Re: Why do some people vote Democrat, especially Hollywood?
- From: william <wlahearn@xxxxxxxxx>
- Date: Fri, 14 May 2010 14:52:39 -0700 (PDT)
On May 14, 3:11 pm, "steve" <st...@xxxxxxxxx> wrote:
First, let me thank you for taking a much more civil and reasonable tone in
this response.
Thank you for at least trying to be specific.
Now to the points of disagreement.
"Conceptual" arguments based on the
dietary supplement market are false and can only be false because one
market has nothing to do with the other.
Several points:
1. If markets are allowed to function and certain, easily met conditions
apply...open market entry, price sensitivity (consumer pays directly), free
flow of nformation...then they can be compared and one can provide
information about another. I see no reason why the drug market is unique in
any relevant sense that precludes comparing it to other markets. There are
plenty of products that are potentially dangerous and for which performance
is measured over a long time horizon.
You just don't get it and this is why I lose my temper. Can you
compare drugs to the shoe market? No. Why? Because if the shoe is
shoddy it becomes apparent to the wearer. The efficacy of drugs
sometimes can't be detected by the user. Let me give you a real life
pharma story about how these people work. In the mid- to late-1990s,
there was a meningitis epidemic in Nigeria. Calls went out from
Doctors Without Borders and other first responders to the pharma
companies for donations of antibiotics. Generally, most antibiotics
will do and pharma companies usually send whatever stock is sitting
around. I've got no problem with that. One pharma company decided to
do its Phase II trials in the field on unsuspecting people of a new
drug on-site at the epidemic. Not sure how many they killed and then
got caught forging Nigerian government documents to insist what they
did was legal. The case is still in that tort law limbo that you hold
so dear. By the way, the drug company never submitted that data and
the drug was approved in the US. It's still available although the use
of it is so restricted as to make that availability pointless. This
can not happen in the shoe business or publishing or window cleaner.
To "measure over a long time horizon" is to make the populace no more
than lab rats. This fluff of yours clearly demonstrates how you lack
the knowledge and credentials to (a) understand that the US
prescription drug market isn't comparable to other markets; and (b)
formulate even a cursory platform to how it might be deregulated.
2. Markets evolve based on the constraints and demand. We have a drug
market that has been heavily regulated for quite some time, and a public
that believes they are being protected by the govt (and we all know how
businesses use politicians and regulation to line their pockets). Absent
regulation, Im sure you agree that potential customers (which includes
doctors and other who know the subject well... not just ignorant patients)
would place a high value on reliable information about the drugs they
recommend and use.
I only have to reiterate the history of Heroin and Oxycontin to show
the lie of your first sentence. Ignorant patients would place a high
value on reliable information about drugs. Where would they get it? I
helped create some of that "reliable" information that can be found in
the medical literature (JAMA, The New England Journal of Medicine,
etc), presented at symposia, pitched to doctors, etc. And your quip
about "businesses using" regulation is just another distraction. On we
going to sink to smear tactics? To boot, most patients -- ignorant or
otherwise -- don't have the background to understand *real*
information about drugs. Here's an excerpt from a drug I worked on and
is contained in the prescribing information:
"LANTUS is produced by recombinant DNA technology utilizing a non-
pathogenic laboratory strain of Escherichia coli (K12) as the
production organism. Insulin glargine differs from human insulin in
that the amino acid asparagine at position A21 is replaced by glycine
and two arginines are added to the C-terminus of the B-chain."
They'll be humming that as they leave the doctor's office. Who is
going to produce "reliable" information? A front company for Big
Pharma?
3. Given that drugs are so important and so potentially dangerous, wouldnt
it make sense that the desire for reliable information would stimulate a
market for that very type of infomation. As I mentioned in an earlier post,
even under the current system, there are independant studies done of drug
effectiveness and publications that sell that information. Without
regulation, demand for that sort of thing could only increase. I find it
baffling that people can both recognize the value of that information and
discount the potential for a market for that information. When people value
something, there is profit potential in providing that product or service..
Hold on. What? Do you even know what "independent" study means? Did
publications like Parade Magazine begin printing journal articles or
did Cosmo start picking up some medico freelancers? First off, most
people -- even college educated -- can't read a journal article and
understand it. The whole medical journal establishment is under
scrutiny because of how the pharma companies have compromised
"independent' studies and bought investigators (journal authors).
Also, there are hundreds of articles on any given drug and many of
them are contradictory and inconsistant. And people do market that
information. It's called advertising. Steve, this is where it stops
being conceptual. Information isn't always power. Sometimes it's
smoke. This was my bailiwick and it's obvious if you don't have a clue
as to how drugs are developed, marketed and sold. This is where drug
selling is different from shoes and sodas. You need to read the
information but you also need to be able to understand it.
The idea that any bonehead
with a lab can market drugs that were once subjected to rigorous
testing before being released on the market is insane. History has
shown -- before and during regulation -- that greed has more to do
with medicine than noble ideas.
