This ended up being a major vent, and therefore quite long. I doubt anyone will read through all the way, but if you do, thanks for listening!
Gary, you and I see this in much the same way, although I have a more provocative way of making the point.
As I said earlier, I am NOT opposed to regulation. Indeed, with something such as healthcare, arguably unique as compared to most other needs/wants that people have, there are moral reasons to regulate the healthcare industry.
Unless I’m delusional, it seems we do regulate that industry and Boy Howdy!
Viewed through the lens of the 3 questions I posed above, again there are moral reasons to regulate so that healthcare is broadly available, affordable, and accessible. Where opinions start to diverge is in how to do this, and what impact various parts of the regulatory apparatus have on meeting these goals.
One “side” argues that lack of regulation is responsible for insane drug prices in the US. The reasoning behind the argument is greed. (I pause for a moment to sincerely ask that my short summary be corrected if I have it wrong – these are the arguments, seen through my own filters admittedly, that I recall).
The other argues that it is over-regulation, in the form of price controls outside the US well below normal market pricing, leading to inflated prices in the US to compensate.
The truth, of course, is almost certainly some mix of these, and other explanations not offered here. However, HOW this problem is addressed – insane drug prices in the US – critically depends on what predominantly is the cause of the problem.
I’ll say this: I’d really like to know. I mean “know” in the cold, emotionless, factual way. I’m not interested in ad hominem “evidence” about how bad executives are, or how evil the industry is in general, or anything like that. Nor are those suspicious of the industry’s integrity too interested in hearing about the marvels of the free market.
So, if anyone has any actual facts, evidence – whatever – to make the case, I’m very open to hearing about it. When I look at the cold facts I can dig up that seem relevant – company financials – it just does seem to support this claim.
This is critically important to me. Unlike @Hay_Dude, I think pharmaceutical treatments and therapies developed over the last 50 years are miraculous countless times over. Diseases have been cured. Some are completely livable now that were horrible burdens before. We discuss how diabetes treatment has advanced regularly in TuD.
I, for one, am gigantically, enormously, incredibly grateful that we are wealthy enough as a country to afford to spend trillions of dollars a decade on pharmaceutical research. Again, unlike you, Sam, I don’t consider insulin analogs just “slightly better”; indeed, they are life-changing compared to the old R/N regimen. I quite surprised your would say this, given what you’ve been posting about Tresiba.
Finally, R&D costs what it does because it takes some of the smartest, most innovative people to do this research. Would the engineer, scientist, doctor, etc. here that feels they are paid well in excess of what their skills, capability, and productivity command? Are you all over paid in your industries?
Or, if your pay was cut in half, are there other things that pay just as well or better that a smart person like you could find to do instead?
That’s how economics works, and that’s why R&D costs what it costs. It’s the same reason physicians are expensive.
You want iPhones? Well, we engineers don’t come cheap, and not a lot of people can do what we can.
You want new incredible drug treatments? Same answer.
Where I see far too many people go off the rails is in focusing on bonafide malfeasance, and then extrapolating that to the industry as a whole across time and space. The truth is quite the opposite – most of the work done in the pharmaceutical industry is laudable, most of it done with care for patients in mind, most of it sincere and ethical. Exceptions stand out – that why we all hear and know about them. Epipen, for example. Or that other drug that jerk raised the price on by something like 4000%, in the news in the last few years. He was dragged before Congress for a tongue-lashing (as he should have been).
For every Tujeo – snake-oil, IMO, and on the ethical edge – there are hundreds of other drugs that have changed, or even saved people’s lives.
This cost a lot to have. Like I said, engineers and scientists are rare and expensive in human society. I don’t want less R&D, I want more! Lot’s more. I want a cure, or a really effective treatment, for Alzheimers in the next 10-20 years. In time to save me, if I’m a victim.
I could go on and on about what miracles are being researched right now, and that I wish we all made a priority to see well-funded. Really, there are few other careers one can devote themselves to that is more socially redeeming than trying to cure disease.
Yet, I’m very pessimistic and melancholy about the whole thing. The “evil, corrupt, greedy drug industry” belief seems to predominate more and more. I’m not surprised, given the burden US patients are carrying to bring these drugs to market. I’m just sad that it doesn’t look good for it to continue, with attitudes like this.