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It’s not often that I say, “Thank God the New Yorker cut right through all this leftist cant,” but let’s give them credit where it’s due. On this one, they’re exactly right.
The Congressmen are acting in a system with incentives as perverse as those that the FDA has created for Shkrelli. It behooves them to go on TeeVee and engage in this imbecile bombast much more than to actually take action and reform the FDA. The financial crisis could be looked at the same way.
Yes. Good point. How do we change their incentives?
Claire – C-SPAN is as much as a curse as it is a blessing. There is no such thing as “reality television.” Once you introduce cameras into anything the process changes.
These committee hearings become a peacock fight. Politicians and witnesses alike fan the tail feathers, preen and prance and try to woo the world. Stop the show. There is no evidence that government is more honest or transparent in the era of C-SPAN than it was before.
We fire them and send them home to live in the system they created.
But they don’t have to live in our system, and we are beginning to realize how true that is … hence Trump/Sanders (who wouldn’t in my opinion do anything but make it worse).
As this shows, the guys on “our side” are just as happy with the posturing, non-reforming, nonsense as theirs. They both come out of congress to enjoy the post-Congressional lifestyle, and that is the problem.
There is no incentive for them to change themselves or the system as represented by Congress/FDA at present.
You know, here is one of those things a candidate could glam onto – a Cruz, Rubio, some other than Trump – a real reform that people could understand in their daily life. A nonpartisan moment, a real moment, oh so teachable, about the corruption of Government power and how it enables the sort of corporate behavior (which is rational if distasteful) that so many Americans see as hateful.
Claire has laid it out with the aid of The New Yorker for Heaven’s sake, and we’ll just hear the crickets in Maracaibo instead.
Term limits constitutional amendment?
Pee Wee Herman runs a drug company?
Term limits. No more career politicians.
Send every last one of them home and start over. New Broom. Sweep clean.
When our town decided to televise our school committee meetings, I witnessed the funniest transformation of people I had known well for many years.
I think televising all levels of government is a good thing though. Even when no one is watching, the people on camera feel watched. If nothing else, it helps committees maintain some decorum. And there is this vague sense among the participants that there is a permanent record, so that adds some seriousness to the proceedings, in and of itself.
Although it attracts grandstanding, I think that is a price worth paying to see people take what they are doing seriously, prepare better, and think before they speak.
Shkreli achieved the impossible: he made congress look like the good guys.
And now he’ll be the poster boy for single payer health care. We just might be seeing his face in Bernie/Hillary campaign commercials. sigh
How could anyone in possession of the information in this story conclude that what we need is more government involvement in this? There is no shortage of inexpensive Daraprim on this planet! All the FDA has to do is say, “Import as much as you need, at your own risk.” Cheap Daraprim would flood to patients via FedEx the very next day. I can’t believe that no one in Congress understands this — or that they pretend not to understand this — and I can’t grasp how the public doesn’t understand it. What’s the cognitive problem? There is no shortage of Daraprim, they’re just not letting it into the country.
Silly Claire. If there was single-payer healthcare, there’d be no profit motive–so he couldn’t jack up the price and swindle the poor sick people.
Scarcity you say? Long lines you say? Poorer quality care? Trouble recruiting doctors? Having to buy something as simple as aspirin at a chemist instead of your corner store? Nonsense! #fairness
Serious question: Why aren’t the patients who need this drug ordering it from India? It costs ten cents a dose there. Everything I know about economics tells me the US should by now have a huge black market in Daraprim. Can’t do it because you’ll go to jail? Come on. As if that ever stopped anyone from bringing drugs over the border before? Indians are really resourceful. This is the age of the Internet. You can get online, meet a nice Indian pharmacist who needs some cash, and ask him to send it to you. He’ll do it: He wants your business.
The only thing standing between people and that drug is lack of initiative and, I suspect, racism. Because only the belief that Indians can’t make drugs as well as Europeans and Americans allows the FDA to get away with keeping Indian drugs off the US market.
Claire — regarding the no shortage of Daraprim, do you remember the “gas crisis” of the Nixon 1970’s?
The Carter 1970s!
I don’t think I would qualify it as racism so much as a lack of familiarity or fear of the unknown. Lots of Americans aren’t world travels who are happy to play food chicken with street meat in Morocco (or have never eaten street meat, or have never been to Morocco….you get my point), never mind imbibe drugs from the subcontinent. What quality controls are in place, they ask?
Now, if the drug is available in Canada for less, why isn’t the same effect we’re seeing in the market for opiates or viagra at play? Good question.
The overwhelming majority of people who need Daraprim in the US are people who are HIV-positive. The overwhelming majority of that population are people whose lives have not been characterized by risk-aversion. You’d have a better chance of persuading me that the hesitant consumers were well-meaning but unsophisticated small-town folk who merely feared the unknown if the drug in question were Maalox.
