Author Topic: Episode #719  (Read 1475 times)

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Offline CarbShark

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Re: Episode #719
« Reply #15 on: April 23, 2019, 10:04:14 AM »
If they’re price fixing insulin or albuterol (asthma inhalers) then that’s conspiratorial.

When any industry has a powerful lobbying group that protects them from regulation and legislation it’s fair to call them big x.

The difference between the supplement industry and the pharmaceutical industry is people’s lives and their health depend on one, giving them an inelastic demand for their product which makes it possible to price gouge.


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and Donald Trump is President of the United States.

I'm not a doctor, I'm just someone who has done a ton of research into diet and nutrition.

Offline daniel1948

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Re: Episode #719
« Reply #16 on: April 23, 2019, 10:39:08 AM »
Implementing universal healthcare and allowing the government to negotiate prices would do a lot to deal with the negative aspects of "big pharma".

Also Big Hospital and Big Insurance.

I've told this story before but I think it needs to be told again (and again, and again, and again):

I lived in Spain for a year and a half. During that time I developed a heart arrhythmia and went to a cardiologist and had a treadmill stress test. On another occasion I got a urinary tract infection and went to the ER. As a visitor to Spain I was not covered by their health care system so I went to a private hospital and paid cash. Here in the U.S. I have health insurance, for which I pay through the nose. I've had treadmill stress tests here, and I've had the occasional trip to the E.R.

In the U.S., where I pay for health insurance that pays part of the cost and negotiates lower prices with hospitals and doctors, my out-of-pocket costs for these visits/procedures has been about three times what it was in Spain where, without insurance, I paid the full cost in cash.

And the quality of care I received in Spain was as good as I receive in the U.S.

Our health care system is broken, and nothing gets done, not because of Big Pharma or Big Hospital or Big Insurance specifically, but because of our idiotic worship of the capitalist system and our dogmatic insistence that the profit motive is always the best way to get anything done.

The problem is Big Capitalism. And because Americans have been brainwashed into believing that private industry is always best, we allow Big Business to run our country by way of lobbyists.

Big Pharma is no different than Big Auto or Big Electronics or Big Retail: They are all industries whose purpose is to make money, and that make and sell drugs or cars or smartphones only as a means to their actual purpose of making money. This is why we need government regulation. We have excellent regulation over the quality of drugs. We do not have proper regulation over their price, and we have no regulation at all over supplements, neither over their price or their quality.
Daniel
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Offline CarbShark

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Re: Episode #719
« Reply #17 on: April 23, 2019, 10:56:13 AM »

Interesting article on why albuterol inhalers cost so much in the US and why we don't care.  It amounts to some bad regulation and law only tangentially related to drugs.  Nobody cares because:

Quote
In large part, that’s because private or public insurance picks up most of the cost, and the size of copays does not necessarily correspond to the differences in the actual cost of prescriptions.
  I recently had some prescribed and it cost about $10.

Do you have a link? My cost for albuterol went from $15 to $250 over the last five years. My copay went from $5 to $75.

Same product, same molecule, same delivery system, same insurance, same pharmacy.
« Last Edit: April 23, 2019, 02:08:28 PM by CarbShark »
and Donald Trump is President of the United States.

I'm not a doctor, I'm just someone who has done a ton of research into diet and nutrition.

Offline Ah.hell

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Re: Episode #719
« Reply #18 on: April 23, 2019, 11:27:27 AM »

Interesting article on why albuterol inhalers cost so much in the US and why we don't care.  It amounts to some bad regulation and law only tangentially related to drugs.  Nobody cares because:

Quote
In large part, that’s because private or public insurance picks up most of the cost, and the size of copays does not necessarily correspond to the differences in the actual cost of prescriptions.
  I recently had some prescribed and it cost about $10.

Do you have a link? My cost for albuterol went from $15 to $250 over the last five years. My copay went from $5 to $75.

Same product, same molecule, same delivery system, same insurance, same pharmacy.



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Added below:
https://undark.org/article/asthma-inhalers-cost-bill-took-breath-away/

Online arthwollipot

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Re: Episode #719
« Reply #19 on: April 23, 2019, 10:32:09 PM »
The problem is Big Capitalism.

Truth. And Americans have been indoctrinated to believe that anything other than Capitalism is evil, satanic, and will lead directly to the destruction of America.
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Offline BAWRFRS

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Re: Episode #719
« Reply #20 on: April 24, 2019, 01:43:09 PM »
The problem is Big Capitalism. And because Americans have been brainwashed into believing that private industry is always best, we allow Big Business to run our country by way of lobbyists.

