce since they hold the patent rights on the product and no one can prove the real cost of the product. The last point is that there is very little original research going on currently. Most "new" medicines are computer modelled clones of existing molecules. Research is going on in many State funded institutions and the PC's often buy the intellectual rights or are involved in providing some funding of this research. The issue of the relationship between what they spend R&D and marketing is raised because whenever they are questioned about the high prices they are charging they always point to how much they have to spend on R&D. The other interesting facet about their pricing is how much they charge for "cosmetic" medicine eg treatments for acne or fertility agents. This is a wicked industry and they have great plans and will strangle health care globally.
Patents are a monopoly granted by governments, right? And the Government of a Sovereign state has absolute jurisdiction within her own borders. So I don't see why the governments of those countries which would have most to gain if it wasn't for such patents, don't simply declare the patents on life-saving drugs invalid, and have done with it.
Seriously, what's the big obstacle? The USA might not like it; but if it's perfectly legal to manufacture drugs in some other country without paying royalties to anyone, it's none of the USA's business.
Je fume. Tu fumes. Nous fûmes!
You must live in the Bay Area.
In most of the midwest, over 80% of the large states were created at least a couple of generations ago. That's why it's so hard to get funding around here: People that have inherited their fortunes are more risk averse than those that actually made the money, so they tend to be uninterested in putting money into startups. Every entrepeneuring teacher could tell you that.
The fact is, your average kids status has a pretty high correlation to their parents and grandparents. Much more so than it was in the 80s. In some european countries, the trends are even more steep, mainly due to the strength of traditional investments and the changes in the way large estates are getting taxed.
Go read on properly sampled statistics, as opposed to relying on personal experience when dealing with national and global affairs. Start by searching "intergenerational social mobility".
You must live in the Bay Area.
Actually, I don't, though I live in a suburb of Los Angeles. I was actually thinking of mentioning that. I didn't make money from a dot-bomb or any sort of "right place, right time" lucky streak. I didn't even use venture capital (in fact, the one time I used venture capital, it was a $20M+ disaster. NEVER again.) I simply made the decision when I was relatively young to be an entrepreneur.
Most people simply are uncomfortable with risk. They'd rather work for someone else and get the relatively guaranteed paycheck. And you know what? That's OK -- it's a good lifestyle. But it irritates me when they assume that people who make different choices must have stolen it or gotten lucky.
Sometimes it's best to just let stupid people be stupid.
That you don't lynch-mob government officials that engage in gerrymandering is proof enough that you don't even care if your elections are even remotely representative.
I'm an American, and I'm not at all happy with the direction our country has been moving over the last several years. But America is also an easy target for criticism because of its huge footprint. The mistakes we make have more of an impact on people in other countries, but that doesn't mean we're alone in making mistakes. It does get tiresome reading rants about America when you don't know where the ranters are from. A simple preface like, "Here in the UK, where things are just peachy..." would be nice once in a while.
Bashing America is ludicrously easy, but it's not the height of integrity to take shots at Americans without at least revealing your own country of origin.
As an aside, perhaps you also underestimate the ability of the American system of government to right itself without resort to violence. You seem to think it would be reasonable to resort to the lynch mob, but I've seen the aftermath of a civil war up close. I prefer the pen to the sword.
Read the EFF's Fair Use FAQ
Wrong.
First, you are blatantly distorting and conflating SG&A costs (Sales, General, and Admistrative) costs as direct-to-consumer advertizing (or "marketing" as the anti-pharma crowd calls it). The SG&A number is basically all costs that aren't those that are directly used to build a particular product or design it. The SG&A figure you cite includes a lot of corporate overhead (e.g., IT, Finance, Legal, Sales, Product Mgmt, etc). What's more, even those costs that you might think of as sales or marketing are largely not consumer advertising. Some examples of things which fall into this category: free drug samples, sales reps visiting doctors, ads in medical journals (for docs), etc. All of these were allowed well before the law regarding direct-to-consumer marketing was changed and they comprise a majority (~90%) of the marketing costs (which itself is an even smaller part of SG&A).
Second, you would be wrong to believe that SG&A costs have skyrocketed relative to R&D costs. They have remained relatively stable since the early 1990s (the relevant laws and guidance regarding DTC changed in the last 90s). For instance, Pfizer's SG&A was 39.4% of revenue in 1991 and is now 33.1% (2005). R&D, for comparison's sake, was 10% in 1990 and 14.5% now. This actually represents a trend in the opposite direction -- far from the picture you paint.
