Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
Martin Shkreli and the Imbeciles
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. Everyone hates Martin Shkreli and everyone’s missing the point:
But was Shkreli’s performance actually more objectionable than that of the legislators who were performing alongside him? Elijah Cummings, of Maryland, is the ranking Democrat on the committee, and he used his allotted time to deliver a scolding. … Cummings acted as if Shkreli were the only thing preventing a broken system from being fixed. “I know you’re smiling, but I’m very serious, sir,” he said. “The way I see it, you can go down in history as the poster boy for greedy drug-company executives, or you can change the system—yeah, you.” Cummings has been in Congress since 1996, and he is a firm believer in the power of government to improve industry through regulation. And yet now he was begging the former C.E.O. of a relatively minor pharmaceutical company to “change the system”? …
The Republican-led committee was no more impressive. As if to establish that Turing was unnecessarily profitable, the committee released documents showing that the company had thrown a lavish party—fireworks included—and given some executives six-figure raises. (If this now counts as corporate behavior worthy of oversight and reform, the committee may soon find its schedule overbooked.) And then there was John Mica, a Republican from Florida, who has vowed to “keep the government out of patients’ sick beds.” Notwithstanding his skepticism of government intervention, he expressed alarm that some drug prices have “skyrocketed.” Even more than his colleagues, he seemed taken aback by the star witness’s recalcitrance, as if he couldn’t fathom why a private citizen wouldn’t be more deferential to his government—at one point, he threatened to move to hold Shkreli in contempt.
The Daraprim saga has as much to do with the Food and Drug Administration as with Shkreli: although the drug’s patent expired in the nineteen-fifties, the F.D.A. certification process for generic drugs is gruelling enough that, for the moment, whoever owns Daraprim has a virtual monopoly in America. (Overseas, it is much cheaper.) [My emphasis] …
Most of our Presidential candidates claim to disdain Washington politicians, but, on Thursday, Shkreli put that disdain into practice—and helped illustrate, to anyone paying attention, why it is so richly deserved.
The New Yorker’s conclusion is, I assume, meant ironically:
He is the American Dream, a rude reminder of the spirit that makes this country great, or at any rate exceptional. Shkreli for President! If voters in New Hampshire are truly intent on sending a message to the Washington establishment they claim to hate, they could—and probably will—do a lot worse.
Nah. You can view Shkreli’s performance as intellectually more consistent, morally more defensible, and less contemptuously disdainful of our intelligence than Congress’s and see Shkreli as a distasteful personality. But on the merits of it, anyone who sees Shkreli as the problem — as opposed to the F.D.A. certification process — is indeed an imbecile. Anyone who blames Shkreli for the high price of this drug instead of blaming those with the power to rein in the FDA and change this situation — to wit, Congress — is indeed an imbecile.
Shkreli scandalized America by saying it was hard to accept that these imbeciles represent the people in our government. No, it’s easy to accept that. What’s hard to accept is that these imbeciles do indeed represent the people.
Published in General, Healthcare, Law
If this point gets made in public debate, it will give the Democrats within hearing all they can handle to pretend they don’t understand it. (Voice of experience speaking here.) And there will be too many Republicans who don’t have the street smarts to understand it.
Well, what do we do about the fact that there’s no deep understanding of the basic principles of market economics in the United States? If Americans Republicans don’t have the “street smarts” — I’d say “common sense” — to understand supply and demand, who’s left to defend this idea?
They’ll be sure to bring up Thalidomide, and that was indeed one instance where the FDA was right not to approve a drug. There must be a happy medium somewhere though.
I’m not sure. I guess we need the issue to go public so we can see what we have among the current players.
I have no objections to your using the term “common sense”, but the reason I said “street smarts” is that they often have no idea how to use an issue like this not only to do the right thing, but for political gain.
A story: Back in 1988 I was doing volunteer work for a congressional candidate who I thought had a good chance to replace our far-left congressman.
I once mentioned to him that I had been reading how Republicans that year were pulling in a lot of the small donations in comparison to the Democrats. I suggested that Republicans could make something of that. I thought it would be obvious how you would use that issue in a populist way.
His reply: “You can’t run a campaign on ten dollar donations.”
Sigh.