Big Pharma is no different than Big Auto or Big Electronics or Big Retail: They are all industries whose purpose is to make money, and that make and sell drugs or cars or smartphones only as a means to their actual purpose of making money. This is why we need government regulation. We have excellent regulation over the quality of drugs. We do not have proper regulation over their price, and we have no regulation at all over supplements, neither over their price or their quality.

IMO nothing wrong with capitalism that robust anti-trust, and other sensible regulation, cannot fix. The trouble is, there's a lot to be fixed. Anti-trust has been steadily weakening over the last few decades, reducing competition. Not to mention issues like regulatory capture, which I suspect of being behind cable and high speed internet monopolies. Copyright and patent badly need reforms. But insofar as the profit motive goes, I have no problem with that if there's a choice of non-colluding sellers. Letting financially senseless businesses fail, I have no problem with that either.
The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.  - Bertrand Russell

Offline daniel1948

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Re: Episode #719
« Reply #21 on: April 24, 2019, 04:18:56 PM »
The problem is Big Capitalism. And because Americans have been brainwashed into believing that private industry is always best, we allow Big Business to run our country by way of lobbyists.

Big Pharma is no different than Big Auto or Big Electronics or Big Retail: They are all industries whose purpose is to make money, and that make and sell drugs or cars or smartphones only as a means to their actual purpose of making money. This is why we need government regulation. We have excellent regulation over the quality of drugs. We do not have proper regulation over their price, and we have no regulation at all over supplements, neither over their price or their quality.

IMO nothing wrong with capitalism that robust anti-trust, and other sensible regulation, cannot fix. The trouble is, there's a lot to be fixed. Anti-trust has been steadily weakening over the last few decades, reducing competition. Not to mention issues like regulatory capture, which I suspect of being behind cable and high speed internet monopolies. Copyright and patent badly need reforms. But insofar as the profit motive goes, I have no problem with that if there's a choice of non-colluding sellers. Letting financially senseless businesses fail, I have no problem with that either.

The root problem with capitalism is that while it produces goods and services efficiently, it systematically excludes a certain percentage of the population from the mainstream economy. It also makes necessities unavailable to a percentage of the population. And while it offers huge rewards for being in the right place at the right time, it provides the lowest wages for the hardest, most backbreaking, and most undesirable jobs. A CEO of a big company has a very difficult job. But a migrant farm worker has a harder job. From the vantage point of a middle-class educated person in an industrial nation, capitalism can look like the best possible economic system. The view is very different if you were born into a poor family in a neighborhood with bad schools and effectively no opportunity.
Daniel
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-- Otto von Bismarck

Offline Jeremy's Sea

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Re: Episode #719
« Reply #22 on: April 24, 2019, 04:40:13 PM »
Turbine aircraft, however, are not currently in the running for practical flying car systems any more than riding baby mammoths with jetpacks.
Nice, deep cut reference there!  :D
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Offline BAWRFRS

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Re: Episode #719
« Reply #23 on: April 25, 2019, 07:37:38 PM »
The root problem with capitalism is that while it produces goods and services efficiently, it systematically excludes a certain percentage of the population from the mainstream economy. It also makes necessities unavailable to a percentage of the population. And while it offers huge rewards for being in the right place at the right time, it provides the lowest wages for the hardest, most backbreaking, and most undesirable jobs. A CEO of a big company has a very difficult job. But a migrant farm worker has a harder job. From the vantage point of a middle-class educated person in an industrial nation, capitalism can look like the best possible economic system. The view is very different if you were born into a poor family in a neighborhood with bad schools and effectively no opportunity.

