> a nerd being bullied by the big buff brocialists who'll shove him into a locker while singing the internationale
Whomst among us doesn't want to get shoved in a locker by buff brocialists singing the internationale?
careful, we'll become Ayn Rand as a [parahuman power](https://forums.spacebattles.com/threads/tank-worm-altpowertaylor-au.700525/page-10#post-55198888)
Huh, he really deleted a big chunk of the original post. Here’s the
part I most wanted to sneer at, reading the post as it was
published:
Good doctors learn to identify and beware a pattern of cascading
interventions. You prescribe someone Wellbutrin for depression, but now
they can’t sleep. So you prescribe Remeron as a sleeping pill, but now
they gain twenty pounds. So you prescribe Topamax as a diet pill, but
now they can’t think clearly. So you prescribe Adderall to make them
more alert, but now they’re jittery and anxious all the time. So you
prescribe Xanax to calm them down, and they end up in the ER with a
Xanax overdose. If they die, the death certificate will just say “You
are an idiot”. The correct action would have been to decide Wellbutrin
wasn’t the right antidepressant for them, and try something else.
Good health care policy wonks need to learn the same lesson. You
prescribe strict FDA regulation for customer safety, but now prices
skyrocket. So you prescribe government regulation of drug prices, but
now companies leave the market and you can no longer produce basic
medications. So you prescribe nationalization of the entire system, and
I don’t know what comes next, except that a lot of people’s death
certificates probably end up reading “You are an idiot”.
Ok sure that’s one way to approach this, but scrolling up to where
Scott describes the current state of affairs, he goes:
The story goes something like this. The FDA demanded that generic
drug manufacturers pass FDA inspection before setting up shop. But the
FDA didn’t have enough inspectors […]
Anyone see an alternative path out of the “cascade” here??
i definitely also think it's hilarious that the actual core problem is "the fda is underfunded"
make the big companies shoulder the costs of paying for their competitors, by taxing them more. this would also have the advantage of discouraging soviet-style corporate monopolies on private healthcare
It's such an odd take - The US, unlike every other developed country, does not have socialized healthcare... But somehow the socialists are to blame for the US's ballooning health care costs, a problem that all those other countries *don't* have.
----
(edit) I've just noticed he's removed the anti-Ezra Klein rant about how government intervention in drug prices is doomed to catastrophe. From looking at the comments; people were pointing out that government intervention in drug prices actually works really well in other countries, so he edited it out.
I'd have thought the Rationalist^^TM thing to do would be to acknowledge the mistake and think about the biases that might have lead you to make it (rather than remove any evidence you'd made the mistake in the first place), but that's just me.
i like how he just takes it for granted that the fda do nothing of value
like, the question isn't even discussed. it's just taken for granted that the government shuts down drug factories because they're virtue signalling sjw bureaucrats - not because it failed to pass a health inspection or anything like that. in scottworld you just put rat poison in all the drugs and let the market sort it out
This is why Rule 1 of talking about the insane bullshit that rationalists spew is:
1. Archive that shit.
Burning the evidence and then denying it ever existed is *absolutely routine* in rationalism.
I had a fight with some econ fans about drug regulation and national healthcare. It was explained to me that pointing to the actual data wasn't good enough, because it contradicted free market hypotheses.
The price of insulin is much too high. Vox argues that this is
because of the “lax regulatory environment” and the “free market
approach”, and that if we could just become socialist like all of the
cool countries, everything would be fine.
I don’t understand what world Scott Alexander lives in if he thinks
Vox is pushing a socialist line on anything. It doesn’t say anything
about Marxism or any kind of socialist theories. It doesn’t suggest that
we make drug production worker-owned and run. So what’s the point of
misrepresenting this Vox article?
Either he didn’t read it, or he’s being dishonest. Or he doesn’t
understand what “socialism” is and is just using it because he thinks it
sounds scary to his readers.
edit: I think one of Scott’s big secrets is that he doesn’t really
read many of the articles he links to. Probably gives them a skim at
best. Over the time I’ve read the blog I’ve pointed out to him a few
times that linked articles didn’t make the argument he said they did, at
which point he would delete the link. I realized that instead of making
him reflect on his political biases (and actually, y’know, read the
article) I was basically just acting as his unpaid proof-reader, so I
stopped doing it.
