Abject Ignorance of things Economic is Destroying our Health Care System

Posted by PITHOCRATES - January 18th, 2014

Week in Review

The problem in America these days is the mass ignorance of the people.  Thanks to a public school system that does not educate but programs our children to be good Democrat voters.  Higher education taken over by the leftist radicals of the Sixties that forever changed the curriculum to teach our children to distrust capitalism and love government.  When controlled by Democrats, of course.  And people who are for some reason respected for their economic prowess who are absolutely clueless on things economic (see The Daily Show Nails Why Healthcare Will Never Work As A Free Market by Christina Sterbenz posted 1/18/2014 on Business Insider).

Steven Brill, author of Time’s in-depth healthcare analysis “Bitter Pill,” appeared on The Daily Show this week to discuss his opinion of Obamacare.

Brill’s work exploded his career into a love-hate relationship with Obamacare, now leading to a book. Speaking with Jon Stewart, Brill certainly made his criticisms known but we also feel like he pinpointed exactly why healthcare just can’t work as a free market.

Brill told the story of a cancer patient forced to pay $13,700 out-of-pocket, up-front for transfusion of a drug. And that cost only constituted part of a greater $83,000 payment. Brill claims, however, the drug only cost the pharmaceutical company $300.

Stewart came back at Brill with the typical, conservative argument — creating a free market for healthcare where patients pick-and-choose their coverage to create competition and therefore, better options.

“Everyone says, well it’s a marketplace. That guy [the cancer patient] has no choice in buying that drug. His doctor told him, ‘This will save your life. You don’t take it, you’re gonna die,'” Brill responded.

He further argued free markets must host two aspects — a balance between buyers and sellers and secondly, knowledge — neither of which the current U.S. system offers.

“That cancer drug has a patent. That is a monopoly that the government has given the drug company. There is no other drug. That’s the drug,” Brill said.

Jon Stewart is a comedian.  So one can almost forgive his ignorance.  But you’d think a person writing for a publication with the word ‘business’ in its name would actually understand business.  But the author hasn’t a clue.  It’s not her fault.  It’s because of the politicizing of our educational system.  As her dual degrees in journalism and public affairs would have taught her squat about the classical, Austrian or the Chicago school of economics.  Instead filling her head with Keynesian nonsense.  The one economic school embraced by power-hungry governments everywhere that has a proven track record of failure.  For it was Keynesian policies that gave us the Great Depression, the stagflation of the 1970s, the dot-com bubble and recession of the late 1990s/early 2000s and the Great Recession.  Where massive government spending did not pull the economy out of recession but only made things worse.

Why does this pharmaceutical company have a patent?  Or perhaps a better question would be why do we have this one cancer drug?  Why is it that this one pharmaceutical company developed a cancer drug that works that no other pharmaceutical company or government developed?  Because of that patent.  The only reason they poured hundreds of millions of dollars into research and development and paid massive liability insurance premiums for taking a huge risk to put a drug onto the market that may harm or kill people.  They do this on the CHANCE that they may develop at least one successful drug that will pay all of their past costs for this one drug, the costs for the countless drugs that failed AND a profit for their investors.  Who took a huge risk investing, giving this pharmaceutical company the money to pay all of their employees over the years it took to come up with at least one drug that wasn’t a loser.

Does the author of this article work for free?  No.  Of course not.  She has bills.  As we all do.  Even the people working at pharmaceutical companies.  Who don’t work there for free.  Even if the vast majority of their work produces nothing that their employer can sell their employer still pays them.  Thanks to their investors who give them the money to do so until they can actually sell something.  But their investors do this only because of the CHANCE that this pharmaceutical will develop that miracle drug that everyone wants.  A miracle drug that would never come into being if it weren’t for investors who were willing to risk losing huge amounts of money.  Something only rich investors can afford to do.

Health care worked as a free market before General Motors made it an employee benefit thanks to FDR’s ceiling on wages.  Once people stopped paying for what they received all free market forces left the health care system.  And costs began to rise.  This whole “healthcare just can’t work as a free market” is a product of the dumbing down of our educational system.  One that produces people who don’t know the difference between insurance and health care.  Insurance protects our assets against a catastrophic and UNEXPECTED loss.  Like when Lloyds of London started selling marine insurance at that coffee shop.  Every shipper paid a small premium to protect against a POTENTIAL sinking and loss of cargo.  A POTENTIAL financial loss.  Not every ship sank, though.  In fact, most ships did not.  Which is why that little bit from everyone was able to pay the financial loss of the few that did.  For the ships that didn’t sink the shippers paid every other cost they incurred to ship things across those perilous oceans.

