Should drug prices be regulated?
Per Bernie Sanders, a good man regardless of what one might think about his agenda:
"When @RepCummings and I asked pharma CEOs about soaring drug prices, they coordinated to block our investigation. @MylanNews and @TevaUSA: Obstructing our inquiry is a crime. The American people deserve answers about your price-fixing conspiracy."
-here
Is he right? Should we be libertarian about drug manufacture and sales? Or should it be under government control?
An argument for a libertarian approach is that iy allows healthcare costs to evolve naturally by market forces.
"When @RepCummings and I asked pharma CEOs about soaring drug prices, they coordinated to block our investigation. @MylanNews and @TevaUSA: Obstructing our inquiry is a crime. The American people deserve answers about your price-fixing conspiracy."
-here
Is he right? Should we be libertarian about drug manufacture and sales? Or should it be under government control?
An argument for a libertarian approach is that iy allows healthcare costs to evolve naturally by market forces.
Comments (38)
That isn’t an argument. There’s a missing premise, presumably that it’s good for healthcare costs to evolve naturally by market forces. But is it?
In fact a case can be made that this is exactly why costs are inflated and that because of this medical issues can financially ruin people, which is bad enough even without factoring in the medical issues themselves.
The libertarian argument is old now, so I assumed an American reader would know it.
For non-Americans: it holds that natural evolution, though sometimes harsh, ultimately brings sustainable and robust entities into being.
Human interference creates entities like the French Merino sheep: an animal that requires lifelong drug administration to survive (in North America, anyway). It's not sustainable.
That may be true if you’re talking about the evolution of species by natural selection but you’d be equivocating if you then apply this to this metaphorical “evolution” of drug prices.
The argument assumes that the basic principles of evolution apply in a variety of situations, so it's not equivocation. If you object to the wider application, could you explain why it should be restricted?
From Adam Smith onward, an economic libertarian view has at least been held to be logically sound. Because of that temporal credential, I'm going to push the burden your way.
The basic principal of evolution is that the heritable characteristics of biological populations change over successive generations due to mutations making an organism more likely to survive and reproduce given its contemporary environment.
If someone wants to explain that drug prices being determined by market forces is comparable to this then the burden really is on them to explain how, not on me to explain how not. And also to explain why this is a good thing. Because the actual effect this is having on people with medical issues in America doesn’t look at all to be desirable. Unless your only desire is for pharmaceutical companies to make big profits?
Inflated prices for medicines lead to higher medical insurance costs which are essentially an additional tax you pay to the pharmaceutical companies for the privilege of having them sell their drugs to you. If the libertarian ideal is that harsher circumstances such as these for the wider population are good for the wider population then why are they so against the governnent raising taxes on everyone directly? If the argument is that it results in more robust corporate entities in the pharmaceutical sphere on the other hand, it can't be because their conditions are harsher, they're considerably easier.
Mutation is only one contributor to phenotypical diversity. What are the others?
Quoting Michael
Again, you're totally failing to grasp the libertarian argument, so your objection is missing the target. I think you hit the cat.
Because the argument doesn’t make any sense to me. Somehow inflated drug prices is like evolution and because human intervention has brought about unhealthy sheep then regulated prices is a bad thing?
Maybe if you could spell it out literally and not just by metaphor and analogy I might actually understand what you’re trying to say.
Because they aren't in favor of harshness. They're opposed to government interference.
Quoting Baden
It isn't. I'm not a libertarian, BTW, I'm just playing devil's advocate. If I could put one tiny idea in your head it would be the same idea I tried to communicate to Michael: your argument isn't hitting a target because you don't understand libertarianism.
Much better. I think you were trying to attack Adam Smith with the assumption that he was an intellectual light weight.
I know you're playing devils advocate, so there's no need to be defensive. I'm responding to what you said, your words, in order to tease out how you would say an American libertarian would respond to my points. If I was sure of the answer, I wouldn't be taking this approach
Adam Smith was a great thinker. It's a pity his ideas are consistently misrepresented by libertarians and others. The invisible guiding hand of the market lie is a good example.
How did you infer that? I was questioning you comparing a free market to evolution.
How would you say they misinterpret it?
I didn't equate them.
1. Government intervention creates a social situation that will continue to require intervention, but the power of a government waxes and wanes. For instance: look at why America's Medicare is running out of funds. It's a natural population shift for the most part. So America is headed for an abrupt transition that it has no idea how to face. A libertarian would argue that this is an inevitable side effect of creating an artificial economic environment.
2. Human bureaucrats are fallible for a variety of reasons. See the Soviet Union for a long list of failures that wouldn't have happened in a free market.
In short, a free market allows a society to face environmental pressures directly instead of cushioned by a government that may do more harm than good in the process of trying to alleviate suffering.
These are libertarian perspectives that have been around for a while. I don't understand why you're trying to direct your objections to me personally.
Well, then we shouldn't have medications at all. They are sustaining the weaker organisms.
But then, here's the thing, evolution did lead to, amongst other things mammals. And mammals have are more complicated than, say, insects. We evolved into creatures that take care, even of their weak, like other social mammals. If anything humans are doing too well.
He mentioned it in the Wealth of Nations once briefly and it had nothing to do with markets and competition.
This is a good summary with more detail:
https://aeon.co/essays/we-should-look-closely-at-what-adam-smith-actually-believed
[Adam Smith] is "usually portrayed as not only an early champion of economic theory, but of the superiority of markets over government planning. In other words, Smith is now known both as the founder of economics, and as an ideologue for the political Right.
...
Yet, despite being widely believed, both these claims are at best misleading, and at worst outright false.
...