It's true that "pure" capitalism doesn't guarantee everyone a well-paying, meaningful job, nor does it provide for a safety net for those physically unable to work. I know of no countries that practice such a form of economic organization with nothing to ameliorate its shortcomings, nor was I advocating something like it. The degree of government involvement in an economy varies. Some industries that are privatized in one country are nationalized in another (and subtle variants in between). The social safety net varies from country to country. When in the current discourse, particularly in the USA, there are arguments for or against socialism, I take it to mean a movement toward nationalization of certain industries and a raising of the social safety net. My comment referred to the former rather than the latter. I realize this wasn't made explicit but I didn't realize my comment could be taken as advocating some libertarian utopia where government did little but national defense and enforcement of property rights (and anything else about such a "pure" view that I've forgotten).
The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.  - Bertrand Russell

Online arthwollipot

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Re: Episode #719
« Reply #24 on: April 25, 2019, 08:45:20 PM »
About the Mercury core. Would it be reasonable to suggest that the heavier material in the protoplanetary disk fell further into the gravity well than the lighter material? This is what I've always assumed was the reason why there are dense rocky planets closer to the sun and less dense gassy planets on the outskirts. It just seems logical to me that Mercury would have a large amount of heavy iron and nickel at its core.
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Offline 2397

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Re: Episode #719
« Reply #25 on: April 26, 2019, 12:29:33 PM »
It's also much more vulnerable to solar wind, and Sol would've had more powerful or more regular flares early on.

Offline daniel1948

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Re: Episode #719
« Reply #26 on: April 26, 2019, 04:37:53 PM »
The root problem with capitalism is that while it produces goods and services efficiently, it systematically excludes a certain percentage of the population from the mainstream economy. It also makes necessities unavailable to a percentage of the population. And while it offers huge rewards for being in the right place at the right time, it provides the lowest wages for the hardest, most backbreaking, and most undesirable jobs. A CEO of a big company has a very difficult job. But a migrant farm worker has a harder job. From the vantage point of a middle-class educated person in an industrial nation, capitalism can look like the best possible economic system. The view is very different if you were born into a poor family in a neighborhood with bad schools and effectively no opportunity.

It's true that "pure" capitalism doesn't guarantee everyone a well-paying, meaningful job, nor does it provide for a safety net for those physically unable to work. I know of no countries that practice such a form of economic organization with nothing to ameliorate its shortcomings, nor was I advocating something like it. The degree of government involvement in an economy varies. Some industries that are privatized in one country are nationalized in another (and subtle variants in between). The social safety net varies from country to country. When in the current discourse, particularly in the USA, there are arguments for or against socialism, I take it to mean a movement toward nationalization of certain industries and a raising of the social safety net. My comment referred to the former rather than the latter. I realize this wasn't made explicit but I didn't realize my comment could be taken as advocating some libertarian utopia where government did little but national defense and enforcement of property rights (and anything else about such a "pure" view that I've forgotten).

Capitalism with a social safety net is still capitalism and in the U.S. the social safety net has holes the size of steamships. A shameful number of children go to bed hungry in the U.S. every day, and another shameful number have no access to routine health care. The wage gap between CEOs and their average employees is disgusting. A single parent working a minimum wage job cannot afford to feed and house her kids without assistance. While it is certainly possible to theorize a capitalist system with fair wages for all, it is an impossibility in real life because of wage competition and the inherent advantage of employers over employees. In the U.S. our political system gives so much power to wealth that meaningful reforms will not happen.

Different people use the word "socialism" differently. For me, state-owned companies are not socialism. Socialism is an economic system where the workers (rather than the investors) own the means of production. It is still a market-based system where companies succeed or fail based on whether people buy their products. But instead of raising money by selling equity in the company to investors, a socialist enterprise vests all the equity equally in the workers (or proportionally to the number of hours they work each week or month) and the company raises needed money by issuing bonds or taking out loans. The investors receive interest on their loans, but do not run the company or pocket the profits.

There is no reason for a socialist country not to be democratic.

A related issue is that having elections is necessary but not sufficient for a nation to be truly democratic. Mexico for many years had elections, but they were always rigged, so the PRI always got elected. In the U.S. we have elections, but our winner-takes-all electoral system guarantees that most voters have no real say in the outcome, and the role of money assures that only the super-rich or those backed by them will have any real chance of being elected. On top of that, our electoral college all too often, and disastrously, gives the presidency to the candidate who lost the vote. The Shrub in 2000 and the Pustule now, were both the candidates who the voters rejected.

The only limitations and regulations the U.S. puts on capitalism are ones that protect huge corporations from enormous corporations. And this is tied to the fact that we are not a democracy. We are a Plutocracy.
Daniel
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Offline PANTS!

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Re: Episode #719
« Reply #27 on: April 30, 2019, 02:33:10 PM »
Sent to Steve:

Steve and co-conspirators,

In episode #719, when discussing the FDA, you mentioned that they were beholden to what Congress decides to write into law.  While that is technically correct, it is not really correct enough, and unfairly places the blame for what the FDA is doing right now.