This is how insurance works.  Which isn’t how our current health insurance works.  Where people don’t expect to pay for anything out-of-pocket.  Not the unexpected catastrophic costs.  Or the EXPECTED small costs that everyone can budget for in their personal lives.  Childhood vaccinations, annual checkups, flu shots, childbirth, etc.  Even the unexpected things that have a low cost.  Like the stitches required when a child falls off of a bike.  Things that would cost less than someone’s annual cellular costs.  Or things that people can plan and save for (like a house, a car or a child).  When we pay these things out-of-pocket there are market forces in play.  For a doctor is not going to charge someone they’ve been seeing for years as much as a faceless insurance company.  Even today some doctors will waive some fees to help some of their long-time patients during a time of financial hardship.  Because there is a relationship between doctor and patient.

When we pay out-of-pocket doctors can’t charge as much.  Because they need patients.  If they charge too much their patients may find another good doctor that charges a little less.  Perhaps a younger one trying to establish a practice.  These are market forces.  Just like there are everywhere else in the economy.  Even a cancer patient requiring an expensive wonder drug would contribute to market forces if there was true insurance in our health care system.  Cancer is an unexpected and catastrophic cost.  But not everyone gets cancer.  Everyone would pay a small fee to insure against a financial loss that can result from cancer.  Where that little bit from everyone was able to pay the financial loss of the unfortunate few that receive a cancer diagnosis.  Because only a few from a large pool would incur this financial loss insurers would compete against other insurers for this business.  Just like they do to insure houses.  And ships crossing perilous oceans.

Health care would work better in the free market.  It doesn’t today because government changed that.  Starting with FDR putting a ceiling on wages.  Which forced employers to offer generous benefits to get the best workers to work for them when they couldn’t offer them more pay.  This was the beginning.  Now the health insurance industry is so bastardized that it doesn’t even resemble insurance anymore.  It’s just a massive cost transfer from one group of people to another.  Instead of a pooling of money to insure against financial risk.  For the few unexpected and catastrophic costs we could not afford and budget for to pay out-of-pocket.

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The Left says Smoking Cigarettes and Drinking Alcohol are bad for you but Smoking Marijuana is OK

Posted by PITHOCRATES - December 28th, 2013

Week in Review

You hear it all the time.  Smoking marijuana is no worse than drinking alcohol.  So we should decriminalize it everywhere.  And allow responsible adults smoke marijuana if they choose.  While at the same time they have banned smoking cigarettes just about everywhere outside of your own home.  Because smoking will kill you.  And anyone near you.  Funny how smoking cigarettes will kill you and anyone near you while smoking marijuana is no worse than enjoying a refreshing adult beverage.

What’s even funnier is that as they continue to make statements like smoking marijuana is no worse than drinking alcohol they are ramping up a war on alcohol.  As drinking alcohol is killing people at record numbers (see Raising the price of booze saves lives and money. Scotland is right to try it posted 12/21/2013 on The Economist).

AMONG man’s earliest artefacts are vessels to store and carry booze. Drunk from Stone Age jugs or Etruscan amphoras, fermented sugars have brought cheer for more than 12,000 years. And headaches too: alcohol stokes rage and gloom as well as jollity and dancing. For liberal-minded types, the downsides are a personal matter—we should be free to frolic.

Within limits. Where the harm extends beyond the individual, there is a case for intervention. Global alcohol consumption is stable. But some people are tippling more, in ways that hurt themselves and others (see article).

At stake are not just vomit-drenched streets. Deaths linked to drinking have tripled since 1990; in that time alcohol has gone from the sixth to the third leading cause of death and disability worldwide. The bill lands on everyone, as does booze-fuelled violence. Including lost output, the harm from alcohol costs Europe and America around 1.5% of national income.