The context of Smith’s intervention in The Wealth of Nations was what he called ‘the mercantile system’. By this Smith meant the network of monopolies that characterised the economic affairs of early modern Europe. Under such arrangements, private companies lobbied governments for the right to operate exclusive trade routes, or to be the only importers or exporters of goods, while closed guilds controlled the flow of products and employment within domestic markets."
Sound familiar?
"As a result, Smith argued, ordinary people were forced to accept inflated prices for shoddy goods, and their employment was at the mercy of cabals of bosses. Smith saw this as a monstrous affront to liberty "
Re the invisible hand:
"Indeed, Smith’s single most famous idea – that of ‘the invisible hand’ as a metaphor for uncoordinated market allocation – was invoked in precisely the context of his blistering attack on the merchant elites. It is certainly true that Smith was skeptical of politicians’ attempts to interfere with, or bypass, basic market processes, in the vain hope of trying to do a better job of allocating resources than was achievable through allowing the market to do its work. But in the passage of The Wealth of Nations where he invoked the idea of the invisible hand, the immediate context was not simply that of state intervention in general, but of state intervention undertaken at the behest of merchant elites who were furthering their own interests at the expense of the public."
"It is an irony of history that Smith’s most famous idea is now usually invoked as a defence of unregulated markets in the face of state interference, so as to protect the interests of private capitalists. For this is roughly the opposite of Smith’s original intention, which was to advocate for restrictions on what groups of merchants could do."
And by restrictions, he meant government regulation (only not the type designed by corporate lobbyists: see below). See, the problem is that those who are most likely to invoke Adam Smith are also those most likely to be not just totally ignorant of what he said but to be actively perverting it.
From Adam Smith on corporate lobbyists:
"To widen the market and to narrow the competition, is always the interest of the dealers…The proposal of any new law or regulation of commerce which comes from this order, ought always to be listened to with great precaution, and ought never to be adopted till after having been long and carefully examined, not only with the most scrupulous, but with the most suspicious attention. It comes from an order of men, whose interest is never exactly the same with that of the public, who have generally an interest to deceive and even oppress the public, and who accordingly have, upon many occasions, both deceived and oppressed .' [my bolding]
Link
I'll get more Smith quotes if you need them.
I wouldn't have a society centered on anything like the traditional idea of money though.
An American libertarian should be understood in the context of all the essentially socialist fixtures that have become part of American life starting with Teddy Roosevelt, through the Great Depression, LBJ's war in poverty, etc.
Well, as @Terrapin Station has demonstrated the terrain is complicated enough for different types of libertarian to be as much, or more, in conflict with each other on certain issues than their traditional big government enemies embodied in Bernie Sanders etc.
The reality is that drug prices, deductibles, and insurance with sufficient coverage are unaffordable to most Americans and that medical costs are a large cause of bankruptcies. so clearly the free market approach to healthcare isn’t working very well. Much like so-called trickle-down economics, the theory is disproven by the facts.
What exactly do you expect to happen if prices are regulated? Is whatever it is really worse than what’s actually happening without regulation?
https://chomsky.info/warfare02/
"[Adam Smith] simply observed in passing, because it’s so obvious, that in England, which is what he’s discussing — and it was the most democratic society of the day — the principal architects of policy are the “merchants and manufacturers,” and they make certain that their own interests are, in his words, “most peculiarly attended to,” no matter what the effect on others, including the people of England who, he argued, suffered from their policies.
...
This truism was, a century later, called class analysis, but you don’t have to go to Marx to find it. It’s very explicit in Adam Smith. It’s so obvious that any ten-year-old can see it. So he didn’t make a big point of it. He just mentioned it. But that’s correct. If you read through his work, he’s intelligent. He’s a person who was from the Enlightenment. His driving motives were the assumption that people were guided by sympathy and feelings of solidarity and the need for control of their own work, much like other Enlightenment and early Romantic thinkers. He’s part of that period, the Scottish Enlightenment.
...
The version of him that’s given today is just ridiculous. But I didn’t have to any research to find this out. All you have to do is read. If you’re literate, you’ll find it out."
Because the price system, or any other economic environment, is carved out of nature. Like, totally not artificial.
I'm a little amazed that you believe this. It isn't true. What I'd like you to do is consider what would happen if it was true.
Quoting Michael
So you're persisting in trying to make this personal. I'm not interested.
No worries. :up:
American price systems for healthcare costs are set by Medicare.
Are they? Who's Medicare and by whom are they set in a non artificial environment?
Medicare pays set prices by diagnosis. So they pay a certain amount for a pneumonia diagnosis no matter how much the healthcare provider spends. There's a set payout for attack by killer whale (believe it or don't).
All private insurance companies set their payouts by Medicare's rates.
Many would be in medical related debt. Others would seek insufficient or no medical help for their health issues. Hopefully most Americans aren't facing such issues?
Quoting frank
Wiki says:
"Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It provides health insurance for Americans aged 65 and older, younger people with some disability status as determined by the Social Security Administration, as well as people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease).
In 2018, Medicare provided health insurance for over 59.9 million individuals—more than 52 million people aged 65 and older and about 8 million younger people.[1] On average, Medicare covers about half of healthcare expenses of those enrolled.[citation needed] Medicare is funded by a combination of a payroll tax, beneficiary premiums and surtaxes from beneficiaries, co-pays and deductibles, and general U.S. Treasury revenue."
I'd ask the same thing to the one who wrote this.
Quoting frank
If this is an answer to the question "by whom are they set in a non artificial environment", I do not get the answer.
The American healthcare system is heavily regulated, directly for quality by CMS, and indirectly for cost by Medicare.
It's an artificial system. What doesn't happen in this regulated system is research for new drugs. That research is funded purely by speculation that a profit can be made to pay for the research.
So looking beyond cases of gouging (as is happening with insulin right now), how would price caps on drugs effect research?
Nature.
wow.