No, the question really is why people would trust Canadian pharmaceuticals over Indian ones when India, not Canada, is the world’s pharma powerhouse.
Fair point on risk aversion and HIV. However, it might well be that the man who acts with reckless abandon in a moment of exuberant health is, later, risk averse when the full weight of his disease comes home to him. He may prefer the “known good”, even if financially ruinous, to the unknown in that case–the assurance in a moment of desperation.
You’re assuming that the consumer is worldly and well read enough to know that India is the world’s pharma powerhouse.
I honestly don’t know why we don’t have a large black market in the drug. But I am trying to find explanations that make some sense of this. I don’t rule out racism as a possibility, but I have a hard time believing that, on a large enough scale to be measurable, men on their deathbeds would cling to such petty hatreds over any hope, false or no.
It’s not that they cling to petty hatreds, it’s that they’re more easily persuaded than any evidence suggests they should be that Indian drugs are unsafe.
Speaking just for myself, yes the fear of going to jail or getting into some sort of legal trouble is probably the deciding factor. Not for Daraprim specifically, but certainly for acquiring other prescription drugs that can be had cheaper overseas.
People who are into street drugs are probably cooler about breaking the law in the first place. For squares like me, though… well, no matter how silly I may consider our drug laws to be in the abstract, the stigma of being caught “dealing drugs”, even if the drugs are obviously no fun at all, actually does serve as a deterrent.
That is true enough. So, lack of imported Daraprim by itself ought to be hard to explain due to mere risk-aversion or “squareness”.
We used to have an urgent care clinic nearby with its own dispensary, run by a nice Pakistani pharmacist who’d sometimes acquire more expensive or difficult-to-find pharmaceuticals from India or Pakistan. I was fine having him dispense those to me. I would still be nervous about placing an online, border-crossing order with some supplier whose reputation could by its very nature not be rated publicly. (Of course there are internet fora where people rate these suppliers informally, but if you’re an outsider to these fora, how do you know which forum to trust?)
Of course, the more of us risk-averse people who were willing to brave our own government’s disapprobation and order from overseas, the more infrastructure there’d be in place to import Daraprim, too.
I object to buying much of anything for sale online that is either not delivered digitally (software, music, books) or something within my core competencies (computers and related hardware). Even with computers, I’ve been burned – or rather singed – in the past. That was due to a cracked video board and attributable to bad luck, not malfeasance.
Drugs would freak me out. Though I might check with the son of the Nigerian Minister of Finance. He might be able to set me up. He owes me.
India has a reputation – deserved or not – of low-quality stuff. I figure the most exposure most people have to India is outsourced, unhelpful tech support. Your average American (even one desperate with AIDS) is probably not going to be too trusting of imported Indian drugs, perhaps thinking that, like cheap Chinese crap, or even street drugs, you get what you pay for. That, and India still has the image of being a third world country, and “sophisticated” folks don’t think good things can come from there, especially when they can’t handle their own health problems (even though those problems come as much from culture as from poverty); there’s a UNICEF campaign to get people to poop in toilets and not on the streets, for goodness sake.
And then add on the fact that it’s highly illegal to import these drugs, combine that with the fact that there isn’t so much of a market for them that your usual illicit drug importers won’t bother with it (for some reason it’s easier to trust your local pusher than a company on the internet), and it’s not surprising that there is a lack of a general black market for this stuff.
What accounts for the ease with which they are persuaded?
My guess is something along these lines. You might call this prejudice of a kind, though I think racism is a bit far:
In Australia when you take a scrip to the pharmacist you’re asked whether you would prefer the generic version of the drug (if available). Saying yes can mean paying one quarter of what you otherwise would have. Quite often the generic is made in India (and it says so on the package).
But this is because of how pharmacies are regulated in Australia, so not a direct result of an untrammelled free market.
Great post, Claire. To summarize:
So much of this story has me seething, but what burns me especially is that we’ve set up a situation in which one cannot be moral without being a criminal. If your life depended on this drug and you couldn’t afford to pay $750 for the American version — but could readily afford the cost of the Indian generic — it would be actively immoral for you to fail to break the law.
This story angers me out of proportion, because I believe it’s an absolutely conscious swindle and it’s obviously the path most Americans want to go down even further. I believe the FDA is wittingly acting to protect our domestic pharma industry — it’s beyond all imagination that they don’t know these drugs are available in India and that India supplies the rest of the world’s generic drugs. With most of the front-running candidates committed to some kind of protectionist platform and to providing “free health care for everyone,” it seems as if the majority of Americans want insane policies like these. So these stories of drug rationing and shortages are just the beginning: Americans will soon start dying in notable numbers of completely treatable and preventable diseases — and they’ll be dying of our own stupidity and corruption, and nothing I say can stop it.
I wish this jerk Shkreli would use his celebrity to spell out the steps of this argument. If he did, yes, I’d say, “Shkreli for president.”