The problem is worsening. Across the rich world, a small share of the population consumes a large share of the liquor. One reason is that many young people have upped their intake. More drinkers are also bingeing—even in southern Europe, where alcohol used to be taken mainly with food…

The best way to tackle excessive drinking is to raise prices through taxes levied on a drink’s strength, so that the most harmful drinks are more expensive. The resulting price-rise should cut the consumption of hard-up heavy topers (who are particularly partial to dirt-cheap supermarket booze) and young drinkers, who can afford only what’s cheap…

Public-health laws often require an unpopular move at the start, but new habits and attitudes can take root surprisingly quickly. A ban on smoking in restaurants and pubs seemed outlandish—until New York City introduced one in 2003. Much of the world quickly followed suit. Even diehard liberals like this newspaper, queasy at first about smoking bans, or mandatory crash helmets and seat belts, would hesitate to scrap those regulations now.

We are drinking ourselves to death three times as much as we were in the 1990s.  And one reason why is that young people are drinking more.  In fact many of the binge drinkers are young people.  It is less uncommon to read about a binge-drinking related death on a college campus.  It’s not happening all of the time but there are deaths.  And sexual assaults.

Getting a woman drunk has long been a prelude to sex.  That’s what singles’ bars were for.  Drinking to lower a woman’s inhibitions.  To get her to go home with a strange man for consensual sex.  But at a party on a college campus?  There’s no need to go home.  For there is always a bedroom or a couch or a floor available in a fraternity house, apartment or dorm room.  And young men with raging hormones in a sexualized culture will take advantage of a passed out college coed.  Even doing terrible things to her as she lay unconscious.  Or getting a video of her while she’s still conscious doing things she’d never do sober.  And posting it online.  Causing great pain and suffering for the girl.

Smoking marijuana will be no different than people enjoying alcohol.  So we should decriminalize it.  For what bad thing ever happened from enjoying alcohol?

Marijuana is a young person’s intoxicant.  We’ve all seen the stoner movies where high school teachers have to deal with stoners.  Like Jeff Spicoli in Fast Times at Ridgemont High.  And this was when the drug was illegal everywhere in the United States.  Imagine the Jeff Spicolis when the drug is decriminalized everywhere.  While being more potent than ever.  If new habits and new attitudes can take root surprisingly quickly then existing habits and attitudes and law should be just as easy to remain rooted.  Especially for marijuana.  For it combines the reckless abandon of youths to over consume like alcohol.  And the harmful effects of smoking cigarettes.

Would the left sacrifice our young just to get their vote?  Yes.  Of course they will.  And are.  For do you really think they care if these people die after they grow up and begin acting—and voting—responsibly?

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FT202: “You can’t indulge selfishness, narcissism and hedonism and expect the young to give up their life of consumption and gratification.” —Old Pithy

Posted by PITHOCRATES - December 27th, 2013

Fundamental Truth

The Generation that won World War II Sacrificed and Saved for the Future

The generation that lived through the Great Depression and World War II were a hardy people.  They knew a thing or two about sacrifice.  And going without.  For their wants often went unfulfilled.  And they were a skinny people.  As there was not a lot of food to eat.  First because of the Great Depression.  When people could barely afford to stay alive.  And then World War II.  Where the government rationed almost everything for the war effort.

So they spent little.  Saved what they could.  Got used to not having what they wanted.  And always worked hard for a better future.  Sound familiar?  No.  Of course not.  No one’s like this today.  That hardy generation survived the Great Depression and won World War II.  Making the world safe for democracy to flourish.  Their free market capitalism made a prosperous world of plenty.  So their children would never have to live in a world they had lived in.  As it turned out, though, that was a mistake.

Their children were not like their parents.  These baby boomers were not as hardy as their parents were.  While they struggled and went without the baby boomers didn’t.  The baby boomers became the Me Generation.  Because it was all about them.  They rejected the hard work and sacrifice of their parents.  And didn’t save for a better tomorrow.  No.  For them it was all about the here and now.

The Me Generation rebelled against their Parents and became Anti-Parents

The Me Generation didn’t save like their parents.  They spent.  Changing the economy forever.  From one made strong and healthy driven by private savings that banks converted into investment capital.  To a Keynesian one.  Where Keynesian economists viewed savings as economic leaks from the economy.  No.  Spending was better.  Consumption was better than saving.  Besides, what did we have to save for anymore with the Federal Reserve printing money?  And the government paying our way for us in retirement?

