The point is that it would be easier for people to digest the costs if they paid for development, not for the cost of producing the pills.

Let's say it costs $1B to produce a certain new type of medication. The company who developed it expects to sell about 100 million pills a year. The pills cost $0.01 to produce.

Sell the pills for $0.02 and for the first 10 years add a $20/pill 'development cost recuperation' charge, list it on the bill as such. The company gets a 200% R.O.I. on initial development, plus a 200% R.O.I on every pill sold.

Few people have problems with a company recovering their costs and making a decent profit. The problems start when the costs have been made back ten times over and they are still keeping the price high using the initial development costs as an excuse.

What I'm trying to say is that companies should adjust their business model to align with how people perceive the world, instead of trying to rewrite millions of years of evolution to fit their business model.

Why are services like Netflix and Spotify so popular ? Not because people suddenly changed their mind about paying for IP. Netflix and Spotify sell a service, and people accept that services cost money.

The true cost of bringing a drug to market - inclusive of the extensive research and development required, the failed candidates, the FDA testing and approval processes, etc. - is around $2,800,000,000.

And so, as the saying goes, the first pill costs $2.8B, the second pill costs $0.01. "People" only consider the $0.01 cost to produce the pills that they desire to take, and seem to easily ignore that initial $2.8B investment. This is why patent protection is so critical to the success of many industries, especially medical devices and pharmaceuticals.

This also explains why drug companies refuse to develop life-saving drugs if the potential market for the drug is too small. In many cases, they would have to charge $1,000,000+ per treatment to break even. There are several medications on the market which, for the full course of treatment, cost around $300,000. This seems to be the upper limit in drug development, and insurance is willing to pay the price because one successful treatment will likely save them 10x that amount in the elimination of future care.

This is a recent (3/2/2017) article [1] on one such $300,000/year enzyme-based treatment for a rare disease which affects an estimated 5,000 to 10,000 people worldwide! Development of drugs for rare diseases has been a major problem for quite a while, with legislation on the matter dating back to 1983. However, it's apparent that it's still a problem.

And here is another article on yet another $300,000 treatment (see, there's that number again) to treat cystic fibrosis.

[1]: http://www.cnbc.com/2017/03/02/pompe-drug-lauded-by-trump-co...

[2]: https://www.statnews.com/pharmalot/2016/09/19/sarepta-duchen...

[1]: https://en.wikipedia.org/wiki/Cost_of_drug_development#Resea...

While it does makes sense that pharma r&d is expensive ,It's really hard to believe those numbers, specially that they always seem to change: first it was ~$700M/drug, than ~1.5B and now 2.8B ?

[1]: https://www.forbes.com/sites/matthewherper/2012/02/10/the-tr...

I'm sure many people would expect that, if they were perform the replication themselves using thier own equipment, as they do for software and media.

Making another 100mg of a medicine may cost essentially zero on a pharmaceutical plant, but you can sell the access to the plant.

Copying data is not just easy, but you have already bought the "factory equipment" needed for it, that is, a computer. Thus the drive to dumb down consumer computers (DRM) or move the essential things from users' possession so that they could not easily copy them (SaaS).

There is a large group pushing for Health Care to be free. This includes medicine.

Germany has arguably the best, but certainly the free-est (in the sense that you are free to choose which doctor to see and what kind of treatment to receive), universal healthcare system. The premiums of almost 40% of the adult population are very close to 0. They don't pay for that. Other folks do.

Enjoy those people voting for more free shit.

One can look at health care type spending as a cost, or an investment.

The cost argument generally boils down to "voting in free shit." From the point of view of those able to pay, it is free to those who aren't. From the point of view of those not paying, they see others getting wealthy, and able to get wealthy for their efforts and a productive, capable society.

The investment view boils down to demand, which also presents two ways:

One way is demand not backed by liquid dollars. People want and need stuff, but cannot participate in the markets for lack of buying power.

The other way is demand backed by liquid dollars, real, effective buying power.

The more of the non participating demand there is, and the more it goes unmet, that society experiences generally lower standard of living, instability, higher crime, etc.

We want real demand, people able to participate in the markets.