Please. Do you have any idea what you're talking about? Universities and research institutes do not develop and have not developed drugs (with very few exceptions). It takes a lot more study, refinement, manufacturing know-host, clinical testing, (even, *gasp*, marketing) etc to bring a drug to market. Prior to the Bay-Dohl act, there was no significant financial incentive for anyone to spend the money and resources necessary to develop a viable drug. Sure, there were a good number of unrefined ideas sitting around in research papers, but they never were ready (as a general rule) to be used on actual patients. Lastly, there were several laws decades before the Bay-Dohl act that allowed transfer of patents to industry; the problem was that they were ambiguous and rarely taken advantage of.
Developing a new drug costs around $1Bn and takes close to 10 years. Here, the patent system works as intended. By granting a limited monopoly on their drug, it rewards the innovators and incites others to do the same.
Whether or not it costs ~$1B to bring a drug to market, the fact is that it's incredibly expensive at this point. Don't forget the millions of dollars poured into drugs that end up being discarded as not effective or too dangerous, before they ever go up for FDA approval. You have to develop the drug, the means to produce the drug, then proceed through tissue, animal, and human trials. Then you have to fund the process needed to get the FDA and other countries's equivalents approval to sell it for human use.
To put it another way, sure, we'd experience a one time benefit if we were to break all those patents. But then companies would be far more cautious about developing new drugs, unwilling to put as much money into research even if it is less than their advertisement budget now. Because it's profit motive that makes the risk represented in medical research worth it to these huge companies. And because it's their money and potential profit at stake, they're very efficient in their research, conspiricy theories aside. Governments and universities can be fairly good at general research, but it's the companies that generally come up with actual treatments.
And what is the advertisement budget for? Getting the word out for the new drug or treatment to doctors and patients, because otherwise it won't be used, leading to no benefit for the people or companies.
As for patenting gene sequences, naturally occuring flowers and such, they're not actually patenting the gene, that's been ruled invalid. What they're patenting is the method to detect the gene, or a modification to a gene that's been patented. Now, there can be some problems with such patents being held as too wide, but we're talking about tweaks here, not throwing out the whole system.
Now, a bounty system would have it's benefits as well, England I know used such a system during the colonial period with some success(develop a system that meets specifications X,Y,Z and we'll pay you $10k). But the government payoffs, to make the risk worth it, would have to be HUGE. Add in that politicians today don't like the bounty system because they can't guarentee the money will go to their favored parties, and it's a tough call to impliment one.
I don't read AC A human right
The invasion has already started.....
-Clio
Karma: Bad (mostly from not giving a fuck)
Blog: http://clintjcl.wordpress.com
The majority of rich people inherited their money and did nothing to get it. So what you said is not right..........
-Clio
Karma: Bad (mostly from not giving a fuck)
Blog: http://clintjcl.wordpress.com
Implicit in your argument is the assumption that the individual is virtually intiguishable from the teaming masses, that they have no marginal value greater than any other part, that they're merely a product of their time and their socio-economic class. You might rephrase your argument to say... "standing on the body parts of a million midgets" instead of "standing of the shoulders of GIANTS".... What a crock of sh*t.
Sure, all great inventors' and scientists' work derive great benefit from the work performed by others. However, these insights aren't derived by some amorphous blob of people going about their daily lives. Innovation comes, by and large, from a handful of exceptional people who do exceptional things. Even small innovation which can scarely be attributed to a specific individual still comes from individuals, who went out on a limb of some sort or other, and most of these individuals don't do it for selfless reasons: it almost always benefits their livelyhood. Without the system which values the individual there would be virtually no collective science to draw from and there would be no new innovation, incremental or otherwise. Even the ever-so-precious OSS system that Slashdot loves to worship depends largely on the work of a few critical individuals, who perform the vast majority of the work, that are either directly employed to do said work or gain great individual notarity for their efforts.
The patent may name just several inventors, but the products those patents support support the efforts of many people that are PAID to contribute and/or are RECOGNIZED in various substantive ways for their efforts. Drug development requires MANY people to do A LOT of work. However, all of this work occurs in the framework of the recognition the unique contributions of each person. People that contribute a lot tend to receive better pay than they might otherwise; those that don't get less pay and tend to get weeded out...They don't just get a "check plus" for participation.
And they developed how many new technologies in the past 500 years outside the framework of named research and patents??? Damn few. It is no coincidence that they've only been making substantial contributions in recent history with the emergence of IP and western-style academic publications.
Prove it. Why is it that so much gain has been had in places which recognize the value of intellectual property as they've recognized its value? The theory and the empirical experience argues against your assertion.
Oh nonsense. This
I was referring to corporations large enough to be traded on Wall Street. Even small businesses can incorporate and that isn't who I'm talking about.
The race isn't always to the swift... but that's the way to bet!