The Me Generation was only too happy to help transform the government from one of savings and investment to one of consumptionand gratification.  And they lived Life in the Fast Lane (by Joe Walsh, Glenn Frey and Don Henley, recorded by the Eagles in 1976 on the studio album Hotel California).   “Everything all of the time.”  And when that wasn’t enough there was cocaine to fill the remaining emptiness.  “There were lines on the mirror, lines on her face.”  Sometimes the drug use became so intense it interfered with another past time of the Me Generation.  Sex.  “He was too tired to make it, she was too tired to fight about it.”

So while their parents won the Second World War they were partying and getting high and having as much casual sex as their excessive drug use allowed.  And because of it the Seventies gave us a new drug in the Eighties.  Crack.  And a war on drugs.  As well as AIDS.  Thank you, Me Generation.  For rebelling against your parents and becoming anti-parents.  Destroying our past culture and traditions.  And our religion.  Just so you can have “everything all of the time.”  Right now.  Without ever waiting to gratify an urge or desire.

Obamacare will Fail because the Young won’t give up their Life of Consumption and Gratification

The counterculture (i.e., the anti-parents) movement then entered academia.  Took over the curriculum in our public schools.  And our colleges and universities.  Where they taught our kids that everything their parents told them was wrong.  That they are destroying the environment.  That American imperialism is the greatest threat to world peace.  That the Founding Fathers were rich white slave owners who wrote the Constitution to further their greed.  That free market capitalism is cruel, callous and unfair.  While government is kind, feeling and fair.

The Me Generation learned something valuable as they entered academia.  And government.  That there are a lot of young people who vote.  And because many of them grew up already rebelling against their parents they pushed these people closer to them.  The anti-parents.  Helping them to hold on to political power.  So they appealed to all the things young people want.  Such as sex.  By providing free birth control and access to abortion.  They attack Christianity and tell their students there is nothing wrong with their life of consumption and gratification.  And, of course, they favor decriminalizing drugs.  And are making great headway in that area with marijuana.  I mean, kids just love the Democrats.  For they indulge their every want and desire.  Without parenting them to sacrifice and save for their future.  Like their insufferable parents.

So our young have never been defined more by selfishness, narcissism and hedonism.  Always living for the moment.  Without a care in the world for the future.  Making even the Me Generation seem selfless.  Who lived in relative anonymity in their narcissistic world.  Unlike today’s youth.  Who can’t survive without Instagram, Twitter and Facebook.   And must share every iota of their existence with the entire world.  Because it’s all about them.  The world revolves around them and the pursuit of their life of consumption and gratification.  So it is rather ironic that the very thing that keeps Democrats in power—indulging in the youth voters’ selfishness, narcissism and hedonism—could deal such a threatening blow to their power.  For Obamacare to work they need these young voters to be more like their parents and less like the people they are.  Thanks to the Democrat indoctrination in our public schools, colleges and universities.  To sacrifice some of their wants and desires to help their parent’s generation.  To consume less.  So the people they rebelled against can have free medical care.

This is why Obamacare (the Affordable Care Act) will fail.  The young and healthy do not want to give up their life of consumption and gratification.  Which means they’re not buying health insurance.  Only the old and sick are.  Because they need health care.  While the young and healthy don’t.  So they are not going to buy costly health insurance policies that they feel they will never use.  Instead they’ll pay the lower-cost fine.  So they can continue to live their life of consumption and gratification.  That the Democrats told them all their life was what they should do.  Not to save for the future.  Or sacrifice.  For their parents.  Their community.  Or their God.  So the Affordable Care Act will fail.  Because you can’t indulge selfishness, narcissism and hedonism and expect the young to give up their life of consumption and gratification.

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Damned if we Decriminalize Drugs and Damned if we Don’t; either way Drugs have Damned Us

Posted by PITHOCRATES - June 2nd, 2012

Week in Review

Drugs are a problem with no easy solution.  The drug market in the U.S. is fueling horrific crime south of the border.  And most violent crime in the U.S. is related to the illegal drug trade.  This makes a very strong case to decriminalize drugs.  And trust in responsible people to use drugs responsibly.  But then you have stories like this (see Miami Cannibal Attack: Horrific Dangers of “Bath Salts” Drug by Lisa Collier Cool posted 6/1/2012 on Yahoo! Health).

The “cannibal” attacker who gnawed off another man’s face in Miami is suspected to have been high on a dangerous street drug called “bath salts.” Police say that during the zombie-like naked rampage that horrified the world, Rudy Eugene, 31, displayed deranged behavior similar to other horrific crimes linked to bath salts, before being shot dead by police on Saturday.