> Or he doesn't understand what "socialism" is and is just using it because he thinks it sounds scary to his readers.
Rightwing Libertarians seem to think any government oversight is socialism.
"Current day regulations are rife with conflict, regulatory capture, and market inefficiencies around patents"
"My fantasy govenment archipelago islands' regulations are common sense, not subject to capture, and objectively good."
-- the same guy
> I think one of Scott's big secrets is that he doesn't really read many of the articles he links to. Probably gives them a skim at best.
This is pretty ironic for someone with explosive logorrhea. Is it possible to write more than you read?
> But how come this is only happening in pharmaceuticals? How come
(in capitalist countries) there are almost never meat shortages, bread
shortages, laptop shortages, or chair shortages?
well it turns out there absolutely are grain
shortages, computer
shortages, and furniture
shortages in capitalist economies, and this shit happens all the
fucking time, but by all means let’s continue pretending that free
markets are magic and wanting to buy something materializes it into
existence
a shortage of something in a global market doesn't mean there's none of something available to USAnians, just that the price gets jacked up and people elsewhere have to do without.
shortages still happen in free market economies, there's always delays between market signals and changes in production and it's just a completely normal function of how economic planning (distributed in a market or otherwise) works and denying it outright just speaks to somebody's economic illiteracy
“So my very tentative guess as to why buspirone is more plagued by
shortages than bread or chairs is because number one, the need for FDA
approval makes it hard for new companies to enter the buspirone
industry, and number two, the FDA’s fee structure favors large-scale
monopolies over small-scale competitors.”
Isn't that exactly what's happening in the place where FDA doesn't regulate, i.e. "supplements", except without the "legitimate" part? Because their only regulatory requirement is that the label says they aren't regulated? Is that the model for this vision of a decentralized drug industry? Because it seems like it's pretty well fleshed out in the real world with no need to speculate.
He cites examples of even big companies abandoning their licenses to produce generics because they have to pay money on a per license basis, so it is not worth it to them to maintain the capability of competing in a market if they are not going to produce at massive scale. It does seem likely that a big pharma company could otherwise easily go make some Daraprim or whatever if there were inflated prices due to a Shkreli-like monopolist or a supply shock.
“all of the cool countries”
Everything is high school for these people.
don’t write a blog post about it then
Huh, he really deleted a big chunk of the original post. Here’s the part I most wanted to sneer at, reading the post as it was published:
Ok sure that’s one way to approach this, but scrolling up to where Scott describes the current state of affairs, he goes:
Anyone see an alternative path out of the “cascade” here??
*gigantic corporations raise the price of insulin by one billion percent, killing thousands*
scott: this is like the soviet union. why would socialism do this.
https://www.vox.com/2019/4/3/18293950/why-is-insulin-so-expensive
I don’t understand what world Scott Alexander lives in if he thinks Vox is pushing a socialist line on anything. It doesn’t say anything about Marxism or any kind of socialist theories. It doesn’t suggest that we make drug production worker-owned and run. So what’s the point of misrepresenting this Vox article?
Either he didn’t read it, or he’s being dishonest. Or he doesn’t understand what “socialism” is and is just using it because he thinks it sounds scary to his readers.
edit: I think one of Scott’s big secrets is that he doesn’t really read many of the articles he links to. Probably gives them a skim at best. Over the time I’ve read the blog I’ve pointed out to him a few times that linked articles didn’t make the argument he said they did, at which point he would delete the link. I realized that instead of making him reflect on his political biases (and actually, y’know, read the article) I was basically just acting as his unpaid proof-reader, so I stopped doing it.
> But how come this is only happening in pharmaceuticals? How come (in capitalist countries) there are almost never meat shortages, bread shortages, laptop shortages, or chair shortages?
well it turns out there absolutely are grain shortages, computer shortages, and furniture shortages in capitalist economies, and this shit happens all the fucking time, but by all means let’s continue pretending that free markets are magic and wanting to buy something materializes it into existence
I actually believe Scott has a good point here:
“So my very tentative guess as to why buspirone is more plagued by shortages than bread or chairs is because number one, the need for FDA approval makes it hard for new companies to enter the buspirone industry, and number two, the FDA’s fee structure favors large-scale monopolies over small-scale competitors.”