The FDA is part of the executive branch.  It and many other agencies are actually functionally beholden to the President.  So while congress passes the law, how the law gets (or doesn't get) enacted is dependant on the President, his staff, and the agency heads.  You probably know that in a general sense, but it is important to recognize how this separation of powers is currently being used to deconstruct agencies without Congress passing any laws one way or the other.

In order to not be political, I am going to use very general terms.  Imagine an executive branch who believes their mandate is to deconstruct government (except maybe the military and pseudo military agencies).  They might (and do) lobby Congress to change the laws, but it is much more expedient to simply underfund, understaff and excommunicate agencies. 

We see this happening today - massive cuts, avoiding making appointments, neglect, and hostile work environments amongst other things are set up deliberately to undermine agencies.  And we can all see the results.  For example - a rollback of FDA regulations means that irrigation water doesn’t have to be tested for dangerous pathogens such as E. coli.  Six months later we have the massive E-coli outbreak - from contaminated irrigation water.  This agency decision flied in the face of the Food Safety Modernization Act (FSMA) congressional law.  So in a very real way, the executive branch chose to not enact a Congressional "mandate". 

All this is not to deny that agencies should not have discretion over how they enforce laws.  Far from it.  It is to clearly delineate the fact that Congress is not the only entity pulling the FDA's strings, and if people want agencies who believe they have a role to serve, and can help the public, that voting "drown gov't in the bathtub" types or worse still nihilists and anarchists to the Executive branch may be a bad idea. 

But it gets worse.

The Judicial branch also gets its say.  In the past, that branch was very hands off with how agencies operate, based off the decision (which came about through the efforts of the EPA under  Anne Gorsuch Burford, Neil Gorsuch's mother) that ensconced the idea of the Chevron defense.  The main concept here is that (generally) agencies should have a lot of autonomy when it comes to how they execute the laws that Congress passes.  So long as they are following the spirit of the law, they are then free to hire career experts to tell them how best to go about their business. 

Now there is a move to overturn the Chevron defense, led by Neil Gorsuch (paging Dr. Freud).  If enacted, every agency move will suffer judicial review, further stifling the agencies' ability to enact laws, and strengthening the memetic mantra "Gov't is always bad".  The agencies will become scholeric, because they will be beholden to judicial ruling, and not able to change law enactment as facts on the ground change.

Even if there is a massive swing towards justices who wish to make gov't function better, they will still be hamstrung by removal of the Chevron defense.  Everyone who get their hand slapped by an agency can now tie a law's execution up in the courts for years, because the barrier to sue agencies over how they do their jobs will become non-existant.

Wrecking the agencies also serves a dual purpose.  Now the anti-government types can say "See - government doesn't work", and cynically lobby for more cuts.  Better if they can do it without Congress passing a law.  Then the line becomes "This is the other party's law that is failing", while neglecting to mention why it is failing.  Destroying is much harder than building, but when one side is nigh upon anarchists, and is rewarded for it, how do you fight the decline of our way of life.  Well, one way, I hope, is to raise awareness of the issues and hand, and maybe get people who are reasonable and critical thinkers to reconsider their current stances vis a vis the practical consequences of voting for people who support deconstructing our gov't as an ends.  It is a vicious feedback loop.

I sorta thought that in episode #720 you would have feedback on this, but it wasn't addressed.  If it has been addressed - sorry to repeat the same ole same ole.  Just one of my personal bugaboos.

Thanks for all you do,

-PANTS! (my SGU forum name)

PS - OKay I did get a little political there.  Sorry, but it is hard to take the "both sides have a point" stance on this one.

References:

Agency Cuts: https://www.washingtonpost.com/graphics/2019/politics/trump-budget-2020/?noredirect=on&utm_term=.6d5cb16b914d
https://www.policymed.com/2017/07/some-programs-entirely-eliminated-under-trump-budget-proposal.html


Agency Staffing:
https://www.brookings.edu/research/after-one-year-in-office-trumps-behind-on-staffing-but-making-steady-progress/

FDA Ignoring Congressional Law:
https://cspinet.org/news/trump-administration-indefinitely-delays-key-food-safety-protections-20180104

The Chevron defense; Ann & Neil Gorsuch:
https://en.wikipedia.org/wiki/Chevron_U.S.A.,_Inc._v._Natural_Resources_Defense_Council,_Inc.

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