Bath salts, which have been called the new LSD, cause people “to go completely insane and become very violent,” said Armando Aguilar, president of the Miami Fraternal Order of Police told CNN. Also known by street names like “Ivory Wave,” “Vanilla Sky,” “Bliss,” “Dynamite” and “Purple Rain,” bath salts made headlines last year after a torrent of ER visits, thousands of calls to poison control centers, and a number of deaths, including murders and suicides…

Banned in several states, bath salts contain amphetamine-like chemicals that have uniquely hazardous effects on the brain. “If you take the worst attributes of meth, coke, PCP, LSD and Ecstasy and put them together, that’s what we’re seeing sometimes,” Mark Ryan, director of the Louisiana Poison Center, told The New York Times…

CNN reports, “The effects include producing feelings of empathy, stimulation, alertness, euphoria, sensory awareness and hallucinations. Other reported effects include rapid heart rate, high blood pressure, and sweating. According to the DEA, MDPV has been reported to cause intense panic attacks, psychosis, and a strong desire to use the drug again.”

Physiological effects include high blood pressure and increased heart rate, according to a report by WebMD. According to a CDC report of bath salt abusers in Michigan, users risk both psychological side effects and physical side effects.

In fact, according to Huffington Post:

•91 percent of users had neurological damage

•77 percent experienced cardiovascular damage

•49 percent had psychological difficulties associated with the drug

•37 percent of the people who suffered mental health problems reported attempting suicide or having suicidal thoughts related to bath salts

Bath salts are a more powerful drug than previous drugs.  In fact if you add the worse a handful of past drugs will do you get what this new drug will do.  In other words, those other drugs were gateway drugs to this drug.  Which is the general trend in using drugs.  Start out small.  And keep moving up to bigger and more powerful drugs.  Not every pothead may move on to bath salts.  But it is very likely that every bath salts user started out a pothead.  Making marijuana the gateway drug to all other drugs.

A lot of drugs will cause neurological and cardiovascular damage.  And a lot will cause mental health problems and suicide.  Sad but primarily only the user suffers these drug affects.  But when the side effects include insanity, violence, psychosis and murder the drug affects tend to affect more than the user.  Which makes a very strong case against decriminalizing drugs.  Even marijuana.  For it is the rare drug addict that starts off with a drug that causes insanity, violence, psychosis and murder. 

People have moved on from marijuana to stronger drugs.  While all of these drugs were illegal.  So if any of these drugs became legal it is only logical that it will pull more people into the drug-using world.  And help more people up the ladder to stronger drugs.  All the way to bath salts.

So when it comes to the big question of whether we should decriminalize drugs the sad truth is that we are damned if we do.  And damned if we don’t.  In short, either way drugs have damned us.

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The NHS using Cheaper Untested Drugs to Cut Costs and make their Limited Resources Stretch Further

Posted by PITHOCRATES - May 6th, 2012

Week in Review

Who is more evil?  The pharmaceutical that has spent time and money to develop a new drug?  And then further time and money going through a lengthy clinical testing process to guarantee (as best as possible) that the new drug is safe?  When proven ‘safe’ by the regulators to sell it at a patent-protected price?  To cover all of these costs.  All the costs for the 20 new pills that failed along the way?  And the inevitable lawsuits when a proven ‘safe’ drug proves NOT to be safe after all?  Or is the health service using a cheaper drug that appears to give similar results?  That hasn’t gone through that extensive clinical testing process?  But they use the cheaper drug because they can treat more patients than they can with the more expensive but clinically tested drug?

Oh, it’s a perplexing and vexing question.  For we want new super drugs to cure all that ails us.  But we want those drugs to be cheap.  And safe.  But if they end up hurting us we’ll sue the bejesus out of everyone who allowed that drug to get into our system.  Which brings us to a great catch-22.  Drugs cannot be both cheap and safe.  For even the expensive ones sometimes prove not to be safe.  Especially if we rush them to market to save lives.  Only to find that by rushing those drugs to market they’ve harmed the lives we were trying to save.

Sadly, they have to balance the quality of health care with the cost of that health care.  Which is a never ending struggle in the NHS (see Using Avastin for eye condition wet AMD ‘could save NHS £84m’ by Branwen Jeffreys posted 5/6/2012 on BBC News Health).