Investments in the people do that, which frees dollars for them to spend, and it improves their capability, improving on their ability to produce.

You may ask how an economy grows.

When people take risks and borrow, banks make new money as the risk is valued. The investments in people help to improve real demand, which lowers risk, increases success. Each success increases the money supply, and that increase is backed by the value created when the risk was taken.

In a very real sense, "free shit" is actually a smart investment everyone does benefit from, even those paying.

Forcing someone to pay for someone elses expenses is application of force. "For the greater good" is immoral. Read Harry Potter :D

The full, maxed-out tax burden of living in germany approaches 70%. Thats too much. It is immoral, and applies to people who make more than roughly 65k a year. Not a lot of money. And they get to keep 1/3rd of it.

People really really don't want to hear that, but the remote freelance economy is coming. Its just software engineers now. Maybe itll be mechanical engineers next. Finance people, really have no reason to be in offices either. Countries will lose the ability to trap us in their tax exploitation schemes and we will leave. I already do. Renegotiate or lose your productive work force.

People think germany cant fail. Germany is oh so great with its amazing education system. Volkswagen can't shit out more than 20 electric cars by 2020. It takes approximately one Elon to shit all over everything the German tech sector has achieved in 20 years.

Starting a company here? Absolutely not going to happen. Germany is a great place when you're poor.

I got approached by a recruiter the other week. I have 11 years of experience across a whole bunch of stuff. I make 200k+ a year contracting, for american companies who value their engineers. This recruiting lady calls me up, wants to recruit me. I play along just for fun. Tell her roughly what I'd consider. Goes back and forth. 3 calls. Comes back with a "salary matrix". Salary matrix says 11 years of experience gets lumped together with 6 years of experience and pays out 46k a year. Please.

Germany has a better standard of living? Completely agree. 100%. If you take a look at the entire population, I agree. But to me, personally, there are a lot of places that would love to have me, and shower me in tax rebates and decades of tax free living. They compete for me. And they are winning this fucking war. And I dont know what Germanyi s going to become once its alienated all its engineers.

What do all the blue collar folks do when the engineers are gone? I'm not sure. I'm not into politics. I really can't tell you. Only thing I can tell you is that they've lost me. And I really liked it here. But fucking me out of 70% of my money and then being told that I should be grateful for it has lost me. At least show some respect. Even if its for the greater good. You can still appreciate the people who make the greater good possible.

And yes, it is 70%. I have done the math. Income tax, social security that I will never benefit from, VAT on top of that and a myriad of smallish taxes and fees and shit amount to roughly that.

I understand that theres free education. And I benefitted from that. Sure. But if you assume that I'm going to pay ridiculous amounts of money for 50 years, by choice, just because I was born into a system that is the way it is, sorry, thats not going to happen. If you want to hold that I against me, I'm going to hold against the system that I was forced into military service, which is essentially slavery, and if anyone ever decides to drop a bomb onto germany, I'm expected to act as cannon fodder for the "military".

In fact, if we simply didn't change them and reprioritized our existing budget, it would begin to work nicely in the US.

As for fact, economics is not a hard science. Agreed.

Our own history is all we need to know here. Regular and consistent investment spending has a solid basis in history. It's as solid as many other ideas are.

We are left with value judgements. Frankly, I value a bit more basic security and stability more than I do a greater share of dollars earned. I am joined by a growing majority of Americans in these things too.

I don't care what you do. Seriously.

Here, cost and risk exposure is very high. While you may not like the amount your society costs, I can say the lack of sane health care policy, for one, here is something I dislike just as much.

I have just as much and just as valid cause for my advocacy as you do.

Did it all right, but someone got sick. I had two choices:

Let them die, or experience financial ruin. That is no fucking joke. A state of affairs faced by millions all the time here.

And I got forced there too. Let's just say others, who felt they needed more threw me under the bus. Other details do not need to be here.

Perspective, huh?

:D

Cheers! May we both somehow arrive at a more equitable place.

What I meant to say is that Keynesian economics is not the only form of economics out there. Even lots of economics folks blatantly deny that fact.