My argument doesnt assume noble ideas or intentions. But, in a real sense,
the govt regulation approach does just that by assuming govt agencies will
not be corrupt. I mentioned the statin market and the (now absurdly low)
FDA recommendations for cholesterol level that essentially recommends
statins for the whole population. No coincidence, Im sure. Would this
happen in a unregulated market? Doubtful, because there would be competing
services to evaluate a drugs effectiveness, and, unless they were all on the
take, they couldnt mount a campaign to get everyone on the drug. If any one
service did anything like that, their reputation and future existence would
be on the line, thier competotoirs would have every reason expose thier
dishonesty, and harm from a drug corruptly recommended would expose them to
liability (can you sue the FDA when they get it wrong?). They wouldnt be
reasonably honest beause they are noble, but because their continued
profitability would depend upon it.
Steve, with all due respect that is naive. Competitors exposing
dishonesty? The above is again "conceptual" nonsense.
Your notion
that new comers to the market can sell their drugs through established
and trusted pharma companies will (a) stifle any notion of competition
and innovation; and (b) there are no trusted and established pharma
companies.
I see no reason why the market would not evolve as I suggested. Newcomers
in all sorts of markets bring thier products to existing companies to
leverage their brand name, marketing, or market share. Is there any reason
why drugs should work differently? And newcomers who decide to go it alone
would have to either sell cheap (with contractually limited liability) or
provide independant research to back thier claims, or no one would take the
risk of selling/using thier drugs.
What "independent" research? From where? Again, Steve, you're lost in
some romantic notions from the 19th Century. Time and again you
demonstrate no real knowledge of the business and rely on how you "see
no reason." Is that the fourth monkey? Yes, there is a reason why
drugs should work differently and you suggest that new drugs by
newcomers have to be sold cheap. Is that what you think spurs
innovation and quality? Your model makes no sense.
The biggest mistake
the FDA made in the 1990s -- that is haunting us today -- is direct to
consumer advertising that translates into TV ads, print ads and the
like that creates a need or belief in the consumer that they need a
particular medication for some ailment real or imagined or that they
can get their physicians to change their prescriptions based on images
of sunshine and a puppy.
I suggest that a big part of the problem is the cost and delay of regulatory
approval. Surely a competitive market could come up with quicker and less
costly methods of testing drug effectiveness and safety. When a company has
to invest massive cash and 10 years to bring a drug to market, the high cost
of scrapping a less effective or unsafe drug becomes a motivator to bring
that drug to market when it's performance is, let's say, marginal. The
problem with regulation is that it is too rigid and evolves slowly (if at
all).
The above is just plain ignorant and scary. I'm getting weary trying
to talk you off the ledge of your own delusions. "Quicker and less
costly" and that implies safety and efficacy to you. Having worked in
the business, I find it scary.
Plus, the tea baggers and the republicans
have tried over and over and over again to minimize tort monetary
damages. Isn't just a tad dishonest to offer tort law as a protection
when your philosophy is to marginalize the damage they can do to Big
Pharma when Big Pharma gets sued?
Well...we agree about something, anyway (though I wouldnt blame the tea
party, just yet). When politicians get ahold of a good idea, they virtually
always turn it into a bad practice. Tort reform that blindly limits damages
is nonsense, and not what I mean when I talk about a rational tort system..
I mean that the system should use the english rule (loser pays) to reduce
junk lawsuits; that damages should be limited to actual damages, not
punitive; that responsible parties alone should pay damages (rather than
tangentially related deep pockets); that contractual limits on liability
would be respected (they are generally not); and the discovery process would
have to be eliminated or scaled back (it's a huge cash generator for law
firms).
No discovery for a plaintiff trying a case that is based on science
and who-knew-what-when? Again, you're in dreamland.
Steve, we're not going to discuss this again because you don't
Anyway, that's how I see it and where we disagree. I hope you will continue
to hold a civil tone if we discuss further.
understand how drugs are developed, you don't understand -- evidenced
by notions of independent "research" -- how they come to market and
how they get prescribed. Interestingly, little of that would change
with deregulation. I have numerous issues with the FDA and I'm not a
fan of a lot of their decisions. The real problem is that the drug
market is many markets and it tends to be divided by disease or
condition. What is true for developing statins isn't always true for
insulin or antibiotics or HIV drugs. Any prudent person can see that
the selling of drugs and medications isn't the same as other markets
and very little of it is transferable either way. When you suggest
that a free market will bring cheaper drugs to the market more
quickly, I can only shake my head at what an irresponsible and
uneducated idea that is. You pontificate as if you're some savvy
market guru and just reading what you wrote above shows me that you
have no true, no grounded, no real-world experience in markets. You
sound like you cribbed this nonsense off of some website. I'm not
trying to be rude or uncivil, I'm just calling it like I sees it. You
haven't offered a single, realistic or reasonable proposal for
deregulating drugs. It's all conceptual and reducing the drug market
to supply and demand is absurd.
So we're done. Be well.
William
www.williamahearn.com
.
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