Rigged justice

[jdshock]

1. The drug I saw they were recommending was for post transplant surgery recovery. Those have nasty side-effects, but the drug was approved by the FDA as safe. They weren't feeding them cyanide disguised as Tylenol. Minimizing side-effects is an interesting issue. I'm curious what this means, how it was tracked, and how it was incentivized. Covering up side-effects is certainly amoral, but I'm not quite convinced they did anymore than just list 25 of the 30 side-effects. Ever been to the pharmacist and then Check the side-effects on line. Did he give you a full list verbally?

2. It was a necessary drug. In fact, patients that fail to take it after a transplant risk rejection of the organ. The pharmacists were encouraging the patients to get refills and stay on the life saving drug they were already prescribed. There was a competitor drug. You have to be on one or the other or you will have a high likelihood of death

3/4. I understand that piece. Why can't a pharmacist recommend a drug to a patient or physician? I do not see this as a moral conflict.

I'm not going to argue each point with you since, for the most part, we agree on the facts, we just disagree on the problem with those facts. I just have one question because I think it gets to the core of our disagreement (on what is obviously just one company out of a handful listed).

How can capitalism function properly when there are secret incentive schemes that the consumer doesn't know about? Economists always assume perfect information in their models. When the pharmacist gets a kick back, that pharmacist has an incentive to leave out certain information (even if it's just a few side effects). When that happens, how can a consumer make an informed decision?

To respond to the inevitable arguments: 1. A consumer can't just go look up the side effects or information at home. We trust doctors and pharmacists since they have more education than we do. 2. It is not functioning capitalism. Capitalism is supposed to ensure the best and cheapest products win. This process ensures the company with the best incentive scheme wins.

Most importantly, though, what the company did is 100%, without a doubt, illegal. A direct violation of the law. The company paid 10% of what they should have by law. People wanted examples of illegal behavior that wasn't punished, and this is one example, regardless of whether you think it's a bad law. Don't let your bias against Elizabeth Warren cloud your judgment of that.

[wufan]

Well stated argument. First of all I agree that what they did was illegal and that they should pay the penalty. Second, they took a legal plea deal and paid a lesser penalty. Whether or not we agree on the law or the penalty, I think it's fair to say justice was served.

How can the consumer make a well informed decision is the question. Great question when it comes to medication! First off, the government has already said that they don't trust the patient to make a good decision. If my issue is back pain, these are the regulations preventing me from making a decision. The FDA must deem the medication safe. Then it must deem it effective for that symptom. The drug manufacturer must be deemed fit for manufacture by the FDA and the DEA. Competititors aren't allowed. If my back hurts I can't go to Wal-Mart and purchase Oxycotton or Morphine. I have to go to a doctor (one that the government has deemed acceptable and that my insurance carrier approves) and that doctor has to decide for me if I get to be treated and with what medication and for how long. Next the pharmacist must interpret the doctor's choice and concur that it is safe and appropriate for intended use. Finally, my insurance company or the government funded insurance I receive determines if it is safe, effective, and necessary. The insurance company, through negotiations with the manufacturer will set the prices.

My response is that the government expects a patient to take its medicine. Four "experts" have already determine your treatment and that is why capitalism is illegal in the pharmaceutical field. The consumer has no right to choose (perhaps there is the perception of choice) and thus the highest quality at the lowest price has been regulated away. Incentivizing the next level up from the consumer (care givers) is a logical step in boosting revenue. This was made largely illegal in the 90s and 2000s when the government decided that if tempted with benefits then these wise people we trust with our health would make poor decisions. Where must these corporations turn to sell their drugs now? The government. Lobbying politicians and regulators to make new laws which hinders the competition is PERFECTLY LEGAL. The government has created a capitalist system in which the only legal way to gain economic advantage is to incentivize the same government folks to make capitalistic practices on the competitor more stringent.

All of the above is currently accepted as a good practice and many left leaning folks believe this leads to safer medication and that the evil corporations are lying cheating and stealing due to their greed. Meanwhile the caring government is watching out for the best interest of the populous, protecting us from the big bad wolf. As you can tell by the way I painted this paragraph, I believe in a different model of governance and economics that believes that individuals are generally good and when given the opportunity will make generally good decisions. I believe that an individual has the right to choice, the right to free will, and the right to succeed or fail. A government believes it is protecting an individual from him/herself is a government on is path to socialism or tyranny.

[jdshock]

Well stated argument. First of all I agree that what they did was illegal and that they should pay the penalty. Second, they took a legal plea deal and paid a lesser penalty. Whether or not we agree on the law or the penalty, I think it's fair to say justice was served.