The NHS could save £84m [about $135 million US] a year by using a cheaper drug to treat a leading cause of blindness, research suggests.

NHS-funded research says both Lucentis and Avastin have a similar effect in preventing loss of sight when used for wet age-related macular degeneration.

Lucentis costs about £700 an injection, and Avastin £60 – but Avastin is not officially approved for eye conditions.

Novartis, which markets Lucentis in the UK, is taking legal action against four NHS trusts for using the cheaper drug.

The company says the use of Avastin – developed to treat cancer – is undermining patient safety…

Lucentis is officially approved for use in eyes, and is the treatment recommended in England and Wales by the watchdog NICE.

Roche, which owns the rights to the similar, but cheaper, Avastin, has never sought to have it approved for use in eyes, which would involve further clinical trials.

But many doctors have been using Avastin at their clinical discretion…

As they both target blood vessels, the IVAN researchers particularly looked at whether there was an increased risk of heart attack or stroke…

Novartis argues that Lucentis has a safety profile proven in clinical trials and approved by the regulators.

It says the US research, which has just published data from the second year, highlights what it describes as “serious safety concerns” about the use of Avastin in this unlicensed treatment of eyes.

It points, for example, to a higher rate of stomach and gut disorders in patients given Avastin…

Cost pressures on the NHS have led to an increased use of Avastin…

The financial stakes are high both for the NHS and the pharmaceutical company.

Perhaps the question should be which is more evil?  The pharmaceutical industry?  Or a national health care system that has put cost considerations before patient care?  For the use of the cheaper drug is driven by the cost of the drug.  Not by the effectiveness of the treatment.  They may determine that the cheaper drug may be as safe as the more expensive drug.  The drug that was specifically clinically tested and approved by regulators for that specific use.  But this points out another issue.  Is the drug approval process not necessary for all drugs?  And, if not, why have it?  If it is only delaying bringing more life-saving drugs to market at affordable prices?  And if this is all true then should there be a ban on all lawsuits against pharmaceuticals?  Who were only doing what everyone demanded of them.  Rushing new life-saving drugs to market.

Perplexing and vexing questions, indeed.  And ones that we will hotly debate as Obamacare comes on line.  For Obamacare will have greater cost constraints than the NHS.  For Obamacare will treat far more people than the NHS.  About 5 times as many as the UK based on population sizes.  Which means the debate under Obamacare will not be about saving $135 million.   But about $683 million.  Over half a trillion dollars.  Or about half of the 2011 budget deficit.  So you know Obamacare will consider these cost savings.  And use drugs that haven’t gone through the clinical testing process like they are in the UK.  And actively search for other savings.  And place incredible pressures on the pharmaceuticals.  Making it very difficult for them to make a profit.  Or to even cover their costs.  And when that happens they will drop out of the business of finding new super drugs to cure all that ails us.  Making what ails us really ail us.  Reducing the quality of our lives.  Perhaps even killing us.

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The UK’s NHS chooses Expensive Drug from US Drug Maker Merck because it’s Better than Anything they Have

Posted by PITHOCRATES - March 11th, 2012

Week in Review

What’s the difference between pre-Obamacare US health care and the UK’s National Health Service (NHS)?  Incentive.  In the US there is an incentive to pour billions of dollars into research and development.  To produce the next super drug.  Whereas in the UK drug companies only make as much as the government allows.  Or is willing to pay.  Creating a disincentive to pour billions of dollars into research and development.  Which is why the NHS’ new hepatitis C drug comes from the US (see Merck’s hepatitis C drug wins UK cost endorsement by Ben Hirschler posted 3/9/2012 on Reuters).

U.S. drug maker Merck & Co’s new hepatitis C drug Victrelis was recommended for use within Britain’s state health service on Friday, despite its hefty price tag.

Critics will say that we shouldn’t allow Merck to charge so much for their drug.  That it is wrong to profit off of disease.  That the US should stop this price gouging like they do in the UK.  So should we?  Well, to answer that question all you have to do is to consider who made this new hepatitis C drug.  And who was that?  The US, of course.  Because Merck COULD charge this much for their drug.  Which just goes to show you that when you want the best you’re better off relying on the profit system than altruism.  Because profits provide incentive to make the best.  While altruism doesn’t.

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