I donated a couple hundred, though, and he understood that. It put me on the list of people to whom he appealed to cover the debts of his unsuccessful campaign.
Sure. I don’t argue that people should be blithely unconcerned about untested drugs or quality control. But I do argue that a public demand for perfect safety and free (or very low-cost) medication results, in many cases, in no medication at all. It’s not an optimal tradeoff. The optimal tradeoff is almost certainly one in which people assume more personal responsibility for the risks they choose to take, and are in more direct contact with the real costs of healthcare. I believe individual people are much better able to decide what procedures, risks, and potential benefits are worth it to them than the FDA — even in an arena such as health care, where it requires more expertise to evaluate the risks and benefits of a given therapy. (I say this to anticipate the counter-argument that’s always made, namely, that lay people can’t make informed decisions about health care because they’re not qualified to do it. Illiterate Indian peasants seem to be capable of making these decisions for themselves, so I assume Americans are likewise capable.)
That is a good point I had never thought of making. But then again, until now I didn’t know about how things have progressed in India.
Here’s a question for Ricochetti:
Suppose a heart bypass in India costs $2,000, and the same procedure in the U.S. costs $100,000. (Those numbers are not too far off some that I found on the Internet.)
Suppose furthermore, that the success rate in India is 99.0 percent, while the success rate of the same U.S. procedure is 99.99 percent. (I made up the latter number. I don’t know if it’s really that high)
Would you be willing to forgo the extra 0.99 percent chance of success if we had a free market health care system and you had to pay out of pocket? Would it be worth it to allow your wife and kids to keep the house if things go wrong? Or would you rather sell your kids into leftwing slavery so you can have that extra 0.99 percent chance of success under a highly regulated FDA-approved safety system in which the costs would be assumed by a universal healthcare system?
Oh, and also tell us which political faction values an entrepreneurial system where people take risks and are sometimes rewarded for it.
As it happens, this is not a hypothetical question to me. My father was recently diagnosed as urgently needing a heart bypass. (He’s had it and is doing very well, thank God.) From the moment he received the diagnosis to the day he checked in for the surgery, we (or really, “he,” but he asked my advice) had to make all sorts of complex decisions about cost, risk, and tradeoff. He’s a French taxpayer and thus covered by the French social security system, and he also has a private insurance plan that would cover him to have the surgery elsewhere, but wouldn’t cover things like the cost of travel. The difference between the hospital he chose and the hospital with the best rate of survival — to which he would have had to travel out of town — was indeed about .99 percent. We decided this difference was probably meaningless, given that we couldn’t figure out from the literature whether the initial patient cohort was in all ways relevantly similar.
Had the difference been more like 5 percent, I would have strongly agitated for paying the difference, if the amount had been anything we could have paid. We could not have paid $98,000,000, but if the difference were any amount we could have raised, I think a 5 percent difference would have made me say, “Let’s sell everything we’ve got: I’ve only got one father.”
The fascinating thing about Devi Shetty’s heart hospital in Bangalore, though, is that survival rates are higher than in most American hospitals — probably owing to volume. With surgeries like these, you want the surgeons who do it ten times a day. But it absolutely did not seem to me a good idea to pack my father off to Bangalore for surgery, given that he had a heart condition. I figured the increased odds of surviving the surgery would be offset by the increased odds of his popping off from stress during his first journey in a rickshaw.
RA,
You have it exactly. We must match horror story for horror story. For every Thalidomide death how many are dead because of hyper-regulation. I use the word hyper-regulation for this not over-regulation. Over-regulation is with us constantly in everything. Hyper-regulation I reserve for the most absurd and destructive of government nonsense.
How many people died this month so far because of the cost of their medication. I know that sounds like a nasty thing to say but if you are going to take on a Federal Regulatory Agency like FDA you had better to be prepared to kick them in the shins or slightly higher.
Regards,
Jim
I agree. Toward the end of my mother’s life a couple of years ago, her pills were more than $500 a month.
Thalidomide blighted a lot of lives, and would have blighted more if it had ever been approved in the US.
Regulation is sometimes onerous, but that isn’t always bad.
Yep, just ask Germany and Canada.
Think of the risks Ms Clinton took with our national security to improve her email life. If those risks were justified, surely we could justify cutting 75 percent of the costs it takes to get new drugs approved.