So, why is it that this discussion hasn't focused on the issue of prevention. The spread of AIDS in Africa, the Indian subcontinent and southeast Asia is largely the result of unprotected sex. Why is it that public health measures (e.g. use of condoms) is more actively promoted? Why is it that some of the govenments of these countries actually promote misinformation?
First,most of my student and of senior faculty thought that property right = property, which is factually, not only ethically, wrong.
Property rights vary from on country to the next- however, the rights for the owner of property (real or itellectual) to do with the property as they see fit, within the scope of local, national, and international law are transferred along with the property. What is unethical about that?
Second, most of them thought that drug companies invested a lot in research (again, wrong, all they do is contribute to some university research, but not as much as they would have us believe).
This is total rubbish, and typical of the naieve thinking of a junior level academic who has never worked in the private sector. The amount of spending on research by any public company is disclosed in their SEC filings and dwarfs what is spent by the NIH. Third, they thought that property was holier than life, which is the basis of the peculiar US notion that you can shoot a thief as soon as he has one inch inside your property (in Europe, this would be manslaughter, in fact, and the happy trigger pusher would end up behind bars).
Sad, isn't it? No, am not trolling, nor thinking Europe is better.
Am just so bloody glad we have the Atlantic ocean between us!
Obviously, you never acquired any property real or intellectual) while here. Otherwise, you would have a much better understanding of how US law actually works. Too bad your stay didn't enrich you better.
Many different approaches have been used to educate the population about the dangers of HIV and condoms are distributed freely but are not used. The governments of the of Southern and Central Africa do not publish statistics and no deaths are ever attributed directly to AIDS. So if a person who has AIDS and contracts TB and dies then the death is attributed to TB. Officially there are no AIDS deaths. Realistically this could be one of the greatest human disasters in history with some 30 - 40 million people in the region dying in the next 20 years.
Finally, some reasoned discussion.
The problem is much deeper than most of the discussants on this board realize. In reality the situation regarding health care in general is not one that has an easy solution, especially with regard to pharmaceuticals. Perhaps that is because the majority of folks who participate in these discussions are enamored with the "sound of their own voices". This is always dangerous.
Good luck to you in your career, where ever it takes you.
I just had an interesting thought... As far as the distribution of wealth goes within the populace, if our influence is tied directly to dollars then we are no longer a Democracy. Capitalistism! Hah... =)
I intensely dislike post-modernism. Thankyouverymuch. I just said that drawing from historical facts to lend credence to arguments on social policy of the here and now is hard to do, and often not worth the additional effort required to do the research, cite the references, then justify the analysis with regards to all likely historical data. As far as the "facts" and other clean issues go, they just aren't useful. It really doesn't matter when the Civil War ended. The meaningful impacts of such events and clean topics are inherently subjective. Of which the meaningfulness is largely dependent on the researcher's own perceptions of reality. For instance, if you read the DoI and then I read the DoI, I'm sure we'd have very different thoughts, opinions, meanings, etc. based on it, even though it's textual base is very factual indeed.
You're going to have to make a good argument as to why the full and fair cost of production of a new drug should not include the cost of development.
That's easy! If the cost only had to fund future development and recoup the cost of past development and manufacturing there would be no problem at all! We are straying from the article again, I fear. The problem is that a lot of the "development" money is being spent on advertising and brand building rather than the drug R&D.
People who are not willing to work for it don't deserve health care.
This is truly disconcerting to me. Tell me... truly... who is not willing to work when their life or a loved one's life is on the line? I don't think that someone's worth in life is in any way related to their income. Take for instance, Steve Ballmer. Sure, he's made a few bucks in his lifetime, does that make him any better than an orphaned 2 year old who apparently can't work for it, thus doesn't deserve proper health care? Maybe he deserves elective health care, but he is most certainly not more deserving of basic health care any more than any other human being.
Though I may be a naif, I do not presume that all poor people are poor by some weird accident and there's nothing they can do to change it. Though the evidence shows it tends to be a hereditary condition, it can also fall on decent people in hard times, and some effectively choose it with their actions (though rarely with that intention). If I ever become poor or destitute for some reason or another (e.g. disability, accident, etc.) I would prefer not to be judged as some failure in life and treated as such by being refused basic health care because I am no longer the money-producing piece of meat I once was.
Sure, the poor have debt and such. However, even that debt pales in comparison to health care costs, especially emergency health care costs for a family below the poverty line. You know, the ones whose bills are the same order of magnitude of their yearly earnings?
I didn't respond directly to a lot of your arguments because they've strayed too far from the article and what I've actually said. Cheers.
>Yeah, why $200 for an xray, when its free at the airport?
I can understand the ignorance--most people have never seen what goes on in a hospital radiology department.