How can the consumer make a well informed decision is the question. Great question when it comes to medication! First off, the government has already said that they don't trust the patient to make a good decision. If my issue is back pain, these are the regulations preventing me from making a decision. The FDA must deem the medication safe. Then it must deem it effective for that symptom. The drug manufacturer must be deemed fit for manufacture by the FDA and the DEA. Competititors aren't allowed. If my back hurts I can't go to Wal-Mart and purchase Oxycotton or Morphine. I have to go to a doctor (one that the government has deemed acceptable and that my insurance carrier approves) and that doctor has to decide for me if I get to be treated and with what medication and for how long. Next the pharmacist must interpret the doctor's choice and concur that it is safe and appropriate for intended use. Finally, my insurance company or the government funded insurance I receive determines if it is safe, effective, and necessary. The insurance company, through negotiations with the manufacturer will set the prices.

My response is that the government expects a patient to take its medicine. Four "experts" have already determine your treatment and that is why capitalism is illegal in the pharmaceutical field. The consumer has no right to choose (perhaps there is the perception of choice) and thus the highest quality at the lowest price has been regulated away. Incentivizing the next level up from the consumer (care givers) is a logical step in boosting revenue. This was made largely illegal in the 90s and 2000s when the government decided that if tempted with benefits then these wise people we trust with our health would make poor decisions. Where must these corporations turn to sell their drugs now? The government. Lobbying politicians and regulators to make new laws which hinders the competition is PERFECTLY LEGAL. The government has created a capitalist system in which the only legal way to gain economic advantage is to incentivize the same government folks to make capitalistic practices on the competitor more stringent.

All of the above is currently accepted as a good practice and many left leaning folks believe this leads to safer medication and that the evil corporations are lying cheating and stealing due to their greed. Meanwhile the caring government is watching out for the best interest of the populous, protecting us from the big bad wolf. As you can tell by the way I painted this paragraph, I believe in a different model of governance and economics that believes that individuals are generally good and when given the opportunity will make generally good decisions. I believe that an individual has the right to choice, the right to free will, and the right to succeed or fail. A government believes it is protecting an individual from him/herself is a government on is path to socialism or tyranny.

Just as a side point (and really the topic of this thread), I would not be willing to say justice was served. The point of the report is that the government gives favorable plea deals to or fails to prosecute large corporations, so them accepting a plea deal can't act as evidence that justice was served. That, is in fact, the problem. A problem that probably stems from many of the same areas that you address: corporate influence over politics.

In regard to the rest of your post, I actually agree with a lot of it, and I would go so far as to say many liberals would too. Medical industry lobbying of Congress is probably far worse for consumers than any kickback scheme or ad campaign. The FDA is a largely ineffective organization for this reason. I think this is one reason Bernie is having a lot of success with many liberals, as he's been very opposed to similar things.

It's the very end of your post that we disagree on. Two people can have internally consistent logic but reach different results if their starting points are different. Individual choice and tyrannical governments, etc. are too philosophical for me to argue about, though. Suffice it to say, we disagree on the importance of the regulations because of our differing beliefs on the role of government.

[wufan]

"It's the very end of your post that we disagree on. Two people can have internally consistent logic but reach different results if their starting points are different. Individual choice and tyrannical governments, etc. are too philosophical for me to argue about, though. Suffice it to say, we disagree on the importance of the regulations because of our differing beliefs on the role of government."

I have no issues with this. Neither view is more right/wrong, just fundamentally different. The ability to come to that conclusion and move forward is important to solving problems of governance.

[Kung Wu]

Problem: Corrupt government is giving favors to sketchy corporations.

Solution: Give more power to corrupt government that governs the sketchy corporations.

Did I get that right?

[wufan]

Problem: Corrupt government is giving favors to sketchy corporations.

Solution: Give more power to corrupt government that governs the sketchy corporations.

Did I get that right?

For me, it's not even a question of whether or not they are corrupt. Someone ALWAYS has the decision making power. I believe in the decision making power of the individual. With every law that is enacted, that decision is further removed from the populous.

The socialist movement, or movement towards socialist values does not seek to remove corruption, rather it seeks to move power towards those that believe they know best how to run a government. It is a government that believes that there are not winners or losers, just citizens of circumstance. In order to improve the circumstance of some, it is the governments responsibility to intervene. This removes the responsibility from the individual and while his/hers failures are forgiven, so to his/her successes are punished (economically speaking).