What a load of self-serving, B.S. Public tax-payer funded health care is not some form of slavery for everyone who pays their taxes and doesn't get sick. And considering the author of Harry Potter benefited greatly from both health care services and other public benefits while writing her books, I think you don't have a leg to stand on there.

More to the point, you don't like the system, you're free to leave Germany, or whatever other country. But if you want to stay, you gotta pay your taxes. It's not "immoral" it's just your decision. The big difference between Germany now, and East Germany of 40 years ago, is you actually can leave anytime you want.

The one thing I do have a problem with is that europe has managed to engineer its population into a situation in which the majority of folks are forced into positions where they can't move out of welfare even if they wanted to, in a reasonable fashion.

In my opinion, both healthcare and internet access have achieved utility status.

This sentence has a ton of negative connotations, so yes you did allude that it may be a bad thing. Sorry, had to call you out.

People were seeing doctors who were over-prescribing opiates, making them cheap and readily available. The DEA (federal Drug Enforcement Administration) cracked down and suddenly these highly addictive prescription opiates were severely constrained, which increased demand for cheap heroin.

Now heroin has replaced prescriptions as the cheap and readily available opiate.

Doctors, in general, are doctors because they wanted to be doctors. Some of them may be in it for the money, but if you are really in it for the money, you become a neurosurgeon at Johns Hopkins, not a primary care physician in Buttfuck, Idaho - where all the rural heroin epidemic victims are.

Sure, some countries hand out opioids more freely than others, but in spain, Codeine is prescription free. Walk into a pharmacy, say you want codeine, you get codeine. I don't see an opioid epidemic in spain. If ease of access was the driving factor behind opioid abuse, spain should be all about opioid abuse. Codeine may not be the most potent opioid in the universe, but it is what it is.

I think its the surgery thing. Because if you fuck up your spine and are in perpetual pain and also cant work anymore which just makes the problem worse because then you cant even afford the morphine, maybe taking the morphine isnt such a bad idea.

You're not seeing it in Europe because you don't have a gigantic portion of your population that's unemployed like we do. (Our official unemployment numbers are complete lies.)

Assuming that people kinda decide to just do drugs because despair is a bit ridiculous. Theres always a reason to do drugs. Almost noone was born an addict, and if you reason that those addictions originated at doctors appointments (prescribed medicine), it was probably not some kind of recreational turned addict thing.

Or are you trying to argue that its the national sport of rural folks to go to their local doctor and check the opioid menu for the flavour of the month opioid to shoot up their vein because they're out of a job and feel despair about it? That sounds a bit far-fetched.

What makes it a fundamental human right? The fact that it says so in the constitution of some countries doesn't make it a fundamental human right.

Is it a fundamental human right like the fact that you can think whatever you want? Because thats a god given ability that nobody can take away. Healthcare is just a modern luxury. You might call it necessary, but healthcare didnt really exist even 60 years ago. People died of really silly little things just 60 years ago. What makes it fundamental?

Yeah, the world sucks in many ways. Good thing we haven't lost our will to fight that.

>Healthcare is just a modern luxury.

Oh your kid was born with cancer and you're poor? Tough luck, no "luxurious" healthcare for you!

>You might call it necessary, but healthcare didnt really exist even 60 years ago. People died of really silly little things just 60 years ago.

And 60 years from now, even fewer people are going to die from really silly little things. What isn't a right now, might become a right in the future. We would call that called progress.

>What makes it fundamental?

Because our evolved brains can contemplate the morality of our actions. A world where health care is a fundamental right is _MORE MORAL_ than a world without.

Rights, laws, rules, the constitution, etc are all abstract ideas that we created to serve us. We get to change them at any point to make them more in line with modern expectations.

>exactly how much healthcare access is a right.

Its not that hard to make a distinction between cancer and catching a cold. Pretty much all laws take into account intent, credibility, reasonable justification and other vague ill-defined criteria.

>what if the required resources are not available in the same amount any more?

Based on available funds, the codified law would be either stricter or looser on the qualifying criteria.

>Are people's rights now violated,

Yes, they would be.

>and if so, by whom?

You should be able to sue the party given the task of dispensing healthcare and make your argument.

No one is saying you need a free ride here, they're saying if you pay your taxes, you should have access the same as for education, or water, or public roads.