Let's look at the airport situation first: you've got an x-ray machine with a motorized conveyer belt. That probably does cost more than a basic flat film x-ray machine for medical use. Then you've got a TSA agent making a modest salary looking at the images on the screen. Little training, and no significant consequences to the agent if s/he makes a mistake (see previous media reports on failure rate in tests when officials tried sending weapons through the screening system, and the hue and cry when it was suggested some of the agents ought to be fired).
Now, in the hospital, you've got the x-ray machine, and a trained and certified RT to operate it. You think that job is just lining up the patient and pushing a button? Wrong--I used to teach them. They have to know anatomy well enough to properly position patients for each different exam that might be ordered (and there are thousands) so the important areas of the anatomy are most clearly depicted in the image. Then s/he has to select the image exposure parameters to deliver the best quality image while minimizing radiation dose to the patient. After the image is acquired s/he has to check to see if it's satisfactory. Not as much training as this as for the radiologist who actually makes the diagnostic interpretation, but the RT does have to know what's going on in the image.
Once the images are acquired, they have to be read by the radiologist (college loans, medical school loans, six years or so residency and fellowship before s/he is qualified to do the job). Look at the area in question, maybe ask for and get previous films, look at the patient's history to see if there may be another explanation for the presenting symptoms and imaging findings, report on the question being asked by the doctor ordering the exam, look at the rest of the images to make sure there's not some unexpected abnormality, dictate the report, and sign it.
But wait, there's more! That $200 has to pay for consumable supplies like film, contrast agent, and linens (you want to use the same table cover as was used by someone with active TB?). It has to pay for the people who order and stock those supplies, the person who answers the phone and schedules the exam (and reschedules it if necessary), the person in the file room who knows where the previous films are and pulls them for the radiologist, and the person who transcribes the report and sends it to the referring doc (making a phone call if the results are urgent). It also has to pay for offices and filerooms for them to work in (plus a person to keep it all clean) and computers and other equipment for them to use.
There's still more. It pays for the RT's time each morning doing quality assurance checks on the x-ray machine and processor (don't have to do that for the airport machine), and the time and equipment for the field service engineer to fix the x-ray system when something goes wrong. As mentioned above, there's malpractice and other insurance to pay for--radiology is one of the most-sued specialties thanks to suits alleging failure to diagnose diseases early enough. And there's gotta be a surplus to make up for the patients who can't or won't pay.
Matt Mitchell
Diagnostic Research Design & Reporting
I can reduce the above screed to 7 words: "Ration medical care according to Bios_Hakr's priorities." Proponents of a monolithic health care financing system think they are getting all impure motivations out of the system, but all they're doing is shifting them around. If you replace our current system with a government-run single-payer system, the critical decisions about whether some service that an individual wants is worth having the entire society pay for don't go away--they merely get shifted to the government. We've already seen this with Medicare. Ultimately, high-stakes medical decisions, like coverage for expensive new technologies, become political questions, and get made by people like Ted Kennedy (Democratic senator from Massachusetts) and Ted Stevens (Republican senator from Alaska). And those decisions are going to be subject to the same conflicting interests every other decision made in Washington faces. It will actually introduce new conflicts and motives into the system--just like decisions about locating military bases and other government facilities depend on how many people and companies from which states will benefit. While you'd like for these decisions to be made purely on clinical evidence (my line of work), they really get made on the basis of a mixture of clinical evidence and lobbying power, even stuff like who was the college roommate of an inflluential senator. There is no health care financing system in the world that does not ration care one way or another, not even ours. Some systems hide the rationing better than others. The American system has less rationing than other systems, but in exchange we have the problem of the uninsured. Most of the systems people hold up as models ration care either by restricting the diffusion of new technologies or by queuing Canada has the purest system of keeping equal access to health care services, but that comes in exchange for some of the worst queuing problems and the greatest restrictions on people's freedom of choice.(*) People in Canada die as the result of having to wait for a necessary medical service like a diagnostic MRI, because the government wants to control health care costs. That's great if you want to punish rich people for wanting better health care than the rest of us, but that's a rather stiff price to pay. Most countries (such as the UK and those in Europe) don't want to create those conflicts, so they allow a two-tiered system with some private service for those willing to pay out of their own pocket. In Canada, you don't have that (#), so you get stories of people being able to schedule next-day cancer surgery for their dog while waiting months for their own surgery. To borrow a phrase, the US health care financing system is the worst system in the world except for every other one. If time permits, I'll follow up with some further takedown of the post. Matt Mitchell Diagnostic Research Design & Reporting *--Any time you create an entitlement for one person to take another person's property, no matter how noble the cause, there's going to have to be some control on that entitlement, or else the entire concept of private property is worthless and the producers will stop producing. #--Though a recent court case may overturn that ban.